Blog suspended

Now that the battle against socialized medicine in America is largely over, I have decided to suspend publication of this blog. I will of course still be posting on the issue when matters of particular interest arise but I will do so on DISSECTING LEFTISM from now on -- as you will see in most weeks.

My AUSTRALIAN POLITICS blog will also continue to cover the disasters of socialized medicine in Australia.

And EYE ON BRITAIN has regular posts on the reality of socialized medicine there. For a long time now, not a day has gone by without a fresh horror story from Britain's "NHS" leading the posts on that blog.

Barack Obama signs health care bill amid warnings of Pyrrhic victory

President Barack Obama will sign into law the historic reform of the American health care system that has eluded his predecessors for a century on Tuesday. The 219 to 212 vote in the House of Representatives, in which 34 Democrats sided with a united Republican opposition, was a significant victory for Mr Obama. But critics warned it would be a Pyrrhic one that could lead to electoral disaster for his party in November's midterm elections. Mr Obama's poll ratings have fallen steadily to just under 50 per cent over the 14 months in which he has pushed relentlessly for health care reform.

The legislation, due to be signed by Mr Obama in a South Lawn ceremony, will expand health insurance coverage to 32 million currently uninsured Americans at a cost of $938 billion (£622 billion) over 10 years.

It will mandate that almost every American carry health insurance-a provision that opponents are set to challenge in the courts. The legislation expands Medicaid, the state health programme for the poor, while those earning more than $200,000 (£133,000) will face higher taxes.

A package of changes to an earlier bill passed by the Senate was still to be considered by the body but Democrats were confident that they had the votes to secure easy passage and Republicans conceded that their only options were future repeal and fighting provisions in the courts.

Robert Gibbs, the White House press secretary, responded jubilantly to the Capitol Hill vote late on Sunday with an email that played on Mr Obama's hope-laden campaign slogan: "Yes we can became yes we did."

Mr Obama himself proclaimed: "We pushed back on the undue influence of special interests. We didn't give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things. This isn't radical reform but it is major reform.

Nancy Pelosi, Speaker of the House and the architect of the successful plan to pass the bill, described it as a "great act of patriotism" that honoured the vows of our Founders for us to be a land of opportunity, all the way back to before we were a country, in the Declaration of Independence talking about life, liberty and the pursuit of happiness".

However, critics warned that voters would have their revenge. Senator John McCain denounced the “euphoria” and “inside-the-Beltway champagne toasting” and predicted that Democrats would be punished by voters in the mid-term congressional elections. “We are going to have a very spirited campaign coming up between now and November. And there will be a very heavy price to pay for it,” he said.

Republicans said the bill would burden the nation with unaffordable levels of debt at a time of economic crisis, leave individual states with expensive new obligations and give an inefficient and overweening government an unacceptably enlarged role in the health care system.

The deal in the House of Representatives was sealed on Sunday afternoon when a handful of anti-abortion Democrats led by Representative Bart Stupak of Michigan agreed to vote yes in return for a White House executive order stating that federal funds would not be used to pay for abortions.

There was a feverish atmosphere on Capitol Hill, where large numbers of conservative protesters gathered to chant "Kill the bill" and wave signs that said "Don't Tread on Me" and "Doctors Not Dictators". John Boehner, Republican leader in the House of Representatives, said: "The American people are angry. This body moves forward against their will. Shame on us."

Representative Paul Ryan of Wisconsin, a rising star in the Republican party, denounced the bill as "a fiscal Frankenstein" while his colleague Virginia Foxx described it as "one of the most offensive pieces of social engineering legislation in the history of the United States".

Rush Limbaugh, the Right-wing radio host, spoke for many American conservatives when he railed: "We're not a representative republic. The will of the people was spat upon."

The legislation will still leave 23 million uninsured in 2019, a third of those illegal immigrants. According to the non-partisan Congressional Budget Office, the cost of the bill will be offset by savings in Medicare, the state health system for the elderly, and by new taxes and fees, including a tax on some employer schemes and on wealthy Americans.

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A Point of No Return?

by Thomas Sowell

With the passage of the legislation allowing the federal government to take control of the medical care system of the United States, a major turning point has been reached in the dismantling of the values and institutions of America. Even the massive transfer of crucial decisions from millions of doctors and patients to Washington bureaucrats and advisory panels-- as momentous as that is-- does not measure the full impact of this largely unread and certainly unscrutinized legislation.

If the current legislation does not entail the transmission of all our individual medical records to Washington, it will take only an administrative regulation or, at most, an Executive Order of the President, to do that. With politicians now having not only access to our most confidential records, and having the power of granting or withholding medical care needed to sustain ourselves or our loved ones, how many people will be bold enough to criticize our public servants, who will in fact have become our public masters?

Despite whatever "firewalls" or "lockboxes" there may be to shield our medical records from prying political eyes, nothing is as inevitable as leaks in Washington. Does anyone still remember the hundreds of confidential FBI files that were "accidentally" delivered to the White House during Bill Clinton's administration? Even before that, J. Edgar Hoover's extensive confidential FBI files on numerous Washington power holders made him someone who could not be fired by any President of the United States, much less by any Attorney General, who was nominally his boss.

The corrupt manner in which this massive legislation was rammed through Congress, without any of the committee hearings or extended debates that most landmark legislation has had, has provided a roadmap for pushing through more such sweeping legislation in utter defiance of what the public wants.

Too many critics of the Obama administration have assumed that its arrogant disregard of the voting public will spell political suicide for Congressional Democrats and for the President himself. But that is far from certain. True, President Obama's approval numbers in the polls have fallen below 50 percent, and that of Congress is down around 10 percent. But nobody votes for Congress as a whole, and the President will not be on the ballot until 2012.

They say that, in politics, overnight is a lifetime. Just last month, it was said that the election of Scott Brown to the Senate from Massachusetts doomed the health care bill. Now some of the same people are saying that passing the health care bill will doom the administration and the Democrats' control of Congress. As an old song said, "It ain't necessarily so."

The voters will have had no experience with the actual, concrete effect of the government takeover of medical care at the time of either the 2010 Congressional elections or the 2012 Presidential elections. All they will have will be conflicting rhetoric-- and you can depend on the mainstream media to go along with the rhetoric of those who passed this medical care bill.

The ruthless and corrupt way this bill was forced through Congress on a party-line vote, and in defiance of public opinion, provides a road map for how other "historic" changes can be imposed by Obama, Pelosi and Reid.

What will it matter if Obama's current approval rating is below 50 percent among the current voting public, if he can ram through new legislation to create millions of new voters by granting citizenship to illegal immigrants? That can be enough to make him a two-term President, who can appoint enough Supreme Court justices to rubber-stamp further extensions of his power.

When all these newly minted citizens are rounded up on election night by ethnic organization activists and labor union supporters of the administration, that may be enough to salvage the Democrats' control of Congress as well.

The last opportunity that current American citizens may have to determine who will control Congress may well be the election in November of this year. Off-year elections don't usually bring out as many voters as Presidential election years. But the 2010 election may be the last chance to halt the dismantling of America. It can be the point of no return.

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THE DOCTORS OF THE HOUSE

House Democrats last night passed President Obama's federal takeover of the U.S. health-care system, and the ticker tape media parade is already underway. So this hour of liberal political victory is a good time to adapt the "Pottery Barn" rule that Colin Powell once invoked on Iraq: You break it, you own it.

This week's votes don't end our health-care debates. By making medical care a subsidiary of Washington, they guarantee such debates will never end. And by ramming the vote through Congress on a narrow partisan majority, and against so much popular opposition, Democrats have taken responsibility for what comes next—to insurance premiums, government spending, doctor shortages and the quality of care. They are now the rulers of American medicine.

Mr. Obama and the Democrats have sold this takeover by promising that multiple benefits will follow: huge new subsidies for the middle class; lower insurance premiums for consumers, especially those in the individual market; vast reductions in the federal budget deficit and in overall health-care spending; a more competitive U.S. economy as business health-care costs decline; no reductions in Medicare benefits; and above all, in Mr. Obama's words, that "if you like your health-care plan, you keep your health-care plan."

We think all of this except the subsidies will turn out to be illusory, as most of the American public seems intuitively to understand. As recently as Friday, Caterpillar Inc. announced that ObamaCare will increase its health-care costs by $100 million in the first year alone, due to a stray provision about the tax treatment of retiree benefits. This will not be the only such unhappy surprise.

While the subsidies don't start until 2014, many of the new taxes and insurance mandates will take effect within six months. The first result will be turmoil in the insurance industry, as small insurers in particular find it impossible to make money under the new rules. A wave of consolidation is likely, and so are higher premiums as insurers absorb the cost of new benefits and the mandate to take all comers.

Liberals will try to blame insurers once again, but the public shouldn't be fooled. WellPoint, Aetna and the rest are from now on going to be public utilities, essentially creatures of Congress and the Health and Human Services Department. When prices rise and quality and choice suffer, the fault will lie with ObamaCare.

While liberal Democrats are fulfilling their dream of a cradle-to-grave entitlement, their swing-district colleagues will pay the electoral price. Those on the fence fell in line out of party loyalty or in response to some bribe, and to show the party could govern. But even then Speaker Nancy Pelosi could only get 85% of her caucus and had to make promises that are sure to prove ephemeral.

Most prominently, she won over Michigan's Bart Stupak and other anti-abortion Democrats with an executive order from Mr. Obama that will supposedly prevent public funds from subsidizing abortions. The wording of the order seems to do nothing more than the language of the Senate bill that Mr. Stupak had previously said he couldn't support, and of course such an order can be revoked whenever it is politically convenient to do so.

We have never understood why pro-lifers consider abortion funding more morally significant than the rationing of care for cancer patients or at the end of life that will inevitably result from this bill. But in any case Democratic pro-lifers sold themselves for a song, as they usually do.

Then there are the self-styled "deficit hawks" like Jim Cooper of Tennessee. These alleged scourges of government debt faced the most important fiscal vote of their careers and chose to endorse a new multitrillion-dollar entitlement. They did so knowing that the White House has already promised to restore some $250 billion in reimbursement cuts for doctors that were included in yesterday's bill to make the deficit numbers look good. Watch for these Democrats to pivot immediately and again demand "tough choices" on spending—and especially tax increases—but this vote has squandered whatever credibility they had left.

Mrs. Pelosi did at least abandon, albeit under pressure, the "deem and pass" strategy that would have passed the legislation without a vote on the actual Senate language. We and many others criticized that ruse early last week, and the House decision to drop it exposes the likes of Norman Ornstein of the American Enterprise Institute and other analysts who are always willing to defend the indefensible when Democrats are doing it.

All of this means the Senate's Christmas Eve bill is ready for Mr. Obama's signature, though only because rank-and-file House Members also passed a bill of amendments that will now go back to the Senate under "reconciliation" rules that require only 50 votes. Those amendments almost certainly contravene the plain rules of reconciliation, and the goal for Senate Republicans should be to defeat this second "fix-it" bill. It's notable that Democrats didn't show yesterday for a meeting with the Senate parliamentarian to consider GOP challenges, no doubt because they fear some of them might be upheld.

