Sunday, November 15, 2009

NHS whistleblower 'sacked for revealing dumped x-ray scans'

A NHS whistleblower who claims that he was sacked because he revealed a leading hospital was dumping x-ray scans will take his case to an employment tribunal next week. Dr Otto Chan, a consultant radiologist, believes that he was labelled a troublemaker after the revelations about the Royal London. He claims that hospital bosses decided to get rid of him and that his dismissal has left him unable to get another job in the health service. He is suing the hospital for loss of earnings, future earnings and pension. But he says that he also want to set a precedent that could help protect future NHS whistleblowers.

Dr Chan, 52, said that problems began after he warned that 10,000 packets of films and scans had built up because the Barts and the London Trust, which runs the Royal London, had neither the people nor the money to analyse them. He also raised concerns about junior doctors treating patients unsupervised. “After that the Trust decided they were going to get rid of me,” he said. He claims he was then accused of causing “disharmony” within the department and was dismissed by the hospital in 2006.

Since then he has been unable to find a permanent job in the NHS since. Dr Chan said that he hoped his case would offer greater protection to other NHS whistleblowers, who he said had a responsibility to expose problems in the health service. He said: “As doctors we have a responsibility to protect our patients. If we do not report them then theoretically we should be taken to the GMC.”

The case, which will start in Stratford on Monday, is being supported by the Medical Protection Society and is already estimated to have already cost between £2 and £3 million.

A spokesman for the trust said: “Dr Chan worked as a consultant radiologist at Barts and The London NHS Trust between January 1993 and his dismissal in June 2006. His dismissal is now the subject of an industrial tribunal. “It would be inappropriate, therefore, to comment further until the conclusion of that process. Dr Chan’s dismissal followed a 19-month investigation, which included a formal hearing by an independent panel. "The panel concluded that there were grounds for dismissal. The dismissal was in no way connected with issues with our radiology processes."


NHS hospitals treat Alzheimer’s patients so badly 'one in three carers complain'

Hospitals are treating Alzheimer’s patients so badly that one in three sufferer’s families have complained about their loved one's care. Even greater numbers of relatives and friends said they wanted to complain but had not, a new report by the Alzheimer’s Society shows. The figures are released just days after an independent review warned that 1,800 dementia patients are being killed every year by controversial ‘chemical cosh’ drugs given to keep them quiet.

Carers told the charity of sufferers left to sit in their own urine and nurses who complained that they had too many patients to look after. The report also heard of patients going hungry because they were not helped to eat or drink and many were generally treated with a lack of basic dignity and respect. One carer said that when nurses were asked for help with cleaning her mother they responded “that’s someone else’s job”.

The charity said that the situation was a “disgrace”. The study also found that almost eight in 10 carers, 77 per cent, were dissatisfied with the quality of dementia care in hospitals. The same number think that hospital staff do not understand the illness. Yet figures show that people with dementia occupy up to one in four hospital beds in England at any one time.

Neil Hunt, chief executive of Alzheimer’s Society, said: “It is a complete disgrace that so many families are receiving such poor care that they are being forced to complain. “People expect and deserve better but these new figures suggest that is far from the case. “As the numbers of people with dementia increase almost exponentially pressure on the NHS will also increase – we need to sort this problem out now.”

Earlier this week an independent report warned that four in five of the 180,000 dementia patients in hospitals and care homes on antipsychotic drugs were being wrongly prescribed the medications, which kill many of them.

Ministers have announced plans to try to cut the number of the drugs prescribed by two-thirds within three years.

More than 700,000 people in Britain suffer from dementia, of which around 400,000 have Alzheimer’s, the most common type. Experts warn that one in three people currently aged over 65 will die with dementia. The disease is also predicted to become increasingly more common in coming decades, as the population ages.

More than 1200 carers of people with dementia took part in the survey, which forms part of a major report the Society will launch next week on the huge variation of treatment of dementia patients on hospital wards across the country. A spokesman for the Patients Association said: "This survey confirms our fears that there is a widespread and disturbing failure in the hospital care of elderly patients."

A spokesman for the Department of Health said: "We have set priority areas for all hospitals to take urgent action, including appointing a senior member of staff to improve quality of care for people with dementia, proper training for all staff, and specialist older people's mental health teams working in hospitals."


Britain's National Health Service Denied Sight-Saving Medicine to Its Own Employee

An employee of Britain's government-run National Health Service was denied medication that could save her from going blind in one eye. Sylvie Webb, a widow from Salisbury, England, worked for 18 years as a secretary at Salisbury District Hospital. Yet, despite her situation, Webb discovered that medical treatment under the public health service is anything but universal.

In February 2007, doctors diagnosed Webb, then 58, with the "wet" type of age-related macular degeneration (ARMD) in her left eye. If not treated in a timely manner, wet ARMD "can lead to blindness in as little as three months and people need prompt treatment if they are to minimize the risk of permanent sight loss," according to a statement by the Royal National Institute of Blind People in London. As such, Webb's medical consultant sought rapid treatment for Webb because her sight was "deteriorating 'day by day,'" as Webb explained, and an infection in one eye can spread to the other good eye.

