Friday, January 15, 2010

Black doctor from Germany employed by the NHS was a disaster for several patients

A locum doctor who gave a patient a fatal dose of painkillers on his first shift in Britain was “dithery” and “muttering to himself”, the dead man’s partner told an inquest yesterday. David Gray, 70, was given more than ten times the recommended daily dose of diamorphine [heroin] by Daniel Ubani, who had flown from Germany to provide out-of-hours GP cover.

Mr Gray’s partner, Linda Bubb, told the inquest in Wisbech, Cambridgeshire, that Dr Ubani arrived four hours after she called for a doctor when Mr Gray began experiencing acute pain from kidney stones. She described Dr Ubani, who could speak only limited English, as “very tired and not as alert as he could have been”. She added: “The doctor seemed a bit dithery. He was muttering to himself.”

Rita Prchlik, from the country’s Department of Health, said he contacted the authorities two weeks after the incident. “He said, ‘I have made a mistake in England due to tiredness which resulted in a death’,” she said in a statement read to the court.

Dr Ubani had been on his first shift for the out-of-hours service provider SuffDoc, now called Take Care Now, when he injected Mr Gray in February 2008 at his home in Manea, Cambridgeshire. Ms Bubb said she told him Mr Gray usually received 100mg of pethidine as pain relief. “I knew they did not carry pethidine so I said it needed to be diamorphine,” she said. “To my knowledge he did not physically examine David. I did not see him take his pulse or blood pressure, but I was out of the room for a short time.”

Ms Bubb said that Dr Ubani gave Mr Gray two injections. “David then took the doctor’s hand and said, ‘thank you’.” Ms Bubb said that she checked on her partner after half an hour and he appeared to be asleep. “Some time later I realised there was something wrong. He did not seem to be moving.” He was pronounced dead after emergency services arrived.

The inquest was told that Dr Ubani’s care of another patient was described by her GP as “unusual and not correct”, while a third patient started vomiting after he gave her an injection. The hearing was told Dr Ubani read the British National Formulary, the guide to medicines, between call-outs.

Phyllis Fletcher, who had a severe form of the lung condition COPD, was given a linctus by Dr Ubani. But in a statement to the inquest, her GP, Carol Walcott, listed seven alternative courses of action that she felt should have been taken. Another patient, Sandra Banks, said in a statement that she had begun vomiting after Dr Ubani gave her an injection. She was later admitted to hospital. Her partner Stephen Cowley said in a statement: “There was something about Dr Ubani I wasn’t quite sure about. The main thing was a breakdown in language.”

Mr Gray’s family say the case raises questions over the use of overseas doctors for out-of-hours cover.

The non-jury inquest is also examining the death of another of Dr Ubani’s patients, Iris Edwards, who died a day after he treated her.

Mr Gray’s case prompted the Care Quality Commission to investigate Take Care Now. An interim report raised questions about the standard of GP out-of-hours services.

Dr Ubani was charged in Witten, Germany, with causing death by negligence over Mr Gray’s death, given a nine-month suspended sentence and ordered to pay ¤5,000 (£4,400) costs, according to the law firm Anthony Collins Solicitors, which is acting for Mr Gray’s family. The prosecution means he cannot be charged in Britain. Dr Ubani is supposed to give evidence tomorrow but is not expected to attend.


Betrayal of a Spitfire hero: NHS withdraws care home funding for war veteran struck down by dementia

As a Spitfire pilot in the Second World War, John Mejor risked his life for this country. He went on to devote his working life to conservation, helping to preserve the nation’s heritage and landscape. But in his hour of need, when he might have expected something in return, the state he gave so much to has betrayed him. The 88-year-old grandfather, who requires round-the-clock nursing at a home because of dementia and diabetes, has had the funding for his care withdrawn despite the advice of his GP.

His family now fear they will have to sell the house where his 94-year-old wife Cecile lives to cover the care home costs. On Thursday his daughter Sally Mejor, 54, said: ‘My father made great sacrifices for his country, he is a war hero and deserves better than this. I feel totally let down and hurt that he has been treated in this way. ‘It is a complete nightmare, a disgrace and an insult. He was, and still is, a very dignified man.’