Though it's hard to believe, the original Senate bill is marginally less harmful than the "fixed" version, not least because the middle-class insurance subsidies are less costly and it would avert the giant new payroll tax. That's the White House increase in the Medicare portion of the payroll tax to 3.8% that Democrats cooked up at the last minute and would apply to the investment income of taxpayers making more than $200,000.

If the reconciliation bill goes down, Big Labor and its Democratic clients would be forced to swallow a larger excise tax on high-cost insurance plans, and it would also forestall the private student-loan takeover that Democrats included as a sweetener. In other words, they'd be forced to eat the sausage they themselves made as they have abused Congressional procedure to push ObamaCare into law.

We also can't mark this day without noting that it couldn't have happened without the complicity of America's biggest health-care lobbies, including Big Pharma, the American Medical Association, the American Hospital Association, the Federation of American Hospitals, the Business Roundtable and such individual companies as Wal-Mart. They hope to get more customers, or to reduce their own costs, but in the end they have merely made themselves more vulnerable to the gilded clutches of the political class.

While the passage of ObamaCare marks a liberal triumph, its impact will play out over many years. We fought this bill so vigorously because we have studied government health care in other countries, and the results include much higher taxes, slower economic growth and worse medical care. As for the politics, the first verdict arrives in November

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Health care reform: We’re being fooled again

The medical system does need reforming — radical reforming. It’s more expensive than it ought to be, and powerful interests prosper at the expense of the rest of us. The status quo has little about it to be admired, and we shouldn’t tolerate it.

Thus, the American people should be fed up with Barack Obama, Nancy Pelosi, and Harry Reid for insulting our intelligence with their so-called heath-care reform. It is nothing of the sort. What they call progressive reform is little more than reinforcement of the exploitative system we suffer today.

Whether intentionally or not, Obama & Co. have misdiagnosed the problem with the current system and therefore have issued a toxic prescription as an alleged cure. They essentially say that the problem is too free a market in medical care and insurance; thus for them the solution is a less-free market, that is, more government direction of our health-care-related activities.

Yet if the diagnosis is wrong — which it is — the prescription will also be wrong.

Note that the attention of nearly all the “reformers” is on the insurance industry. What ostensibly started out as “health-care reform” quickly became health-insurance regulation. A common theme of all of the leading proposals is that insurance companies have too few restrictions on them. So under Obamacare, government will issue more commands: preexisting conditions must be covered; policy renewal must be guaranteed; premiums may not reflect the health status or sex of policyholders; the difference between premiums charged young and old must be within government specs; lifetime caps on benefits are prohibited, et cetera.

In return for these new federal rules, insurance companies are to have a guaranteed market through a mandate that will require every person to have insurance. So what looks like onerous new regulations on the insurance companies turns out to be a bargain they are happy to accept. Instead of having to innovatively and competitively attract young healthy people to buy their products, the companies will count on the government to compel them to do so. Playing the populist role, Obama & Co. bash the insurance companies, but in fact the “reform” compels everyone to do business with them.

What about this would the insurance companies dislike? Health insurance is not the most profitable business you can be in; the profit margin is 3-4 cents on the dollar. So a guaranteed clientele is an attractive prospect. The people who will be forced to buy policies are the healthy, who will pay premiums and make few claims. The only thing the companies don’t like is that that penalty for not complying with the mandate is too small. Many young people may choose to pay the penalty rather than buy the insurance because it will be cheaper. But that presents a problem: when the uninsured get sick and apply for coverage, they won’t be turned down because that would be against the law. So look for harsher penalties in the future to prevent this gaming of the system. The insurance companies win again.

What’s missed is that the “reformers” leave untouched every aspect of the uncompetitive medical and insurance cartels that exists entirely by virtue of government privilege. Most of this privilege is extended by state governments through monopolistic licensing, but Congress could repeal the prohibition on interstate insurance sales and the tax favoritism for employer-provided medical coverage. The ruling party has refused to consider those sensible moves.

The upshot is that this reform is a fraud. It leaves in place the government-created cartels and throws a few crumbs to people who are struggling — but mostly by bolstering the insurance monopoly.

Two myths must be shattered. First, the choice is not between this phony reform and the status quo. The “reform” merely puts makeup on the status quo. The free market is the real alternative.

Second, the free market couldn’t have created the medical mess because there has been no free market in medicine. For generations government has colluded with the medical profession and the insurance industry to force-feed us the system we have today.

The Who was wrong: We are being fooled again.

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Our future under Obamacare

The bill will cost more than advertised. It won't be long before Congress is shocked — shocked! — to discover that health-care reform is going to cost a lot more than expected. It's not just the budgetary gimmicks that Democrats have been employing to hide the bill's true cost. It's also that government programs — and government health-care programs in particular — almost always end up exceeding their cost estimates.

For example, when Medicare was instituted in 1965, it was estimated that the cost of Medicare Part A would be $9 billion by 1990. In actuality, it was seven times higher — $67 billion. Similarly, in 1987, Medicaid's special hospitals subsidy was projected to cost $100 million annually by 1992, just five years later; it actually cost $11 billion, more than 100 times as much. And in 1988, when Medicare's home-care benefit was established, the projected cost for 1993 was $4 billion, but the actual cost in 1993 was $10 billion.

Insurance premiums will keep rising. The president has tried to convince people that health-care reform will cut their insurance costs. They are in for a surprise. According to the Congressional Budget Office, insurance premiums will double in the next few years. The bill will do nothing to diminish that increase. In fact, for the millions of Americans who get their insurance through the individual market, rather than from an employer, this bill will raise premiums by 10–13 percent more than if we do nothing. Young and healthy people can expect their premiums to go up even more.

The quality of care will be worse. Doctors' reimbursements for providing care will be squeezed, making it harder to find a doctor. A new survey in the New England Journal of Medicine reports that 46 percent of doctors may give up their practice in the wake of this bill. While that is probably exaggerated, many doctors will likely decide to reduce their patient loads or retire. At the same time, increased demand will create additional problems.

In Massachusetts, after the passage of Romneycare, the wait to see a primary-care physician increased from 33 to 52 days. Research and development will also be cut back, meaning there will be fewer new drugs and other medical breakthroughs. And the government will increasingly intervene in medical decision making, micromanaging medical decisions and deciding what treatments are most effective or, frighteningly, most cost-effective.

The Left will keep pushing for more. Speaker Nancy Pelosi's inner censor was clearly on the fritz this week when she said, "Once we kick through this door, there'll be more legislation to follow." Faced with rising costs and higher premiums, not to mention millions still uninsured, Democrats will blame the "evil" insurance companies and demand further reform. They will argue that we tried "moderate" reform and failed. Pelosi could no longer keep a lid on what the hard Left has been restraining itself from saying all along: It sees this legislation as the perfect first step in the long march to universal single-payer health care.

Republicans won't really try to repeal it. Republicans will run this fall on a promise to repeal this deeply unpopular bill, and will likely reap the political advantages of that promise. But in reality there is little chance of their following through. Even if Republicans were to take both houses of Congress, they would still face a presidential veto and a Democratic filibuster.

But more important, once an entitlement is in place, it becomes virtually impossible to take away. The fact that Republicans have been criticizing Obamacare for cutting Medicare shows that they are not really willing to take the heat for cutting people's benefits once they have them — no matter how unaffordable those benefits are. Paul Ryan put forth a serious plan for entitlement reform — and attracted just six co-sponsors at last count. Enough said.

As Scrooge asked in A Christmas Carol, "Are these the shadows of the things that will be, or are they shadows of things that may be?

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A View from Britain

A British friend who has been following the health-care debate writes in:

In Britain the introduction of the NHS was passionately supported by both parties. Tory opposition to the legislation accepted the principle of medical care free at the point of consumption and concentrated instead on secondary questions. It could hardly have done otherwise since Churchill's wartime coalition government had developed its own plans for a single-payer system of universal health insurance—along with other statist social welfare measures.

At the time of its passage the cost-benefit structure of the new British system was radically opposite to that of Obamacare. Its benefits—mainly the extension of free medical care from the poor to the middle class—came at once; its costs were delayed for a decade and a half as almost all budgetary health allocations went to current spending and almost none to capital investment. Not until 1962 did a British government embark on a hospital building program; until then—and for many years afterwards—the national health service lived off the fixed capital invested by private Victorian philanthropy. (Even a few years ago you could tell this from the appearance of the buildings.) The advance of medical science today makes a repeat of this performance quite impossible. So the money to meet the increasing demand for medical services will have to come from somewhere other than the capital budget. Where?

Rationing is implicit in both Obamacare and the NHS. But the customers of both systems are very different. Most modern Americans get good health care. They have learned to expect it. They will complain if they don't get it. And they have their present care as a method of comparison to any new system. Brits in 1948 had just survived a terrible war. Rationing was part of their everyday lives. They were a deferential people to begin with in a much more hierarchical society. Brits of today would be much much harder to convince—if they had not got used to getting free but inadequate health care.

And the ratio of winners to losers in both cases is very different. As the previous paragraph suggests, there were no real losers in the Britain of 1948. Only a tiny handful of very rich people had any experience of great medical care—and they were rich enough to pay higher taxes AND private insurance premiums. Everyone else got roughly the same medical care; but now the middle class got it for nothing as most of the poor had done before. Nobody lost—not for another fifteen years when the quality of medical care began to decline noticeably. And by then they were hooked. By contrast almost every insured Ameerican is a potential loser under Obamacare. And some of those considered to be winners—i.e., the currently non-insured—will feel like losers if they are forced to insure and then remain inconveniently healthy.

So, for all sorts of reasons, opponents of this bill should not feel deterred from hope of repeal by the British experience. At the very least they have a window of opportunity to reverse the legislation of about eight to ten years. It's doable if you think it's doable—not if not.

Finally the wise words of . . . John Maynard Keynes: "The unexpected always happens; the inevitable never."

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Landmark health care plan passes

House Democrats rallied late Sunday night to pass President Obama's landmark health care overhaul plan and send to the president's desk the politically risky initiative, which Republicans vow to wield against the Democrats in November's mid-term elections. A companion package of repairs to the bill now heads to a Senate fight. But regardless of the outcome there, Mr. Obama's yearlong struggle for his signature initiative is just a stroke of his pen away from becoming law.

The Senate's health care bill squeaked through the House in a 219-212 vote, with 34 Democrats joining all 178 Republicans in opposition after a last-minute White House executive order convinced a small group of pro-life Democrats that the bill wouldn't fund abortions. The companion "fixes" bill passed 220 to 211, with 33 Democrats joining all 178 Republicans in opposition.

Democrats hailed the vote as one of the most significant change in American social policy since the creation of Medicare in 1965 or Social Security in 1935. "This is an American proposal that honors the traditions of our country," House Speaker Nancy Pelosi said, adding that access to health care is in the same league as the Declaration of Independence's claims about the inalienable rights to "life, liberty and the pursuit of happiness."