But to Webb's dismay, for nearly a year her local public health authority, Dorset Primary Care Trusts, refused to provide Webb with the expensive "anti-VEGF" drugs she desperately needed to save her sight. Though two such effective drugs, Macugen and Lucentis, are licensed for general NHS use, the Dorset Trust, which controls funding prescriptions, dragged its feet. Dorset Trust said it has yet to formulate a policy in a "fair and equitable way" to treat Webb's condition and thus it could not provide her with the VEGF drugs.

As Webb explained at the time, "At the time, the PCT [Dorset Primary Care Trusts] said it hadn't got a policy and it would address the situation in April [2007] - but it has now postponed this until June. I'm extremely worried that time is running out for me and other patients." The prospect of going blind terrified Webb:

"I'm a young woman and want to carry on working, and then I'd like to do all the things I had planned for my retirement. I'm also worried about the health of my other eye. I know I'm at increased risk of getting wet AMD in that eye and this could mean I end up losing my sight. The women in my family live into their 90s; I can't accept the possibility of being blind unnecessarily for the next 35 years."

In May 2007, the Trust agreed to review Webb's case on an urgent basis. But for Tom Bremridge, CEO of the Macular Disease Society in Andover, UK, there is no excuse for Webb being without the available sight-saving drugs she needs. "It is outrageous that in this day and age Mrs. Webb faces losing her sight owing to bureaucratic idleness," he said. Steve Winyard of RNIB echoed Bremridge's outrage:

"This is disgraceful... It's little comfort for Mrs. Webb that she can't get treatment simply because her PCT has yet to decide a policy. The PCT needs to get its act together and ensure these drugs are available to patients now and without a struggle... There is a moral imperative to save the sight of people where we can."

Finally, in 2008 new health guidelines permitted Dorset Trusts to prescribe Lucentis for Webb. The guidelines published by the National Institute for Clinical Excellence, the government's health advisory authority, allow for funding for the first 14 injections of Lucentis once wet ARMD is diagnosed in one eye. If additional injections are necessary, the drug's manufacturer, Novartis, will pay for additional treatment.

Webb was delighted that she would at last receive the sight-saving drug. "I'm so relieved that Dorset PCT has finally realized the long-term benefit to me of this treatment and has agreed funding," she said. "I only hope that all patients are given treatment to help save their sight because while this is good news for me, there may be hundreds of others with wet AMD who cannot get the funding they desperately need."


Who needs facts when theory will do?

"The number of US veterans who died in 2008 because they lacked health insurance was 14 times higher than the US military death toll in Afghanistan that year, according to a new study," Agence France-Presse reports, in a dispatch titled "Lack of Health Care Killed 2,266 US Veterans Last Year: Study."

Now, you can get a list of names of soldiers who died in Afghanistan last year. There is no such list here, because this is where the number comes from:
The analysis uses census data to isolate the number of US veterans who lack both private health coverage and care offered by the VA.

"That's a group that's about 1.5 million people," said David Himmelstein, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program who co-authored the study.

Himmelstein and co-author Stephanie Woolhandler, also a Harvard medical professor, overlaid that figure with another study examining the mortality rate associated with lack of health insurance.

"The uninsured have about a 40 percent higher risk of dying each year than otherwise comparable insured individuals," Himmelstein told AFP.

Garbage in, garbage out. Even a reporter should be smart enough to realize that you can't derive a precise number like 2,266 from hazy ones like "about 1.5 million people" and "about a 40% higher risk." This is junk science with an obvious political agenda.


Obamacare is a devastating tax on the working class

Given the recent announcement that the government's measure of unemployment has hit 10.2 percent, and given that the official House version of Obama's healthcare plan, HR 3962, has now passed, a close examination of the effects of "Obamacare" on the labor market is important. It will be no surprise to readers of this site to learn that the Democrats' bill will seriously harm precisely those poor and uninsured citizens it is ostensibly designed to help. The harm will come by compounding mass unemployment and depriving these citizens of consumption choices.

According to pages 269–273 of the gargantuan bill,Download PDF employers of full-time workers will be required to cover at least 72.5 percent of the premium of the least expensive health-insurance plan available that fulfills the bill's minimum criteria of "acceptable coverage." In cases in which family coverage is provided, 62.5 percent of the premium is to be borne by the employer. Depending on the specific plan and other variables such as location, this amounts to a direct labor tax of approximately $300 per month for an individual, or nearly $700 for family coverage.Download PDF

The implication of this increased cost is that workers whose revenue productivity is less than $300 per month higher than their wages will be laid off, or have their hours cut to the level that will classify them as part-time. Ignoring established labor law, the bill leaves the definition of part-time and full-time to the discretion of the Commissioner of Obama's massive new health bureaucracy. The lower the new "Health Choices Commissioner" sets the threshold in an attempt to maximize the number of people receiving the employer contribution, the more hours of production employers will have to shave off to push their employees under the threshold, and the less those workers will take home in wages each week.

