Thursday 27 August 2009

'Cruel and neglectful'


The Patients Association report is all over the Blogosphere and the media today, the Telegraph has the usual.

'Cruel and neglectful' care of one million NHS patients exposed

One million NHS patients have been the victims of appalling care in hospitals across Britain, according to a major report released today.

In the last six years, the Patients Association claims hundreds of thousands have suffered from poor standards of nursing, often with 'neglectful, demeaning, painful and sometimes downright cruel' treatment.

The charity has disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff.

The Patients Association said the dossier proves that while the scale of the scandal at Mid-Staffordshire NHS Foundation Trust - where up to 1,200 people died through failings in urgent care - was a one off, there are repeated examples they have uncovered of the same appalling standards throughout the NHS.

While the criticisms cover all aspects of hospital care, the treatment and attitude of nurses stands out as a repeated theme across almost all of the cases.

They have called on Government and the Care Quality Commission to conduct an urgent review of standards of basic hospital care and to enforce stricter supervision and regulation.

Tell me about it, I have seen first hand the “treatment” given to Mrs. A, I have seen the arrogance of doctors, consultants and nurses, and the lack of diagnostic skills, nursing skills and “people” skills.

I have told every “power that be” about it, and their response? Nothing: cover ups, protection of medics, hospitals and CEOs, I have seen the lack of understanding by the same, and the indifferent attitude of Medical staff.

The NHS is a wonderful institution, and the majority of treatment given is good, the Mid Staffs thing was only a one of because of the scale of deaths and bad treatment, but it happens in all hospitals, I have said this before and I will reiterate, poor medical treatment is caused by poor attitude of staff, poor training, and worst of all poor management, not the “top floor” management but the frontline management.

There is a basic lack of training of frontline management, and screaming about lack of staff and resources is not the answer, the answer is “speak up”, don’t moan about it, get off your arse and DO SOMETHING about it.

But staff won’t because of the threat to their jobs, whistleblowers are usually fired, doctors won’t say anything because the GMC will pounce on them and take away their livelihood, consultants won’t say or do anything because they are already at the top and it “isn’t their concern”.

Time was when you could get things done by clubbing together and making changes, but not anymore, we have become insular, someone else’s’ problem is ignored because it would involve doing something and the attitude today is-let somebody else do it, not my problem, as long as I am alright sod the rest.

This is fine until it happens to you, until you go into hospital for a “routine” operation and end up in ICU for 23 days, then die from cancer because it was not diagnosed, then the screams will begin, then it will matter, but by then it will be too late.

What we must remember is that we are all patients, and the treatment given to others could very well be the treatment you receive when it is your turn.


Angus

Angus Dei on all and sundry

AnglishLit

Angus Dei politico

Saturday 22 August 2009

Gosport War Memorial Hospital deaths-GMC decision delayed until 2010



From Portsmouth today

Earlier post is here

The doctor at the centre of elderly patient deaths at a hospital could face harsh consequences for her actions – even if she is not struck off.

A General Medical Council disciplinary panel has a choice of five sanctions if they find Jane Barton's fitness to practise is impaired.

Dr Barton has admitted a string of allegations relating to her care and treatment of 12 patients at Gosport War Memorial Hospital between 1996 and 1999.The News reported yesterday that following a 10-week hearing the five-strong panel has found her guilty of prescribing 'potentially hazardous' doses of powerful painkillers and sedatives to patients on Dryad and Daedalus wards where she was clinical assistant.Examining the GP's conduct they also found wide dose ranges she prescribed could have led to some patients being overdosed.They said she was guilty of poor note-keeping and prescribing drugs that were inappropriate and not in the best interests of some patients.The panel has now adjourned and will reconvene in January.

They will then hear legal submissions relating to 220 charges proved and then decide whether those findings amount to serious professional misconduct by Dr Barton

The panel will then decide what sanctions – if any – should be imposed.

It has already found evidence 'would not be insufficient' to support her being found guilty of serious professional misconduct.

