Tuesday, September 30, 2008

Patient to sue NHS over top-up drug

A woman's fight to halt the withdrawal of her free care could shatter goverment rules on drugs. But fancy having to sue to get the healthcare you have already paid for! I guess that's what's called socialist compassion

A WOMAN cancer patient is taking a landmark legal action against the National Health Service for withdrawing treatment because she has chosen to pay for a drug that the NHS does not fund. Sue Bentley, a potter, has had her NHS care withdrawn after paying privately for the drug Avastin to increase her chance of fighting lung cancer. The legal action will put pressure on the government to change its policy of penalising patients who try to improve their chances of survival by buying additional drugs.

An inquiry into the scandal, to be published at the end of October, is widely expected to propose that patients should be allowed to pay for additional drugs without losing their NHS care. Ministers will then consider changing the rules but patients such as Bentley say they do not have time to wait. Bentley, 67, from Monmouthshire, who was diagnosed with the disease last December, said: “We were told there was no way we would be allowed to top up and that we would need to opt out of the NHS and pay for everything. “It is quite frightening because, if I become ill, I know that we will need to pay up to $900 a day for me to go into hospital, as well as all the treatment costs.”

In addition to the Avastin, Bentley is also receiving two other drugs, cisplatin and gemcitabine, which are normally available on the NHS. She is now being charged for these drugs which are free to other NHS patients. She added: “Everyone else is getting the cisplatin and the gemcitabine for free. I am sitting beside them and I am being billed. It is horrendous.”

Bentley will challenge in court the decision by her hospital, Velindre NHS Trust, Cardiff, to refuse to allow her to pay for an additional drug without losing her NHS care. In previous legal challenges, the NHS has capitulated either by agreeing to fund the additional drug or by the hospital allowing co-payment. This is unlikely to happen in Bentley’s case.

Bentley’s solicitor, Melissa Worth, of Halliwells, the Manchester-based law firm, has a QC’s opinion stating that the NHS has no legal right to prevent Bentley paying for a private drug while continuing to receive her state-funded care. Worth said: “Ms Bentley has paid for her NHS care through insurance contributions and there is no bar to a patient purchasing a drug not ordinarily available on the NHS, bringing that to a hospital and having the NHS administer that drug. “These patients are not taking anything away from the NHS.”

Halliwells is not charging Bentley for its representation. Doctors for Reform, a group of 1,000 doctors, has a $70,000 fighting fund to pay any legal costs awarded to the NHS if Bentley loses her case.

Bentley’s companion of 24 years, Steve Rogers, 52, a conservationist, has paid for Avastin, which costs about $6,600 a month, from savings. He found trials on the internet showing that patients who add Avastin to their treatment are more likely to see their tumours shrink and will increase the time before their cancer returns.

The couple must also pay for the cost of the chemotherapy drugs, which would otherwise have been available to Bentley on the NHS, and the charges for administering them. Bentley’s oncologist, who is backing their decision to pay for Avastin, has waived his fees.

Velindre NHS Trust defended its decision to withdraw NHS care. Malcolm Adams, medical director, said: “Velindre’s policy is that patients cannot switch between NHS and private healthcare within a particular treatment episode. “The Trust awaits the outcome of this [Department of Health] review with considerable interest.”


Monday, September 29, 2008

Nasty British bureaucrats surrender! They knew that their petty harassment of private medicine would not stand up in court

IVF watchdog lifts ban on Mohammed Taranissi to avoid challenge in High Court. He was so successful he made the NHS look stupid: Unforgiveable!

Mohammed Taranissi, Britain’s most successful fertility doctor, has been cleared to continue running his London clinic by the IVF watchdog, after it agreed to rescind a disciplinary ban imposed last year. The Human Fertilisation and Embryology Authority (HFEA) will annul its ruling that Mr Taranissi was unfit to be in charge of his Assisted Reproduction and Gynaecology Centre (ARGC), to avoid a judicial review.

The doctor, who has long boasted Britain’s highest IVF success rates, was stripped of his right to be “person responsible” for the clinic last July, after an HFEA committee found that he had been practising without the proper licence.

Mr Taranissi, however, was granted permission to challenge the decision in the High Court, on the ground that the panel could have appeared to be biased against him. Rather than risk a defeat that would have been highly damaging to the authority, it will set aside the decision and pay his legal costs. The climbdown is the latest of a string of costly legal embarrassments for the HFEA over its handling of the doctor. In June last year the High Court ruled it had illegally obtained a warrant to search Mr Taranissi’s clinic, leaving the regulator facing a legal bill that could reach $2 million.

It was also forced to clarify in court comments made by Angela McNab, then its chief executive, in a BBC Panorama programme broadcast last January. Mr Taranissi is suing the BBC for libel over allegations in the documentary that his clinic put pressure on patients to pay for unnecessary treatments.

The HFEA’s climbdown will also encourage the doctor as he prepares to defend a General Medical Council hearing into complaints from two unnamed patients, which begins on Monday. One of the women alleges that the ARGC put inappropriate pressure on her to have particular treatments, and the other claims he failed to examine her properly and was insensitive to her husband. In both cases, he is also accused of failing to keep proper records. Mr Taranissi denies the allegations, which the HFEA investigated in 2003 and 2004 without ruling against him.

The HFEA’s action against Mr Taranissi followed Panorama’s claim that he treated patients during 2006 at a second London clinic, the Reproductive Genetics Institute, while it did not have the correct licence. Mr Taranissi has always rejected the charge, contending that he had been given special permission to continue therapy after the licence expired. He appealed against the sanction, which is among the toughest that the HFEA can impose, and which has been used only once before. The decision to strike out the licence committee’s ruling means that appeal will now not be heard. Instead, Mr Taranissi has been cleared to continue practising while he applies for a fresh licence. The agreement between the parties still has to be sealed by a judge, but this is expected to be a formality.

His application will be considered by six new members of the authority, who were appointed this month at the request of Dawn Primarolo, the Public Health Minister. It was agreed that authority members who had deliberated on the doctor’s case before could not be involved without the appearance of a conflict of interest.

Mr Taranissi said yesterday: “I always maintained that the decision was wrong, and I am delighted it has been set aside. I hadn’t done anything wrong and I wouldn’t accept it.” He said his case had highlighted serious flaws in the HFEA’s appeals process. “It is impossible to complain about their decisions to anyone apart from the HFEA, and that cannot be right,” he said. “I was fortunate enough to be able to afford to take legal action, but most people won’t be. There needs to be a way for people to appeal to a third party, without having to go to court.”


Sunday, September 28, 2008

Sleepy British paramedic service kills woman

The evening of May 25 last year had all the makings of a great night for Rebecca Wedd. She had turned 23 the day before and was on her way to a summer ball to celebrate finishing her final year at college. Instead, it ended in her death.

Ms Wedd was knocked down by a car near Coates on her way to the party at the Royal Agricultural College in Cirencester, Gloucestershire. An ambulance was called but it took 42 minutes to arrive. By the time she reached an A&E department, almost 40 minutes later, "it was too late", her father said.

Peter Wedd, 53, from Cambridge, said that his daughter had been let down in the worst possible way. "I had always thought that Britain's ambulance services were the best in the world. Clearly, I was wrong. I could blame anybody for her death. Becky was clearly in a position she shouldn't have been. The car driver didn't see her. But the fact is . . . Great Western Ambulance Service did not do its job."

The service's target response time for life-threatening emergency calls is eight minutes. "They missed it by 34 minutes," Mr Wedd said. "It's appalling."

The Healthcare Commission investigated Great Western Ambulance Trust over Ms Wedd's death. It found that the trust had "learnt lessons" from the case and made improvements to its service.

Mr Wedd said: "People should be aware of how the ambulance service failed that night. Services . . . should sit up and say, `This is not going to happen here'."


Emergency NHS patients still waiting too long to see doctor, review says

Patients who need emergency medical care are facing unnecessary delays in seeing a doctor, despite government targets to speed up urgent treatment, a review says today. In the most comprehensive review yet of NHS emergency and urgent care, the Healthcare Commission found significant variations in how patients are treated across England, particularly on evenings and at weekends.

In some hospitals only 40 per cent of patients were seen by a doctor or nurse within an hour of arrival at the accident and emergency department, while others achieved 100 per cent. The proportion of children with a broken arm or leg who attended A&E and were given pain relief within one hour varied from 20 per cent in some hospitals to 100 per cent elsewhere.

The review, which measured the performance of local ambulance trusts, accident and emergency departments, out-of-hours GP and telephone services and walk-in centres, found that patients were often confused over where to seek help. Overall, emergency care services were "least well performing" or only "fair" in four out of ten areas, with some patients facing delays in transfers to hospital, which are not covered by existing targets.

A new national target is needed to measure how quickly patients receive care from the moment they call an ambulance to the point of admission to casualty departments, the commission suggests. This would provide a more accurate assessment of patients' experience than existing measures, which only cover ambulance response times or stipulate a maximum four-hour waiting time in A&E.

In some A&E departments, for 95 per cent of the time, ambulances are back on the road within 15 minutes of delivering a patient, but in other departments this figure is as low as 10 per cent. This could reflect delays because of a lack of staff or beds to admit a patient, the commission said.

Its review found on average, that services in rural areas performed better than those in urban areas, such as London.

In total, out of 152 primary care trust areas, a third were ranked "best performing" in urgent and emergency care; 41, or 27 per cent, were better performing; 33, or 22 per cent were fair-performing; and 28, or 18 per cent, were categorised as least well performing. Services in the North East performed best overall, with all of the region's trusts rated as "best" or "better performing".

Anna Walker, chief executive of the Healthcare Commission, said there had been improvements in performance on government targets, with 97.9 per cent of A&E patients being treated within the four-hour target in 2007-08, up from 91.2 per cent in 2003-04.

Mike Penning, Conservative MP for Hemel Hempstead, said the Government was "hitting self-imposed targets, but missing the point in providing care. Patient outcomes are being neglected."


Saturday, September 27, 2008

Canada: Man dies after 34-hour wait in ER

Despite him being drawn to the attention of hospital personnel several times and despite the presence of staff employed to check up on waiting patients. Basically, no-one gave a sh*t

It's an unacceptable tragedy that a man waited 34 hours in a Winnipeg hospital emergency room and was dead for several hours before he was finally brought to the attention of medical staff, Premier Gary Doer said yesterday. Although the 45-year-old man - who CTV Winnipeg identified as a double amputee named Brian Sinclair - was "a regular" at the emergency room, regional health officials say he was never registered or seen by triage nurses over the weekend until it was too late.

