Wednesday, December 02, 2009

Thank heavens my sick mother wasn't at the mercy of the NHS

By British writer, Richard Littlejohn

For the past two weeks I've been in Detroit, Michigan, where my mother is recovering from a car accident. It was touch and go for a while, but I'm delighted to report that she's on the mend. The level of care she has received has been extraordinary. Mum owes her life to the superb doctors and nurses at the William Beaumont Hospital. Not for the first time. She's on the same ward where she was treated for a heart condition two years ago, which inspired me to write about this remarkable medical institution and contrast it with our own sacred National Health Service.

From the $4-a-day valet parking at the front door to the space age facilities in intensive care, it is not so much a different world as another planet.

The last time I visited one of our flagship NHS hospitals, a small fortune had been spent tarting up the reception area but the toilets were filthy and the rubbish bins were overflowing, squalid incubators for every superbug known to man - and probably some still to be discovered. For valet parking, read wheel-clampers. I don't doubt the dedication of the medical staff, but the management of the NHS is a disgrace. No one seems to take any responsibility, nor cares less.

Mum's treatment has been co-ordinated by her own GP, who has visited the hospital every single day, even over the Thanksgiving holiday. He's been what the Americans call the 'go-to guy', available night and day. From the beginning, it was abundantly clear he wasn't going to give up on her.

Try to imagine an NHS general practitioner visiting his patients on Christmas morning. They won't lower themselves to do out-of-hours house calls. You can't even get to see your GP the same day unless you're prepared to get up at the crack of dawn and keep hitting the redial button until the automated answering system sees fit to let you speak to a real human being - or, failing that, a hatchet-faced 'Computer Says No' receptionist. Even then, the chances of getting an appointment which suits you are about as remote as winning the Lottery and you'll be lucky to see the same doctor twice.

If you are unfortunate enough to get admitted to hospital, there's a good chance of contracting a fatal disease once you're in there, as a result of the criminally negligent standards of hygiene. The father of a friend went into an Essex hospital for a minor operation and was dead within days from MRSA. According to reports over the weekend, he was just one of thousands killed by the NHS every year.

Dozens of British hospitals have been exposed as having unusually high mortality rates, even though some had been given 'excellent' ratings under a complacent regime of self-serving, self-certification, which has allowed those nominally in charge to reward themselves with ever fatter bonuses while the coffins are being carted out of the back door.

This callous breed of bureaucrats is epitomised by the chief executive of Essex's Basildon and Thurrock University Foundation NHS Trust, Alan Whittle, who received an 11 per cent pay rise to £150,000 a year, even though more than 400 patients in his 'care' have died because of appalling hygiene, including blood-splattered wards and mould-infested equipment. He was last seen feeding his smug face at a family dinner, while simultaneously texting his 20-stone lover, Karen Bates, who was supposed to be in charge of patient safety and with whom he is now shacked up in hospital accommodation usually reserved for medical staff.

In America, he would have been sued for every cent he had and would probably be in prison for corporate manslaughter. In Britain, even if he gets sacked he'll receive a six-figure pay-off and no doubt be re-hired by another NHS Trust at an even higher salary.

At the Beaumont, in Michigan, the cleaning staff are all employed by the hospital, not an indifferent outside contractor, and there is a clear chain of command. The hygiene regime is relentless. Stand still for more than five minutes and you are likely to be vacuumed and disinfected. I'm sure MRSA exists in the U.S. health system, but not because of institutionalised neglect.

President Obama is currently facing fierce resistance to his attempt to bring in a form of nationalised health care. Medical treatment is undoubtedly expensive in the U.S., but the majority of people are happy with what their money buys. They instinctively don't trust the politicians to run hospitals. And looking at the NHS, who can blame them?

It is a myth to claim that patients are turned away in America and left to die because they don't have health insurance. There are already two government-run schemes, called Medicare and Medicaid, and hospitals like the Beaumont provide millions of dollars worth of free health care every year to those who could otherwise not afford it.

Mum's medical bills this time are being picked up by her car insurance policy, which covers up to $1 million in hospital expenses. We all have to pay motor insurance, so why not insure our health, too? Especially when you see the money people are happy to spend on foreign holidays, cars and drive-in televisions.