Mr Mejor was moved from his house in Exmouth, Devon, to a care home 18 months ago because his family could no longer look after him following a series of mini-strokes. At first his NHS Trust paid the £800-aweek costs at the nearby Linksway Care Home under its ‘continuing health care’ scheme. Mr Mejor was eligible for the scheme, which is not means tested, because of the assessment of his GP.

But now his health needs have been reviewed by a different doctor acting for the trust. Officials say he is no longer considered a ‘severe’ case and will only receive £106 per week towards his care. Miss Mejor, however, says her father’s condition has not improved and his GP does not agree with the findings.

Miss Mejor, who lives at the family home in Exmouth as her mother’s full-time carer, said: ‘I cared for him myself for the first five years of his illness and if I could manage to continue I would. At no point was it said there would be any timeframe or, that should his condition improve, even slightly, it would be pulled from us. ‘If there was plenty of money to cover it, I would be willing and happy to pay. But because there isn’t, I have to stand up for him.’

Mr Mejor was born in Belgium but moved to Britain as a young boy and was awarded the Distinguished Flying Cross for bravery in the war. During a mission over Malta in 1942, in which he shot down German bombers, he was forced to bale out over the sea after his plane was hit – but returned to battle the very next day. His last operational flight was on D-Day, and after the war he rose to the rank of wing commander, in charge of a squadron of Vampire fighters. He retired in 1964 and set up the Devon Conservation Forum and the Devon Historic Buildings Trust.

Miss Mejor said: ‘What worries me is the money we are going to have to find for his care is going to have an effect on my mother’s life. ‘I’m fearful for her future, too, because we’re going to have to sell this house and she very much wanted to spend the rest of her life here.’

The family could apply for the NHS to pay for the residential care, but this is means tested and it is highly likely they would be unsuccessful. A health care source said that because Mr Mejor’s health was thought to have improved, extra funding would be an issue of social care – such as help with washing and dressing – rather than health care. This would make it a matter for the local authority, not the NHS.

On Thursday NHS Devon said the cost of Mr Mejor’s care would still be covered while an appeal was heard. This could take several months. Parveen Brown, who is responsible for continuing health care funding at NHS Devon, said: ‘There is no question of funding being suddenly cut off, or of houses having to be sold abruptly. ‘We deal with these issues as sensitively as we can and we will offer our support throughout.’

The Daily Mail’s Dignity for the Elderly campaign has repeatedly highlighted the unfairness of the system. Means test rules in England state that anybody who has been assessed as ineligible for nursing care must pay for residential care if they have assets worth more than £23,000. Last month it was revealed that at least 3,000 elderly people a year are forced to sell their homes to pay for residential care. There are fears that cash-strapped health trusts will use public spending cuts as an excuse to reduce funding further.


Unions struck a deal to exempt them from 'cadillac tax' funding health care reform?

National Journal is reporting that the unions have struck a deal on health care reform:
Unions tentatively struck a deal Tuesday to exempt collectively bargained healthcare plans from a tax on high-cost plans expected to be used to help raise revenue for the healthcare overhaul.

AFL-CIO President Richard Trumka, Service Employees International Union President Andy Stern and United Auto Workers President Ron Gettelfinger met with House Speaker Pelosi Tuesday, a day after labor leaders met at the White House to express their opposition to the excise tax.

House and Senate Democratic leaders are to meet with President Obama this morning at the White House to discuss health care. House Ways and Means Chairman Charles Rangel said he hopes there could be an agreement on the excise tax as early as today after the White House meeting, but then conceded: "That's stretching the word `hope.' "

Exempting collectively bargained plans would appease unions that often offer expensive health plans in lieu of higher wages. The deal could also help Obama avoid breaking his promise not to tax those earning less than $200,000. Obama recently expressed a preference for the excise tax.

The excise tax could further be tweaked to ensure Obama's promise is kept for non-union workers as well.