"The bottom line is we are not making an excuse for this," Doer said yesterday following a grilling over the incident in the legislature. "This is a tragic incident and it shouldn't have happened."

Sinclair was dropped off at the hospital by a taxi Friday afternoon after visiting a downtown health clinic, which is part of the regional health authority. Some hospital staff did speak with the man at some point, but it was not until shortly after midnight on Sunday that he was examined and pronounced dead. The cause of death has not been released.

CTV Winnipeg quoted a man who did not want to be named as saying he had been in the emergency room on the Friday night and had seen Sinclair sitting in his wheelchair, looking like he was asleep. When the man came back the following night, he noticed Sinclair's position had not moved so he told nurses and security workers, who responded they were too busy to check on Sinclair. He also told a security officer of Sinclair's condition, but the guard told him the case would be "too much paperwork." "The nurse said we'll go and check, (but) nobody ever went and checked on him," said the man. "We waited another hour or so and we told another nurse twice to go and check."

Doer said the province followed the recommendation of an earlier task force and hired reassessment nurses who are required to check up on registered patients waiting in the emergency department, but Sinclair was never even registered with the triage nurses.

"This system broke down and there were tragic circumstances," Doer said. The hospital wasn't short-staffed at the time and a re-assessment nurse was on duty, he added. Brock Wright, chief medical officer of the Winnipeg Regional Health Authority, said he's baffled about how Sinclair could have fallen through the cracks. When the man was finally discovered by emergency room staff, Wright said he "had been dead for some time." "It's hard to imagine how somebody could be in the department for 34 hours and somehow it not be apparent that the individual was waiting for care," Wright said yesterday.

On cold nights, Wright said it's not unusual for homeless people to take shelter in the emergency room. But he said any potential confusion that may have arisen from that practice doesn't explain why Sinclair died without treatment.


Australia: Lots of surgery on wrong patients in Queensland public hospitals

THIRTY-three public hospital operations have been performed on the wrong patient or body part in a year, with four of the bungles killing or permanently impairing patients. The deaths and permanent impairments were among 127 identified as being due to bungles in the hospital system. Queensland Health today released the latest patient safety report revealing a 30 per cent spike in reported incidents within the department to 46,990 cases.

Almost a quarter of those cases involved patient harm. Three patients died or were permanently impaired after surgical tools were left inside them while six patients suffered the same fate after being given the wrong medication. Seven patients died or were permanently impaired after delays caused by long waiting lists or the department's failure to order or sanction procedures.

Queensland Health strongly defended the results, saying the increase showed more staff were reporting incidents. The report covered 2006-2007 and was compiled as part of recommendations which came from the Bundaberg Hospital Inquiry report which called for greater transparency. However, Queensland Health Patient Safety centre director Dr John Wakefield was unable to exactly how many deaths occurred during the period.

The report showed 127 patients died or suffered permanent impairment, but did not provide a break-down of deaths or impairment. Dr Wakefield said Queenslanders should have confidence in the health system, saying the figures showed it was getting safer. "Sharing information in an open and honest way is fundamental to improving patient safety and building trust in the community and our staff."


Friday, September 26, 2008

Charming NHS worker abuses woman for needing a Caesarian

Go NHS and get treated like cattle

A pregnant woman about to have a Caesarean after a difficult three-day labour was sworn at by a hospital worker who demanded to know why she couldn’t give birth naturally, a hearing was told today. Samantha Shepherd was told that her baby’s life would be in danger if she didn’t have a Caesarean. But the conversation with her doctor was interrupted when Nigel Baglin, a surgery assistant, stormed into the room and shouted “F****** hell, why can’t women in this hospital give birth naturally?”

Mr Baglin, an anaesthetic support agency worker at Newham University Hospital, East London, crashed his trolley into the door of the room during the outburst, the competence committee hearing heard. The worker said he made the comments because he was “aghast” at the number of Caesarian sections being carried out at the hospital. “It was like every patient on the ward wanted one and had consented to them. “As a personal opinion, I did not think this was natural. It was a sarcastic comment aimed at the doctor and it was a mistake on my part,” Mr Baglin, who now works in Derby, said.

Mrs Shepherd, a mother of three, said she already had reservations about the Caesarean and was left devastated by the confrontation. “I felt I was a complete failure,” she said. “I was really nervous about having the baby. I had two previous births naturally. Every woman has a plan and this labour was not going along as hoped,” she said. “The doctor was explaining that I needed to have a second epidural when he (Mr Baglin) entered the room and banged the door with his trolley.” She said everyone in the room heard his outburst. “He stormed out and everyone was in shock. I felt worthless and told my husband I was a complete failure.” She said she would not use the hospital if she fell pregnant again.

Mr Baglin said the outburst was not intended personally. He said: “It was an off-the-cuff comment. I admit it was inappropriate but I was being rushed around.” But a witness said Baglin’s comments were directed straight at Mrs Shepherd. The woman said: “He was so angry you could see the veins in his neck. He wanted to be an exhibitionist and he wanted it to be heard.”

After the incident in February last year, the hospital reported Mr Baglin’s outburst to his agency, and said it would not employ him in future. Mr Baglin told the inquiry at Park House, Kennington Park Road, south east London, he resigned from his work at the hospital the day after the incident when a formal complaint had been made against him. A panel on the committee will rule whether Mr Baglin’s fitness to practise is impaired. The hearing continues.


Australia: Deadly danger of hospital overflow

TASMANIANS could die because of ambulance delays and paramedics say there is nothing they can do about it. Angry paramedics parked their ambulances outside the Royal Hobart Hospital's Argyle St entrance yesterday to highlight the problem of "ramping". Ramping refers to when patients are forced to stay on an ambulance stretcher because there are no hospital beds free. "Overnight we had crews who were ramped for nine hours out of a 14-hour shift," one paramedic said. "They just get snowed under."

Another said ambulance officers were "baby-sitting" seriously ill patients because there were no beds for them. "We're getting ramped even with people with chest pains," he said. "There is no doubt people will, or already have, died because of this problem," another ambulance officer said.

The Health and Community Services Union said there were 36 patients in 33 cubicles in the RHH emergency department early yesterday. Nineteen of those patients were waiting to be admitted and some were given intravenous antibiotics in the waiting room. "This situation is nothing short of appalling," said HACSU assistant state secretary Tim Jacobson. "Some months ago the RHH established a committee to look at reducing the incidence of ramping. This committee has not produced any results."

He said providing extra nurses and opening beds would solve the problem. But Health Minister Lara Giddings said it was not that easy. "We are asking staff to work overtime to ensure that beds are not closed, but when you've got staff sick as well and you're already having to stretch your resources to cover the existing beds, it's certainly not an easy thing to just simply open up more beds," Ms Giddings said.

She said a flu outbreak was exacerbating the problem. "At the moment we've got around 35 nurses who are away on sick leave and we have increased admissions to our medical wards as well," Ms Giddings said. "This is putting strain on the hospital and it is impacting on ambulance ramping too."

RHH spokeswoman Pene Snashall confirmed the emergency department experienced "high demand" on Tuesday night. "There's no rhyme or reason," she said. "Saturday night was our quietest Saturday in months."


Thursday, September 25, 2008

Canada: Man Dies Waiting 34 Hrs at Emergency Room

(Winnipeg, Manitoba) It's unexcusable! A man waits 34 hours at a Winnipeg hospital emergency room and dies before he is seen. Not only that but he was dead for several hours before it was noticed that he had become a corpse progressing toward rigor mortis.
Although the 45-year-old man -- who CTV Winnipeg identified as a double amputee named Brian Sinclair -- was "a regular" at the emergency room, regional health officials say he was never registered or seen by triage nurses over the weekend until it was too late.

"The bottom line is we are not making an excuse for this," [Manitoba Premier] Doer said yesterday following a grilling over the incident in the legislature. "This is a tragic incident and it shouldn't have happened."

Sinclair was dropped off at the hospital by a taxi Friday afternoon after visiting a downtown health clinic, which is part of the regional health authority.

Some hospital staff did speak with the man at some point, but it was not until shortly after midnight on Sunday that he was examined and pronounced dead. The cause of death has not been released.
Although it's arguably unethical, immoral and illegal to deny emergency treatment to people out in society, denying treatment to someone at the emergency room, even by neglect or incompetence, must border on being a prosecutable offense.
NHS midwives deal with three births at once

Midwives are "overworked and overstretched", sometimes caring for three women in labour at the same time, according an expert.

Since 2001 there has been a 16 per cent rise in birthrates yet there are vacancies for midwives in every part of the country, according to the Royal College of Midwives. The Government has pledged 3,400 extra full-time jobs (4,000 including part-time workers), but research for the Darzi review into the NHS shows a shortage of 4,288 midwives. The shortfall is estimated after comparing it with the NHS "gold standard" for safer childbirth, which demands one midwife per 28 births. London has the worst shortages with 1,150 more midwives needed to meet a 20 per cent rise in the birthrate.

Louise Silverton, deputy general secretary at the RCM, said: "Women keep hearing about Government policy statements, such as one-to-one care from a midwife, but they are not getting that sort of treatment in many areas. "Our members are telling us that they are overworked and overstretched and are running between beds dealing with, in some cases, three women at once." The RCM added funding for maternity services has been cut by $110 million. Miss Silverton added: "The maternity services have long been described as a postcode lottery - but our regional NHS responses paint a shocking picture of just how loaded that lottery for maternity care is."

By next year ministers have promised women will be able to choose whether to have their child in hospital, at home or in a midwife-led birth centre. The Government has promised $660 million of extra funding for maternity services over three years.

But, according to Miss Silverton, research shows nine out of 10 maternity units do not know where their share of the œ330 million had gone, and it could have been diverted into other services. She said: "It is not enough for the Government to say it has put money into maternity services, but then fail to make sure the money actually goes where it is supposed to." The Department of Health said: "Our maternity services are the safest they have ever been. We are committed to improving outcomes for both mothers and babies."


