Thursday, December 17, 2009

British hospital accused of 'gross negligence' after 10-year-old boy dies

A hospital has been accused by a coroner of "gross negligence" after a 10-year-old boy died following a seven hour wait for an ambulance

Kieran Howard, from Fordcombe, Kent, was taken to three hospitals after emergency staff failed to diagnose the severity of his condition, Southwark Coroner's Court heard. Doctors were aware there was potentially a problem with the child's brain, but the boy sill had to wait 12 hours to receive a scan which would have allowed a diagnosis and meant life-saving surgery could have gone ahead.

Kieran suffered the burst tumour after sneezing at his home on the morning of Saturday March 28 last year. Paramedics did not spot he was suffering from a neurological problem, so took him Pembury Hospital, the nearest to his home. Kieran was moved to the children's intensive care ward where he suffered an "epileptic-like" fit before his condition worsened and he was sedated.

Southwark Coroner's Court heard that doctors treating the schoolboy should have checked his pupils with a torch every 15 minutes, but this was not done.

Coroner Dr Fiona Wilcox said there was a "four hour window of opportunity" after the boy's eyes had become fixed and dilated to perform surgery which likely would have saved his life. She described the Pembury doctors failures to check his eyes as "gross negligence" and "neglect".

Medics at the hospital called the South Thames Retrieval Service, which shuttles seriously ill children between hospitals, over an hour after Kieran arrived requesting he be moved to London for a brain scan. The STRS was supposed to arrive within two hours, but later warned there could be further delays of up to four hours.

The coroner said that the hospital should either have taken the him to the nearby Kent and Sussex Hospital for a brain scan or reduced his sedation to see how responsive he was. But neither of these were done which Dr Wilcox said may have contributed to the boy's death.

Kieran eventually arrived at St Thomas's Hospital in London where he received a scan at 1am the following morning, before being moved again to King's College Hospital where he received unsuccessful surgery at 4am. He died on April 2 at the hospital.

Dr Wilcox recorded a death by natural causes contributed to by neglect, saying: "What killed Kieran could have been prevented by prompt neurological assessment and treatment – and that is what did not happen."

Outside the coroner' court, Kieran's mother Vanessa said: "After 20 months of fighting to get answers we have finally been vindicated – our son's death was preventable. "We hope that all those who made mistakes may now begin to acknowledge them to stop something like this happening again."

Dr Wilson Bolsover, of Maidstone and Tunbridge Wells NHS Trust, which includes Pembury Hospital, apologised on behalf of the trust "for not doing our level best" in caring for Kieran and said "every lesson that can be learnt, will be learnt." "We accept the coroner's findings fully and have already made significant improvements," he said. [Like what??]


Britain spends half of what it reasonably could on medicines

Britain spends less on medicines than similar countries making it the 'poor man of Europe', a report has said

Britain spends less than half that of Greece, Portugal and Spain on medicines, the report from the Association of British Pharmaceutical Industry, the trade association for companies making prescription drugs said. As a proportion of gross domestic product Britain spends one per cent on medicines, compared with 2.32 per cent in Greece, 2.17 per cent in Portugal and two per cent in France. Britain also pays the lowest price for drugs out of any European country.

David Fisher, commercial director of the ABPI, said: “What we are talking about here is the breakthrough medicines which make huge differences to people’s lives. Prices in the UK are less than in any other comparative European country, yet the UK Government, via NICE, continues to tell patients we can’t afford new medicines. "I think patients, many of whom have paid into the healthcare pot for many years, should be asking hard questions about why they are not being allowed to get their investment back.” He added: “Spending by GDP provides an indication of what is affordable. No matter what measure you use, the UK is the poor man of Europe. Patients in the UK deserve better.”

However other experts said Britain was using the spending power of the NHS to get better value for money on medicines and makes greater use of generic drugs instead of more expensive branded ones.

There has been criticism of the National Institute for health and Clinical Excellence (Nice) which evaluates the cost effectiveness of medicines as some drugs which can prolong the lives of cancer patients or ease symptoms of Alzheimer's disease have been turned down. Nice, however, does not consider the NHS budget on its deliberations or whether the drugs are affordable, it only looks at whether the drug delivers enough extra benefit to justify the extra cost over standard treatments.

A spokeswoman for the Department of Health said: "These figures need to be treated with caution as the fall in value of the pound between 2004-2008 accounts for much of the change of the position of the UK relative to other countries over this period."


