Saturday, January 30, 2010


Four current horror stories from Britain below

Is this the worst diagnosis and treatment of all time? NHS told dying woman she was lying and locked her up in a mental hospital!

I had chronic fatigue syndrome once but luckily I have a very good immune system and it only lasted a month. It was a very real debility, though -- JR

As Criona Wilson knelt beside her dying daughter’s bedside, she promised her that her death would not be in vain. Before the frail body of 32-year-old Sophia finally succumbed to the medical complications and ravages of ME, she replied in a whisper: “Then it’s all worth it.” In the years that followed, Mrs Wilson, 66, a former midwife, dedicated her life to proving that her daughter’s condition was not a figment of imagination, nor one that merited her youngest child’s incarceration in a mental hospital.

Her battle saw her take on the medical profession and accepted thinking about the diagnosis and treatment of ME, also known as chronic fatigue syndrome. Eventually, in 2006, a coroner ruled that Sophia’s death was the result of myalgic encephalomyelitis — the first such ruling at an English inquest.

The fierce debate over ME has been highlighted once again by the case of Kay Gilderdale, who admitted assisting her daughter, Lynn, to kill herself after suffering from ME for 17 years. When she walked free from Lewes Crown Court on Monday, having been cleared of murder, Mrs Wilson was among those cheering her from the public gallery. “I had to be there,” said Mrs Wilson yesterday. “It was such an important case. And the verdict was a vote for common sense in a trial that highlighted what people suffering ME and their carers have to face.”

Her daughter, Sophia Mirza, was a talented and popular arts graduate living with her mother in Brighton in 1999 when she contracted ME at the age of 25. She became confined to her bedroom and, just as Miss Gilderdale had, needed round-the-clock care. In 2003 she was visited by a psychiatrist, even though Miss Mirza complained only of physical discomfort. The psychiatrist told her that she was making up her symptoms and if she continued to pretend to be ill he would section her under the Mental Health Act. Mrs Wilson said: “I knew my daughter. There was no way she was mentally ill or pretending.”

When the dread knock on her door finally came in 2003, there was little she could do. A policeman forced the door open and the psychiatrist and a social worker locked themselves into Miss Mirza’s room to prepare her for her trip to a psychiatric ward. Her condition took a dramatic turn for the worse. After 13 days she was released and taken back to the care of her mother. “That spell in a mental hospital set her back terribly. We lost all faith in medical professionals. We were alone,” said Mrs Wilson.

In 2005 Miss Mirza could barely muster the energy to speak, eat or drink. She and her mother had already agreed that no doctors should be called in case she would be sectioned again. On November 25, 2005, Miss Mirza died in her bed at home.

Wiping tears from her eyes, Mrs Wilson said: “We did everything we could.” Determined to get to the bottom of why her daughter’s treatment had been so bad, she got hold of her medical records. After being contacted by the 25 Per Cent ME Group, which campaigns for those with the most acute form of ME, she agreed to her daughter’s body being examined.

At the inquest the next year a neuropathologist told the court that Miss Mirza’s spinal cord was inflamed and three quarters of her sensory cells had abnormalities. It was, the court heard, a clear physical manifestation of ME. The coroner ruled that she had died from “acute renal failures as a result of chronic fatigue syndrome”.

A year later, the National Institute of Clinical Excellence (NICE) issued its first guidelines on the diagnosis and treatment of the illness, describing it as “relatively common”, affecting up to 193,000 people in Britain. At the heart of that guidance is the need to take into account the opinions of the patients. Mrs Wilson is campaigning to get the Government to fund research into ME. “It’s not over yet.”


NHS doctors can kill people but that's OK

A doctor who prescribed “potentially hazardous” levels of painkillers to elderly patients who died has escaped being struck off the medical register. Jane Barton will be allowed to continue working as a doctor, despite being found guilty of serious professional misconduct, a fitness to practise panel ruled.

She was accused of a series of serious failings in her care of 12 elderly patients at Gosport War Memorial Hospital, in Hampshire, in the 1990s. These included prescribing prescription drugs at “excessive” and “inappropriate” levels, a hearing at the General Medical Council (GMC) was told.

The fitness to practise panel found that Dr Barton was guilty of putting patients at risk of premature death at the hospital between January 1996 and November 1999. She was found to have prescribed diamorphine, the opiate painkiller, at varying levels “and created a situation whereby drugs could be administered which were excessive to the patients’ needs” the panel found. However, it said that it had taken into account her ten years of safe practice as a GP in Gosport and 200 letters of support and ruled that she could continue working under certain conditions.