It's not as if the NHS is 'free'. It costs billions, without any real accountability and the amount of waste and unnecessary expenditure is grotesque.

Opponents of Obama's Bill have been attacked for talking about the horror of 'death panels' under State-run systems. But what is Nice, our own horribly mis-named National Institute for Clinical Excellence, if not a 'death panel' when it routinely denies patients proven life-saving drugs available elsewhere simply to save money?

The U.S. system is not perfect, but then neither is the National Health Service. Not by a long chalk. Who can blame the 62 per cent of Americans who have concluded of their medical provision that if it ain't broke, there's no need to fix it?

I am not seeking to denigrate the British doctors and nurses who daily perform miracles, but I am haunted by the thought of what might have happened to my 81-year-mum if she had still been living in Essex, at the mercy of the NHS, and not in America.


Prostate cancer patients are losing out on the NHS while women with breast cancer get faster, better care

Patients with prostate cancer receive far worse care on the Health Service than women with breast cancer, MPs said last night. They get less prompt treatment and are less likely to be offered counselling and support, warned the All-Party Parliamentary Cancer Group.

The group's report also found that thousands of elderly cancer patients lose their lives needlessly every year because of ageism in the NHS. As many as 15,000 over-75s die because they are less likely to be offered life-saving treatment than younger patients, they say.

A separate study from the Department of Health has uncovered a postcode lottery of cancer care, with patients in one part of the country three times as likely to still be alive with lung cancer after a year than patients in another. Critics say the two reports expose Labour's failure to improve cancer services, despite the billions of pounds that have been poured into the NHS.

Around 35,000 men are diagnosed with prostate cancer in Britain every year, and some 45,000 women get breast cancer. But prostate cancer charities have long complained that they fare much less well in attracting funding and support from the NHS because it is a less high-profile disease.

All women aged between 50 and 70 are invited to breast cancer screening every three years, for example - but for prostate cancer there is no reliable screening programme available, largely because there has been less research into it.

The report from the all-party group says patients get a different quality of treatment depending what type of cancer they have. For example, those with prostate problems are half as likely as breast cancer patients to have had a discussion with their clinician about their treatment. Breast cancer patients were also five times more likely than prostate patients to have been directed to support groups.

The MPs also concentrated on ageism in the NHS. Figures show that between 1997 and 2007, cancer mortality fell by 18 per cent in those under 75 - largely down to the presence of a Whitehall target. But there is no target covering cancer among the over 75s, and among this age group the fall has been 5 per cent. The MPs' report says the lack of a target means over-75s get worse cancer care and are undertreated. This leads to 15,000 dying prematurely every year. They demanded a new target on cutting the number of people who die with cancer in less than a year - and they said it should apply to all age groups.

Group chairman John Baron said: 'Our inquiry found evidence of truly appalling inequalities in the care, treatment and survival rates of different groups of cancer patients. 'We are particularly concerned that ageism may well be a significant problem within the NHS. We see a radical one-year survival measure as a way of speeding up early diagnosis. This will improve outcomes for all, and in doing so help stamp out ageism.'

The MPs also demanded ministers ban under-18s from sunbeds, and said they should order rationing body NICE to fund more drugs for rarer cancers.

A separate report by cancer 'tsar' Michael Richards shows the extent of regional differences in the quality of cancer care. In one year, survival rates for lung cancer were three times higher in Kensington and Chelsea than in Herefordshire (44 per cent still being alive a year after diagnosis compared to 15 per cent). Bowel cancer survival rates in Telford were 80 per cent, but 58 per cent in Hastings. And while 99 per cent of breast cancer victims in Torbay are alive after a year, in Tower Hamlets in East London the figure is 89 per cent.

Professor Richards said that poor survival rates were usually down to late detection of symptoms. Harpal Kumar of Cancer Research UK, said: 'These shocking statistics confirm that the cancer postcode lottery remains a real problem.'


Huge pay rises for shamed British hospital bosses

The bureaucracy is a sacred cow to Leftists

Hospital bosses received huge pay rises as up to 5,000 patients in their care died needlessly. The heads of some of the worst NHS trusts shamed yesterday in a damning report saw their salaries rise by up to 32 per cent. They included the chief executive of the discredited Basildon and Thurrock trust in Essex - who was yesterday revealed to be having an affair with his patient safety manager.