Mixed sex wards to be abolished in Britain next year

More promises. Talk is cheap

Mixed sex wards in NHS hospitals will finally be abolished next year, ministers have said - 13 years after Labour's first pledge to end the degrading practice. Men and women sleeping next to each other in hospitals has proved one of the most difficult issues in the NHS for the Labour government. Despite repeated pledges to end mixed sex wards in the 1997 and 2001 election manifestos, earlier this year one in seven trusts admitted they still used old-style Nightingale wards sleeping rows of both men and women. In total 85 per cent of trusts said they had some form of mixed sex sleeping areas, washing facilities or toilets.

Now ministers have claimed that £100m of investment will mean all trusts will provide single sex sleeping areas by June next year or face fines. Only patients needing very specialist or emergency treatment will be allowed to be admitted to a mixed sex area but their privacy and dignity must still be maintained, the report from the Department of Health said.

A lack of privacy and dignity is one of the most common complaints made to the NHS and is especially upsetting for vulnerable and elderly patients, critics pointed out.

Katherine Murphy, Director of the Patients Association said: "After all the announcements on mixed sex wards since 1997 when the original pledge was made, we are still waiting for the only announcement patients are interested in - that they have abolished this undignified practice. We look forward to hearing that in June next year."

In November 1996 Tony Blair asked if it was 'beyond the collective wit' of the government to eliminate mixed sex wards. The Labour election manifesto in 1997 said: "We will work towards the elimination of mixed sex wards," and in 2001 the manifesto went further saying: "Mixed sex wards will be abolished." However in November 2006 then Health Secretary Patricia Hewitt said there was 'more work' to be done to 'eliminate mixed sex accommodation wherever possible'.

The change in terminology was to reflect that 'wards' could contain both sexes but that each sleeping area with partitions, known as 'bays' should be single sex. In January 2008 then junior health minister Lord Darzi told the Lords that always separating the sexes was 'an aspiration that cannot be met'. In April 2008 then Health Secretary Alan Johnson told the Royal College of Nursing Conference that he hoped that 'by next year' the 'frayed-at-the-edges' manifesto commitment would be met.

In January this year Mr Johnson announced that trusts not providing single sex accommodation would face financial consequences in April 2010. Now Ann Keen, health minster has released an interim report saying the NHS is on target to deliver the pledge. The report, Delivering same-sex accommodation – the story so far, said that sleeping in same-sex bays or wards and having access to same-sex lavatories and bathrooms facilities is now the everyday experience of the overwhelming majority of NHS patients, at every stage in their journey through care.....

Shadow Health Secretary Andrew Lansley said: “Time and again we have heard Labour Ministers boast about how they are within touching distance of abolishing mixed sex wards. But sadly, the reality for thousands of patients is that they still have to suffer the indignity of sharing a room with members of the other sex when they are trying to recover in hospital. “If we are going to get rid of mixed sex wards once and for all we need to focus on building more single rooms in NHS hospitals. But instead Labour have focused on buying thousands of extra curtains. This is simply not good enough."


Prominent Democrat: “Kill The Senate Bill”

In a blow to the bill grinding through the Senate, Howard Dean bluntly called for the bill to be killed in a pre-recorded interview set to air later this afternoon, denouncing it as “the collapse of health care reform in the United States Senate,” the reporter who conducted the interview tells me.

Dean said the removal of the Medicare buy-in made the bill not worth supporting, and urged Dem leaders to start over with the process of reconciliation in the interview, which is set to air at 5:50 PM today on Vermont Public Radio, political reporter Bob Kinzel confirms to me.

The gauntlet from Dean — whose voice on health care is well respsected among liberals — will energize those on the left who are mobilizing against the bill, and make it tougher for liberals to embrace the emerging proposal. In an excerpt Kinzel gave me, Dean says: “This is essentially the collapse of health care reform in the United States Senate. Honestly the best thing to do right now is kill the Senate bill, go back to the House, start the reconciliation process, where you only need 51 votes and it would be a much simpler bill.”

Kinzel added that Dean essentially said that if Democratic leaders cave into Joe Lieberman right now they’ll be left with a bill that’s not worth supporting.

Dean had previously endorsed the Medicare buy-in compromise without a public option, saying that the key question should be whether the bill contains enough “real reform” to be worthy of progressives’ support. Dean has apparently concluded that the “real reform” has been removed at Lieberman’s behest — which won’t make it easier for liberals to swallow the emerging compromise.