Relatives of the patients who had died reacted furiously to the verdict and walked out of the hearing in central London today. Iain Wilson, the son of Robert Wilson, one of the patients who died, shouted at the panel: “You should hang your head in shame.”

The GMC, which regulates the work of 150,000 doctors in Britain, had recommended that Dr Barton be struck off and also criticised the decision. Niall Dickson, the council’s chief executive, said: “We are surprised by the decision to apply conditions in this case. “Our view was the doctor’s name should have been erased from the medical register following the panel’s finding of serious professional misconduct. “We will be carefully reviewing the decision before deciding what further action, if any, may be necessary.”

The case will now be reviewed by the Council for Healthcare Regulatory Excellence, an ombudsman of misconduct cases. If found to be unduly lenient the decision could be referred to the High Court and possibly overturned.

In April last year a jury inquest at Portsmouth Coroner’s Court ruled that at least five elderly patients who died at a hospital in Hampshire were overprescribed strong painkillers that hastened their deaths.

In the cases of patients Robert Wilson, 74, Geoffrey Packman, 66, and Elsie Devine, 88, the use of painkillers was found to have been inappropriate for their conditions. Arthur Cunningham, 79, and Elsie Lavender, 83, were prescribed medication appropriate for their condition but in doses that contributed to their deaths, the jury found.

Dr Barton, who worked as a clinical assistant at the hospital, was the only individual to be investigated by police in connection with the deaths but was not charged with any offence.


Grandmother disgusted at filthy NHS hospital nursed and bathed other patients on her ward

A grandmother was so disgusted by the filthy conditions and neglect on a hospital ward that she bathed and cared for the patients herself. Janet Halsall, 74, was admitted to Hinchingbrooke Hospital in Huntingdon, Cambridgeshire, for three days to have a scan on her liver, when she was shocked to see staff repeatedly ignore pleas for help and leave fellow elderly patients to ‘fend for themselves’. The kind-hearted pensioner was so appalled by the conditions in the hospital that she bathed, washed and tucked in the frail elderly patients herself.

The grandmother-of-seven said fellow patients were distressed after being left without water, and when she went to the pantry to clean their glasses, she found it in a ‘disgusting state’. When one elderly lady got no help after repeatedly complaining to staff she was cold, Mrs Halsall was moved to search a store cupboard for a blanket. The former hairdresser even washed and bathed one lady who needed help to clean herself and took another pensioner to the toilet after staff continually ignored her requests because they were ‘too busy’. When she was discharged on Monday afternoon, her fellow patients cheered and clapped her - branding her their 'guardian angel'.

Speaking from her home in Little Staughton, Beds., she said: ‘I was absolutely disgusted when I entered the ward. ‘At 7pm I arrived in the ward and was appalled to find the bed was unmade and the water jug and glass were on the floor. ‘There was no locker or table to put my things on or bag to dispose of rubbish. ‘The patient in the next bed to me kept asking staff if she could go to the bathroom to have a wash and clean her teeth before breakfast. The reply was always “in a minute”. ‘She was really upset so I found her a bowl and washed her from head to toe and made her feel better. She was so grateful.

‘Never before have I seen so many people rushing around, working so hard but achieving nothing.’

Mrs Halsall, whose partner Eric died five years ago, blames the shoddy treatment on a shortage of staff. She added: ‘There simply weren't enough staff looking after the ward. People were asking for help and it was falling on deaf ears. ‘The poor nurse was running around and didn't have time to help everyone. I couldn't just sit there and watch so, being quite agile, I got up and helped them myself. ‘When I left the ward on Monday they all cheered me out and said I was their guardian angel.’

Mrs Halsall was referred to the Hinchingbrooke Hospital at around 11am on Friday amid fears she was suffering a liver complaint. She was told she could not have the scan until Monday and was later transferred to the Appletree Ward for the weekend. But within minutes of arriving, she became angry after spotting a number of patients who were not being cared for. Pensioner Joyce Bates, who was also on the Appletree Ward as she underwent physiotherapy for rheumatoid arthritis in her legs, hailed Janet a 'heroine'. Widower Mrs Bates, from March, Cambs., said: ‘I don't know what we would have done without Janet. The place was an absolute disgrace and our treatment was even worse. ‘I've stayed in hospital 38 times and I've never watched as a patient is forced to give another a bed bath because the nurses won't. ‘She truly was magnificent in what was a nightmare situation.’