The rises were awarded after the trusts gained foundation status. Chief executives of foundation trusts are paid more because they have greater independence from Department of Health control.

The report by healthcare analysts Dr Foster found that 12 trusts are putting patients at serious risk because of life-threatening errors and 'systemic' safety failings - even though eight of them were praised as 'good' or 'excellent' by the Care Quality Commission health watchdog only last month. It also found that 27 trusts - a fifth of the total - have unusually high death rates - equating to almost 5,000 excess deaths.

More than half of the 27 are supposedly elite foundation trusts. The joint-tenth-worst, Blackpool, Fylde and Wyre, is said by Dr Foster to have a death rate 15 per cent higher than the national average. Yet its chief executive, Julian Hartley, saw his pay rise by 32 per cent from £125,000 to £165,000 when his trust attained foundation status in December 2007. He has now left to join South Manchester, another of the least-safe trusts on the list.

Another high pay rise was enjoyed by Tameside hospital foundation trust chief executive Christine Green, despite the fact that safety is sixth-worst in England and its death rate is the third-worst at 19 per cent above average. She faced calls to quit two years ago when an independent review concluded that the care of elderly patients had been deficient. Yet her pay went up 17 per cent from £120,000 to £140,000 when foundation status was attained in February last year.

The Dr Foster report, which covers 2008/09, shows that Basildon and Thurrock tops the list of the worst trusts, with death rates 31 per cent higher than would be expected across the NHS.

Last week the foundation trust regulator Monitor sent in a task force to help run the hospital after the health watchdog carried out a spot check which uncovered filthy conditions on the accident and emergency ward which led to dozens of deaths. Despite the failings, Basildon's chief executive Alan Whittle recently saw his pay shoot up by 11 per cent in a year, to £150,000.

And Peter Murphy, chief executive of Colchester hospitals, enjoyed a 16 per cent pay rise to £163,000. Last week the trust's chairman was sacked - but Mr Murphy survived. Basildon and Thurrock University Hospital had been rated good but last week a task force was ordered in to sort out failings at the trust

Trusts are awarded foundation status if they can show Monitor that their finances are in order and they are meeting Whitehall targets such as those on waiting times. Critics say Monitor awards trusts foundation status without taking into account the quality of the service to patients. Foundation status gives trusts significant autonomy from Department of Health rules. This is why chief executives and other key staff can command extra pay - because they say running the trust is a much more onerous responsibility. It means chief executives effectively receive higher wages for impressing the regulator on their financial acumen rather than on how good they are at driving up standards in the hospital.

The Dr Foster report uncovered a litany of failings in the NHS, showing that shocking safety lapses are widespread across the Health Service. It concluded that some trusts, many of them foundations, were guilty of 'systemic under-performance' and were subjecting patients to 'life-threatening errors'. The report found that almost four in ten trusts do not routinely investigate unexpected deaths, or cases of serious harm, on their wards; and one in ten trust boards does not routinely discuss patient safety.

Last year, 2008/09, saw at least 209 incidents in which foreign objects, such as swabs and drill bits, were left inside patients after surgery. There were also 82 cases of surgeons operating on the wrong part of the body. More than 5,000 patients died last year after being admitted for low-risk conditions, including 220 with asthma and 56 with appendicitis.


Deadly Decline

As the Senate begins to debate reform legislation, the deadly disasters inherent in socialized medicine in the model nation of Britain should make the discussion a sober one.

While Washington lawmakers, accustomed to the comfort of top-notch medical treatment, consider a federal takeover of the health care sector, patients in Great Britain are dying because that government's system is a mess. "Up to 10,000 people," the British Guardian reported Sunday, are dying needlessly of cancer each year "because their condition is diagnosed too late, according to research by the government's director of cancer services."

Britain is home to the sort of government-run health care that the political left has tried to push on this country for decades. It is also the home of government-rationed medical treatment. So the sad story of 10,000 needless cancer deaths a year doesn't surprise.

Not every needless cancer death can be blamed, of course, on Britain's National Health Service. In some cases, patients themselves are responsible for the late diagnoses of their diseases.

But the rest can be blamed on the system. Researchers at Durham University have identified four other types of delays patients encounter in receiving cancer care: doctor delay, delay in primary care, system delay and delay in secondary care. All are part of a state-operated system that has a poor record of keeping its trapped patients alive and healthy.

