Sunday, February 21, 2010

Whistleblower being 'hounded out' of evil British public hospital

The senior consultant who warned of "serious failings" at the Great Ormond Street Hospital clinic which sent Baby P home to die is being "hounded out," according to her husband. David Holt said his wife, Kim, a consultant of 25 years' standing, was "in shock" after the world-famous hospital advertised her job recently without even telling her. "She couldn't believe it," he said. "She was speechless. This kind of behaviour completely blows out of the water any belief in the hospital's good faith, or their ability to change the oppressive culture Kim has experienced."

The move is the latest in a string of cases where the NHS's promises to protect whistle-blowers have proved false.

The inquiry into the Stafford hospital scandal has heard how medical staff who tried to warn of fatal failings at the trust were threatened into silence by NHS managers.

This month, a London consultant, Ramon Niekrash, won an employment tribunal case against Queen Elizabeth Hospital, Woolwich, after he was victimised for raising concerns about cost-cutting.

Dr Holt's MP, Lynne Featherstone, has said that colleagues who supported Dr Holt are being "bullied" and "pressured" by the hospital into retracting their statements. However, further staff have come forward to speak of serious problems at Great Ormond Street.

In December, Great Ormond Street promised to reach a "swift and amicable solution" with Dr Holt after a damning NHS London report largely vindicated her criticisms of the child abuse clinic in Haringey, for which Great Ormond Street provided the doctors. Dr Holt has spent the last three years on "special leave" since warning – more than a year before Baby P came to the clinic – that she and other doctors there were dangerously overworked and a child would die unless action was taken.

Tomorrow Dr Sabah al-Zayyat, the temporary locum who replaced Dr Holt after she was forced out of the clinic, goes before the General Medical Council, accused of missing serious injuries to Baby Peter two days before he died.

Great Ormond Street promised to implement the recommendations of the NHS London report, one of which was that Dr Holt had done nothing wrong and should be reinstated. However, more than two months after its publication, said her husband, there has been no movement. "Saying that nothing has happened is almost too positive," said Mr Holt. "What has happened is that they are pushing forward with their plan to drive Kim out of the service."

Dr Holt herself – who first raised her concerns in The Sunday Telegraph – has been warned by the BMA not to speak to the media again for fear that the hospital will use it as a pretext to sack her. But her husband said she had been asked to sign an agreement that was tantamount to a "death warrant." "They called it an independent mediation agreement, but it looked more like an exit agreement," he said. "Kim would have to agree to be bound by it, and the hospital was given the final say over her fate. There is no case for mediation, even if it was genuinely independent, because NHS London has already said Kim should return to her job. This is just another way of disposing of her."

Shortly after the mediation agreement was proposed, Dr Holt opened the British Medical Journal to find that the job she was supposed to return to was being advertised. "That was the most blatant example of the way Great Ormond Street act," said Mr Holt. "They clearly believe they are completely impregnable and beyond the law and they intend to carry on exactly as they always have done."

Mr Holt said that his wife had received "overwhelming support" from fellow staff at the hospital since her Sunday Telegraph interview. "She was approached by a number of other senior individuals in the Trust who feel the same way she does, particularly about the way in which Great Ormond Street is being managed and the oppressive culture there," he said. "Maybe Kim is being treated in the way she is because the management are desperately trying to deter others from going public."

Mr Holt, who is director of finance at the FTSE 100 property giant Land Securities, said: "I have been in the business world for 25 years and I have never seen anything like this. "In most blue-chip organisations people are allowed to express a view without being quashed or targeted."

Mr Holt appealed to potential staff to avoid Great Ormond Street. "Don't believe the hype," he said. "Don't work there. There are clearly major problems at this hospital and my concern is that by ignoring them, they could bring down a great national institution."

A Great Ormond Street spokesman said: "We are committed to resolving the matter with our employee but regard it as a private matter."


Quack medicines being funded on the NHS

While real medicines are often denied to patients

Homoeopathic medicines should not be allowed to make claims they cannot justify and should not be paid for by the taxpayer, MPs will recommend. A report from the Commons science and technology committee is expected to criticise the use of NHS resources to fund the remedies based on the current evidence for them. The committee will also argue that medicines should not be allowed to use phrases like "used to treat" in their marketing, as consumers might think there is clinical evidence that they work.

Latest figures show 54,000 patients are treated each year at four NHS homoeopathic hospitals in London, Glasgow, Bristol and Liverpool, at a cost of £4 million. A fifth hospital in Tunbridge Wells in Kent was forced to close last year when local NHS funders stopped paying for treatments.

Homoeopathy is based on a theory that substances which cause symptoms in a healthy person can, when vastly diluted, cure the same problems in a sick person. Proponents say the resulting "remedy" retains a "memory" of the original ingredient – a concept dismissed by scientists.

During the committee's inquiry, the British Medical Association said the use of homoeopathic medicine could not be justified on the current evidence. The Royal Pharmaceutical Society of Great Britain said there was no possible reason why such treatments, marketed by an industry worth £40 million in this country, could be effective scientifically.

Advocates of homoeopathy say even if the effect of the remedies is to work as a placebo, they are chosen by thousands of people, and do not carry the risks and side effects of many mainstream medicines.