Unfortunately, the bill also requires employers to cover a (smaller) percentage of the premium of the same minimum plan for part-time workers. The effects here are even worse than above, because they weaken the ability of an employer to escape the labor tax by employing his workers for fewer hours. Instead, with a labor tax on part-time workers as well, some low-productivity workers who are currently only working a few hours per week will be forced out of work entirely.

The Burden of Obamacare

We can say, as a mathematical certainty, that this labor tax is a regressive tax. Because the tax is defined as 72.5 percent of the same premium for all workers, that absolute tax will fall more heavily on workers for whom the tax represents a higher percentage of their wages or salary.

To understand this better, we will apply a $300 monthly labor tax to the differences between wages and revenue production for two different workers. If we make the simplifying assumption that a laborer is paid 99 percent of his revenue productivity, we can see that the absolute difference between productivity and wages is larger for high-income workers.

For example, a worker producing $50,000 of revenue per month will be paid $49,500 over the same period, delivering $500 in profit to his employer. A worker producing $10,000 in revenue monthly, meanwhile, will receive $9900, for a difference of only $100. Despite the differences in their absolute return, in a free economy, both laborers are profitable hires and thus employed.

In a post-Obama America, however, only the high-wage worker will be employed, leaving the low-productivity worker out of employment. When a $300 per month charge is added to the cost of employing either worker, it is plain to see that only the high-wage worker's absolute profit will remain positive.

The firm will continue to make $200 by employing the high-productivity worker, while it will be forced to lay off the low-productivity worker rather than lose $200 by employing him. The Obamacare health tax thus will fall directly on the same employees who are hurt by minimum wage increases: teenagers, the disabled, and disadvantaged minorities.

If they do not wish to be laid off or cut to part-time, these low-productivity workers will accept a lower salary to keep their position and work schedule. Thus, the worker who produces $10,000 monthly will offer to accept a salary of $9700 or less to save himself from a complete loss of employment or cut to part-time. These workers will offer to shift the cost directly onto themselves rather than burdening the employer with it, which would result in their unemployment.

Predictably, though, the Democrats fully intend to "protect" workers from the choice to save their jobs by working for less. Page 273 of the bill stipulates that any amount pledged for the minimum-health-insurance plan that corresponds to a fall in salary or wage will not be considered a contribution at all. Page 310 establishes a $100 per day, per case fine for any privately negotiated fall in wages. Thus, salaries will be locked in at current rates, with any cuts being considered an attempt to subvert the labor tax, and thus being subject to financial penalties.

In reality, this clause is no favor to workers, and instead acts as a wage floor to ensure that the unemployment effect will be immitigable and widespread. Because any drop in wages during the months following the bill's enactment would be considered a violation of the employer-contribution mandate and therefore would carry heavy fines, literally all wages will be prevented from falling below their current levels.

Implementing these indirect wage floors in literally every industry during a recession is downright ludicrous. During a recession, wages rise and fall in different lines of production to align producers' demand for laborers with consumers' demand for the goods each type of labor produces.

In a dynamic market — that is, any market in which people are free to change their minds — different workers' wages must rise and fall every day to accommodate changing consumer preferences. To prevent this process from taking place is to prevent the structure of production from being corrected.

These wage floors will also hasten the decline of industries that are less valuable to consumers than they were at an earlier time, but that may still be a productive use of resources at a lower price. Businesses in these industries will be unable to legally cut their labor costs to lower their prices and satisfy consumers who are less eager to buy their goods. Without this option, such firms will need to either lay off part of their labor force, or simply go out of business entirely.

Destroying Real Production

It is equally important to consider the other end of the production chain, which is to say the actual output of goods and services. By destroying the demand for marginally productive labor, Obamacare's labor tax will necessarily destroy that labor's end product, which is of course marginally-valued goods and services. Thus, it is rational to expect fewer late-night fast food options, less-cleanly hotel rooms, fewer sales associates at retail outlets, and the like.

While these effects may not be as easily visible as a plant closure, they are real losses of consumable utility. Free-market firms produce convenience and extra quality until the point at which it is no longer profitable to do so. Destroying the production of these goods and services would destroy the niceties that capital accumulation and progress allow Americans to take for granted.

The effect of Obamacare on the prices of produced goods is obviously inflationary. Increasing the cost of employing every single laborer by $300 a piece is certain to increase the price of all produced goods. Combining price increases with rising unemployment is hardly a laudable strategy for improving the lives of poor citizens.


The historic passage of HR 3962 by the House of Representatives is not an event to be celebrated. Obamacare will exacerbate the nation's rising unemployment and will prevent wages from fluctuating according to market demand. Just as with other sectors, a supposedly beneficial social policy hurts the poorest and least-able citizens the most.


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