A General Medical Council spokesman said: 'If the panel concludes that the doctor's fitness to practise is impaired, the following sanctions are available – to take no action, to accept undertakings offered by the doctor provided the panel is satisfied that such undertakings protect patients and the wider public interest, to place conditions on the doctor's registration, to suspend the doctor's registration or to erase the doctor's name from the medical register, so that they can no longer practise.

'Dr Barton – who denies serious professional misconduct – is subject to seven restrictions on her license imposed after the General Medical Council launched its investigation in July last year.

They include a ban on prescribing the powerful painkiller diamorphine.

Any bets on sanctions? Or not as the case may be.

I make no other comments, because I am expecting the GMC to perform to its usual level of competence.

Angus

Angus Dei on all and sundry

AnglishLit

Angus Dei politico

Friday 21 August 2009

GMC-still can’t organise a piss up in a brewery


BBC NEWS Wales Inquiry into exam error doctors

Four medical students were told they passed their finals when in fact they had failed, must be investigated, the General Medical Council has said.

The medics, who had started work at hospitals in south and west Wales, have now been suspended from duty.

The hospitals are reviewing the cases of patients seen by the junior doctors as a precaution and suspended them.

Cardiff University said it "fully recognises and regrets the resulting circumstances".

The four students had been working as junior doctors at Llandough Hospital in Cardiff, Swansea's Morriston hospital, Prince Philip Hospital in Llanelli and Withybush Hospital at Haverford west, Pembrokeshire.

A statement from Hywel Dda NHS Trust said it had been informed of the error in the exam results of two junior doctors who have now been relieved of their clinical duties at Prince Philip and Withybush.

"They had been practising for no more than eight days and were heavily supervised. However, as a precaution, the trust is reviewing the care of patients seen by the students."

Ian Lane, medical director at Cardiff and Vale NHS Trust, said it had "no choice" but to relieve the junior doctor of her duties after being informed of the error.

"I offer her my sympathy and encouragement to continue with her medical career," he said.
Abertawe Bro Morgannwg (ABM) University NHS Trust, which is responsible for Morriston in Swansea, also said the junior doctor they had employed was immediately relieved of clinical duties.

"The member of staff had been practising for less than 10 days, and this time included induction sessions," a trust statement read.

"All foundation programme trainees are heavily supervised and would have formed just one part of the wider clinical team caring for patients.

"No significant decisions about the medical care of a patient would have been made without the involvement of a more senior doctor.

The General Medical Council (GMC) said it will be asking the university to begin and investigation and to demonstrate that action will be taken to prevent a reoccurrence.

"We have spoken to each of the students affected to explain that we will have to remove their names from the medical register, we will refund their registration fee in full," a spokesman said.



GMC Role of the GMC

The purpose of the General Medical Council (GMC) is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.

The law gives us four main functions under the Medical Act 1983:

· keeping up-to-date registers of qualified doctors
· fostering good medical practice
· promoting high standards of medical education
· dealing firmly and fairly with doctors whose fitness to practise is in doubt.

Not the “doctors’” fault, it is the Universities, but it is the GMC’s responsibility.


Angus

Angus Dei on all and sundry

AnglishLit

Angus Dei politico

Monday 17 August 2009

The GMC, couldn’t organise a piss up in a brewery


They really are in another world is the GMC, The doctor who has been suspended from practising in the UK after failing to spot Baby P's broken back two days before he died is still entitled to work in Ireland.

Dr Sabah Al-Zayyat was the last medic to see tragic toddler Baby P and failed to notice his injuries – inflicted after horrendous abuse by his mother, her boyfriend and their lodger.

Dr Al-Zayyat (53) was suspended from practising by the General Medical Council in the UK last November while an investigation takes place.

A spokesperson for the Irish Medical Council told the Herald: “Dr Sabah Al-Zayyat’s name is entered on the General Division of the Register of Medical Practitioners and as such she is entitled to work in Ireland.

“The Medical Council is aware of matters under consideration by the General Medical Council that are in the public domain.”