'Pointless' NHS complaints system to be made less rigid

The Department of Health has promised to overhaul the system for making complaints about NHS care after a survey found that more than two thirds of patients think that the process is pointless. The report by the Patients Association described the NHS complaints system as "cumbersome, variable and takes too long". Of nearly 500 patients polled, 69 per cent said that they had wanted to complain about the healthcare they had received in the past five years.

For those who complained, 29 per cent described the process as totally pointless, 20.5 per cent as pointless and 19 per cent as slightly pointless. Only 2 per cent said that the experience had been "very useful". More than four fifths (81 per cent) believed that there was not a culture of openness in the NHS when errors occurred and that staff were not encouraged to report mistakes.

The association's report concludes: "While patients will always accept that errors will occur in any health service, what they will not accept is the fact that staff are not open about admitting such errors occur."

On the matter of recent MRSA outbreaks and other healthcare-acquired infections, 47 per cent of patients blamed NHS trust managers. Nurses and cleaning staff were blamed by 16 per cent of respondents, and 10 per cent believed that doctors were responsible.

Three quarters of respondents felt that trust in doctors and nurses has decreased compared with five years ago. As a result, 96 per cent said they believed that patients questioned the actions of doctors and nurses more than they used to.

The Department of Health said it would be reforming the system so that patients' concerns were taken seriously. An official said: "We know that people find the current complaints system confusing. Some may also avoid complaining because they feel too intimidated or worry about damaging their relationship with their GP or social worker. This must change. "We are introducing a streamlined approach that will remove the need to follow a rigid set of procedures and replace them with a more open, flexible and personal service." If patients fail to resolve complaints at a local level they can forward their concerns to the Healthcare Commission, the NHS regulator.

The Patients Association called for NHS trust boards to be publicly accountable for an "open, transparent and timely resolution of complaints". It also wants an end to system where standard complaint responses vary depending on the region. Katherine Murphy, the group's communications director, said: "Every complaint matters. Ignoring complaints results in wasted resources, frustrated patients and cynicism about the system."


Wednesday, September 24, 2008

Bureaucratic NHS control freaks quite happy to let patients die rather than lose any control

Bosses in the National Health Service have refused to administer a drug to a patient with advanced kidney cancer even though the medicine is being provided free. Barrie Clark, 61, was told in May that he could receive a free supply of a new kidney cancer drug on compassionate grounds from the pharmaceuticals company that makes it. Clark was then astonished to be told by the NHS that he could not take up the offer at his local hospital because it was against management policy. He could receive the drug, which has been approved as safe, only by paying for nurses to administer it privately.

Clark is in a similar predicament to patients being denied NHS care if they choose to pay for drugs that the health service does not fund. Campaigners are outraged that the ban on allowing NHS patients to pay for private drugs has now extended to letting them receive additional medicines for free.

In a letter of complaint to NHS Grampian, which runs Aberdeen Royal Infirmary where Clark is being treated, the father of four said: "I have been denied a free drug for a long time when there was no alternative treatment. "We find this appalling and demand that the drug be offered free of charge immediately. How many other people has this happened to? You have jeopardised my life and caused great anguish to me and my family. That is disgraceful."

The medicine, temsirolimus, which has the brand name Torisel, was granted a licence for the European Union in November. The European Medicines Agency (EMEA) has ruled that its benefits outweigh the risks. Dozens of NHS patients have received it on compassionate grounds from Wyeth, the manufacturer, in advance of its commercial launch in Britain. The National Institute of Health and Clinical Excellence (Nice) is assessing whether Torisel is cost-effective enough to be prescribed on the NHS.

Managers at NHS Grampian told Clark that he could not receive it because it was not yet on its list of prescribed drugs, known as the hospital formulary. The trust says it will not be placed on the formulary until it is assessed by Nice or the Scottish Medicines Consortium. Clark, a manager in the oil industry, has been helped by Kate Spall, a cancer drugs campaigner with the Pamela Northcott Fund. Spall said: "I have never heard such rubbish. They are saying this medicine cannot be given because it is not on a drug list, but patients elsewhere across the country are getting it. Are we now in a position where a terminally ill patient is denied a free medication?"

Cancer professors dismissed the explanation as "bureaucratic nonsense". Will Steward, a consultant oncologist at Leicester Royal Infirmary, said: "I really do not understand the decision not to allow a free drug to be administered from the hospital. We do this frequently. "Many trusts have allowed this in the past and this decision is perverse." Jonathan Waxman, a consultant oncologist at the Hammersmith hospital in London, added: "This is an effective treatment. This shows the mess we are now in."

After Clark told the hospital he was going to speak to the media, managers said he could pay to have the drug administered privately. He would need to pay about $2,000 a month as it is taken intravenously. Clark said that, although appalled at his treatment by the NHS, his own oncologist had done his best. NHS Grampian declined to comment on the individual case.

The Sunday Times has been campaigning to end the ban on NHS patients paying for private drugs that the state does not fund. Last week two patients won appeals to receive cancer drugs on the NHS after they featured in the Sunday Times Right to Pay campaign.

Sheila Norrington, 59, a cancer patient from Maidstone, Kent, was denied NHS care after paying privately for Erbitux, which costs about $6,000 a month. After the paper highlighted her case, the Peggy Wood Foundation, a charity, agreed to pick up the bills, but last week West Kent Primary Care Trust reversed its decision.

Barry Humphrey, 59, from North Walsham, Norfolk, was told that if he paid for Nexavar, the only available treatment for his advanced liver cancer, he would be billed for his NHS care. His local trust refused to fund the drug but neighbouring Suffolk Primary Care Trust has recommended that the NHS should provide it.

The British Medical Association and the NHS Confederation, which represents hospital managers, support a patient's right to co-pay for cancer drugs without losing NHS care.


NHS clinics to be built `where they are not needed'

Is anybody surprised?

The Government is planning to build dozens of new NHS clinics in areas where they are not required, independent research seen by The Times suggests. Ministers have told each of the 152 local health authorities in England to build at least one "GP-led health centre" in a $500 million scheme to improve patient access to doctors. The 1 million pound walk-in clinics will combine surgeries with services such as dentistry and chiropody.

Local primary care trusts (PCTs) are proposing sites for the health centres that would result in many being built in the wrong areas, analysts say. More than 1.3 million people have signed a petition against the clinics, which doctors' leaders and the Conservatives say could close hundreds of surgeries.

Demographic research by CACI, a market research firm, says that inner-city areas may need up to four health centres while rural locations might need none at all. The Department of Health said that the centres were intended to complement, not replace, existing practices.


Tuesday, September 23, 2008

Another drug trial disaster in Britain

A 27-YEAR-OLD man has died in a government-funded medical trial, in which at least two other patients were given overdoses. Gary Foster, a graphic designer who was planning to get married this month, was on seven occasions given double the amount of chemotherapy he should have been prescribed. His mother, Colleen Foster, said: "Gary was slowly poisoned to death."

The mistakes raise questions about the safety of medical trials in Britain two years after the notorious "elephant man" trial, which was supposed to have led to tighter supervision. Six men nearly died after their bodies swelled horrifically after taking the experimental drug TGN1412.

University College London Hospitals NHS Trust (UCLH), one of Britain's largest trusts, has been forced to suspend the trial although it is continuing at other UK hospitals. Foster's death was due to a fundamental error in the setting-up of the trial on the hospital computer system. A second UCLH patient was affected by the same error, but survived.

Another patient, who died at a different hospital, and whose name has not been disclosed, also received an overdose of the drug bleomycin. In that case, the overdose was due to an error by a nurse or doctor rather than a basic flaw in the setting-up of the trial. According to the Medical Research Council (MRC), the government-funded organisation which ran the trial, the drug was not the direct cause of his death.

When the MRC suspected that patients had been given overdoses, instead of calling UCLH immediately, it posted a letter on October 3, 2007. An inquest into Foster's death heard that a nurse failed to open the letter until October 16, two days after his death. The family concede that by October 3 it was too late to save Foster because he was already dying of organ failure caused by the overdoses.

Foster, from Waltham Abbey, Essex, was eager to join the medical trial in June 2007. He had just been diagnosed with testicular cancer, and he had a 60% chance of survival. The disease has a survival rate of about 95% if caught early. Doctors told Foster that, if he was accepted for the trial, his chances of survival would increase.

Colleen Foster said: "The trial sister said: `Good news, Gary, you have been selected for the trial.' At UCLH they said, `Don't worry, testicular cancer is curable. We will monitor Gary for 10 years - you don't have to worry.' They made us feel so confident." His fiancee, Paula Collins, 35, added: "When Gary became involved in the trial, we thought it was fantastic news because we thought Gary's chance of survival would be greater and the care would be better."

The trial, called TE23, was testing whether a combination of five existing chemotherapy drugs was better at treating testicular cancer than the standard treatment of three drugs. Foster was in the group receiving the new therapy. From June until mid-September 2007 he made regular trips to UCLH in central London, to receive the drugs. On seven occasions between July and September last year, he received 30,000 units of one of the drugs, bleomycin, instead of 15,000. Foster and his family had no idea the drugs they believed were saving his life were killing him. Colleen Foster said: "We just thought Gary was getting tired because of the chemotherapy."

Eventually Foster developed a dry cough, a symptom of lung damage, caused by an overdose of bleomycin. An inquest heard that the cough should have been recognised by doctors and nurses as a warning sign that the bleomycin was damaging his lungs. Despite the cough, Foster was given a final dose. The coroner ruled that Foster died as a result of lung damage caused by an overdose of bleomycin. The coroner also found that the instructions for the trial had been wrongly set up on the electronic prescribing system at UCLH.

Colleen Foster said: "An overdose gives the impression that it was a one-off. It was seven times. Every week my poor Gary was going into hospital, we thought he was getting better but, actually, he was being slowly poisoned and poisoned to death." Eventually he became so ill that he was transferred to intensive care and put on a ventilator, but attempts to save him were in vain. Foster's family blame his death on a trial they say was set up in a hurried and piecemeal manner.

Collins said: "Checks should have been carried out. It is incomprehensible that they were dealing with the most dangerous medicines and they were so blase. It was so slapdash. "We had dreams and lots of plans together," she said. "Gary also had his own ambitions. We were supposed to be getting married on Saturday September 6, instead, on the Tuesday before, we were at the inquest. He was such a lovely person. He was so well liked and had so many friends."