The 10-year, $940 billion overhaul plan aims to reshape the nation's health system by imposing new reforms on the insurance industry and guaranteeing insurance coverage to nearly all Americans with hopes of reducing health care costs and the federal deficit. "This is what change looks like," Mr. Obama said at the White House shortly after the vote, which he watched in the Roosevelt Room with Vice President Joseph R. Biden Jr.

Outside the Capitol, a few hundred protesters shouted "Kill the bill." Walking from a House office building to the Capitol on Sunday afternoon, Mrs. Pelosi linked arms with Rep. John Lewis, a Georgia Democrat who walked in the civil rights marches in Selma, Ala., in the 1960s and who said he was called a racial epithet by health care protesters on Saturday. Republicans called it an isolated incident and maintained their opposition to the health reform plan.

They argue that cuts to Medicare would undoubtedly hurt seniors' coverage, that insurance premiums for all Americans would spike, and that Democrats won't be able to make good on Mr. Obama's often-repeated promise that "if you like your plan, you can keep it." "The decisions we make will affect every man, woman and child in this nation for generations to come," Minority Leader John A. Boehner said. "This bill is not what the American people need." Mr. Boehner and Sen. Jim DeMint, South Carolina Republican, separately promised to introduce legislation to try to repeal the plan.

Mr. Obama, in his pitch to Democrats on Capitol Hill in recent weeks, said that much of his presidency is on the line with passage of his overhaul plan. It marks the most significant legislative accomplish of his presidency. But it would be a victory with a large asterisk. The Senate promised House members that it will be able to pass a companion bill to "repair" controversial provisions in the bill, such as a tax on high-cost insurance plans and state-specific deals that critics say were meant to buy votes. Mr. Obama could sign the Senate bill into law immediately. But doing so without the Senate repair bill would likely anger House members.

The debate over how to reform the $2.5 trillion health care industry has taken on a deeply partisan tone for more than a year. Many of the moderate Democrats who won Republican-leaning districts on Mr. Obama's coattails in 2008 acknowledged that their support may cost them their jobs this November as the overhaul hasn't polled well.

Democrats say that support will shift once Americans see the plan's benefits -- the poor will get tax credits to help them meet the requirement to buy insurance coverage; their insurance company won't be able to impose lifetime or annual caps on coverage or deny coverage because of pre-existing conditions; young adults can stay on their parents' plan until age 26; and Medicare's gap in drug coverage will be filled. It's paid for through cuts to Medicare funding, which Democrats say will only cut waste and fraud, and a new Medicare tax on unearned income, such as investment profits, of couples making over $250,000 and individuals making over $200,000.

Abortion threatened to hold up the vote until almost the last minute. A group of about 10 pro-life Democrats said they wouldn't vote for the Senate plan unless they had a guarantee that it wouldn't allow for federal funding of abortions. They were concerned the bill would allow federal tax subsidies to fund insurance policies that cover the procedure and that funding for community health centers would not come with a prohibition on covering abortions. But their objections were met with an executive order Mr. Obama issued on Sunday affirming that the bill wouldn't do so.

Catholic groups have been divided over whether the Senate bill would authorize the federal funding of abortions, with the U.S. Conference of Catholic Bishops staunchly opposed to the Senate plan; but others, such as a group of hundreds of nuns, endorsed the plan last week. Catholic Advocate, a 501(c)(3) lobbying group, said Sunday that passing the Senate bill would account for one of the greatest expansions of abortion since the landmark Roe v. Wade Supreme Court ruling and promised to contest House members who supported it.

But the executive order was thought to be enough to push Democrats over the 216 mark required for passage. The companion reconciliation bill would remove the Senate's tax on high-cost insurance plans, federal funding for Nebraska's Medicaid costs and other problems House members had with the Senate plan. The Senate is expected to start work on the bill on Tuesday.

Over the weekend, Democrats decided against using a controversial procedure, called "deem and pass," that would have allowed both bills to pass with one vote. Republicans had called it a parliamentary trick. The vote required House members to take a bit of a leap of faith that the Senate was going to be able to deliver on the companion bill. They now have no leverage left since the Senate bill can go to Mr. Obama's desk and become law despite their grave misgivings about it. Senate Democratic leaders are expected to easily come up with the 51 votes they need. "There's a strong desire to do what's in that bill," Sen. Debbie Stabenow, Michigan Democrat, told reporters last week.

But it's a potentially difficult climb for the Senate as reconciliation rules allow Republicans to introduce an unlimited number of amendments and require each provision of the bill to affect the budget or be struck by the Senate's nonpartisan parliamentarian. If the bill is changed at all, in the form of amendments or budget strikes, it will have to go back to the House for another vote, throwing another wrench into the process.

Republicans have promised a fight, warning they plan to put up every procedural obstacle they can. They've already eyed parts of the bill that they contend are not related to the budget and can be brought up as a violation of the so-called "Byrd" rule.

Mrs. Pelosi said Friday that she doesn't foresee any Byrd-rule violations surviving. "We tried to have a 'Byrd' scrub," she said, but "the parliamentarian would not necessarily give us definitive answers on anything."

Republicans said Sunday they like their chances on an objection that the bill affects Social Security, which would be a violation of budget rules. If the parliamentarian agrees and the presiding officer of the Senate upholds the decision, Democrats would need 60 votes to override the decision. All 41 Republicans recently signed a letter saying they will object to overriding the parliamentarian. "We've informed our colleagues in the House that we believe the bill they're now considering violates the clear language of Section 310g of the Congressional Budget Act, and the entire reconciliation bill is subject to a point of order and rejection in the Senate should it pass the House," said Don Stewart, spokesman for Senate Republican leader Mitch McConnell of Kentucky.

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Democrats' death by suicide

The government takeover of health care will go down in history as the worst piece of legislation to emerge from a Congress held in general disdain by the American people. The only bipartisanship on the health bill was in the opposition.

Usually autopsies are reserved for after the patient has died, but in this case it is useful to get ahead of the matter. The malformed health legislation is not the only reason Democrats are facing political extinction in November, but it is one of the most dramatic. The legislative process in this country has never been so unseemly. Arm twisting, backroom deals, special privileges and potentially criminal "government jobs for votes" agreements became a normal way of doing business. House Speaker Nancy Pelosi fixated on the mantra that the Democrats' health plan is "historic," but so was the Black Plague.

President Obama went to Capitol Hill on Saturday to give a final pep talk to Democrats, where he absurdly called his socialist health care measure "one of the biggest deficit reduction measures in history." This contradicts the chief actuary at the Centers for Medicare and Medicaid Services, who says his staff currently has no idea what the impact of the plan is "due to the complexity of the legislation." Democrats have been hoodwinked into believing they won't pay a political price for their actions, but they will soon discover they miscalculated.

The new system will suffer a tsunami of bad publicity when states sue the federal government over unfunded mandates, when the IRS begins enforcing the aspects of the bill that voters never knew existed, when small businesses start firing employees because they cannot afford the higher costs of the new system, when new and unforeseen costs blow out the already record federal budget deficit, and when seniors begin to feel the impact of Medicare cuts. All of this is what Mr. Obama euphemistically calls "bending the curve" but which seniors will find out is better termed "denial of care." Whether the formal "death panels" will convene before the November elections is still to be determined.

Many members of Congress probably don't know exactly what is in the bill. The 2,300 pages of "fixes" to the Senate bill presented last week were only a draft, and no member can be certain what has been slipped in. A frantic Democratic Party memo sent out Thursday instructed members -- twice, in italics -- not to "get into a discussion of details of the [Congressional Budget Office] scores and the textual narrative" with the bill's opponents. But the devil was in those details. Mrs. Pelosi's offhand statement that members would learn what was in the bill after it was passed should have been a warning.

The majority party was even having problems over the weekend determining if they could vote to amend a law before it was signed by the president. It is a sad day for America when senior members of Congress either dont understand the Constitution or no longer think it applies.

Democrats in Congress refuse to believe the contempt with which the American people hold them. Gallup shows congressional approval ratings in the teens and headed downward. Gallup also found that "more Americans believe the new legislation will make things worse rather than better for the U.S. as a whole, as well as for them personally."

Democrats are in much worse shape than in 1994 when they lost power, and the opposition is far more energized. Once voters have a chance to tell the most irresponsible government in American history that enough is enough, the Democrats' brief reign will expire, and be deemed death by suicide.

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Burned girl 'turned away' from British hospital

A five-year-old girl with severe burns was turned away from hospital and her parents forced to drive 25 miles before doctors would treat her. Madison Healy was turned away from Coventry's University Hospital after her clothes caught fire in a freak accident at home. Her mother Alana Regan, 27, took her to A&E, expecting her daughter's injuries to be treated swiftly.

Instead, she says a doctor merely "poked at her leg" before telling her and her partner John Austin, 33, they would have to drive Madison to a specialist burns unit 25 miles away themselves. The Coventry couple, who had no money for petrol and did not know the way drove for an hour before doctors at Birmingham Children's Hospital were able to treat her. There it was discovered Madison had third degree burns requiring a skin graft plus years of treatment and physiotherapy in the future.

Now, Ms Regan has filed an official complaint against University Hospital, saying they let down her seriously injured child. Ms Regan said: "She is only a five-year-old girl and she should have been treated with more priority. "She suffered long term, life-changing injuries and they should have treated her with more compassion and urgency."

A spokesman for University Hospital said Madison had been seen by triage staff within four minutes of arriving at A&E and given painkillers. He added within 50 minutes she went on to be reviewed again by a doctor. "In line with our pediatric pathway relating to burns and scalds Madison was referred to Birmingham Children's Hospital who were advised to expect her arrival and provide ongoing specialist service.

"As the burn was categorised as a small burn covering less than one per cent of the total body surface it is considered safe and within guidelines to transfer by car with a written referral and full directions. "The Trust do apologise if the family felt distressed, however Madison did not require resuscitation or treatment during her transfer."

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MORE INSPIRATION FROM BRITAIN

Four articles below from ONE DAY show what Americans can expect under Obamacare

The NHS bungles never stop

Man left infertile after wrong testicle disabled

A man was left infertile when he had part of the wrong testicle removed by surgeons. Doctors were supposed to cut away the patient's right epididymis - one of two narrow tubes connected to the testes which is used to store mature sperm. But the patient's left epididymis was removed by mistake at the West Suffolk Hospital in Bury St Edmunds. Surgeons had to operate on his again to take out his other epididymis after the blunder was discovered and the man was left infertile.

Officials at the NHS hospital have refused to identify the man or confirm if he was paid compensation.

A major investigation was launched into the error and the hospital has now introduced more stringent procedures to stop it happening again. Nigel Kee, the hospital's interim chief operating officer, said: "The safety of our patients is our number one priority. "As such, we take any incidents which compromise safety extremely seriously.

"A thorough investigation into this case was carried out by an independent consultant, who advised us to introduce an additional hospital-wide policy giving clearer instructions on marking and verifying sites prior to surgery. "We implemented this recommendation immediately."

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British TV star's death was 'unnecessary and preventable': Her doctor launches attack on NHS

Jade Goody's death was preventable and a result of 'incompetence and neglect' by the NHS, a leading doctor and Harley Street consultant claimed today. One year after the 27-year-old died on March 22, Dr Ann Coxon said Goody's symptoms - which included heavy and irregular bleeding, pain and abnormal smear tests - were 'glaringly obvious'.