Meanwhile, it is understood that Dr Al-Zayyat is suing Great Ormond Street Hospital, London, for unfair dismissal following the decision not to renew her fixed term contract.

She is expected to claim that she was never shown the child’s medical history and so was not given an opportunity to realise he was the long-term victim of abuse.

Her case may also focus on a shortage of doctors at St Ann’s Hospital in Tottenham, which is run by the Great Ormond Street Hospital NHS Trust.
Lawyers are also likely to argue that she is a scapegoat for wider failings in the child’s care. Last year she issued a statement saying: “Like everyone involved in this case, I have been deeply affected by the shocking and tragic circumstances of this young child’s death.”

She added that her professional career had been devoted to the care of children. Baby P, whose name has recently been revealed as Peter, died after months of sadistic torture in one of the worst cases of child abuse the UK has ever seen.

Dr Al-Zayyat has previously worked in a number of hospitals in Ireland between 1999 and 2006.

They HSE told the Herald that it has no records of complaints against her.

How does the GMC tenet go again? Oh yes:

The duties of a doctor registered with the General Medical Council

Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and you must:

Make the care of your patient your first concern

Protect and promote the health of patients and the public

Provide a good standard of practice and care

Keep your professional knowledge and skills up to date

Recognise and work within the limits of your competence

Work with colleagues in the ways that best serve patients' interests

Treat patients as individuals and respect their dignity

Treat patients politely and considerately

Respect patients' right to confidentiality

Work in partnership with patients

Listen to patients and respond to their concerns and preferences

Give patients the information they want or need in a way they can understand

Respect patients' right to reach decisions with you about their treatment and care

Support patients in caring for themselves to improve and maintain their health

Be honest and open and act with integrity

Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk

Never discriminate unfairly against patients or colleagues

Never abuse your patients' trust in you or the public's trust in the profession.

You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions.


And the GMC tenet for itself:

The purpose of the General Medical Council (GMC) is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.

The law gives us four main functions under the Medical Act 1983:

Keeping up-to-date registers of qualified doctors

Fostering good medical practice
Promoting high standards of medical education

Dealing firmly and fairly with doctors whose fitness to practise is in doubt.

Protecting the public

The General Medical Council is the independent regulator for doctors in the UK. Our statutory purpose is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.
We do that by controlling entry to the medical register and setting the educational standards for medical schools. We also determine the principles and values that underpin good medical practice and we take firm but fair action where those standards have not been met.

We have strong and effective legal powers designed to maintain the standards the public have a right to expect of doctors. We are not here to protect the medical profession - their interests are protected by others. Our job is to protect patients
.
Where any doctor fails to meet those standards, we act to protect patients from harm - if necessary, by removing the doctor from the register and removing their right to practise medicine.
Independence and accountability

Patients’ interests are best served by independent, accountable regulation. The GMC must be independent of government as the dominant provider of healthcare in the UK; independent of domination by any single group; and be publicly accountable for the discharge of its functions.
Independent, accountable regulation must:

Put patient safety first

Support good medical practice

Promote fairness and equality and value diversity

Respect the principles of good regulation: proportionality, accountability, consistency, transparency and targeting

Yeah right!

Wednesday 12 August 2009

Is there a point to Tamiflu?


The Tamiflu debate rages on, should we, shouldn’t we?

Not being a medic I suppose I can see some point, but the Gov has spent hundreds of millions on Tamiflu which is rapidly approaching its sell by date, to treat, as far as I can tell a minor but highly infectious illness.

It seems that the people most at risk are children, but Tamiflu cannot be given to under one year olds, and side effects are beginning to emerge; “Between April 1 and August 6 there were 418 reports, of which 125 were received in the last week alone.

The 418 reports detailed 686 suspected adverse reactions, including allergy to Tamiflu and nausea. The Medicines and Healthcare products Regulatory Agency (MHRA) is collecting data on suspected side effects - not all of which are confirmed as being caused by the drug.

Tamiflu, which is manufactured by Roche, has vomiting and nausea listed as its main side effects on its packaging.