Director of the Patients Association Katherine Murphy said: ‘Unfortunately we hear far too many examples of the kinds of things described by Janet Halsall. ‘It is completely unacceptable for patients not to be treated with dignity and respect and not to receive the help they need with things like personal hygiene. ‘That should be fundamental to NHS care-whenever it's not it's an appalling indictment of our treatment of some of the most vulnerable users of our health services.’

A spokesman for Hinchingbrooke said: ‘Hinchingbrooke Health Care NHS Trust takes all complaints extremely seriously. ‘We would ask Mrs Halsall to contact us directly so that a full investigation can be conducted into her experience on the ward. ‘Until we can look into these incidents in more detail it would be inappropriate to comment further at this time.’ [Blah, blah, blah!]


Don't fall sick out of hours in Britain: GPs refusing to work nights and weekends claimed boy's life

Like so many proud parents, Jean and Nicola Seevaraj meticulously recorded the milestones in the life of their first child, Joseph. He smiled when he was a month old, stood up on his own four days before his first birthday and loved the movie Madagascar. And there was so much more to look forward to - his first day at school, learning to read and to ride a bike. Instead, at the age of three years, one month and 19 days, Joseph was dead. 'I remember checking on him around 4am,' says Mr Seevaraj, 33, a church minister from Hove, East Sussex.

'I went back to bed and the next thing I knew it was 7.30am and my wife was screaming. She was absolutely frantic and I knew something terrible had happened. She was next to Joseph's bed. His eyes were open, but he wasn't responding to anything she did or said. 'It was the worst moment of my life. We called 999 and they told us to try to resuscitate him, but I knew inside myself that it was too late. He'd already passed away. 'The paramedics arrived and rushed him to hospital, but it was hopeless. And that was the beginning of our nightmare.'

It was a nightmare that would be made all the more ghastly because of the fact that Joseph's death had been avoidable. His parents had sought medical help for their son, who had tonsillitis. Joseph was prescribed antibiotics, but when he started to vomit and had diarrhoea, Mr Seevaraj phoned for further help. Because it was a Sunday, he could not talk to the family doctor. Instead, he was connected to the out-of-hours service and was put through to a German-trained medic. The locum doctor, who Mr Seevaraj claims struggled to understand what was being said to him, told him there was nothing to worry about and that, no, it wasn't necessary to bring in the child for further treatment.

Mr Seevaraj followed that advice - and the following morning woke to find that his son was dead. An inquest would later hear that had Joseph been taken to hospital, then the septicaemia that claimed his life could have been treated. 'He needed basic medical attention,' the coroner said, ruling that neglect had contributed to Joseph's death. 'The failure to provide it was gross failure.'

Mr Seevaraj says: 'If we had been able to speak to our family GP that weekend, I believe Joseph would still be alive. There are lots of holes in the out-of-hours system - it needs to be sorted out.'

And he is not alone in that view. New figures show that serious complaints about out-of-hours care have shot up by 50 per cent in just two years. The Medical Defence Union, the leading insurance company that covers most GPs, reported a sharp rise in the number of grievances against doctors following deaths, misdiagnoses and negligence. In 2007 and 2008, there were 517 complaints related to consultations at evenings and weekends - up from 337 over the previous two years. Seventeen insurance claims followed the deaths of patients.

And then there is the shocking case of David Gray, a 70-year-old kidney patient, who died in February 2008 after being injected accidentally with ten times the maximum recommended dose of morphine. It was administered by Dr Daniel Ubani, a locum who had travelled to Britain from Germany and had slept for just three hours before going on his first out-of-hours weekend shift in Cambridgeshire. As well as giving the fatal injection to Mr Gray, an 86-year-old woman died of a heart attack after the Nigerian-born Dr Ubani failed to send her to hospital.

While the deaths of Mr Gray and young Joseph may differ in their circumstances, both serve to shine a spotlight on the growing scandal of British doctors' refusal to work nights and weekends, with their places too often being filled by doctors from abroad, some of whom speak poor English.

All this, of course, is the result of one of the Government's most disastrous pieces of meddling, which allowed British doctors to opt out of out- of-hours duties - and meant they were no longer responsible for the care of their patients 24 hours a day, seven days a week.