The former NHS doctor claimed the reality television star had a tangerine-sized tumour which medical experts failed to spot. 'There should have been alarm bells ringing,' she told The Sun. 'Jade's death was completely unnecessary and preventable. She died of neglect and incompetence.'

Despite strong evidence of cervical cancer, Jade did not suspect anything serious was wrong due to her medical history. 'She'd had abnormal smear tests since she was 16 so by the time she was 27 it didn't worry her much, because she didn't really know what it meant,' Coxon said. 'It had never been properly explained to her.

'After she was diagnosed she said to me, in that typically Jade way, "I'm not daft. If I'd known it was to do with cancer, I'd have been checked out every three months". She added: 'Jade realised she had been let down. She simply said, "Sometimes people make mistakes".'

The mother-of-two, who became a star as a contestant on Big Brother, refused to attend scheduled smear tests after being told she could not have any more children, Coxon alleged. This was nine months prior to her diagnosis.

Jade was given an ultrasound at the Princess Alexandra Hospital in Harlow, Essex, in August 2008. She then flew to India to appear in a reality television show after doctors had confirmed she could travel. However, results of a smear test - only performed because a nurse noticed she had skipped appointments - revealed cancerous cells. Goody received the news she had cervical cancer on camera and flew back to the UK where she was treated by Coxon.

The doctor said: 'An ultrasound should be able to pick up lesions just 1.2mm wide, and Jade had a tumour the size of a tangerine. It should have been blindingly obvious.'

Jade underwent an emergency hysterectomy, chemotherapy and radiation therapy - but it was too late to save the star. 'She probably had cancer for at least a year before her diagnosis. The abnormal smear tests were signs that she was high-risk,' said Coxon. 'She was only diagnosed because of one nurse bothering to do her job.'

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Girl, 9, saved by optician after NHS doctors fail to spot plum-sized brain tumour SIX times

For money reasons, diagnostic scans are avoided

A nine-year-old girl whose brain tumour was missed by doctors six times was saved by opticians after her worried mother took her for an eye test. Shanice Bailey could have been left paralysed by a rare plum-sized 'schwannoma' tumour growing out of a nerve and pressing on her brain stem. She visited GPs six times between September 2009 and January this year complaining of headaches and sickness but was repeatedly diagnosed with asthma and sent away.

Only when Shanice developed a squint in her left eye did her mother Laura, 27, decide to take her for an eye test - where Specsavers optician Nadia Ahmed immediately spotted the growth. Ms Ahmen told Ms Bailey to take her daughter straight to Queen Elizabeth Hospital in King's Lynn, Norfolk, where a scan revealed the two inch tumour. Eleven days later surgeons removed the tumour in a nine-hour operation.

Despite spending a month in hospital with side-effects Shanice is now at home recovering with her family. Ms Bailey, from Wisbech, Cambs., said she would be forever grateful to the optician. ‘It's so lucky we went to Specsavers when we did, otherwise the effects could have been devastating. ‘I kept taking Shanice back to the doctor as her symptoms got worse and more frequent. ‘Originally they said her symptoms could mean anything but then they thought it was asthma because she was coughing when she was sick. ‘She has been so brave it was unbelievable - she hasn't cried once.

‘If they hadn't have found the tumour she could have died because it was blocking fluid at the top of her spine. ‘I don't necessarily blame the doctors but they should be given more training to check for problems in these areas. Just because it's rare doesn't mean they should ignore it.’

Laura took Shanice to the Clarkson Surgery in Wisbech over five months where she was seen three times by one GP and by a different doctor on every other occasion. On their last visit, the doctor referred Shanice for an appointment with a paediatrician on January 20 to work out why her mystery symptoms were persisting.

But she had the eye appointment on January 3 where optician Ms Ahmen used a magnifying light that picked up swelling on the optic nerves.

The schwannoma tumour is usually only found in elderly women but the benign growth was coming out of Shanice's hyoglossal nerve and blocking fluid at the top of her spine. A week after her surgery the youngster also suffered from a vasospasm, where blood gets into the brain, and needed a second operation to drain cerebrospinal fluid.

Shanice said she felt great after her ordeal. ‘I feel so much better now. I can do things I couldn't do before like my favourite street dancing classes,’ she said.

Trevor Lawson, a spokesman for Brain Tumour UK, said Shanice's type of tumour was extremely rare in such a young child. ‘To my knowledge in the last five years no children were reported to have suffered that from type of tumour, which was responsible for only six per cent of all adult cases,’ he said. ‘The challenge for doctors is that brain tumours can present with common symptoms and we regularly support people who were diagnosed after an eye test.’

Paul Eagling, manager of Specsavers in Wisbech, said he was ‘extremely pleased’ they had been able to spot the growth. ‘Benign tumours can leave people with long term problems and we believe every brain tumour case should be given the same level of attention as cancer. ‘People tend to only go to the opticians when they have problems with their eyesight but regular visits to the optician are vital for checking general eye health.’

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Hundreds may have died in British ambulance blunder

An inquiry is being demanded into ambulance services after a Sunday Telegraph investigation uncovered a major flaw in the 999 [emergency number] system that may have left hundreds dead. Doctors, politicians and charities have called for the inquiry to examine how a mistake by ambulance chiefs led to delays in despatching paramedics.

The scandal is exposed by the death of a woman who was left for 38 minutes after an emergency call was received despite the fact that she was unconscious and breathing abnormally, having fallen 12ft. Call handlers following automated advice provided by a computer program categorised the case of Bonnie Mason, who died last May, as a lower priority than that of a drunk woman who had fallen on the pavement. By the time paramedics reached Mrs Mason, 58, she could not be saved.

An investigation by The Sunday Telegraph has uncovered a critical danger placed in the software used by most ambulance services. It meant that for a decade, 999 calls in which a patient lay unconscious and struggled to breathe after a fall of 6ft or more were “downgraded”, with call handlers told not to send the most urgent response. Some services told operatives to “override” the flaw, but The Sunday Telegraph has established that five out of 12 of England’s ambulance trusts told call handlers not to diverge from the automated advice.

Last night experts demanded an inquiry to establish how many patients had suffered because of the blunders. John Heyworth, of the College of Emergency Medicine, said the potential risks were devastating. He said: “Any system which isn’t prioritising accurately needs review because the consequences are so catastrophic.”

Peter Walsh, of the charity Action Against Medical Accidents last night expressed horror at the dangers. He said: “Who knows how many people this could have harmed and how many may have died? Given the volumes of 999 calls involving people who have fallen and are unconscious, there is a risk that thousands were affected. Who knows how many might have died – it could be hundreds, but even if it’s just one needless death, we need a full review.”

The problem occurred when a government committee which governs the use of computerised 999 software allocated a lower priority to falls of 6ft or more than had been recommended by the system’s makers. As a result, the automated system instructed call handlers to class such calls as category B even if the person was also unconscious or breathing abnormally – life-threatening conditions which should have had the most urgent response. The Department of Health said the risk had been eliminated from the latest version of the software, introduced last year.

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Paging Doctor Kildare

If Obamacare becomes law, about 30 percent of the primary care doctors in America will consider leaving the medical profession. That bit of brightness comes from a survey by The Medicus Firm, the results of which were posted by The New England Journal of Medicine. Medicus interviewed more than a thousand American physicians, and 55 percent of them believe the quality of medical care in America will decline if the Democrats pass the current health care reform proposals. Apparently, many of them want no part of it.

Although the media largely ignored the Medicus study, the story is huge. Perhaps as many as 30 million more Americans may have access to health insurance. The question is: Who will treat them? The Bureau of Labor Statistics projects a 22 percent increase in practicing physicians over the next decade. But that will not be enough to treat the universal health care crush, especially if a bunch of doctors now on the job pack it in.

There are essentially two reasons why Obamacare nauseates some doctors. First, control. Medical people simply do not want federal pinheads telling them how to treat their patients. The medical profession attracts intelligent, assertive people who are motivated to help others. This is not a docile crowd.

Second, money. Right now, many doctors are already seeing too many patients in order to pay the bills and provide a decent living for their families. Obamacare does nothing to bring down the outrageous expense of medical malpractice insurance, and it is likely to cut Medicaid and Medicare reimbursements. Doctors can do the math. Their expenses remain high; their incomes decline. Again, these are smart people who could make good money doing something else.

In Canada and Great Britain, where socialized medicine is practiced, it is difficult to actually see a doctor in some places. Instead, nurses, physician assistants and other medical personnel fill the need. That is what could happen in the United States if the feds begin calling the health care shots.

Not since the Iraq war has America been so divided on an issue. Yes, ideology is playing a part. Conservatives despise government intrusion in the marketplace, but liberals love it. Right now, however, most polls show that the majority has turned on Obamacare. The latest Wall Street Journal poll, for example, found 48 percent opposing and just 36 percent supporting.

Here's my question: What would Marcus Welby, M.D., and Dr. Kildare say? These guys usually had the answers, back when wise doctors were the subjects of TV programs and health care seemed to be a glamorous profession. Would Ben Casey support Obamacare? We know the "M*A*S*H" guys would. Dr. Jekyll might like it, but Mr. Hyde? I don't know. What I do know is that many Americans are sick of the whole health care thing. And no prescription on earth will change that.

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16,500 more IRS agents needed to enforce Obamacare

New tax mandates and penalties included in Obamacare will cause the greatest expansion of the Internal Revenue Service since World War II, according to a release from Rep. Kevin Brady, R-Texas.

A new analysis by the Joint Economic Committee and the House Ways & Means Committee minority staff estimates up to 16,500 new IRS personnel will be needed to collect, examine and audit new tax information mandated on families and small businesses in the ‘reconciliation’ bill being taken up by the U.S. House of Representatives this weekend. ...

Scores of new federal mandates and fifteen different tax increases totaling $400 billion are imposed under the Democratic House bill. In addition to more complicated tax returns, families and small businesses will be forced to reveal further tax information to the IRS, provide proof of ‘government approved’ health care and submit detailed sales information to comply with new excise taxes.

Americans for Tax Reform has a good breakdown of the bill by the numbers. Isn't it reassuring that at a time of recession, government will do what's necessary to ensure its growth?

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The corruption never stops

Health-vote ally Nelson to get new VA hospital for Nebraska

The Obama administration has delivered another budget plum to Democratic Sen. Ben Nelson and the state of Nebraska, adding more than a half-billion dollars for a new veterans hospital in Omaha.

The move reverses a decision by Mr. Obama's own Veterans Administration of a year ago, which called for repairing an existing hospital.

The Veterans Administration made the budget switch during internal deliberations in 2009 at a time when the White House was wooing the moderate Democrat to vote for President Obama's health care overhaul bill.

Mr. Nelson was among the last of the Senate Democrats to sign on to the health bill, deciding to vote "yes" after securing special Medicaid payments for Nebraska in a deal known as the "Cornhusker Kickback." Health care reform opponents have widely panned that deal.