The so called "cadillac tax" on expensive health plans is a major funding mechanism for health care. So if a huge percentage of people with expensive health care plans now become exempt from the tax, isn't this going to have a radical impact on the bill's finances and how it is being paid for? Won't the CBO have to re-score the whole thing? It's hard to imagine that exempting unions from the tax isn't going to make the bill much more expensive without some new mechanism to raise revenue.

It's also utterly bizarre that the Senate just passed health care reform without addressing this issue with the unions. Striking a deal now makes Democrats appear completely captive to union interests.


Who, exactly, wants this health bill anyway?

When I think about what I like most about American liberalism, I think of my father's great, good friend, Smiling Bill. A Roosevelt Democrat, Bill believes in using the power of the government (and the money of rich people) to ameliorate the pain of the poor and lighten the load of the "little man." The son of a large, upwardly mobile Irish Catholic family, Bill started out on a familiar path for men in the middle of the American Century: college (Notre Dame) and then the service (Air Force in the Aleutians) before starting a family and career.

While my old man followed a similar path straight through (51 years with my late mother and a career as a corporate commander), Bill took a more circuitous route. Bill's midlife change in direction gave my father one of his best lines. When a big business associate asked my dad how the economy was back in West Virginia, he quipped, "I don't know, but my stockbroker just joined the Peace Corps."

Bill is now an artist and doer of quiet good deeds who shares a home in the hills with his lovely wife and scruffy dog. If a hopeless drunk needs a ride to rehab or the nuns at the after-school center can't make budget, Smiling Bill is there. For more than 30 years, he and my father have been perfecting their "Grumpy Old Men" routine over tennis games and piles of pancakes that obliterated the benefits of their on-court exertions.

During the Bush years, Bill razzed my father mercilessly about the "Republican wars" and crony capitalism, arguing that George W. Bush operated the government for the benefit of the few at the expense of the many. It was payback for too many Clinton jokes the decade before. A year ago, their harassment cycle promised to continue with my father teasing Smiling Bill about Barack Obama's socialist agenda and wimpy foreign policy. But as the year went on, Bill wasn't smiling anymore.

One morning as I fried eggs for them on a visit home, Bill said he was "so disappointed" that he "felt sick" about Obama. Obama's deal with the drugmakers to block reimported pharmaceuticals from Canada and acquiescence on a second surge in Afghanistan had dashed his hopes. Bill had believed that the little man would finally have an advocate in Washington but found that Obama had other priorities.

I've had reason to think of Bill almost every day since then as the administration and Democrats in Congress have continued to justify cynical actions with liberal goals. The president has argued that Congress needed to pass his health plan, despite widespread opposition in the center and Right, because otherwise the Democratic base would desert them in this fall's elections. Now, as Massachusetts voters are demonstrating, Democrats might be in worse trouble with the Left if they actually pass the plan.

The legislation has become an appalling welter of special interest deals crafted in secret and funded through middle-class taxes and impractical cuts to services for the poor and elderly. Worst for Obama, it shows him to be neither liberal nor a policy pragmatist, but a politician who favors expedient means to self-preservation.

Liberals of the Washington breed say that giving the federal government responsibility for all health care is the first step toward a single-payer system. They believe what's on the cusp of passage will fail in practice, but that its failure will lead to successive reforms that eventually fulfill the New Deal dream.

To conscientious liberals, selling out to Big Pharma and the insurance industry sounds idiotic. But they do not feel the burning need to beat Republicans, by any means necessary, as their representatives in Washington do.

The Democratic Party is begging Massachusetts voters to give them the 60th Senate vote they need to finally squeeze through a scrofulous health bill and get on with the business of the next election. But in a weird referendum on the plan, ultra-liberal Bay Staters don't seem moved by the pleas, expressing apathy or even hostility about helping Obama save face by sending him a winning health care vote in Martha Coakley. Watching her bag contributions from drug and insurance lobbyists on Tuesday night in Washington couldn't have helped their affection for Coakley or the plan. She may still prevail, but Democrats in Washington may soon fear victory on health care as much as they once feared defeat.


Pink slips could kill socialized medicine

Last chance to put Congress on notice!