That's why, six years on, Suffolk - a county of 600,000 people - has just two British doctors on call overnight and at weekends. Similarly poor coverage is offered elsewhere, as sick patients are fobbed off with telephone assessments or forced to make their own way to overloaded Accident & Emergency hospital departments.

Before the introduction of the new contracts in 2004, GPs were responsible for providing out-of-hours care to their patients. Since then, however, the responsibility for in-hours and out-of-hours care was split, so that primary care trusts took on responsibility for patients at nights and on weekends. As a result, despite the fact that British GPs are the highest-paid in the developed world - average earnings are £106,000 - they earn their crust during office hours.

Under pressure to return profits and cut costs, primary care trusts introduced ways of dealing with patients that reduced the need for time- consuming home visits while looking for 'cheaper' doctors from elsewhere. Though precise figures are not available, research by the Daily Mail suggests that a third of primary care trusts are flying in GPs to fill these posts. The doctors come from as far away as Lithuania, Poland, Germany, Hungary, Italy and Switzerland, and are attracted by the comparatively good rates of pay.

While the NHS has a long history of employing foreign doctors, their presence on the front-line of healthcare has raised specific concerns. Top of these are question marks over the foreign medics' qualifications and language skills.

It's something that 66-year- old Renee Forrow discovered when her husband Derek died at their Suffolk home two years ago after a longterm illness. It was a Saturday evening and, with her GP surgery closed, she called the out-of-hours service - Suffolk Doctors on Call (Sufdoc) - to request that a doctor be sent to certify the death. But what should have been a dignified process quickly degenerated into what Mrs Forrow describes as a 'Monty Python farce'. First, the Polish doctor and his driver could not find the house and took two hours to arrive.

When he did arrive, there were no sympathetic words. Instead, the doctor asked the stunned widow to fill in a form with her husband's name, address and other details. 'When he came in, he didn't say anything to anybody,' she says. 'He just scuttled in, pointed at my husband on the bed and said: "Accident?" 'He then examined him, gave me a form and said: "You say, you do. You fill in. I don't understand." I felt it was wrong that I had to fill in the details myself, but it was impossible to have a proper conversation with him. He simply could not converse in English adequately.'

As if that was not distressing enough, the doctor then pointed at her husband's morphine pills and asked: 'How many you give him?' Mrs Forrow said: 'It sounded insensitive because it almost suggested that he could have overdosed. It was almost as if I had done my husband in.' Just minutes after his arrival, the Polish doctor left. Shocked by what had happened, Mrs Forrow decided to speak out. She is concerned by what might have happened had the doctor been called to treat a complicated case.

'Suppose he visited an ill, old lady and was trying to pick up the nuances of what she was saying,' she says. 'Communication is half of diagnosis and he was like a little scared rabbit caught in the headlights.' A letter of apology subsequently arrived from Sufdoc. It stated: 'There is no question about his (the doctor's) competence as a clinician. It is just an issue about communication.'

It is these twin issues - competence and communication - that are at the heart of concerns over the role being played by foreign doctors in the out-of-hours service. While concerns over the competency of foreign doctors are pressing-there is a growing belief that the way to address them is by a fundamental overhaul of the outofhours system that would make their presence unnecessary.

This would be achieved by handing back responsibility for roundthe- clock care to family GPs. In this way, continuity of care between patient and doctor would be ensured, as would direct accountability. Perhaps unsurprisingly, doctors' leaders oppose these suggestions, saying that it would be 'unsafe' to make GPs work longer hours.

It is not an argument that cuts much ice with the likes of Dr Frank Newton, who worked as a GP for 25 years in rural Northamptonshire before retiring in 1989. 'When I started, there were two of us and we covered 200 square miles with about 4,500 patients,' the 80-year-old told me. 'I worked every hour the other guy didn't work. We took it in turns during the week for the nights, and in turns for the weekends. 'We took a fortnight's holiday each, so if the other guy was away you would be on for two weeks in his absence and he would do the same when you took your fortnight. 'I can tell you that we weren't on our knees with exhaustion and we were not unsafe - we were used to it. We wanted to be involved because we were part of the community and that is what the job was about. 'I find it very sad the way things have gone today, because I think that the people who are missing out are the practitioners themselves as well as the patients. What pleasure can you get from doing only half a job?'