At the time that deal was being made, Mr. Nelson was getting another boost from the VA as it formulated its next budget.

Jake Thompson, a spokesman for Mr. Nelson, rejected the idea the new hospital was awarded in exchange for the senator's health care vote.

"It was never discussed," Mr. Thompson said. "He wasn't discussing the Omaha VA hospital in any relation to health care. The answer is no."

The spokesman added that Mr. Nelson "has been advocating [a new hospital] with this administration, with the previous secretary of the VA and the current secretary of the VA. But in relation to health care, it wasn't discussed at all. I think the VA's own study was the principal reason it was moved up" on the construction priority list.

But Rep. Steve Buyer of Indiana, ranking Republican on the Veterans' Affairs Committee, said, "This one doesn't smell right or feel right."

Mr. Buyer said testimony by VA officials to the Senate last August showed managers recommended renovation and some expansion of the existing Omaha site -- not an entirely new hospital at a much higher cost.

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Study Shows ‘ObamaCare’ Could Cost 700K Jobs

As many as 698,000 jobs could be lost if the health care reform plan (a.k.a., “ObamaCare”) being pushed hard by liberal Democrats is passed by Congress and signed into law by President Barack Obama, according to a study released today that was the subject of a blogger conference call this morning.

The executive summary for the study, conducted by the Beacon Hill Institute in conjunction with Americans for Tax Reform, boils down the findings in a nutshell:

Nancy Pelosi, the Speaker of the House of Representatives, has urged passage of the massive health reform plan moving through Congress as a way to create up to 400,000 jobs. Speaker Pelosi bases her claim on a report by the Center for American Progress (CAP) in which the Center estimates that the Patient Protection and Affordable Care Act (PPACA) would create 250,000 to 400,000 jobs per year over 10 years.

This estimate by CAP amounts to a hurried effort to add academic heft to the claim that national health care reform offers a collateral benefit in the form of an economic “stimulus.” It turns out, however, that its methodology, stripped of unsupportable claims about savings in health care costs, shows just the opposite of what CAP intended. PPACA is a job killer, not a job creator.

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MORE OF WHAT OBAMACARE HAS IN STORE FOR AMERICANS

Three new reports from just ONE DAY about Britain's NHS below

Life-saving cancer scans delayed in NHS funding crisis

Vital scans for patients who may have cancer are being postponed by up to six weeks as the NHS grapples with a major funding crisis. GPs have also been ordered not send elderly people for osteoporosis scans, to refer children with tonsillitis to specialists - or even allow men to have vasectomies. In addition, wards are threatened with closure and thousands of key staff have been told to work shorter hours or take unpaid 'career breaks'.

Charities and patient groups said the delays could have disastrous consequences if early signs for potentially fatal conditions go undetected. The drastic cutbacks illustrate a funding nightmare threatening to overwhelm the NHS within months, as trusts battle to save millions of pounds in the wake of the credit crunch.

Last night the Royal College of Physicians warned ministers and NHS managers against 'slash and burn' cuts. In a strongly-worded pre-budget briefing to MPs, they said: 'Following a decade of growth, the NHS is being asked to deliver considerable efficiencies. 'There is a risk that without careful management, a supportive rather than confrontational culture and a high degree of medical engagement, any effort to reduce productivity could easily subside into a process where services and posts are indiscriminately slashed and burnt. 'Over-hasty decisions now to cut back on the medical workforce, biomedical research, and audit programmes could have implications for generations.'

Ministers say the NHS needs to save 20billion pounds over the next five years. Although both Labour and the Tories have pledged not to cut NHS funding, rising demand and an ageing population means the money will not go as far as in the past, necessitating cuts.

Dozens of hospitals are already considering closures of A&E departments and maternity wards, while others are asking staff to consider voluntary redundancy and early retirement. The respected King's Fund think tank says it may be necessary to freeze NHS pay until 2014.

One NHS trust under pressure is North East Essex primary care trust, which last month asked its GPs not to refer patients for MRI scans - used to diagnose possible tumours and kidney disease - and other tests until April 1.

Sarah Woolnough of Cancer Research UK said delays in MRI scans could run the risk of early signs of cancer being missed. She said: 'Speedy access to diagnostic tests and quick referral can help to diagnose cancer as early as possible which can ultimately lead to better treatment for patients and improved survival.'

Matt Bushell, director of commissioning at the trust, said: 'As part of the procedures to ensure budgets are balanced at the end of the current financial year, we have, just for the month of March, asked GPs to defer referrals for a very small number of non-urgent, therapeutic services: heel scans, vasectomies, ENT and nonurgent MRI scans. 'We have maintained priority for urgent MRI scans. These arrangements will remain in place only until April 1 2010.'

Other examples of cuts across the NHS include:

* GPs in Hertfordshire being told to get 'approval' before referring patients for hysterectomies, tooth extraction and removal of skin 'lumps and bumps';

* Planned closures of A&E wards at Whittington Hospital in North London, Queen Mary's in Sidcup, Chase Farm in Enfield and others;

* Almost 4,000 workers at Stepping Hill hospital in Stockport, and 2,000 at Scunthorpe general hospital, being asked to consider early retirement, voluntary job cuts or shorter hours.

Tory health spokesman Andrew Lansley said: 'This will be very worrying for patients. The NHS has had increased funding this year, so just where has the money gone?'

Matthew Elliott of the TaxPayers' Alliance said: 'It's infuriating that despite billions of pounds being poured into the NHS, patients are having treatment delayed thanks to a failure to plan properly.'

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Blundering NHS surgeon in £10m lawsuit after 100 women patients take him to court

Bungling surgeon George Rowland was allowed to operate for almost FOUR YEARS after the first alarm was raised

More than 100 women suffered botched bladder surgery at the hands of a gynaecologist who continued to work for four years after the alarm was raised. Patients of George Rowland suffered chronic pain or worsening bladder symptoms after he operated on them. But it was only after doctors expressed concern about his behaviour that the scale of his mistakes was realised and he was told to stop carrying out procedures.

Yesterday, as a report criticised managers for not picking up on the problem sooner, it emerged that more than 100 of his patients are taking legal action - leaving the NHS facing a compensation payout of as much as £10million.

Ian Cohen, of Goodmans solicitors which is representing most of the women, said: 'There have been devastating, life-changing outcomes for many patients. We have a substantial number of women who should never have had that surgery, who have been left worse following the surgery. Some have been left in a bad state, with chronic pain. 'Some women have complete difficulty passing urine. 'The trust's board appears to have allowed an obsession with targets and anxiety about potential damage to its reputation - and that of the consultant - to bar earlier action to prevent patient harm.'

Mr Rowland, aged in his 50s, was a respected urogynaecologist performing hundreds of operations a year at Aintree Centre for Women's Health in Liverpool.

In 2004 concerns were raised that he was carrying out more surgery than colleagues, often 'bundling' different procedures into single operations, such as hysterectomies with surgery for incontinence. But it was not until colleagues began expressing concern in 2007 that an investigation was launched. Mr Rowland was not suspended until the following year.

Last year the General Medical Council barred him from performing urogynaecological procedures until further notice, and hundreds of his patients were recalled to the hospital for a further consultation. Some complained they had been left in chronic pain and that their incontinence had not improved. Lawyers representing others say the surgery was simply inappropriate for their conditions.

The highly regarded Liverpool Women's Hospital, which runs the Aintree centre, commissioned an independent report into the affair, and yesterday criticised bosses for not noticing the mistakes earlier. It pointed out that Mr Rowland was responsible for picking up such problems as the clinical governance lead - a clear conflict of interest, the women's lawyers say.

Its report found warning signs dating back to 2004 were not acted upon, criticised the 'cultural divide' between staff at the Aintree centre and the main hospital, and said more needed to be done to stop doctors from working in isolation from their departments. Jonathan Herod, clinical director of gynaecology, admitted Mr Rowland often worked alone. If the case was repeated, 'it would be picked up on straightaway', he added.

Trust chief executive Kathryn Thomson said: 'We decided it was important to look at governance practices more widely to ensure we learnt as much as possible.'

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£250,000 victory for war vet who sold home to pay care bill that NHS should never have charged him

NHS bureaucrats don't care about people at all. Saving money is their no.1 priority

The family of a war veteran suffering from Alzheimer's has won more than £250,000 from the NHS for nursing home fees he should never have been charged. The payout, which is believed to be the biggest of its kind, was awarded to relatives of Leslie Terry, 86, whose home was sold to pay for his £3,500-a-month care. Despite being totally immobile - he has not been out of bed for four years - and in need of constant nursing, Mr Terry was denied funding under the NHS's ' Continuing Care' scheme.

The scheme is meant to fully fund patients with health needs resulting from conditions such as Alzheimer's and Parkinson's disease. It applies mainly to those who are in nursing homes, or long-term hospital or home care.

Mr Terry's nephew, Bryan Talbot, 71, from Banbury, Oxfordshire, who mounted a legal challenge to recover the backdated fees covering eight years, said: 'My uncle has been unable to get out of bed for four years, he is at risk of choking, has to be fed, and is unable to communicate verbally. 'I felt it was clear that his health needs meant he should be the responsibility of the Health Service. I am amazed that, despite him having annual assessments, the NHS did not inform me about possible available funding. It's important people take advice. 'We've had a rough ride to get to this point but I want other people to know you don't have to sell your home to get the care you need. He has received first class care from very professional staff at Gloucester House Nursing Home.'

The payout comes after three families last year won a total of £350,000 - with the family home sold in two cases - after being wrongly denied Continuing Care. So far, more than £9million has been recovered by solicitors representing 2,000 families who claim they have been wrongly charged nursing home fees. Under English law, the elderly must pay for residential care unless their needs are health-related, when the whole cost is met.

However, Department of Health criteria on who qualifies for health needs are subject to interpretation by individual NHS trusts. The Daily Mail's Dignity for the Elderly campaign has repeatedly highlighted the unfairness of the system, which means many families of Alzheimer's sufferers are being charged for long-term nursing care. Many are denied funding by Primary Care Trusts, which have to foot the bill, because the disease does not automatically make the patient eligible for NHS 'continuing care'.

Mr Terry, who joined the Army in 1942 and fought in India and Burma, retired from his job as a porter at Sevenoaks Hospital in Kent, in 1983 before succumbing to dementia in his 70s. He never married. Mr Terry also suffers from a severe skin disease, which needs monitoring.

Solicitor Lisa Morgan, of Welsh law firm Hugh James, who acted for him, said: 'Under current government policy, there should be a full assessment on health needs, which determines whether patients pay for their nursing care fees. 'That is not happening in many cases. With the cost of nursing homes averaging £675 per week, families are still being left with huge fees to pay. There is a clear disparity across the country and, despite national guidance, Primary Care Trusts still apply their own judgment.'

Michelle Mitchell, charity director for Age Concern and Help The Aged, said: 'The system for deciding where the line is drawn between free NHS Continuing Care, and paid for social care has been a mess for years. 'We are still very concerned older people may wrongly be forced to pay for their care when it should be free. We strongly encourage anyone who believes they are unfairly missing out to fight for their rights.'