Inside sources on Capitol Hill say a new surge of pink slips could effectively derail the passage of the health-care bill – now facing reconciliation between the House and Senate. So far, a record 9 million pink slips protesting socialized medicine and other big-spending legislation have been delivered to every member of Congress. "I truly believe, based on what I'm hearing from members of the House and Senate, that we still have a chance to kill a government takeover of health care," said Joseph Farah, editor and chief executive officer of WND and one of the organizers of the campaign. "Quite honestly, I believe if we hit 10 million this month, we have a legitimate shot at this big goal."

Farah says there are several factors working toward that goal. Next week, a replacement for the late Sen. Ted Kennedy, D-Mass., will be elected in Massachusetts. Polls show Republican candidate Scott Brown edging ahead of Democrat Martha Coakley – an event considered next to impossible a month ago.

In addition to that possibility, polls showing formerly entrenched Democrats in House and Senate leadership positions faring badly in their own states and districts are giving many members of Congress pause for reconsideration of their support for the health care bills approved separately in the House and Senate. "What I'm hearing from Capitol Hill is really simple – give the pink slips one more big push," says Farah. "Hit 10 million and it may be the end of health care."

The pink slip campaign is the most economical way ever devised to send out 535 personalized messages to Congress delivered individually to every office in the Capitol. That's what the pink slip program is all about. And it is winding down now with a big push to the 10 million mark. "Be a part of history," says Farah. "Be a part of a program that will result in a voter revolution this fall. Show them you mean what you say ands say what you mean."

He adds: "If you are one of those Americans who can't wait to vote this fall, let every member of the House and Senate know what's coming in November. Let them know it's time for them to start job hunting – just like so many other American they helped put out of work with this reckless spending and unconstitutional practices."

For just $29.95 you can send an individualized notice to every member of Congress in the form of a "pink slip." The grassroots effort, organized by Farah and WND columnist Janet Porter, has warned members of the U.S. House and Senate they could be facing a "pink slip" as early as 2010. The pink slips campaign ensures Fed Ex will deliver this powerful message to all 535 members of the House of Representatives and the U.S. Senate – all for a remarkably low price based on economies of scale. At $29.95, that translates to 6 cents per message – shipped by Fed Ex.

So far, the onslaught of support for the campaign has twice wiped out supplies of pink paper across North America. As boxes of "Send Congress a Pink Slip" notices pile up in their offices, many members of Congress have embraced the effort and openly admit that they're getting the message. Others are "talking about it, but they're only talking about it behind closed doors and in the elevators as they go up and down and in very whispered tones," said Rep. Tom Price, R-Ga.

"What you hear are people saying, 'How many of those did you get or how many people came to your office today? And what are you going to do and how are you going to vote on this?'" Price continued. Price recently joined Reps. Trent Franks, R-Ariz., Steve King, R-Iowa, Michele Bachmann, R-Minn., and Louis Gohmert, R-Texas, in publicly thanking Farah and Porter for the program's results. "It's an amazing feat, to get that many slips to Congress," King told WND. "If you look through them, you can index each one back to an individual. That's powerful. There is a person behind each one of the slips."

"This is putting everyone on notice," said Sen. Jim DeMint, R-S.C., during an interview on Fox News. "And I think this is what the American people have been doing for months now, saying if you keep spending and borrowing, you're going to get fired." Rep. Todd Akin, R-Mo., said: "The pink slip campaign serves as a good reminder of the unavoidable fact that every member of Congress answers to their constituents and that they ignore their voices at their own peril."

Voices in unison pose the best hopes for stirring the conscience of Congress, said Farah, and the program makes the cost of sending mail to 535 people not only manageable but a downright bargain. "We encourage citizens to take individual actions," said Farah. "But when we act as a group, it's more cost-effective and the results more dramatic. Just try Fed Exing members of Congress yourself and see what it costs. We have learned from past experience that Fed Ex actually ensures delivery to members. What they do with them at that point is their choice."

If all the pink slips Congress has received were put end to end, the stripe of pink would stretch from Washington beyond Phoenix, at more than 2,400 miles. Stacked, they would soar 3,000 feet in the air, or nearly six times as high as the Washington Monument.


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