A total of 11 per cent of adults and adolescents taking the drug experience nausea and 8 per cent have vomiting, according to the summary of product characteristics.

Headaches are another side effect when the drug is taken preventatively rather than as a treatment.

In children, the most commonly reported side effect is vomiting, with 15 per cent suffering it and 10 per cent having diarrhoea.

A total of 3 per cent of children will get nausea and 5 per cent have reported abdominal pain.

Clinical studies accepted by health bodies in the UK and worldwide show that the drug should not aggravate asthma.

A total of 4 per cent of children with asthma experienced worse asthmatic symptoms when taking the drug - the same proportion as in a group of asthmatic children taking a dummy drug.
The study, on 334 asthmatic children aged six to 12, found the drug did not help cut the length of the illness.

But by the last day of treatment (day six) the lung function was better in children taking Tamiflu, with their Forced Expiratory Volume having increased by 10.8 per cent compared with 4.7 per cent among those on the dummy drug.

The Government has 23 million treatments of Tamiflu and 10.5 million treatments of another anti-viral, Relenza.”

An MHRA spokesman said: “We have allocated a dedicated section of our website to receive reports of side effects to Tamiflu and Relenza from doctors and the public in order to spot any developing trends.

“We have set up this specific site so that people can log on and report any potential side effects.
“This will assist us in monitoring the safety of these anti-viral medications.

“A report of a reaction does not mean it has been caused by the drug in question - a mere suspicion will suffice.

“The MHRA is very keen to promote this website as we want people to know about it and use it - http://swineflu.mhra.gov.uk/.”

I still fail to see what all the fuss is about, it’s FLU for god’s sake, some people won’t even know they have it, many people think they have it and demand Tamiflu from the “help line”, a lot of people will use it as an excuse to have a week off work, hysteria and panic are rife, the media are still upping the panic rating, but most of us will carry on as normal, if we get it we will retire to bed for a few days and get on with life.

I wonder that if the Gov hadn’t paid out all this money for a fairly pointless drug there would be all the hype, are they just trying to justify what seems to me to be yet another fiscal cock up by Gord and his gang.

Monday 10 August 2009

Another Labour legacy

Hospitals to cut services to pay for £60bn private finance deal



From:- http://www.telegraph.co.uk/health/healthnews/5995025/Hospitals-to-cut-services-to-pay-for-pay-60bn-private-finance-deal.html

Hospitals will be forced to make cuts to pay for a massive rise in the bills for Labour's controversial private finance programme after the next general election.
Whitehall documents seen by The Sunday Telegraph reveal a financial bombshell which will hit the next Government.

The cost of NHS building deals agreed since 1997 will swell by almost one quarter from 2011 to 2014, necessitating billions of pounds in "efficiency savings", which are already being drawn up by trusts.
Economists described the pressures about to hit the health service as "horrendous" while opposition politicians warned that taxpayers and patients were about to pay the price for "financial recklessness on an unprecedented scale".

More than 100 NHS trusts are operating private finance initiatives (PFIs) agreed since 1997. Under the deals, private companies build hospitals and lease estates and services back to the health service over a period of around 30 years.

Of a total £60 billion debt owed to the developers, less than £5 billion will have been paid to them by the time of a likely general election next May, the document, disclosed under the Freedom of Information Act, shows.

The contracts allow trusts to build hospitals that they could not afford to pay for outright, with the bills excluded from Britain's public sector borrowing limits, allowing the Government to take on more debt.

Repayments during the next spending review period – from 2011 to 2014 – will reach £4.18 billion, almost £1 billion more than current levels, according to the documents, sent from the Department of Health to the Treasury.

The steep increases come as the NHS prepares for its annual budget to be frozen, meaning cuts in real terms as PFI and other costs rise.

As a result, hospitals have been ordered by Sir David Nicholson, the NHS chief executive, to make "efficiency savings" of at least £15 billion over the same period.