So, should GPs be involved in arranging out-of-hours care for their own patients? As providers or commissioners of this care, they would not necessarily be obliged to return to outofhours work themselves, but they would be obliged to organise it (experts predict that if this happened, more local doctors and nurses would get involved). Even the NHS Alliance - an independent body that represents NHS professionals working outside hospitals, including some GPs - is calling for doctors to take back at least some of the responsibilities they cast off in 2004.

Many patients who have experienced the shortcomings of the system - such as negotiating complex phone systems or being forced to take a sick child to a dropin centre in the middle of the night - would go further and demand that, in return for their increased salaries, doctors would be available when they were most needed.

As Katherine Murphy, director of the Patients Association, points out, ill-health can strike at any time. 'There should be no less emphasis put on the out-of-hours care than there is on the care on offer between 9am and 6pm,' she says. 'No one decides when they get ill, so the same importance should be given to the provision of care whatever the time of day.'


Democrats shelve health care overhaul

Democratic leaders on Thursday shelved plans to push through a major health care overhaul, casting aside President Obama's top legislative goal, which has bedeviled congressional Democrats for more than a year.

Senate Democrats put a positive spin on it, arguing that they're sidelining it until later this year - possibly until the summer - so they could deal immediately with Mr. Obama's State of the Union call to address the economy and job creation. But House Speaker Nancy Pelosi, who said a comprehensive bill is still a priority, already has plans to pursue small, targeted health bills, such as a repeal of insurance companies' antitrust protection.

Rank-and-file Democrats aren't optimistic about the fate of a comprehensive overhaul. Sen. Mary L. Landrieu, Louisiana Democrat, classified the legislation as on "life-support" and with a pulse, but warned that resuscitating the legislation would take a lot of work. "Can we come out of the dugout in the second half and fight and come back and win in the second half of the game?" she said. "Yes. But it's going to take some serious strategic excellence ... and absolutely extraordinary communication and coordination to do that."

Mr. Obama said Wednesday that he still wanted a health care reform bill - an uphill legislative effort that headlined his first year in office - but suggested that lawmakers take a step back before renewing their work. "As temperatures cool, I want everyone to take another look at the plan we've proposed," Mr. Obama said in his address. "But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know. Here's what I ask of Congress, though: Do not walk away from reform. Not now. Not when we are so close."

But Democrats on Capitol Hill, eager to prove to voters that they're listening to their concerns about the hobbled economy and the job market, are ready to move a jobs bill. "The president made it clear that our No. 1 focus this year is putting Americans back to work," said Senate Majority Leader Harry Reid, Nevada Democrat. "And we couldn't agree more."

Democrats plan to release a jobs package, possibly next week, that could include a mix of funding for infrastructure projects, targeted tax cuts and small-business loans. The plan could include a "cash for caulkers" program or even forgiving some payroll taxes for companies that hire unemployed workers, said Sen. Richard J. Durbin, Illinois Democrat and majority whip.

Leaders stressed that health care reform legislation is still important and is still going to get done. "We're going to do health care reform this year," Mr. Reid said. "The question is, at this stage procedurally, how do we get where we need to go."

The yearlong effort to push reform legislation through five congressional committees and both chambers of Congress dominated Mr. Obama's first year in office. Presidents had tried for decades to pursue a universal health bill, but never got nearly as far as Democrats did last year.

The debate over a public insurance plan, federal funding of abortion, costs and other issues divided the public. Mr. Obama said Wednesday that he holds himself responsible for never clearly explaining what he wanted the bill to do. Republicans seized on the opportunity to label the plan over the summer, telling voters that the bill would lead to a government takeover of the health care system, tax hikes and even at one point to the infamous "death panels."

The public's distrust of the effort came to a head in Massachusetts when Republican state Sen. Scott Brown on Jan. 19 won the seat long held by Sen. Edward M. Kennedy, shocking Democrats and giving Republicans enough votes to sustain a filibuster of the bill. Mr. Brown won in the traditionally blue state by promising to vote against it.

Mrs. Pelosi is already planning on pursuing small pieces of the Democrats' health bill - an indication that House Democrats are anxious to take action and declare a small victory. She said she would and wait to see how the Senate pursues obtaining a comprehensive bill now that Democrats no longer have a supermajority. Legislation to repeal insurance companies' antitrust protections could be introduced as soon as next week. "We will move on many fronts, any front we can," she said. "But we are going to get health care reform passed for the American people for their own personal health and economic security and for the important role that it will play in reducing the deficit."


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