The unnecessary cancer deaths are not the only recent example of the rot in Britain's system. The Times of London reported Saturday that the health secretary has ordered an immediate probe into "claims that patients are dying due to poor care in at least 27 hospitals around the country."

These are just the latest stories. The poor care that has become the hallmark of Britain's public medicine goes back many years. The long waiting times to see a doctor in the British, Canadian and Swedish government-run systems, as well as the denial of some drugs and what seems to be an institutional neglect of patients, are not new problems.

More government involvement won't correct the ills government has already created. Yet the Democratic leadership in Washington is determined to force more federal control over health care on a public that doesn't want it.

The left wants to be responsible for providing care for all. But what it will be responsible for, if it gets its way, is a deadly decline in the quality of American health care.


Cancer Patient Takes on Canadian Bureaucracy in Desperate Fight for Life

Suzanne Aucoin of St. Catharines, Ontario never imagined that dealing with the Canadian health care bureaucracy would be as tough as battling terminal cancer. Aucoin had to go to the U.S. for treatment initially denied to her. While ill, she then engaged in a prolonged and complicated fight to get access to a life-extending anti-cancer drug and to recover the exorbitant amount she was forced to spend out of her own pocket on treatment.

In 1999, Aucoin was diagnosed with colorectal cancer. Surgeons removed large portions of her intestine and colon. But about four and a half years later, Aucoin became easily fatigued and felt pain in her side. A follow-up visit with her doctors revealed that the cancer had reappeared and spread to her lungs and liver.

In January 2004, Aucoin began chemotherapy treatment for stage IV colon cancer, the most advanced stage. A CT scan showed that chemotherapy had been ineffective at destroying the tumor in her liver. Aucoin's oncologist recommended that weekly doses of the powerful anti-cancer drug, Erbitux, offered her the best hope for staying alive. The problem was the drug - which can shrink tumors in advanced cancer patients - was not publicly-provided or even available for purchase in Ontario.

Worse yet, Ministry of Health officials denied Aucoin's application for out-of-country funding to permit Aucoin to get the potentially life-extending drug in the U.S. However, Aucoin claimed, the government was paying for three other patients with a similar form of cancer to receive treatment abroad. Reviews are on a case-by-case basis, but the health ministry did confirm it paid for some patients to receive Erbitux in the U.S. "I just find it ridiculous that I have to go to these lengths when the government is glaringly wrong. They have all these inconsistencies, and I'm the one who suffers because of it," Aucoin said.

Despite the government's refusal to fund her treatment, Aucoin began receiving weekly treatments of Erbitux at a cost of $14,000 (USD) a month at a clinic in West Seneca, NY. The U.S. Food and Drug Administration approved Erbitux in February 2004. Thankfully, friends and supporters raised more than $180,000 (CAD) over several years to help pay for her treatment. "You can't wait with this cancer," she said. "You can't wait for people to make decisions about your health. You can't wait for forms to be filled out. You have to go where the drug is."

In fall 2005, Health Canada - the Canadian agency responsible for evaluating drugs - approved Erbitux. But health officials refused to cover Erbitux and limited the number of patients who could have access.

Fortunately, a loophole existed. In December 2005, Aucoin was the first patient allowed Erbitux under a Special Access Program set up for seriously ill patients. She would have to pay over $6,000 (CAD) a month for treatment, which she received at a Hamilton, Ontario clinic, while the government paid the administrative costs. "I just want to take care of myself," Aucoin said. "My job is to get well and I feel like my government's letting me down because they're not doing their job."

Following another appeal for out-of-country funding several months later, the government changed its mind and, without explanation, agreed to cover Aucoin's treatment. The decision meant Aucoin would no longer pay out-of-pocket, but she would again need to travel across the border. Oddly, the government directed her to a Buffalo, NY cancer hospital that charged thousands of dollars more for Erbitux than the West Seneca clinic Aucoin used for out-of-pocket treatment. She began treatment at the Roswell Park Cancer Institute in April 2006.