Prince Charles, one of the best known proponents of the concept, which originated in Germany 200 years ago, founded the charity The Prince's Foundation for Integrated Health, which promotes the use of alternative medicines. Dr Michael Dixon, the charity's medical director, urged the Government not to restrict the use of homoeopathy, which he said would mean "abandoning patients". "For all those people with long term conditions for whom there is no evidence-based medicine, it doesn't matter how it works, what matters is whether it helps them get better," he said. A survey carried out at England's NHS homoeopathic hospitals found 70 per cent of [self-selected] patients said they felt some improvement after undergoing treatment.

David Colquhoun, professor of pharmacology at University College London, said: "It really is very simple, there is nothing in the pills. The danger is that people get diverted from the actual medicine which could cure them."

Last year an Australian homoeopath and his wife were found guilty of the manslaughter of their baby daughter because they did not seek conventional medical treatment for the nine-month-old, who died of septicaemia.

Cristal Sumner, chief executive of the British Homeopathic Association, said: "We feel the [select committee] inquiry was too narrow in its remit, there is plenty of evidence to support homoeopathy, with 100 randomised controlled trials, and many more on outcome measures, which reflect how patients say they feel."


What Americans Don't Understand about Obamacare

In his State of the Union speech, President Obama tried to offer a mea culpa of sorts for the unraveling of his health care bill. Calling health care "a complex issue," the president said, "I take my share of the blame for not explaining it more clearly to the American people."

Mr. President, you are correct. We Americans don't understand. However, our lack of understanding is not because we're incapable of deciphering complex issues. Rather, we don't understand how Obamacare itself is supposed to make our health care system any better. Here is a short list of what we specifically don't understand:

* How will our health care system improve by giving a $300-million payoff to Democratic Senator Mary Landrieu in Louisiana in exchange for her vote? Three hundred million was the price tag for Landrieu's "yes" vote on the 3,000-plus-page Obamacare bill. This may improve the health of Senator Landrieu's reelection prospects, but not the health of our nation.

* What is positive about exempting Nebraska from having to pay future Medicare costs but making other states foot the bill? Democratic Senator Ben Nelson was the final Democratic senator holding out support for the bill. After closed-door negotiations, Senator Nelson provided his full support. The reason for Nelson's sudden change of heart? His state was given a special exemption and would not have to pay the projected billions of dollars in additional Medicare costs that Obamacare would create.

* Why are labor unions singled out from all other Americans and given an eight-year pass on paying taxes, while non-union workers have to pick up the tab? In another closed-door negotiation, this time with Big Labor bosses and lobbyists, union members were exempted from paying the dreaded "Cadillac tax" on premium health care plans until 2018. In dollar terms, this would save union workers over $60 billion, while the rest of us have to come up with an additional $90 billion over the same time period.

* Why should taxpayers be forced to pay for elective abortions? After being repeatedly reassured by you, Mr. President, that taxpayer-funded abortions would not be included in your health care bill, why did your Secretary of Health and Human Services brag to the pro-abortion lobby that the Senate version of Obamacare includes taxpayer-funded abortion? How does this improve our health care system?

* How does putting the federal government between Americans and their doctors improve anyone's health? The Senate version of Obamacare would make Americans enroll in a "qualified health care plan" and then dictates that doctors may receive compensation under such plans only if they perform procedures allowed by the federal government.

* How does a closed-door legislative process help us understand the complexities of Obamacare? If health care is a "complex issue" that requires clear explanation to the American people, then how does it help when all of the explaining is being done to lobbyists behind closed doors?

Mr. President, what we don't understand is why a bill that is so good and necessary requires secrecy, bribes, and lies to ensure its passage. Why do you feel the need to hide the bill from us? Why do your biggest supporters need their palms greased before they come on board with your plan? Why do you tell us one thing about the cost of your bill, only for us to find out later that you understated the actual cost by over 300 percent?

In short, Mr. President, why should we believe anything you tell us about health care anymore?


Obama keeps all-Democratic health care option open

The White House signaled Thursday that an aggressive, all-Democratic strategy for overhauling the nation's health care system remains a serious option, even as President Barack Obama invites Republicans to next week's televised summit to seek possible compromises.

The administration's stance could set the stage for a political showdown, with Democrats struggling to enact the president's top domestic priority and Republicans trying to block what many conservatives see as government overreach.

A senior administration official said Democratic congressional leaders have nearly finished efforts to reconcile two health bills, which the House and Senate passed separately last year with practically no Republican help. Obama will use their legislation to expand coverage to some 30 million and require most Americans to carry insurance as the basis for a proposal that the White House will post online by Monday, three days before the Feb. 25 summit, said the official.

He spoke on the condition of anonymity to discuss private negotiations.

Obama says he is open to Republican ideas for changing the health care system. But many Democrats seriously doubt GOP leaders will support compromises that could draw enough lawmakers from both parties to create a bipartisan majority.

If next week's meeting does not break the logjam, congressional Democrats will face a tough choice. They can pass a highly diluted health care bill or nothing at all, which would send them into the November elections with a high-profile failure despite their control of Congress and the White House.