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Democrats offer a new budget of lies



In the final push to pass a health care overhaul, Democratic leaders on Thursday sought to sway anxious party members with a new $940 billion plan that cuts the deficit, raises Medicare revenue with a new tax on the investment income on wealthier Americans and placates unions by slashing the tax on high-end insurance plans.

The concept, backed by President Obama, is designed to build positive momentum ahead of a Sunday vote on the landmark health care overhaul, which would extend insurance coverage to more than 30 million Americans, fill the Medicare prescription drug "doughnut" hole of limited coverage and curb insurance industry abuses. It swung two former "no" votes to the "yes" column.

Majority Leader Steny H. Hoyer called the plan "the biggest deficit reduction bill that any member of Congress is going to have an opportunity to vote on" with hopes of swaying fiscally minded Democrats to support it.

Republicans remain steadfastly opposed to the plan, leaving Democrats to come up with all of the support themselves. "The reason House Democrats don't have the votes is because the American people know this is a government takeover of health care," said Rep. Mike Pence of Indiana.

The 153-page bill released Thursday represents repairs that Mr. Obama and House leaders requested in exchange for voting for the Senate's health care plan. If passed, the "repair" bill would also have to pass the Senate through complicated reconciliation procedures that can circumvent a Republican filibuster.

Critics of the plan already spotted two provisions that they say are tightly focused on specific states, possibly in exchange for support of the legislation similar to the now infamous "Cornhusker Kickback." They plan to rally against the bill as the final vote nears.

White House spokesman Robert Gibbs said Thursday that Mr. Obama would postpone his Asia trip, originally scheduled to start Sunday, to help corral votes for his chief domestic agenda item.

The Congressional Budget Office analysis found that the plan would reduce the deficit by $138 billion over the next 10 years - $20 billion more than the House's original plan - and continue to drive down the deficit in later years.

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Slaughter House Rules

How Democrats may 'deem' ObamaCare into law, without voting



We're not sure American schools teach civics any more, but once upon a time they taught that under the U.S. Constitution a bill had to pass both the House and Senate to become law. Until this week, that is, when Speaker Nancy Pelosi is moving to merely "deem" that the House has passed the Senate health-care bill and then send it to President Obama to sign anyway.

Under the "reconciliation" process that began yesterday afternoon, the House is supposed to approve the Senate's Christmas Eve bill and then use "sidecar" amendments to fix the things it doesn't like. Those amendments would then go to the Senate under rules that would let Democrats pass them while avoiding the ordinary 60-vote threshold for passing major legislation. This alone is an abuse of traditional Senate process.

But Mrs. Pelosi & Co. fear they lack the votes in the House to pass an identical Senate bill, even with the promise of these reconciliation fixes. House Members hate the thought of going on record voting for the Cornhusker kickback and other special-interest bribes that were added to get this mess through the Senate, as well as the new tax on high-cost insurance plans that Big Labor hates.

So at the Speaker's command, New York Democrat Louise Slaughter, who chairs the House Rules Committee, may insert what's known as a "self-executing rule," also known as a "hereby rule." Under this amazing procedural ruse, the House would then vote only once on the reconciliation corrections, but not on the underlying Senate bill. If those reconciliation corrections pass, the self-executing rule would say that the Senate bill is presumptively approved by the House—even without a formal up-or-down vote on the actual words of the Senate bill.

Democrats would thus send the Senate bill to President Obama for his signature even as they claimed to oppose the same Senate bill. They would be declaring themselves to be for and against the Senate bill in the same vote. Even John Kerry never went that far with his Iraq war machinations. As we went to press, the precise mechanics that Democrats will use remained unclear, though yesterday Mrs. Pelosi endorsed this "deem and pass" strategy in a meeting with left-wing bloggers.

This two-votes-in-one gambit is a brazen affront to the plain language of the Constitution, which is intended to require democratic accountability. Article 1, Section 7 of the Constitution says that in order for a "Bill" to "become a Law," it "shall have passed the House of Representatives and the Senate." This is why the House and Senate typically have a conference committee to work out differences in what each body passes. While sometimes one house cedes entirely to another, the expectation is that its Members must re-vote on the exact language of the other body's bill.

As Stanford law professor Michael McConnell pointed out in these pages yesterday, "The Slaughter solution attempts to allow the House to pass the Senate bill, plus a bill amending it, with a single vote. The senators would then vote only on the amendatory bill. But this means that no single bill will have passed both houses in the same form." If Congress can now decide that the House can vote for one bill and the Senate can vote for another, and the final result can be some arbitrary hybrid, then we have abandoned one of Madison's core checks and balances.

Yes, self-executing rules have been used in the past, but as the Congressional Research Service put it in a 2006 paper, "Originally, this type of rule was used to expedite House action in disposing of Senate amendments to House-passed bills." They've also been used for amendments such as to a 1998 bill that "would have permitted the CIA to offer employees an early-out retirement program"—but never before to elide a vote on the entire fundamental legislation.

We have entered a political wonderland, where the rules are whatever Democrats say they are. Mrs. Pelosi and the White House are resorting to these abuses because their bill is so unpopular that a majority even of their own party doesn't want to vote for it. Fence-sitting Members are being threatened with primary challengers, a withdrawal of union support and of course ostracism. Michigan's Bart Stupak is being pounded nightly by MSNBC for the high crime of refusing to vote for a bill that he believes will subsidize insurance for abortions.

Democrats are, literally, consuming their own majority for the sake of imposing new taxes, regulations and entitlements that the public has roundly rejected but that they believe will be the crowning achievement of the welfare state. They are also leaving behind a procedural bloody trail that will fuel public fury and make such a vast change of law seem illegitimate to millions of Americans.

The concoction has become so toxic that even Mrs. Pelosi isn't bothering to defend the merits anymore, saying instead last week that "we have to pass the bill so that you can find out what is in it." Or rather, "deeming" to have passed it.

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Landmark Legal Foundation readies constitutional suit if Obamacare passes with Slaughter Solution

Landmark Legal Foundation president and Talk Radio powerhouse Mark Levin promised today that his foundation will file suit in federal court challenging the constitutionality of Obamacare if it is approved in the House using the Slaughter Solution.

“Landmark has already prepared a lawsuit that will be filed in federal court the moment the House acts. Such a brazen violation of the core functions of Congress simply cannot be ignored. Article I, Section 7 of the Constitution is clear respecting the manner in which a bill becomes law. Members are required to vote on this bill, not claim they did when they didn’t. The Speaker of the House and her lieutenants are temporary custodians of congressional authority. They are not empowered to do permanent violence to our Constitution," Levin said.

Even if Landmark never does another good thing for the Republic, what it has been doing for more than a decade to expose the facts about the partisan political partnership between the National Education Association and the Democratic Party makes it an invaluable asset. You can check that out here.

Landmark also has done superb work in exposing how federal bureaucrats at the EPA have funneled billions of tax dollars to radical environmental groups that lobby on behalf of more regulatory power, bigger budgets and expanded staffing for ... EPA. Check that out here.

Levin may be best known for his New York Times best-seller, "Liberty and Tyranny: A conservative manifesto." I knew something remarkable was bubbling "out there" among the American people last year when Levin's book zoomed to the top of the best-seller's list and people lined up for blocks in places like Fairfax County, Va., to buy signed copies of the book and to meet him.

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Into the twilight zone

Nancy Pelosi has scheduled a vote for Sunday, maybe to vote by not voting. The president has canceled his trip to Asia and the atmosphere in Washington grows surreal and surrealer. The speaker yearns to be a suicide bomber, blowing up her party's November prospects, or at least the leader of the Democratic squadron of kamikaze pilots.

No one can quite remember when a party in power has been so determined to self-destruct, with the speaker as provocateur, egging everyone on. Rep. Mike Honda, a Californian of Japanese descent, objects to some of the metaphors applied to Mzz Pelosi's mission of death by obsession, but to neutral observers - assuming any are left - her execution of the president's obsession looks like the Bataan death march, or at least a ride to the gallows in a Toyota.

Everything the Democrats are doing is turning to mud, or maybe even the smelly stuff wives accuse husbands of tracking into the house. Barack Obama even chose this week to pick an unnecessary fight with Israel, our only true friend in the Middle East. When Joe Biden quickly wore out his welcome in Jerusalem, he was brought back to Washington to employ his considerable Irish charm to entertain the Irish prime minister, Brian Cowen, who dropped in for a St. Patrick's Day visit to the White House. Nobody could mess up such a jovial occasion, even with beer dyed green for the occasion.

Good old Joe, ever the bumbling uncle we've come to love (so far the president hasn't consigned him to the attic where crazy aunts and uncles usually live), nevertheless pronounced obsequies on the prime minister's ailing mother: "God rest her soul." Good old Joe quickly learned that the elderly Mrs. Cowen's soul is still among us. Never mind. He rewrote his benediction to "God bless her soul," and recalled the Irish proverb that "a silent mouth is sweet to hear." To the relief of all he turned the podium over to the president's teleprompter, and no further harm was done. No need for the media's Gaffe Patrol even to fire up the engines on their ancient Jennies.

But what other explanation for Mr. Obama's damn-the-torpedoes strategy could there be other than a suicide wish? The only outcome worse for him than losing the health care vote would be winning the health care vote. The debacle in Massachusetts has taught him nothing, but it has surely taught the public a lot. Gallup now puts the president's approval rating at 46 percent, the lowest yet, and his disapproval at 47 percent. These are dreadful numbers for any president, and particularly for a messiah who arrived at the White House little more than a year ago with approval ratings in the high 70s.

The debacle in Massachusetts will be small stuff if Mzz Pelosi proceeds with the aptly named "Slaughter solution," the bright idea of Rep. Louise M. Slaughter of New York, to dispense with actually voting for the Senate bill and declaring that the House "deems" the Senate measure enacted. This would avoid a voice vote and guilty congressmen could go home to tell credulous constituents that they should deem them as having voted against the monstrosity that almost nobody wants. Such a solution is so nutty that only Nancy Pelosi and Harry Reid would have imagined using it. But if they succeed Congress will have opened up vast new avenues of chicanery, deceit and dishonesty. A husband caught staying out all night can tell his angry wife that she should "deem" him to have slept on the sofa discarded in the garage; a schoolboy who wouldn't dare claim the dog ate his homework can now tell a teacher that she should "deem" the homework done.

Mr. Obama, who long ago perfected the verbal sleight of hand that has served him well until now, got particularly flustered and visibly irritated when he sat down for an interview with Fox News and learned for the first time how uncomfortable a real interview can be. The more interviewer Bret Baier pressed the more the president wiggled and the more the interviewer persisted. Soon it descended into presidential argle-bargle. The president doesn't have an opinion on "deeming" because "I don't spend a lot of time worrying about what the procedural rules are." He's not concerned about "the Louisiana Purchase" or the "Cornhusker Kickback" - special deals for Louisiana and Nebraska to buy Senate votes - because special deals "also affect Hawaii, which just went through an earthquake." It did?

But maybe it was a slip of the tongue and he meant Haiti. But surely he doesn't think Haiti is one of the 57 states. We can't be sure.