The Department of Health returns to the Treasury show the £60 billion total cost of the schemes to taxpayers is more than five times the capital value of the buildings. Annual payments will rise from less than £500 million at the last election, in 2005, to £1.5 billion by 2014, peaking at £2.2 billion by 2029.
Something else the Gov has cocked up.
Angus

Thursday 6 August 2009

Taking the money and the piss

Hospitals are making more than £111 million a year for car parking, according to new figures.

The overall amount made by NHS trusts was up from the £102 million they made the previous year, with 23 hospitals collecting more than £1 million each from parking during 2007-08.

Addenbrooke's in Cambridge came top of the list, making £2.8 million from patients, according to figures obtained by the Liberal Democrats. Welsgrave Hospital in Coventry made £2.7 million, while Southampton General made £2 million.

The hospitals, which charge hourly rates from between of up to £4, have been accused of "taxing the sick" as many of them fail to publicise discount schemes in place for people with long-term illnesses.

Norman Lamb, the Liberal Democrat health spokesman, said: "This is a staggering amount of money for the NHS to be making from car parking charges.

"Many hospitals are still not offering real discounts to those with chronic illnesses and are effectively operating a tax on the sick."

Duleep Allirajah, policy manager from Macmillan Cancer Support, said: "It is appalling that hospitals are making money from vulnerable patients, visitors and staff and that their profits are increasing year on year. It is morally wrong that cancer patients undergoing regular treatment for a potentially life-threatening disease should be forced to pay unavoidable travel costs such as hospital parking.

"Hospitals are either ignoring guidance issued over two years ago, which said that people travelling regularly to hospital must get free or reduced parking, or not making patients aware of the concessions they have in place."

Earlier this year the NHS Confederation said that cark parking fees were "often necessary" because running car parks was expensive, while they were also useful to deter non-visitors from taking up space.

While the NHS in England makes £111 million, charges have been abolished in all but three hospitals in Scotland while they are all being phased out in Wales.

And what happens to the money?

Angus

Angus Dei on all and sundry

Angus Dei politico

Saturday 1 August 2009

Well there’s a surprise


Organic food is no healthier than ordinary food, a large independent review has concluded.

There is little difference in nutritional value and no evidence of any extra health benefits from eating organic produce, UK researchers found.

The Food Standards Agency who commissioned the report said the findings would help people make an "informed choice".

But the Soil Association criticised the study and called for better research.

Researchers from the London School of Hygiene and Tropical Medicine looked at all the evidence on nutrition and health benefits from the past 50 years.
Among the 55 of 162 studies that were included in the final analysis, there were a small number of differences in nutrition between organic and conventionally produced food but not large enough to be of any public health relevance, said study leader Dr Alan Dangour.

Overall the report, which is published in the American Journal of Clinical Nutrition, found no differences in most nutrients in organically or conventionally grown crops, including in vitamin C, calcium, and iron.

The same was true for studies looking at meat, dairy and eggs.

Differences that were detected, for example in levels of nitrogen and phosphorus, were most likely to be due to differences in fertilizer use and ripeness at harvest and are unlikely to provide any health benefit, the report concluded.

The review did not look at pesticides or the environmental impact of different farming practices.

"This study does not mean that people should not eat organic food.

"What it shows is that there is little, if any, nutritional difference between organic and conventionally produced food and that there is no evidence of additional health benefits from eating organic food."

She added that the FSA was neither pro nor anti organic food and recognised there were many reasons why people choose to eat organic, including animal welfare or environmental concerns.

Peter Melchett, policy director at the Soil Association said they were disappointed with the conclusions.

"The review rejected almost all of the existing studies of comparisons between organic and non-organic nutritional differences.

"Although the researchers say that the differences between organic and non-organic food are not 'important', due to the relatively few studies, they report in their analysis that there are higher levels of beneficial nutrients in organic compared to non-organic foods.

"Without large-scale, longitudinal research it is difficult to come to far-reaching clear conclusions on this, which was acknowledged by the authors of the FSA review.

"Also, there is not sufficient research on the long-term effects of pesticides on human health," he added.


But the good news is that it costs twice as much.


Angus

Angus Dei on all and sundry

Angus Dei politico