Or they can use an assertive and contentious tactic, known as reconciliation, to pass a far-reaching health care bill in the Senate without having to face GOP delaying tactics. Democrats lost their ability to block filibusters when Massachusetts Republican Scott Brown won a Senate seat last month.

Both parties have used reconciliation rules in the past. But Republicans have practically dared Democrats to do so on health care, citing polls showing significant opposition to the legislation.

It's unclear whether the House or Senate can muster the necessary votes. Democrats, who now hold 255 of the House's 435 seats, drew only one GOP ally when the House passed its health care bill, 220-215, last November. Since then, one Democrat who voted for the bill has resigned, one has died and a third plans to leave office Feb. 28. Moreover, changes meant to meet Senate demands could peel away enough liberals on one end, and party centrists on the other, to cause the revised bill to fail.

In the Senate, Democrats control 59 seats, and reconciliation rules require only a simple majority. But several Democratic senators have expressed discomfort or outright opposition to using the rules to thwart filibusters on health care.

Health and Human Services Secretary Kathleen Sebelius said Thursday that Obama plans to have a health care proposal that "will take some of the best ideas and put them into a framework" ahead of the Feb. 25 summit. The White House has invited Republicans to bring their own proposals, but GOP leaders have treated the event warily at best.

House Republican leader John Boehner of Ohio said Thursday, "a productive, bipartisan conversation on health care starts with a clean sheet of paper." His office labeled next week's meeting the "summit of all fears."

But at least one moderate Republican was optimistic about the session.

Sen. Susan Collins of Maine said if the summit succeeds, a bipartisan bill could be put together and passed within six weeks. "My advice to our Republican leadership is we should view this as a good faith effort and go in there with a consensus list of provisions that we could support and that would make a difference," she said in an interview with The Associated Press.

House Democrats are insisting on several changes to the bill the Senate passed on Christmas Eve, before Brown was elected to succeed the late Sen. Edward M. Kennedy. The changes include reducing or eliminating a proposed tax on generous employer-provider health plans, and eliminating a Medicaid subsidy aimed only at Nebraska.

Also, some House Democrats who oppose legalized abortion are demanding that the Senate's more permissive language on the topic be replaced by the House provisions. It was unclear Thursday how that might be achieved.

The cost of the legislation _ about $1 trillion over 10 years _ would be paid for through Medicare cuts and a series of tax increases. House officials said Democratic leaders are not yet pressing wary colleagues to back a health care bill under the special procedural rules. That could happen soon, however, if next week's summit fails to produce a bipartisan breakthrough.

House congressional aides said they expect leaders such as Speaker Nancy Pelosi, D-Calif., to tell colleagues that using all their parliamentary muscle to pass a health care bill _ even if it triggers withering criticism from the right _ is preferable to facing voters empty-handed this fall.


Australia: Irrational Medicare system delivers inverse health care

(Australians already have a "public option" for all, which they call "Medicare". It delivers cheap visits to private doctors but third-rate hospital care)

By Dr Jeremy Sammut

This week, two health stories from different states point to some fundamental problems with Medicare.

In Victoria, The Age has reported on a convicted conman investigated twice in recent years for suspected Medicare fraud who continues to bill the system for hundreds of thousands of dollars.

Meanwhile, the Daily Telegraph has alleged that the Federal MP for the NSW Central Coast seat of Robertson, Belinda Neal, offered (though she strongly denies it) to have a local Labor Party branch member moved up the waiting list for hip-replacement surgery in return for supporting Neal in a bitter pre-selection contest.

The extent to which Medicare may be being ripped off is unknown. Incredibly, healthcare providers are not obliged to hand over their billing records to investigators, and one in five who are audited refuse to do so.

The federal government spends about $14 billion a year on bulk-billed general practice and other allied health services, or about half the amount state and federal governments spend on Australia’s 750 public hospitals.

Expenditure on this part of the Medicare program (which all governments treat as a political sacred cow) is uncapped and demand-driven. Unquantifiable amounts of health dollars are being wasted due to not only fraud but also overuse of bulk-billed services consumed without upfront charges and co-payments.

By contrast, public hospital budgets are capped and this part of the system is supply-driven. Budget limits determine services levels, and public hospital care is rationed not only by elective waiting lists but also by emergency patients waiting for hours, sometimes days, before a free hospital bed is found.

Australia’s ‘free and universal’ public health system is therefore well-described as an irrational ‘inverse insurance system.’ The worried well can see the doctor for ‘free’ an unlimited number of times although their health needs are mostly minor, leaving taxpayers to pick up the ever-increasing bill. But when medical problems are most serious, an ‘inverse care law’ applies, and patients are forced to queue to receive hospital treatment.

The diminishing numbers of true believers who think Medicare the unblemished jewel in the crown of Australian social democracy are truly deluded. Medicare is not free, let alone universal, and beyond the cost to taxpayers, the highest price is being paid by the truly sick who are routinely denied timely access to essential hospital care.

The above is a press release from the Centre for Independent Studies, dated February 19. Enquiries to Snail mail: PO Box 92, St Leonards, NSW, Australia 1590.

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