Update: The full interview is now up at Vermont Public Radio.


Health Care Reform unpopular: Rasmussen Poll

Fifty-six percent (56%) of U.S. voters now oppose the health care plan proposed by President Obama and congressional Democrats. That’s the highest level of opposition found - reached three times before - in six months of polling. The latest Rasmussen Reports national telephone survey finds that just 40% of voters favor the health care plan.

Perhaps more significantly, 46% now Strongly Oppose the plan, compared to 19% who Strongly Favor it.

Overall support for the health care plan fell to 38%, its lowest point ever, just before Thanksgiving. This is the fourth straight week with support at 41% or less. With the exception of a few days following nationally televised presidential appeals for the legislation, the number of voters opposed to the plan has always exceeded the number who favor it.

“The most significant detail in the data is that 63% of senior citizens oppose the plan, including 52% who strongly oppose it,” says Scott Rasmussen, president of Rasmussen Reports. “Seniors are significant in this debate both because they use the health care system more than anyone else and because they vote more than younger voters.”

Democrats, whose legislators control both the House and Senate, continue to be the big supporters of the health care plan. Seventy-one percent (71%) of those in the president’s party favor it. Eighty-one percent (81%) of Republicans and 69% of voters not affiliated with either party oppose the plan.

But again the emotion is on the side of the opponents: Thirty-eight percent (38%) of Democrats strongly support the plan, but 74% of GOP voters and 57% of unaffiliateds strongly oppose it.

Only 21% of voters say the quality of health care in the country will get better if the plan passes. Fifty-four percent (54%) say quality will get worse, while 18% expect it to stay about the same.

Fifty-seven percent (57%) say health care costs will go up if the plan passes. Seventeen percent (17%) say costs will go down, as the authors of the plan contend. Twenty percent (20%) say health care costs will remain about the same if the legislation becomes law.

More here

Liberals swallow another health compromise in Senate

In a last-ditch attempt to come up with the 60 votes needed to pass health care legislation this year, Senate Democrats appeared ready to dump plans to expand Medicare, with leaders telling their liberal faction to accept a stripped-down proposal because it is better than passing nothing at all. Sen. Joe Lieberman, I-Conn., who is opposed to the provision to allow people as young as 55 to enroll in Medicare, told reporters after a 90-minute caucus meeting that Democratic leaders are likely to remove it. Lieberman said Senate Democratic leaders did not give him "an explicit assurance" that it will not be in the bill, but he added, "let's just say I'm encouraged by the direction things are going in."

Majority Leader Harry Reid, of Nevada, refused to answer questions after the meeting, but other Democratic leaders signaled that liberals are being asked to accept a bill that falls fall short of their original proposal, which at one point included a large, government-run health insurance program. "It's a lot easier to envision the legislation you want than to pass the legislation you need," said Sen. Chris Dodd, D-Conn., chairman of the Health, Education, Labor and Pensions Committee.

When the meeting ended, several liberal Democrats wearing grim expressions, brushed past waiting reporters, refusing to talk. But a few did speak, and justified their support by pointing to the bill's proposal to expand Medicaid to non-elderly adults earning up to 133 percent of the poverty level, which will expand government health care coverage to millions of people.

Sen. Jay Rockefeller, D-W.Va., said he told colleagues in the meeting that he believed it was wrong for anyone to hold up passage of the bill, which also proposes a national insurance plan similar to the one offered to federal workers. "How could I not vote for the bill?" Rockefeller said. "I have to consider who is looking to me for results and what can I give to them. This makes it easy for me to vote for it."

Sen. Paul Kirk, D-Mass., also seemed ready to accept the compromise. In the closed-door meeting, he called for everyone else to go along too, invoking the name of his predecessor, the late Sen. Edward Kennedy, and his desire to pass health care reform. "If some of the things I wanted in the bill aren't in the bill, the pluses offer so many more benefits," Kirk said after the meeting.

While the Medicare expansion idea is all but dead, it could somehow be revived if the Congressional Budget Office calculates a more rosy outlook on its cost than many are expecting. Rockefeller said Reid told the caucus he expects the CBO analysis of both the Medicare buy-in and the national health insurance plan to be ready on Tuesday.

In the meantime, Reid is counting votes. It was not clear to anyone on Monday whether he has 60. "That's something nobody can answer," Rockefeller said.


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