Then the Ontario government stonewalled Aucoin's attempt to be reimbursed. In June 2006, health officials denied her application for reimbursement saying the government would "only approve [reimbursement] if it's in a certain setting, i.e., a hospital," not a private clinic. Moreover, Aucoin was not granted funding approval before she went abroad for treatment. "I am completely disgusted with our health care system," Aucoin said. "I am very discouraged and frustrated by the lack of professionalism, the lack of consistency and the lack of care for me as an individual patient." She added, "I'm not asking for Botox, I'm asking for life-saving treatment."

After losing on appeal and running out of options, Aucoin appealed to Ontario's ombudsman, Andre Martin. Following his investigation, in January 2007 Ontario's health officials finally agreed to pay over $76,000 (CAD) for Aucoin's out-of-country care and for legal expenses. The ombudsman blasted health officials for their "cruel" treatment and "slavish adherence to rules at the expense of common sense."

"I should never have had to deal with this, it takes all my energy to fight cancer," Aucoin said. "It rights a wrong on some levels but you cannot put a price tag on my mental strain and stress." Tragically, Aucoin lost her fight against cancer. She passed away in November 2007.


Major Australian resort area runs short of public hospital beds

BOOMING coastal populations in the southeast and north are facing the gravest shortages of public hospital beds in Queensland. The lack of overnight beds, especially on the Gold and Sunshine coasts, has led AMA Queensland president Mason Stevenson to angrily accuse State Treasury of "holding sway" over patients' lives. "If you are a citizen of the Gold or Sunshine coast, (your) health and safety is compromised," Dr Stevenson said. "Dollars and cents appear to come first. "And patients will continue to suffer, and some patients will die, as a result."

For the Gold Coast, the picture only gets bleaker. The Courier-Mail can reveal the new Gold Coast University Hospital will open in late 2012 with up to 150 fewer available beds than promised. Queensland Health deputy director-general (planning and infrastructure) Michael Walsh said staff recruitment delays – not budget cuts – were to blame.

Gold Coast Medical Association president Philip Morris said the hold-up was in stark contrast to the Government's rhetoric. "They keep saying they've got a 750-bed hospital," Dr Morris said.

The Courier-Mail's hospital-by-hospital analysis found the Mackay Health Service District was Queensland's poorest provider of overnight public beds – with six hospitals, 252 beds and only 1.5 beds per 1000 people. The rate was almost half the national average of 2.5 beds for every 1000 residents. According to State Government projections, the Mackay region was expected to be one of the top growth spots from 2006-2026, increasing its population by 37.4 per cent.

However, the Gold Coast was the next most under-resourced area. And its 1.72 beds per 1000 people – based on an Australian Institute of Health and Welfare figure of 855 beds – could well be flattering. A Queensland Health spokesman told The Courier-Mail the latest departmental count for the coast was 745 overnight public hospital beds. The Gold Coast Hospital claimed 472 of those, while its Robina campus had 210 and Carrara Health Centre a further 63.

Dr Morris said the coast's population was expected to balloon from 500,000 to 823,000 over the next two decades. He warned that without expansion beyond the University Hospital, the tourism mecca would dive towards a 1000-bed deficit in 25 years. "This will be a disaster for the community," he said.

Dr Stevenson said the Sunshine Coast, the third-worst facilitated district with 1.8 beds per 1000 people, was so bereft of wards and specialist treatments that 180 of its constituents occupied a Brisbane public hospital bed every night. "By 2016-17, the number will have increased to 280," he said. "That denies those beds to Brisbane residents, and also puts enormous pressure on our ambulance and patient transfer systems."

A Coolum Beach GP, Dr Stevenson said the Sunshine Coast population would grow from about 300,000 to 460,000 in 2017. Yet it was missing "tertiary-level services that are now regarded as mainstream throughout the western world". "We do not have access to public cardiology, neurosurgery, vascular surgery or public cancer radiotherapy," Dr Stevenson said.

Brisbane's Metro South Health Service District also failed to meet the national standard, with 2.13 beds per 1000 people. The zone includes major hospitals such as Logan, Mater Adult, Mater Children's, Mater Mothers, Princess Alexandra and QEII.

However, Health Minister Paul Lucas insists there is no crisis. "Of course we want to build more beds and . . . we are doing it," he said. Mr Lucas said the Commonwealth's inadequate subsidising of nursing homes was driving providers out of the sector. "(As a result), there are on average 400 (acute) beds being occupied by Queenslanders who are eligible for nursing home placement," he said.


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