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Hiding the true cost of Obamacare

President Obama keeps saying America needs the Democrats' health care bill to reduce costs. In reality, the government takeover of health care will raise costs and cause a large number of people to lose their health insurance.

"Well, if [the health care bill] doesn't pass, I'm more concerned about what it does to families out there who right now are getting crushed by rising health care costs and small businesses who were having to make a decision, 'Do I hire or do I fix health care?' " Mr. Obama claimed to Fox News on Wednesday.

Saying his bill will reduce costs doesn't make it true. Take the legislation's huge $500 billion cuts in Medicare. The government already reimburses hospitals and doctors less than their costs. Further cuts mean even more cost shifting to privately insured patients to cover deeper Medicare losses. Private insurance won't cover all of these exorbitant losses, which will force many doctors and hospitals out of business.

This week, the New England Journal of Medicine released a survey of doctors showing that 46.3 percent of "primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine." Not only will doctors leave medicine, but "27 percent [of physicians] would recommend medicine as a career but not if health reform passes." The survey is merely suggestive, but if the real reduction in the number of doctors is even 5 percent or 10 percent, medical costs will rise significantly. A lower supply of doctors amid rising demand for care means higher medical prices.

Another example is the ban on insurance companies charging different premiums based on pre-existing health conditions. Imagine what would happen if motorists could buy auto insurance after an accident and were allowed to drop it once a car was fixed. People would wait until they were in an accident to buy insurance, and insurance premiums would skyrocket. The same will happen if insurance companies can't charge higher premiums for sick people.

Even the few purported cost-reducing measures in the Senate bill are being gutted by the president's proposal. The reconciliation bill delays a tax on high-quality insurance, dubbed Cadillac plans. The idea was if the cost of insurance was raised, fewer people would want such extensive medical coverage and thus would not seek medical care as often. Reduced demand therefore would reduce the price of medical care. But after striking a deal with unions, Mr. Obama decided to delay the tax for eight years, until he's out of office.

The Democrats' plan will destroy American health care. Obamacare will dramatically raise the cost of medical care, forcing many Americans to drop their insurance. Responsible members of Congress have to vote this down.

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The unbelievable NHS again

Bungling foreign nurse can KEEP his job... despite barely speaking English and 'worrying' lack of competence

An Indian nurse who could barely understand English and refused to learn the language was told yesterday he could return to his hospital and carry on working. The decision by the Nursing and Midwifery Council came despite despite the watchdog commenting on his ‘worrying’ lack of competence.

Biju John, 38, had insisted he was able to understand instructions and wrote to the council stating: ‘I never be confused at all.’ But staff felt they were ‘carrying’ him and did not feel safe leaving patients in his care, an NMC hearing was told.

Mr John also had a limited knowledge of basic nursing skills and did nothing when a patient was struggling to breathe, it was claimed. The NMC heard Mr John should have started basic airway management as the man gasped for breath after coming round from an operation. But instead he had to be helped by a colleague who rushed over when she heard the man’s wheezing from the other side of the anaesthetic unit at Leicester Royal Infirmary.

On another occasion Mr John almost caused a patient to go into shock when he wore latex gloves to treat him despite being told he was allergic to the material. The hospital then devised a set of objectives for the nurse, including meeting the required standard of English so he could effectively communicate with staff and colleagues. But he failed to reach the targets and was kept on supervised practice.

A further incident on October 20, 2004 led to Mr John being suspended and a disciplinary meeting was scheduled for January 20, 2005, but he quit seven days before. He was later reported to his regulating body. Mr John, from Cambridge, was found guilty of seven charges relating to his lack of competency when he worked at the hospital between July 2003 and December 2004. These include failing to complete basic skills required of a nurse, not demonstrating his English was sufficient to communicate with colleagues effectively – which gave rise to the incident with the latex gloves – and failing to take appropriate action when a patient’s oxygen levels dropped. He was cleared of mistaking the Surgical Assessment Unit for the Surgical Acute Care Unit.

NMC chairman David Kyle said his lack of competence was ‘worrying’ but ‘not irremediable’. He added: ‘Although the registrant was a caring nurse, he lacked confidence, was reluctant to act on his own initiative and could not be trusted to work unsupervised. ‘Other nurses felt they were carrying him. ‘Anaesthetists were nervous about leaving their patients in his care and adopted a practice of returning to check on their patients because they were concerned about them.

‘The panel has heard evidence of a worrying lack of competence demonstrated over a considerable period of time and that lack of competence, in some basic areas of practice for any registered nurse, particularly in communication, is still present.’

But the panel ruled Mr John could return to work subject to conditions. Mr John must tell the NMC where he is working, remain supervised, complete a personal development plan and an English language test he complies with the conditions he will be allowed to return to normal practice after 18 months.

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SOCIALIZED MEDICINE IN PRACTICE

Below are five reports from just ONE DAY in Britain

Terrifyingly inept foreign doctors are a symptom of a sickness in the NHS - not the cause

By Professor Karol Sikora

When a supposed cure has instead become a new kind of sickness, then surely something is badly wrong. Yet that is what has happened in the modern NHS. The target culture brought in to benefit patients is having fatal consequences. A system that originally aimed to improve performance and efficiency is now threatening patients' lives, distorting clinical priorities and encouraging the use of foreign doctors, who may be too inexperienced or unqualified for the jobs they have been given.

The tragic case of 94-year-old Ena Dickinson is a heart-rending example of what can go wrong in a health service that puts compliance with political requirements above the real needs of patients. Mrs Dickinson, a Lincolnshire grandmother, died in 2008, soon after she underwent a hip replacement operation which was carried out at Grantham Hospital by a German locum surgeon, Dr Werner Kolb. In an appalling series of errors, Dr Kolb cut through the wrong muscle, severed an artery and used the wrong cutting tool, with the result that Mrs Dickinson lost almost half her blood in an operation that should have been routine. One witness, another doctor from the hospital, said he was 'horrified by what I saw', while an expert surgical witness, Professor Angus Wallace, told the inquest on Tuesday that he 'could not believe the level of neglect in the operation'.

The episode raises troubling questions about the NHS's increasing reliance on foreign doctors, both from the European Union and from further overseas, a practice that has been driven partly by the Government's fixation with meeting targets and partly by an inadequate supply in the number of domestic trained doctors.

We do not, of course, live in an insular world and overseas doctors have long been an integral part of the NHS. Indeed, when I first worked in the NHS in the early Seventies, I saw that the service would not have been able to function without the support of doctors from Asia. And, whether we like it or not, Britain is part of the European Union, one of whose guiding principles is the free movement of labour throughout the member states. So, without drastic political changes to the very nature of our society, we would not be able to adopt a siege mentality when it comes to employment in the NHS.

Nevertheless, the disastrously botched operation that Mrs Dickinson suffered highlights a worrying trend, where too often foreign doctors have been imported to provide cover in the NHS, without any proper checks on their background, their ability to speak English, their experience or their competence.

According to reports about Dr Werner Kolb, he had actually performed few hip operations during his career and had spent most of his recent years giving lectures, hardly a record to inspire confidence in the operating theatre. Dr Kolb's negligence may be particularly graphic, because of the way he sawed through the wrong muscle, like some grotesquely inept carpenter.

Some might argue, therefore, that it is particularly dangerous to let foreign doctors carry out surgery without rigorous monitoring. But this would be a fallacy. Every branch of medicine, from general practice to pathology, has the potential to do mortal harm because of its intimate connection with the delicate structure of the human body. In my own field of cancer care, disasters can occur because of a misdiagnosis or the administration of the wrong dosage of drug.

The calamitous risks of incompetence by GP locums were illustrated in early 2008 by Dr Daniel Ubani, who flew in from Germany to Cambridgeshire to provide weekend cover for a local practice, only to end up killing one pensioner, David Gray, by accidentally giving him ten times the maximum dosage of diamorphine. The coroner then said Mr Gray's death had been caused by 'gross negligence', words that carry a chilling echo in the Dickinson case.

One of the key problems is that, under an EU directive of 2004, doctors who qualify in any EU country can move to work in any other EU state without even the most limited examination of their skills, aptitude or language. In contrast, foreign doctors (ie from outside the EU) must pass a skills and English language test - yes, even the Australians and Americans.

EU countries are also not forced to provide information on their doctors' professional histories - for example, whether they have been struck off for committing a criminal offence or killing a patient through negligence.

There are estimated to be around 20,000 EU doctors registered to work in the NHS, a quarter of them from the former Eastern Bloc countries.

Now the vast majority of them are certainly perfectly competent, but, even so, difficulties will inevitably arise over language and culture. Every nation, for instance, has its own medical hierarchies, differing relationships between doctors and nurses, or unique approaches to patient care.

Moreover, foreign doctors without a sound grasp of English will not understand what their patients are telling them, something that is a particular concern in GP services.

It is telling that EU doctors are twice as likely to face disciplinary hearings before the General Medical Council as their British counterparts, in which foreign doctors from outside the EU are three times as likely to be struck off the medical register - statistics that point to the laxity of checks.

We cannot blame foreign doctors for wanting to work in the NHS. Britain has one of the best-rewarded medical professions in the world, with GPs earning on average over £100,000-a-year and leading consultants far more. These are incredible riches for doctors from the old Soviet sphere of influence. In Poland, where my family has some of its roots, a doctor is likely to earn around £500 a month or £6,000-a-year, a sum that can be made with a few weekend or holiday stints in Britain. As a consequence, one in six of Poland's doctors now works abroad.

Nor is the NHS management entirely to blame for the catalogue of controversies that has arisen from the employment of foreign staff. NHS bosses are under tremendous pressure to meet waiting lists targets set by the Government, so they will take any action, bear almost any cost, to achieve this. So rather than postpone operations during periods when staff are on leave, they bring in foreign doctors to keep the conveyor belt moving.

In Ena Dickinson's case, it would not have mattered if her hip replacement operation had been delayed by a week or two, but no doubt the management of Grantham Hospital was appalled at the idea of slipping behind the Government's arbitrary 18-week deadline for such routine surgery. So, in a disastrous misjudgment, Dr Kolb was brought in so the needs of bureaucracy, if not the patient, could be met.

The problem has been compounded by the Government's failure to assess correctly the needs of the NHS for doctors, with the result that foreign doctors have been brought in to cover gaps in supply. It must be admitted that the demands on the NHS have grown enormously in recent years as a consequence of increasing numbers of elderly patients, a growth in the British population and advances in medical care. Twenty years ago, the idea of carrying out a hip replacement operation on a 94-year-old grandmother would have been unthinkable.

Moreover, the EU working time directive drastically reduced the number of hours that any doctor could be on duty, which meant that more staff had to be made available. But the need to increase the supply of doctors only emphasises the need to scrutinise their competence more vigorously. What we need, therefore, is an assessment of their skills by practical and verbal demonstration, accompanied by checks on their background and a basic language test. We're doing it for our own graduates, after all. That is what our NHS patients deserve. We cannot allow any more tragedies like that of Ena Dickinson.