"We do need trials but there need to be more controls," Collins added. "I would encourage other people thinking about taking part in trials to proceed with caution. I would hate to think of anyone else going through what we have gone through." .....

The MRC said it had reviewed its trial procedures as a result of the tragedy and introduced additional checks. It said it followed its normal procedures by posting its concerns rather than making an emergency phone call. "During the processing of the forms for the UCLH patients, a possible dosing error for these two patients was spotted. A query form was then returned to the hospital." Dr Stephen Harland, who was in charge of the trial at UCLH and supervised Foster's care, declined to comment....


Australia: A bigger hospital is better?

Public hospitals are impersonal and bureaucratic enough as it is and a bigger hospital is going to be even more so. And the bigger the bureaucracy the more error-prone it is. But both in Australia and in Britain the move is to phase out lots of small hospitals and build a few huge ones

A NEW children's super hospital in Brisbane would save lives, foster research and improve training opportunities, says a respected specialist. As a turf war intensified between doctors over the merger of the Royal Children's and Mater Children's hospitals, Melbourne intensive care specialist Frank Shann said having a single facility was overwhelmingly the best choice for patients.

Professor Shann, who has consulted on children's hospital care worldwide, said bigger institutions delivered better quality care and at lower cost. "Very large centres that do a lot of work have lower mortality rates," he said. "The more you do, the better at it you get." Professor Shann said the existing public children's hospitals were both too small to offer advanced intensive care training for doctors. "Queenslanders who want to train in intensive care of children have to train in other states," he said.

Although some doctors have warned of an exodus of specialists from Queensland if the merger goes ahead, Professor Shann predicted it would attract better qualified staff.

A group of University of Queensland researchers last week warned the pending closure of the Royal Children's Hospital at Herston, in Brisbane's inner north, would cripple research into a vast array of diseases. But Professor Shann said the existing children's hospitals generated far fewer research papers than stand alone facilities in other states. "There'll be a bigger group of people working together rather than having two small groups. You can bounce ideas off each other," he said. "If you have an interest in a particular group of patients ... you'll also double your exposure to those patients."

The Queensland Government has pledged to build a $100 million research facility close to the new hospital but has yet to secure funding. Acting Premier Paul Lucas yesterday accused critics of being afraid of change. "The Government is not doing this to annoy people. The Government is doing this for all the mums and dads out there who expect to have world's best practice in our children's hospital," he said. Mr Lucas defended the current plans, saying all the evidence and analysis showed the Government was on the right track.


Monday, September 22, 2008


Three articles below

No meat at debt-ridden NSW hospitals

MEAT is off the menu at two NSW hospitals because the health service hasn't paid its butchers' bills, a State MP claims. Kevin Humphries has offered to pick up the tab so Gilgandra and Coonabarabran hospital patients, and local Meals on Wheels recipients, can have their meat supply restored. The Greater Western Area Health Service - which has already been accused of failing to pay a Sydney software supplier $22,500 for five months - has conceded it owes money to a number of creditors and has apologised.

Mr Humphries said he was appalled when he found cooks at Gilgandra and Coonabarabran hospitals were forced to provide meatless meals. "Our patients deserve better. It is a sad day when staff are forced to compromise patient care with a reduced and inadequate diet," he said. "I have even heard stories of staff buying meat for their patients out of their own pockets."

Murray-Darling MP John Williams said he knew of several cases of unpaid bills from the western health service. One Broken Hill business was owed almost $2000 and another business in his electorate had been owed more than $12,000 since May. "It's a bleeding ulcer for them - they are all suffering from the drought and they don't need this," Mr Williams said.

Greater Western Area Health is not the only one unable to pay suppliers. Yass air-conditioning mechanic Touie Smith said he is owed $18,386.50 by the Greater Southern Area Health Service for work at Yass and Goulburn hospitals. Part of the debt related to work done as far back as April and Mr Smith said it was putting a strain on his business. Most annoying was the fact that the health service would not return calls to discuss the problem. "We've been shunned," he said. "We are a small business with quite a low turnover - we have to be careful with our money management and outstanding amounts of this size can be very stressful." Mr Smith said the local hospital administrators were embarrassed by the situation caused by their head office.

It's understood Leeton Diagnostic Imaging is owed more than $30,000 by the Greater Southern Area Health Service. Part of that debt dates back to May and the business cannot get any answers about when it will be paid.

Health Minister John Della Bosca said it was reasonable for businesses to expect to be paid "in a fair and timely manner". "Since 2004-05, the department has set a benchmark that creditor payments should not exceed between 35 and 45 days from receipt of invoice," he said. "I believe the benchmark is being met in the majority of cases but I have asked the department to work closely with health services to ensure they're paying suppliers within the set time. "It is important these benchmarks are met as late payments can hurt small businesses."


North QLD Health Services Third World Despite Billions in Mining Royalties

The mismanagement of the Queensland Health service in rural & regional Queensland is a disgrace. In the home of resource rich North Queensland all surgical proceeds now have to be performed at Townsville Hospital which is in crisis. Just 2 weeks ago the ABC `World Today" reported:
"In recent days, Brisbane's biggest hospitals have closed their doors to ambulances and the hospital in the major regional centre of Townsville has resorted to using conference rooms to accommodate patients."

TWO regional north Queensland hospitals at Richmand and Hughenden will close their fully equipped operating theatres. These theatres have not operated for 18 months after the QLD Labor government pulled the plug on funding the popular and very successful flying surgeon service to the centres. The Richmond and Hughenden communities had been waiting and hoping that the service which had operated successfully for many years would be re-instated. Hughenden & Richmand are 400 and 500kms by road from Townsville.

Following on from last months announcement of the closure of the Aramac hospital the people of north-west Queensland are shocked and angry after the latest Bligh Labor Government health plan had promised to close the gap in regional health care. In an email to Agmates QLD Shadow Health Minister Mark McArdle is scathing of the QLD Labor governments treatment of rural and regional Queenslanders:
"The Townsville Hospital is already at crisis point and this incompetent Health Minister is just making it worse instead of taking stress off the Townsville Hospital by de-centralising demand for surgical facilities," The Health Minister's claim that the operating theatres were closed because they didn't provide any surgical procedures as dishonest and arrogant. The reason these surgery theatres wasn't performing surgical procedures is because it didn't fund them.

This is another example of the Beattie-Bligh Government's systemic withdrawal of health services from rural areas. The Beattie-Bligh Government is killing off opportunities for accessible regional health services now, while it is spending millions of dollars on glitzy ad campaigns about what proper health services in 2020."

North West, North and Central Queensland is home to the vast fortunes generated by Queenslands resources boom. Last year the QLD state government collected $1.027 billion in coal mining royalties alone from the region. That figure this year is budgeted to explode to $3.213 billion yet the people of North Queensland have what can only be described as third world health services.

Those mining royalties have made QLD along with resource rich Western Australia the two financial powerhouse states that have largely insultated Australia against the world economic down turn caused by the credit crisis. Yet North Queenslands have seen there health services largely disappear.

It's no wonder that the WA Nationals are the King Makers after the recent state election. They campaigned on a "royalties for regions" policy that promised to return 25% ($700 million a year) of mining royalties too the regional communities of WA. If that policy was adopted in Queensland that would be $800 million just from coal royalties which would be invested into infrastructure & services in rural and regional Queensland each year just from coal royalties.


Nurse backs reports of chaos at a major Brisbane hospital

A SENIOR nurse who recently resigned from Logan Hospital has backed up comments by emergency department doctor Michael Cameron that the hospital is "too dangerous and too dysfunctional". Bill Atkinson, a nurse for nearly 20 years, worked in the same high-pressure emergency department as Dr Cameron. He said his pleas for support were also ignored by hospital bosses and Queensland Health. "I have a lot of respect for the man," Mr Atkinson said. "He had the courage to step up and voice his concerns."

Dr Cameron, senior staff specialist in emergency medicine at Logan Hospital, revealed exclusively in The Sunday Mail last week that he had quit because staff were "overworked and overwhelmed". He had first spoken out about problems in Queensland's besieged health system in a frank open letter published in The Sunday Mail in May. The letter from Dr Cameron prompted Premier Anna Bligh and Health Minister Stephen Robertson to meet with him and appoint him as a special adviser to the Government. But he was largely ignored and the problems at Logan only got worse. "It had got to the point where I dreaded going to work each day," he said last week.

Mr Atkinson, who was a registered nurse and then a clinical nurse in the Logan Hospital emergency department's short-stay unit, had a similar story to tell. He kept detailed records showing a doubling of the number of patients pushed through the short-stay unit, which had a $7.5 million upgrade last year. "However, with this increase in patient turnover, there was no increase in the level of staffing or support," he said. "Like Dr Cameron, I too was dreading coming to work to the job I loved to do. I would often go home feeling overstressed and burnt out from a day's work." He asked the nurse unit manager about the possibility of increasing staff numbers. "I was bluntly informed that it was not going to happen as there was no budget for it," he said.

Mr Atkinson said he wrote to the director of nursing for medical services seeking a meeting. "I stressed that the pressure was overwhelming and that there was not enough staff and support to address the current issues . . . that it was not about me, it was about the quality of care that we were not able to provide to the community of Logan." Mr Atkinson resigned two months ago and said he was not the first experienced emergency nurse to leave Logan Hospital this year. "I know of four other clinical nurses leaving emergency before I did and a clinical nurse and clinical nurse consultant leaving after I resigned," he said.

Ms Bligh last week acknowledged the "very high-stress, high-pressure environment" at Logan but told staff there was "light at the end of the tunnel". The Premier said the State Government had bought nearby Logan Private Hospital and would refurbish it to provide extra beds by 2010. Mr Atkinson, who now works at Redland Hospital, will be joined there by Dr Cameron in emergency.


Sunday, September 21, 2008

Thousands of British elderly ‘denied best thinning bones treatment’

Thousands of women with thinning bones are being denied the best available therapies because of “unethical and shortsighted” NHS rationing, senior osteoporosis specialists say today. Guidelines from the National Institute for Health and Clinical Excellence (NICE) are unfairly restricting access to osteoporosis drugs that can prevent pain, disability and even death, leading doctors and charity executives say.

In a letter to The Times, a group of 36 experts has called on NICE to revise restrictive draft guidance, which is the subject of an appeal that begins today. They urge NICE to widen access to alendronate, the cheapest generic osteoporosis drug, which costs only £50 a year, and to ease strict eligibility criteria for slightly more expensive options. NICE approves alendronate only for patients older than 75. It is also unsuitable for a quarter of patients.


Saturday, September 20, 2008

Another black eye for arrogant medical regulators

The TGA is Australia's version of the FDA. I don't blame the TGA for disliking alternative therapies (though some of the things they have approved -- such as statins -- are arguably no better) but that does not excuse ruinous Gestapo-type attacks on a law-abiding businessman and the destruction of his business. And the two devious feminazis at the heart of the TGA action -- Fiona Cumming and Rita Maclachlan -- are apparently still in their jobs! Since their hatreds have already cost the taxpayers huge sums, they should be relegated immediately to clerk-typist duties only. Their involvement in the destruction of records should in fact lead to criminal charges being laid against them

The Commonwealth Director of Public Prosecutions has dropped four criminal charges against former alternative medicine tycoon Jim Selim. Mr Selim, the founder of Pan Pharmaceuticals, had been charged with failing to disclose material information relating to four separate board meetings. Last month, Mr Selim won a $55 million compensation payment from the Federal Government over the collapse of his company.

Pan Pharmaceuticals went into liquidation in 2005 after a decision in 2003 by the Therapeutic Goods Administration (TGA) to suspend its licence and withdraw 219 of its products.

Outside the court, Mr Selim said he felt vindicated by today's decision and he would push ahead with preparations for a $200 million class action against the TGA over the collapse of the company in 2003. "It's good because here everything's over, nothing's left, there's no deal or anything," Mr Selim said. "That's the end of it."

He said an apology from the Federal Government would mean a lot to him, following his "persecution" over the past five years. "I think so," he said, when asked whether an apology should be forthcoming. "I was disappointed with the TGA from the start."

His solicitor, Andrew Thorpe, said there was a "high degree of interest" from former customers and creditors of Pan Pharmaceuticals in pursuing a class action. "We believe that the sort of value of the class action will be in the order of $200 million and perhaps greater than that," Mr Thorpe said. There would most probably be hundreds of parties involved and a claim would be made on behalf of companies which lost money as a direct result of the TGA's handling of the Pan matter, he said.

Mr Selim said it had been a "hard five years", with today's case the latest in a long series of court actions involving Mr Selim and Pan Pharmaceuticals. "We hope justice will be done and we hope people who were damaged and hurt by the TGA action will get compensation, will get justice," he said.


Note: The firm was convicted of offences to do with disregard for government paperwork requirements but those offences were some years before the matters referred to above. And in the paperwork case the judge found no individual culpable but rather a firm-wide indifference to government paperwork. That attitude may have contributed to the TGA animus against the firm but does not excuse their reckless shutting down of the firm. The paperwork matters should have been and were dealt with by a court

Friday, September 19, 2008

Re persecution of "Dr Scot Jnr":

Further to my recent reports about NHS attacks on free speech by doctors, I thought it fair to make clear that the whole of the NHS should not be tarred with this. Below are particulars of the very senior feminazis actually involved

Professor Elisabeth Paice saw the scatological comment on the forum about Prof. Black and reported it to Prof. Black. Paice is Dean Director, Postgraduate Medical and Dental Education for London; Chair of the Conference of Postgraduate Medical Deans; Chair of the forum for Modernising Medical Careers.

From a recent anonymous blog comment: "Readers may be interested to learn that the London Dean involved is also implicated in copying material from DNUK in order to report another doctor to the GMC. This doctor has sadly committed suicide. Whilst cause and effect are hard to prove, the involvement of Elisabeth Paice in yet another tragic abuse of power has caused much anger amongst doctors, as is her unaccountability."

Professor Dame Carol Black. Either Black or Paice called Needham to get Scot suspended. She is National Director for Health and Work, Chair of the Academy of Medical Royal Colleges and Chair of the Nuffield Trust. From Wikipedia: "Junior NHS Doctors were upset when Dame Carol Black was re-elected Chairperson of the Academy of Medical Royal Colleges (unopposed) in 2008. One junior surgeon launched a scatological attack on Dame Carol on the doctor discussion forum Doctors.net.uk which resulted in Dame Carol's colleage, Professor (Dean) Elizabeth Paice complaining to the junior's dean in Highland (Professor Gillian Needham). The junior doctor was suspended. This caused outrage in the medical blogging and discussion forums, with many authors calling this an abuse of power by the Deans as Carol Black is a public figure and many juniors were justifiably very upset by the problems with the Modernising Medical Careers changes to junior doctor training and held that Dame Carol Black should accept responsibility for the problems that occurred."

Professor Gillian Needham is Post Graduate Dean of Medical Studies, Aberdeen University; Head of the Highland Deanery which is responsible for overseeing Dr Scot Jnr's surgeon training. (Note, she is NOT his employer so has no legal right to suspend/sack him. She allegedly prevailed upon Garry Coutts, Chair of NHS Highland (Scot's employers) to do the deed).

Thursday, September 18, 2008

NHS bullies trying to silence another doctor who dared to criticize low standards

Report from Dr Rant this morning that another doctor has been sacked for speaking out about low standards/lack of funding. The article from the local paper is here.

What isn't reported here is just as important as what is: the newspaper piece does not mention the actual reason for Dr Shirine Boardman's dismissal, except to say that "... it does not relate to any issues of patient safety or clinical competence."

This utter failure to report the real reasons for such disciplinary action and clinicians' real reasons for speaking up is almost tantamount to a 'D notice' - where editors are not allowed even to report that they are not allowed to report....

What is it that NHS chiefs are so desperate to hide?


Newspaper article follows:

Specialist doctor sacked by hospital

A Warwick Hospital consultant who set up a health project to help combat diabetes in and around Leamington has been sacked. Dr Shirine Boardman worked at the Lakin Road site as a diabetologist for eight years and established a clinic for Asian people at Leamington's Queensway Community Centre last year. She was sacked by the hospital's bosses on July 22, but is appealing against the decision.

Hospital chief executive Glen Burley said: "Dr Shirine Boardman was dismissed following an internal hearing carried out in accordance with our disciplinary procedures. "We are not going to comment in detail on the nature of the misconduct, but we can say that it does not relate to any issues of patient safety or clinical competence." Dr Boardman declined to comment until after the appeal, but said she was "passionate" about her job.

Chairman of the South Warwickshire Diabetes UK support group David Gent said: "She was our vice-president and we hope that she will continue in that role. "Her loss is going to be great. She will be very difficult to replace because she had a passion for what she did. "She gave us her full support in what we were trying to do - get better services for diabetes patients in this area. "We will have to await the outcome of the appeal, but we hope it will be in her favour and ours."

Dr Boardman was featured in the Courier in June calling for Warwickshire Primary Care Trust to improve services. She said more specialist services in the community, closer working with GPs and greater public consultation could help "transform" it. The Apnee Sehat clinic was created with Warwick University to try and reduce high levels of diabetes, heart disease and stroke in the Asian population. The research clinic, where doctors and nurses have been involved in teaching Sikhs and Hindus about managing and preventing the illnesses, was heralded by the NHS's director of GPs Professor David Colin-Thome as "the start of a new era in community care". Funded by the university and charitable grants, it has been nominated for a number of awards including the NHS's Reducing Health Inequalities social care award.

The Primary Care Trust's former director of public health Dr Tim Davies has said the clinic's future would be reassessed this year based on whether it had achieved better results than the hospital service.


"Dr. Scot" update

Re: Silencing attempt noted here on 15th.

Dr Scot Jnr. was reinstated and went back to work on 16th. The powers that be had managed to keep the story of his dismissal out of the national newspapers/television, incredibly. But bloggers and others took up the story. Once it went global, it's likely that the game was up for the young doctor's bullies.

The story doesn't end there exactly because there has been a formal complaint to the General Medical Council about these senior medical women's behaviour. This is likely to roll on interminably as state bureaucracies do. But there will be a story in that - a sort of test case even.

Wednesday, September 17, 2008

NHS productivity falls as spending rises by billions under Labour

The National Health Service has become less efficient despite Labour pumping millions into its budget. Official figures compiled by the Office for National Statistics show that the amount of treatment the NHS delivers is lagging behind the pace of increase in the service's budget. Critics said the statistics showed the NHS had absorbed huge amounts of money with very little to show for it and the Government must reform its management instead of pumping in ever more funding.

NHS productivity fell by 2.0 per cent a year between 2001 and 2005, according to the Centre for the Measurement of Government Activity, the ONS unit that monitors public spending. That was the period of the biggest funding increase in NHS history. From 2005 to 2006, productivity fell less quickly, by 0.2 per cent. From 1995 to 2006, the NHS annual budget more than doubled from 39 billion to 89.7 billion.

Andrew Lansley, the Conservative shadow health secretary, said the figures proved that Labour's approach to the NHS had failed. "Spending more money if it's not spent well doesn't necessarily deliver the services you are looking for," he said, accusing Labour's use of centralised targets and management of undermining the delivery of healthcare. As an example, Mr Lansley cited the latest central NHS contract for GPs' surgeries. A Whitehall audit earlier this year found that the contract had lead to family doctors earning 58 per cent more for doing 5 per cent less work.

The Department of Health said it was more important to focus on improvements in the quality and availability of treatment. A spokesman said: "Ten years ago people died waiting for operations, today waiting lists are at the lowest ever. The NHS is treating more patients, treating them faster and treating them more safely "It is also easier to access NHS treatment - through NHS Direct, walk in centres and at A&E where over 97% of people are now seen within four hours. And it is easier to see your GP because of extended opening hours in the evening or at weekends "There are 280,000 more doctors, nurses and other essential staff working for the NHS than in 1997 and all NHS staff have enjoyed well deserved pay rises. "Most importantly when people are asked, their experience of the NHS has improved.


Tuesday, September 16, 2008

Nasty British socialists determined to grind everyone's medical care down to a low level

A naval commander's wife is being billed for all her NHS care after paying for a drug privately

A LIEUTENANT-COMMANDER awarded an MBE for services to the Royal Navy is preparing to hand back his decoration in protest after his terminally ill wife had her free NHS cancer care withdrawn for buying a drug privately. Diane Winston, 53, who has kidney cancer, is being billed by her local trust for all her NHS care, including scans and hospital appointments, after paying privately for the drug Nexavar, which her health service consultant recommended.