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Killer Muslim doctor with repeated disregard for patients is suspended for just FOUR MONTHS by British regulators

A doctor with a 'disregard' for patient safety was suspended for just four months today for sending home a baby girl who died the next day from blood poisoning. Dr Salawati Abdul-Salam failed to spot little Aleesha Evans' deadly condition and sent her home saying she had a viral infection that needed only Calpol and Nurofen. She died the next day.

A year before the baby's death, another of Abdul-Salam's patients died after a wrong diagnosis, while a pensioner suffered a collapsed lung under the trainee's care. GMC panel chairman Professor Denis McDevitt said the doctor's actions demonstrated a 'total lack of attention to detail' and a 'serious degree of carelessness.'

Colin Perriam, 66, had died after Abdul-Salam analysed six-month old blood samples, then wrongly diagnosed a ruptured ulcer as constipation. Mr Perriam was discharged from Cardiff's University Hospital of Wales on December 15, 2004 with a prescription of laxatives.

Widow Pamela Perriam had told the hearing: 'She said that he was suffering from constipation. 'We were given some powders that you mix with water for mild constipation and we were not given any other instructions. 'We were not given anything else except to say that it was mild constipation and mild laxatives should deal with the problem.'

But the next day Mr Parriam could not get out of bed and when his stomach appeared swollen and blotchy the following evening, his wife called an ambulance. By the time it arrived her husband was unconscious. Mr Parriam underwent emergency surgery but never recovered and died the next day on February 5, 2005.

A month earlier, Abdul-Salam gave a 79-year-old woman an unnecessary chest drain after reading the wrong x-ray. She had to apologise after the elderly woman's lung collapsed.

On August 9, 2006, Aleesha Evans was rushed to the Royal Gwent Hospital in Newport, Wales, vomiting with a rash and a temperature of 37 degrees. But the trainee specialist registrar did not even examine the baby and discharged her two hours later after noting her condition was 'unremarkable.' The doctor had seen the patient by this stage and noted she appeared to be better than she had been and that she was playing. But her heart rate was still high and her temperature had risen to 39 degrees, the hearing was told. The baby was discharged at 11pm with a diagnosis of viral illness.

But she was suffering from meningococcal septicaemia - blood poisoning - and died the following day. Abdul-Salam was placed under supervision at the Princess of Wales Hospital in Bridgend after Aleesha's death. She was only allowed to perform three hours of clinical work a day and had to sign every patient off with a supervisor. But within three weeks Abdul-Salam had broken the terms of her training and more than a third of her patients had been discharged without her superior's consent.

One of these patients was a 10-year-old girl with a broken wrist who attended A&E on 22 September 2008. The child required treatment under anaesthetic but Abdul-Salam discharged her to the outpatient fracture clinic.

Prof McDevitt told Abdul-Salam: 'The panel has concluded that you have not yet fully appreciated the magnitude of your deficient performance and misconduct. 'You demonstrated poor judgment when under pressure. Your lack of careful clinical method resulted in the inadequate assessment and management of patients and you failed to appreciate fully the discordance between the patients' clinical condition and the results of investigations. 'The panel considers there remains of risk of you repeating errors and exercising poor judgment, particularly if you were to return to work in a more pressures environment than you are currently exposed to.'

Prof McDevitt said the panel had considered imposing conditions on Abdul-Salam's practice but concluded her actions involving baby Aleesha Evans were too serious: 'Taking all the factors into account, the panel concluded that your registration should be suspended for a period of four months. 'Your misconduct was sufficiently serious to undermine public confidence in the profession. It is also important that you, and the medical profession, are left in no doubt that such behaviour, which clearly had consequences for patient safety, is unacceptable.'

The doctor had been working as a locum at the Kent and Sussex Hospital in Tunbridge Wells, Kent for the last five months, but she will now be unable to keep her job.

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British doctors who wouldn't listen allow little girl to die

An eight-year-old girl with an acute fear of dentists who starved to death after her milk teeth were taken out under anaesthetic died because of a “lack of communication” between health agencies, an investigation has concluded.

Sophie Waller refused to open her mouth even to eat after the operation. She had developed her phobia at the age of four when her tongue was scratched during a routine check-up. When she refused treatment after cracking a tooth on a boiled sweet her parents became so concerned they took her to their GP who referred her to the Royal Cornwall Hospital in Truro.

Surgeons decided to remove eight remaining milk teeth under anaesthetic to avoid problems in future. But she was left so traumatised by it she refused to open her mouth to eat or drink.

A report by the Local Safeguarding Children Board has now found there was a “lack of clarity” from the agencies responsible for Sophie’s care after her discharge from hospital. She was sent home despite her condition and her parents did not know who to turn to when her health deteriorated.

By the time of her death in December 2005 Sophie, from St Dennis in Cornwall, was severely malnourished and weighed just 22kg. Her parents had been feeding her a diet of yoghurt and mashed fruit and tried to get help from their GP and the hospital but were instead referred to a child psychologist.

She was found dead in bed by her mother four weeks after her discharge and the cause of death was given as kidney failure as a result of starvation and dehydration. An inquest in February 2009 found there was no blame attached to her parents who had tried to get help for their daughter.

The serious case review found of a lack of communication between all the health agencies involved in her care. The report says: “No clear written plan was made on discharge and there was lack of clarity about responsibility for medical review following discharge.

“The clinical psychologist made telephone contact with the child’s parents in the week after discharge but did not see her again. “There was a lack of clarity over the open door arrangement which was intended to allow the child’s parents to bring her back in the week following discharge. When they phoned for advice on the seventh day, they were referred back to the psychologist for support.”

Her mother Janet Waller, a nursery school teacher who has two other children, said the report highlighted how their pleas should have been heard. She said: “All we’ve wanted all along is for people to listen to us. People ask me how many children I have, I say three, but technically I haven’t any more. I’ve got to live with this for the rest of my life.”

At Sophie’s inquest in February last year the Cornwall coroner, Dr Emma Carlyon, said that the Royal Cornwall Hospital was guilty of a number of failings which led to Sophie’s death. She said: “The severity of her malnutrition and dehydration was not recognised. This prevented her from receiving the medical support that could have prevented her death.”

Dr Ellen Wilkinson, Medical Director of Royal Cornwall Hospital Trust, said: “We would like to apologise to the family of Sophie Waller. Everyone involved in her care was saddened by her tragic death. This was a very unusual case. “There were shortcomings in the communication between the health organisation and Sophie’s parents.”

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'Blood-spattered walls and mouldy equipment': How a quarter of British government hospitals fail to meet basic hygiene tests

A quarter of NHS hospital trusts are failing to meet basic hygiene standards, with some treating patients on blood-spattered wards or with dirty equipment, a damning report has found. A third of ambulance trusts have also missed the targets set, according to the Care Quality Commission. The watchdog's report follows the introduction of tough new hygiene standards after a series of scandals at hospitals in Maidstone, Basildon and Stafford.

It also came as a survey of NHS employees found many are too overstretched to do their jobs properly because of staff shortages.

On hygiene, the CQC found 42 out of the 167 NHS trusts inspected were in 'breach' of registration requirements by failing to meet standards, with some hospitals being warned over blood-spattered wards and dirty equipment. In Basildon, where at least 70 patients died as a result of poor hygiene last year, investigators found a commode soiled under the seat and 'procedure trays, used by staff to carry equipment when they take blood samples or give injections, had blood spattered on them'.

At children's hospital Alder Hey, in Liverpool, the inspection revealed dirty toys, hair stuck to medical equipment and 'nappy changing mats stored on the floor next to a toilet'. Water 'ran brown' from taps in patient areas.

A total of 36 trusts did not provide areas to decontaminate instruments, three trusts failed to flush unused water regularly to control legionella outbreaks, and a dozen failed to keep clinical areas clean. The situation was so bad at four ambulance trusts that they were given written warnings about the state of their vehicles and stations.

Nigel Ellis, the CQC's head of inspection, said: 'We have on rare occasions found evidence of a direct risk to patients and have intervened using our enforcement powers to ensure swift improvements were made. 'In over half of trusts we have made some suggestions or requirements for improvements to ensure their practices are the best they can be.'

A spokesman for the Department of Health said: 'There's no doubt that the trusts rose to the challenge --we've seen swift and tangible improvements in their performance, and on follow-up meetings all met the required standards.'

Meanwhile, half of NHS workers claim that staff shortages are stopping them doing their jobs properly. Of the 160,000 workers questioned by the CQC, 46 per cent said they were unable to do a proper job.

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One in ten doctors in Britain is foreign and untested

Almost one in ten doctors on the medical register comes from the EU and has not had to take any language or competence tests before working in Britain. The shocking figure exposes the lax controls over European locums taking up hospital posts in the NHS and providing out-of-hours GP cover. Unlike doctors from elsewhere in the world - who are forced to prove language skills and medical knowledge before being registered - such testing is forbidden for doctors qualified in Europe and Switzerland.

Campaigners want a complete overhaul of the system after the death of a grandmother following appalling blunders by a German surgeon flown in by the NHS. Ena Dickinson, 94, lost nearly half the blood in her body during what was meant to be a routine hip operation at Grantham Hospital in Lincolnshire. Werner Kolb, who had been working in the NHS for three weeks, severed an artery and became so flustered he started speaking German in the operating theatre.

An expert witness described it as the worst case of negligence he had come across - yet Dr Kolb, pictured today for the first time, was left free to work in the UK for a further eight months before being suspended by the General Medical Council.

Dr Kolb, who had been mainly lecturing for four years before the tragedy, refused to attend the inquest and denied his conduct had anything to do with Mrs Dickinson's death eight weeks later from pneumonia. Last night a colleague at Bethesda Hospital in Stuttgart insisted: 'I find it hard to reconcile the words said against him in Britain with the precise surgeon I know.'

But Mrs Dickinson's daughter Kathy Ingram, 57, said: 'The system is disgraceful and clearly isn't working. NHS trusts have to assume that locum doctors' qualifications from Europe are reliable without doing their own checks. 'You trust your doctor because he's in authority but if he hasn't been verified and isn't monitored, you never know what standard of treatment you'll get. The law has to be changed so that there is closer monitoring.'

Figures show there are more than 230,000 doctors on the GMC register of which 21,451 - almost 10 per cent - gained their qualifications in other EU countries. The ban on checks comes from a European directive ordering member states to allow workers free movement. This means the GMC is forced to accept qualifications at 'face value', according to its chief executive Niall Dickson.

The GMC has protested about the rights of doctors to work freely across Europe being put ahead of a patient's right to safe treatment. In a presentation to the EU's Green Paper on the European Workforce for Health, it said: 'Legislation must be amended to allow healthcare regulators across Europe to establish that a doctor has the level of language proficiency necessary to practise safely. 'We are also prevented from adopting a general requirement to prove competence and cannot specify the standard of acceptable competence. 'The current situation is profoundly at odds with the pursuit of safe and high quality health care.'

Dr Vivienne Nathanson, head of science and ethics at the British Medical Association, said: 'Whilst it is essential doctors are able to communicate with their patients and the regulatory authorities are able to assess fitness to practise, it is also important we don't make it impossible for those that do have the appropriate skills to work in the UK.'

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