Winston's husband, Lionel, 57, is so disappointed at the way his wife has been treated that he is prepared to give up the MBE, which he hangs with pride on his wall. "If this situation is not changed, in protest, I will formally return my MBE," said Lionel. "I am so disgusted by the government, and the nation that I have given the last 37 years of my life to, and for which they have awarded me the MBE, that I would give it back."

The Winstons have fallen victim to the government ban on "co-payment", under which a patient who pays privately for any treatment cannot receive free state care for the same condition.

Lionel Winston was awarded his Member of the Order of the British Empire decoration by the Queen in 1994. The ceremony was attended by his proud wife and their two sons, Sonny, now 30, and Tel, 28. Lionel, who was born in Dominica, worked his way up from the lower decks to become an officer. "From extremely humble beginnings, Lionel has come a very long way and for him to have that medal is hugely important to him. I am extremely proud of what he has achieved," said Diane. "To even think about giving it back shows the extent of his disgust."

In addition to the Nexavar, which costs about 3,000 pounds a month, Portsmouth Hospitals NHS Trust, where Diane is being treated, has also issued bills for scans costing up to 480 each. Diane's consultant is so sympathetic to her plight she has given her time for free, but the trust charges an administrative fee for every appointment.

Last week, the couple, from Gosport, Hampshire, discovered that a deposit they had paid of about 3,700, which they believed had contributed to the cost of the drugs, had been used to pay for NHS care such as scans and appointments.

Kate Spall, campaigner at the Pamela Northcott Fund, a kidney cancer group, said: "This couple have had to rely on family, friends and fundraising to buy drugs to keep Diane alive. They are now in a position where they need to pay not only for the drug their NHS consultant desperately wants Diane to have, but also for NHS services, which is absolutely scandalous."

The trust insists it advised the Winstons that their deposit would be used to pay for scans and hospital appointments and not medication. A spokeswoman said the trust was following guidelines by charging for the routine treatments.

On October 2, Lionel will hold a fundraising dinner and auction on HMS Victory in Portsmouth to raise more money for his wife's care. Diane is one of thousands of patients with advanced kidney cancer who have been denied medication on the NHS that could prolong their lives. Last month, the National Institute for Health and Clinical Excellence (Nice), the government's drugs rationing body, ruled that four drugs to treat kidney cancer, Sutent, Nexavar, Avastin and Torisel, are not good value for money despite admitting they are effective.

The decision prompted 26 leading professors of cancer medicine to write, in a letter to The Sunday Times, that the current system for assessing new drugs was not working. The Sunday Times has been campaigning to end the government ban on co-payments.

Public outrage at the way patients have been treated prompted a review of the policy. The inquiry, by Professor Mike Richards, the national cancer director, is widely expected to allow patients to top up their care. Leading health insurers are preparing to offer policies that would enable patients to buy life-saving drugs not funded by the NHS. Axa PPP and Saga are drawing up plans for the policies in anticipation of an end to the NHS ban on patients "topping up" free care by paying for private treatment.

One company, WPA, has already launched its health top-up policy, showing that the NHS ban on co-payment has begun to crumble in the face of patients demanding the right to buy the latest drugs. Fergus Craig, commercial director for Axa PPP healthcare, one of Britain's biggest medical insurers, said: "We are considering introducing policies to enable people to top up their NHS care with privately funded treatment." A spokesman for Saga added: "We are looking at how Saga health insurance might be able to provide payment for drugs that the NHS won't pay for."


Australian public hospital blamed for woman's death

ROYAL Darwin Hospital forgot to X-ray the bowel of a grandmother who died days later of septicaemia when the bowel burst, her family says. Alma June Green, 83, was admitted to the hospital after complaining of bowel pain, family members told the Northern Territory News. But while she was waiting to have an X-ray she fell out of a wheelchair and broke her leg. Doctors operated on the broken leg before sending Ms Green home. Her son-in-law, Jim Egan, said he believed the hospital staff had forgotten to X-ray Ms Green's bowel.

Ms Green died at her Palmerston flat on November 11 when her bowel burst, causing blood poisoning. Royal Darwin Hospital spokeswoman Michelle Foster said the death was reported to the coroner's office, but she could not comment further.

Mr Egan, 63, of Bakewell, said what started as a complaint of bowel pain at RDH around November 9, 2007, ended in disaster. He said his mother-in-law went in for a bowel obstruction and was admitted and booked for an X-ray. Although she could walk, she was given a wheelchair before a nurse allegedly left her waiting for the radiographer. When called to be X-rayed, Ms Green stood up and the weight of the chair pulled it over, knocking her to the ground and breaking a bone at the top of her right leg near the hip. She was taken to theatre where doctors put "all the plates and pins in".

Mr Egan said he suspected hospital staff forgot to X-ray Ms Green's bowel before she was released from hospital. "Two days later, her bowel burst and she died of blood poisoning," he said. "As far as I am concerned, it is neglect - she should have had a nurse with her. "I think they let the bowel X-ray go and it killed her."

Mr Egan said despite the great-grandmother being aged 83, she was healthy. "There was nothing wrong with her other than the bowel obstruction," he said. "I was wild, she wasn't just a mother-in-law, but a friend for over 30 years."

Justice Department spokeswoman Lorelei Fong Lim said the matter was with the coroner's office. "A decision about whether it will be an inquest or not, has not been made," she said.


Monday, September 15, 2008

Free speech punished by senior NHS doctors

The NHS is just another nasty bureaucracy

A junior doctor made a rude comment on a doctors' only forum about one of the top bananas who masterminded the plan to 'improve' doctors' training and 'career paths'. 'Modernising Medical Careers', as it's called, is very widely disliked. Its benefits seem to be mostly for employers and the government - not doctors or patients.

Our Dr Scot Jnr, who works in a Highlands hospital, made some forthright comments (which included some 'Anglo-Saxon' words) about one of the MMC architects who is a career medical politician.

He was immediately suspended from work: a high-powered London close friend of the top banana architect had seen the comment and called another chum, another big tamale medical woman, up in the Highlands. A plot - allegedly unlawful - was hatched between them, Chinese-whisperish, to silence and punish Dr Scot Jnr forthwith.

This summary activity has deep implications for the freedom of doctors to speak out against diktats they don't agree with, and it demonstrates how bullied and harassed clinical staff are. One in four junior doctors report being bullied and intimidated by senior doctors (figure from BMA report). Ultimately it has deep implications for the quality of care and treatment doctors are allowed to give patients.

Fundamentally, this silencing and intimidatory activity is an onslaught on freedom of speech for all of us. In the NHS particularly, this toxic culture is so deeply entrenched that it goes barely noticed by most, it's part of the environment like targets or management suite shagpile. This hidden culture of intimidation and fear is also the reason that so many patients are not able to get the treatment they need or the apologies they deserve when things go wrong.


Australia: Senior doctor quits 'dangerous' public hospital

A SENIOR emergency department doctor has quit one of Queensland's busiest public hospitals because it is "too dangerous and too dysfunctional". Dr Michael Cameron, senior staff specialist in emergency medicine at Logan Hospital, on Brisbane's southern outskirts, said the Bligh Government continued to ignore the problems in the health system.

He said doctors, nurses and other medical staff were under extreme pressure and patients' lives were at risk - but the Government was doing nothing to solve the crisis. "Everyone is overworked and overwhelmed . . . it had got to the point where I dreaded going to work each day, to a job I loved and was good at," he said yesterday.

Dr Cameron first spoke out about problems in Queensland's besieged health system in a frank open letter published in The Sunday Mail in May. At the time, he asked to remain anonymous, fearing that going public could have severe ramifications for himself, colleagues, patients and Logan Hospital. In his letter, Dr Cameron, who has worked for 25 years in the state's public hospitals, revealed the chaotic life in a typical hospital emergency department at Logan. His insightful words about sickness, accidents, drunken abuse, overdoses, death and miracles touched many Queenslanders.

The letter also drew an immediate response from Premier Anna Bligh and Health Minister Stephen Robertson, who met with Dr Cameron and discussed the most serious issues. Ms Bligh said at the time Dr Cameron had much to offer the Government as it continued to implement its $10 million health action plan and she vowed to turn to him for help as her special adviser. But Dr Cameron has been largely ignored since the May meeting, with neither Ms Bligh nor Mr Robertson speaking to him since.

He said one of Ms Bligh's staff had contacted him and sought his comments on proposed health funding and spending outlined in the June State Budget. Dr Cameron told him there was inadequate funding for Logan Hospital - but no extra money was provided when Mr Robertson announced a $1.2 billion boost for health for 2008-09. The doctor had also asked the Government to urgently address mental health issues at the hospital, but measures were put off for several years.

Dr Cameron said another flu-hit winter - with Logan's emergency department inundated with sick and elderly patients - was the straw that broke the camel's back. "We have seen it for eight years . . . the winter crisis. Every year the Government promised they would fix it. They said it again this year, but nothing was put in place. "It all fell over again. Every year it starts earlier, it lasts longer and is more intense. "The pressure definitely got on top of me. I just could not go through it again. I could not go through another year of that."

Dr Cameron said he decided it was time to quit, which went against all his beliefs. He even contemplated leaving the public health system altogether and finding another career. "Logan Hospital has become the dumping ground. Hospitals on the Gold Coast and in Brisbane are overflowing . . . if they are blocked they just send them to Logan. "We were overwhelmed. We could not cope. Logan (Hospital) needs to be twice the size with twice the number of staff."

Dr Cameron said other senior staff had also resigned from Logan and he felt shame for leaving the hospital in the middle of a crisis. "I felt it was personal failure . . . I should have been able to take it." He spoke to colleagues who had worked at other public hospitals in Queensland, interstate and overseas and they offered their support. "Everyone there recognises that Logan is under extreme pressure. It is too intense, too dysfunctional, too dangerous. "They had all experienced the same pressures as me. I have been there for nine years . . . I felt I could move on without any shame."

Dr Cameron confirmed reports of a system in crisis: of patients left hours without being treated, left on trolleys in corridors because there were no beds, and people dying. "The Government needs to address these problems urgently . . . but that is never going to happen, at least not in my working lifetime," he said. Dr Cameron said there had been a major recruitment program at Logan this year "but it has not had a very good response".

He has decided to stick with public health and take his emergency medical skills to Redlands Hospital, which has just undergone a $20 million upgrade. "It has a new emergency department . . . it is the right size with the right numbers . . . with limited population growth in the Redlands, it is more controlled . . . it is more closely aligned to demand. "I am looking forward to it," he said of the senior role that he will start in January.


Sunday, September 14, 2008


Two articles below

Doctor fatigue a problem in public hospitals, says coroner

A CORONER has slammed the Medical Board of Queensland for not stopping doctors working long hours, warning fatigue is a problem in many hospitals. Brisbane Coroner's Court was told yesterday that failures in the health system meant that a 10-year-old girl who had fallen from a bunk bed had very little chance of survival.

Elise Susannah Neville died on January 9, 2002, from an extensive extradural haematoma and a fracture to the left side of her skull after falling 1.4m from a top bunk bed with no guard rails in a Caloundra holiday unit two days earlier. She was taken by her parents to Caloundra Hospital but was sent home an hour later by a junior doctor who was in the 19th hour of a 24-hour shift. Elise was rushed back to hospital and then flown to Brisbane, where she later died, mainly because of delays in medical treatment, the Brisbane Coroner's Court found.

Brisbane coroner John Lock said Elise had died because Dr Andrew Doneman at the Caloundra Hospital failed to assess and diagnose the child's injuries correctly. Mr Lock yesterday also criticised the Medical Board of Queensland for failing to deliver its promised policy to regulate doctors' working hours in hospitals around the state, saying doctor fatigue was a significant problem. "The Medical Board of Queensland accepted responsibility to develop a standard or other policy alternative on doctors' working hours," he said. "It has not completed its work and should do so with priority."

He also criticised the Office of Fair Trading for dragging its feet on work to ensure all bunk beds in domestic and commercial settings were compliant with safety standards.

Outside court, Elise's parents, Gerard and Lorraine Neville, said they were relieved that the inquest was finally over and they were satisfied with most of the coroner's findings. "We believe the doctor should have been charged; the coroner doesn't feel there is evidence to support that," her father said.

But Mr Neville said he was staggered that Caloundra Hospital still would not be getting until August next year a CT scanner - which could have helped diagnose his daughter's injuries and save her life.

In 2004, Dr Doneman pleaded guilty to unsatisfactory professional conduct before Queensland's Health Practitioners Tribunal and he was ordered to be stringently supervised for one year.

Dr Lock said Queensland Health should review the capacity of rural or remote hospitals to perform emergency neurosurgical and vascular surgical procedures which may have saved Elise's life. Queensland Health director-general Michael Reid said Queensland Health had worked hard to address the issues raised by the inquest, with work still continuing.


Public hospital coverup

Some cancer patients at the Royal Adelaide Hospital are believed to have had their lives shortened by up to two weeks because of a radiation treatment bungle. An independent report into the error warns of the possibility of "a reduction in survival of up to two weeks for (five) patients who were receiving radiotherapy for high-grade brain tumours". Health Minister John Hill has ordered a second investigation into the decision by the then RAH management "to not notify patients" or the Government.

The report, tabled in Parliament yesterday, labels the error "significant" and "serious" and states 869 patients were exposed to an under-dose of radiation treatment of about 5 per cent. "In terms of error, this incident is considered significant because of the volume of patients exposed to the error," the report states. "Although . . . the overall clinical impact might be small, an error such as this can provide significant warning for a potential more serious error in the future and should be considered serious."

A review panel led by NSW radiation oncologist Professor Geoff Delaney found the under-dose on a malfuctioning radiotherapy machine at the RAH between July 28, 2004, and July 21, 2006, would not have an impact on the "vast majority" of patients. However, the panel said its "educated estimate" was the under-dose had shortened the lives of a group of brain tumour sufferers by up to a fortnight. This was said to be a "best guess". The panel also said it was not able to study every individual case or assess individual risk because that would take months. Rather, the panel consulted international literature before generally reviewing patients' diagnosis and treatment.

They then identified seven patients in three different tumour groups who may have had a "small but real" clinical impact. Aside from the five brain tumour patients, there was one head and neck cancer patient who "may have had their cancer compromised" and another prostate cancer patient who requires follow-up care. Health Department chief executive Dr Tony Sherbon said he was trying to contact the seven patients yesterday. He said 14 other patients in high-risk categories had since died. "We are not in a position to say whether the under-dosing affected their survival," he said.

The Government has accepted the report's 14 recommendations, including to hire six more staff. When the error was discovered two years ago the dosage was rectified. But the then RAH general manager Virginia Deegan, currently employed by the University of Adelaide, and the hospital's director of cancer services, Professor Dorothy Keefe, decided it was not significant enough to alert the public, the department or the minister.

Dr Sherbon only found out about the error on July 16 this year, after a complaint. He took up his position as Health Department chief executive just weeks after hospital management found out about the error. "I would have liked to have been briefed on it, yes, I would have liked to have known," he said. Dr Sherbon said that in 2006, Ms Deegan was notified by Professor Keefe, who advised "the under-dosing was not signficant and the manager (Ms Deegan) took that advice".

Although he will await the outcome of a second inquiry, by former Premier's Department chief Ian Kowalick, into the hospital's handling of the matter, Dr Sherbon said he will take any action recommended against Professor Keefe. "Mr Kowalick will make reference to the standards of public sector management," he said.

But RAH medical staff society chair Dr James Moore last night warned Dr Sherbon not to "overstep the mark". "He runs a very real risk of making it impossible to attract people to come and work in this state," Dr Moore said. "If he believes that all problems are going to be reported now, he's living in cloud cuckoo land. "The Government had been warned a good 12 months before this emerged that there was a risk of something like this happening because of the staffing problems.

Opposition health spokeswoman Vickie Chapman said the investigation should be widened to include the department.


Saturday, September 13, 2008

British watchdog's $9 million PR budget: NICE spends more on 'spin' than drug tests

The health rationing watchdog has come under attack for spending more money on spin than on evaluating drugs which could save patients' lives. The National Institute for Health and Clinical Excellence (NICE), which has been widely criticised for banning drugs from NHS use as too expensive, squandered 4.5million pounds on 'communications' last year. This was 1.1million more than the 3.4million the controversial organisation spent on assessing new medicines.

The money forked out on press officers, marketing executives and consultants included 25,000 on top public relations firm Weber Shandwick to defend NICE's ban on Alzheimer's drugs. It could have paid for 5,000 Alzheimer's sufferers to get 2.50-a-day drugs for a year. Alternatively it would have funded nearly 200 patients with advanced kidney cancer to have a drug for 12 months that would double their life expectancy. Tens of thousands of people across the country are waiting for NICE to assess drugs that could extend their lives or alleviate conditions such as rheumatoid arthritis and thinning bones.

MPs, patients groups and medical organisations branded the amount spent on communications as a 'scandalous waste of money'. Myeloma sufferer Jacky Pickles, one of the 'Velcade Three' - three mothers who launched a campaign after being denied anti-cancer drugs - said: 'It is disgraceful that money which could provide drugs that make the difference between someone living and dying is being spent on communications.' Mrs Pickles, 46, of Keighley, West Yorkshire, added: 'NICE should either use the money to improve their evaluation process, or give it back to the NHS to spend on people who are ill.'

Shadow Health Minister Mark Simmonds, who uncovered the budget breakdown tucked away in NICE's annual report, said: 'These figures typify New Labour's approach to Britain's health service. 'Thousands of patients across the country who are still waiting for NICE to evaluate new medicines will rightly be asking why Labour insists on spending more on spin than on speeding up people's access to lifesaving drugs.'

NICE has an annual budget of 34.4million pounds, and spends 1 in every 8 pounds on communications. In contrast, 1 in every 10 is spent on evaluating new drugs. The rest is spent on such things as salaries - NICE's annual report for 2006/07 revealed that wages accounted for almost 37 per cent of the budget - accommodation (eight per cent) and external contracts. Almost 300 full-time staff are employed in London and Manchester.

The watchdog looks at whether drugs are cost-effective for the NHS, with the annual cost threshold set between 20,000-30,000 pounds, above which they are considered too expensive. The 'value-for-money' calculation, which does not take into account factors such as severity of a disease, means British patients are denied drugs that are freely available abroad.

NICE was condemned recently for handing a 'death sentence' to 1,700 patients with advanced kidney disease each year who will be deprived of four life-extending drugs. One, Sutent, which costs around 24,000 a year, can double the life expectancy of patients to 28 months.

NICE has also been accused of 'dithering' over the evaluation process. It has taken several years for the watchdog to approve the use of some drugs. Chief executive Andrew Dillon was forced to make a grovelling apology last month for a two-year delay in approving a new treatment for blindness during which time many Britons lost their sight.

Michael Summers, vice-chairman of the Patients Association, said spending 4.5million on communications was 'immoral and indefensible'. He said: 'If NICE has reached the situation where it is so unpopular that it has to spend money improving its image, maybe it should be less dilatory and improve its performance.'

Nick Rijke, of the National Osteoporosis Society, said: 'I would have thought that an organisation that spends so much on communicating would be rather better at listening to the views of clinical experts and patient societies.'

NICE said the majority of its communications budget was spent informing doctors about which drugs had been approved and new guidelines for treatments, although it admitted that it had a 'small' marketing budget.

Mr Dillon said: 'The actual cost of assessing new drugs for the NHS includes money spent on NICE's behalf by the Department of Health. When you add them together, the total cost of the NICE technology appraisal programme far outstrips the cost of NICE communications.'


Australian public hospitals kill as many as the roads do

The number of deaths caused in Australian hospitals by emergency department overcrowding is equal to the road toll, a new report has revealed. The report by the University of New South Wales, in preparation for a Friday summit on emergency department access block in Melbourne, also revealed that patients face up to 30 per cent more chance of dying if they attend an over crowded emergency department. Children and the elderly are among those most likely to be affected. Queensland hospitals are among the most overcrowded in the country.

The report, prepared for the Australasian College of Emergency Medicine, suggested that increasing hospital bed numbers is the only method to reduce access block. Access block is when patients are left to wait longer than eight hours for a bed in an emergency department. "A large amount of human suffering (in emergency departments) is preventable," the report said. "There is a 20-30 per cent excess mortality rate every that is attributable to access block and ED overcrowding in Australia. "This equates to approximately 1500 deaths per year, which is similar to the road toll."

The report criticised a lack of extra hospital beds in recent years despite enormous growth in emergency department patient presentations. Bed occupancy rate should not be higher than 85 per cent. "There are not enough available beds to meet demand," the report said. "This results in access block and ED overcrowding. "This is associated with significant mortality and human suffering."

The report claimed that telephone hotlines and after-hours GP clinics did little to improve access block. It also criticised methods of treating patients in non-treatment areas such as hospital corridors and waiting rooms. "Access block and overcrowding have also been associated with increased return rates of hospital re-admissions, return visits to the ED, and inappropriate follow-up care," the report said.


Friday, September 12, 2008

Cancer patient with months to live wins court order for last-chance drug on NHS

A cancer patient yesterday won a legal battle against the NHS to be given a drug that doctors say could prolong his life by up to three years. Colin Ross, 55, of Horsham, West Sussex, has multiple myeloma, a cancer of the blood cells, and was not expected to survive to see Christmas unless he was given a drug described as his “last chance”. The High Court overruled the decision by West Sussex Primary Care Trust that treatment would not be cost-effective, and said that Mr Ross should receive Revlimid as an exceptional case.

Mr Ross had incurable cancer diagnosed in May 2004. In an interview with The Times last month he said that he was “sickened” that he was being denied the $60,000-a-year treatment even though the drug was available to patients living only a few miles away in East Sussex. But despite the exhortations of doctors treating Mr Ross at the Royal Marsden Hospital, the specialist cancer hospital in London, the trust had, since March, repeatedly refused to fund the drug, raising the issue of a so-called postcode lottery for NHS treatments.

However, Judge Simon Grenfell, sitting in London, condemned the trust’s decision yesterday as “one which no reasonable authority could have made on the application before it”. Revlimid is among the most expensive of new cancer treatments and is readily available to patients across Europe and in the United States and Scotland. But it has not yet been granted approval by the National Institute for Health and Clinical Excellence (NICE) and, because of the cost, is likely to be rejected. It is provided by only some trusts in England and then only in exceptional circumstances.

The case is likely to encourage other cancer patients who may have been denied expensive drugs on the NHS, but experts emphasise that the case does not set a legal precedent and that decisions will be taken case by case in other areas. The judge issued an emergency injunction to enable Mr Ross to begin treatment today, but the ruling was made on an interim basis pending a further appeal and not as the start of permanent treatment.

Mr Ross was too ill to attend court for the ruling but his long-term partner and carer, Wendy Forbes-Newbegin, 52, who has breast cancer, cried after the victory. She said after the judgment that the family’s treatment by the NHS had been “appalling”. “The mental anguish that we have been through has at times been unbearable, and wholly unacceptable in this day and age,” she said. “Colin’s diagnosis and recent prognosis have been so awful in the first place, but to have to endure all the months of waiting for this life-prolonging treatment has been nothing short of shameful in the first degree.”

Mr Ross, who has two children and four grandchildren, told The Times that he feared that delays incurred by his appeals to the trust and ensuing legal action may have reduced the effectiveness of the treatment. “Depending on what the judges say, I could start treatment with Revlimid, or the doctors will simply refer me to start receiving palliative care,” he said last month. “My bed in the hospice is already booked. I realise the drug is expensive for the NHS, but to think that I could have a few extra months or years to spend with my daughters and watch my grandchildren grow up – I’ve never wanted anything more.”

The former engineer in the oil and gas industry had suffered years of pain and disability from the disease, which made his bones brittle and prone to fracture. He had already been prescribed other drugs on the NHS for myeloma, Thalidomide and Velcade, but was forced to stop taking them because of painful side-effects. Before yesterday’s ruling he was taking a cocktail of painkillers and other drugs “just to keep my head above water”, and was advised that Revlimid was now the only option.

In March, Mr Ross’s clinicians asked West Sussex PCT to fund Revlimid for three to four courses at a cost of $10,000 a course and presented evidence to show that it could give Mr Ross up to three more years of life. He had been unable to purchase the drugs privately, he said. “Even if I could, the law states that I would have to become a private patient and forfeit the rest of my NHS care.”

Richard Clayton, QC, acting for Mr Ross, told the court during a two-day hearing: “This application for this drug is the end of the road for him. Either he gets the drug and is able to have life-prolonging treatment, or he doesn’t and treatment ceases, with inevitable consequences.” He added: “Were the claimant to live a mile and a half in either direction from where he does, he would have received the drug.” West Sussex PCT said that it was considering whether to appeal. [What total, complete and utter assholes!]


Australia: Perverted doctor charged over mutilation of women

This should have been done many years ago -- when the complaints first began. Yet another regulatory failure

A FORMER New South Wales doctor has been charged in relation to alleged sexual assaults and genital mutilations of patients who were undergoing surgery. Graeme Reeves, 58, who was banned from practising obstetrics by the Medical Board in 1997, has been charged with 17 offences against 10 women, Detective Superintendent John Kerlatec said.

Mr Reeves was arrested in the Sydney suburb of Baulkham Hills this morning after extensive investigations into more than 113 allegations of patient misconduct between 2001 and 2003 at Baulkham Hills and at Bega on the state's south coast. The Daily Telegraph was on the scene when Mr Reeves was brought in to a local police station at about 6.45am (AEST) in the back of an unmarked police car.

"It's been a lengthy investigation due to the fact there have been numerous people we've had to speak to including in excess of 100 (alleged) victims and witnesses, medical professionals, plus also examine numerous medical records," Supt Kerlatec said earlier on Macquarie Radio. "We also had to engage our own medical expert to give us advice on the difference between malpractice and what we consider to be criminal action. "This is the first investigation of this size and nature conducted by the NSW Police force and officers are treating the matter very seriously," the Daily Telegraph quoted him as saying.

Police from Strike Force Tarella raided a storage unit allegedly belonging to Mr Reeves last week at Gladesville in Sydney's northwest, where officers allegedly located a raft of medical documents. Mr Reeves is expected to face court today, but police said the probe was continuing. "Today's arrest marks the first phase in this lengthy and complex investigation and inquiries are ongoing," Supt Kerlatec said.

He praised the courage of the former patients of Mr Reeves who had come forward with their allegations. "We were extremely encouraged throughout this whole matter by the strength displayed by these women," he said. "It's been a very traumatic experience for them and it's taken a great deal of courage for them to come forward."

Mr Reeves' appointment by the Southern Area Health Service in 2002 has been examined by Peter Garling SC as part of his wider investigation into the NSW public hospital system. He found that when Mr Reeves applied in 2002 there were "deficiencies" in the system that meant authorities failed to detect he had been banned from practising obstetrics. "I find that Dr Reeves' intentional and calculated dishonesty was the main reason he was recruited to a position he was legally unable to fill," Mr Garling wrote in his report.


Australian public medicine at work

On a day the State Government promised to fast-track compensation for as many of 100 of Graeme Reeves' alleged victims one woman tells her story in the hope of creating a more accountable health system

MY DAUGHTER Sarah was delivered by Graeme Reeves at Hornsby Hospital in 1995 - her heart rate was falling, she was in foetal distress and he didn't care. The nurses kept coming back to me saying he wouldn't come in, he wanted them to fax through a copy of the foetal heart monitoring strip because he didn't believe them. I had visited him earlier that day and had an ultrasound and everything was OK, I went into labour that night and the nurses rang him at home and he said 'You couldn't be in labour, you're only 34 weeks'. He got me mixed up with another woman, I was 38.5 weeks.

By the time he arrived and delivered her, Sarah was dead. She was revived, it took some time before she took her first breath and I never really saw him again after that. Sarah has cerebral palsy. It is quadriplegic spasticity which means it affects all four limbs. She's blind, she has an intellectual disability and epilepsy, she is in a wheelchair, she has no communication and is reliant on me for everything. The midwives gave me my paperwork when I left the hospital and said 'you might need this one day'. It was that comment that kept in my head. At the time I was sleep deprived and Sarah was fighting to survive but they knew. That is the sad part. I know nurses complained, a lot of nurses complained but what happens to nurses who complain? They get crucified.

I don't work any more, Sarah is 24/7 care, I have equipment costs, medication costs, I have to lift her in and out of our car because I can't afford to have a wheelchair conversion done, which is about $25,000. We're in hospital at least once every year for several weeks a year. She has had six hip operations, she had more than 100 per cent scoliosis of the spine.

But as much as our family has suffered, it is Sarah who paid the ultimate price, it is her life. She has been deprived of the life she should have had and, while we're doing everything to give her the best life possible, it is nothing compared to what she should have had. She would have been one of these kids that is always running. Sarah is beautiful and we love her to death but the Government was supposed to be protecting us from people like Graeme Reeves. There is no system to provide that protection. Sarah loves life, she is a fighter, she loves music and people. Going out in the car, going for coffee and shopping are some of her favourite things, she is such a girl.

I wrote to the Health Care Complaints Commission in 1997. They wrote back to me that the public interest had been served, Graeme Reeves was no longer practising as an obstetrician and his gynaecological business was under supervision. I was happy no one else could be injured by this man but I still protested to have my individual case investigated. I did the right thing, I put in a complaint with the HCCC. That was the system and the system didn't work, it doesn't protect anyone. When it came out in the media in February, that's when I learnt they hadn't done what they had said, he had been practicing that whole time and no one had been supervising him. I felt sick.

We took action against Hornsby Hospital and Graeme Reeves and that's when we found out Reeves was theoretically uninsured and bankrupt. I had a statement of claim against Hornsby Hospital. It was at a time when the full history of Dr Reeves wasn't known and we had to withdraw from our action in 2003. I had to sign a consent judgment to release us with no costs, which means I could not make another claim. With all this new information and the fact there were 35 complaints received at Hornsby Hospital between 1986 and 1997, I wanted to apply to make another claim with the Government's insurance company. They have rejected us.

My lawyer wrote to Hornsby Hospital lawyers in July asking for their consent for the judgment in favour of the hospital from 2003 to be set aside. It was the only way I could make another claim and it was met with outright refusal.

Former health minister Reba Meagher said in February: "I want to assure the community the NSW Health system will take responsibility for any failings of public hospitals relating to Dr Reeves' practice." The Government has not fulfilled its duty to protect Sarah and cover her needs. It is not interested in my daughter. I am happy charges have been brought against Graeme Reeves for allegedly assaulting women but it should never have got to this point.