Indian doctor faces being struck off after ignoring ‘persistent’ symptoms of cancer victim for six years
A GP who ignored a cancer patient’s symptoms for six years faces being struck off. Dr Navin Shankar dismissed 26-yearold Nicola Sams’s irregular bleeding and abdominal pains as ‘ nothing to worry about’.
She died of cervical cancer that had spread to her spine, neck and arms and left her unable to walk or move her hands. The extent of the disease was only discovered when Miss Sams fractured her neck in a car accident. She had an emergency hysterectomy in May 2006 but died a year later.
Shankar was yesterday found guilty of serious misconduct at the General Medical Council. He has been declared unfit to practise without restrictions after failing a series of knowledge and skills tests.
In a letter to the GMC a month before her death, Miss Sams explained the disease. She wrote: ‘Nothing positive came from my numerous meetings with Dr Shankar. ‘I was generally cut off by him and he would tell me “there’s nothing to worry about young lady”. ‘I begged him, please can I be sent to the hospital to have a camera put inside me.’
But every time she visited Shankar between 1999 and 2005 at the Wigmore Lane Health Centre in Luton, he told her there was nothing to be concerned about, the hearing was told.
She added: ‘I have an occurrence of cancer half way up my spine, at the base of my neck, an occurrence of cancer in my lung. ‘I have pains in my hands which don’t function. This means it is cervical cancer which has spread because my original condition was not diagnosed early enough.’
Her father Mike Sams told the hearing: ‘There was absolutely no progress made. The thing that was said every time was there was nothing to worry about and a different diagnosis came back.’
Just after the desperate hysterectomy Miss Sams begged her father to ‘make sure he [Dr Shankar] does not do this again’. Her father became her full time carer but she died a month later at their Luton home, on August 14 2007.
Miss Sams had registered with another doctor months before her accident, after Shankar was banned from his practice for another incident of malpractice. The 60-year-old was found guilty of misconduct after he failed in the care of nine-day old baby Daniel Miller in September 2003. He sent the infant home despite the fact that his foot had turned blue and was cold to touch.
The child had a life-threatening blood clot, and became so ill he lost almost a third of his body weight and his toes became gangrenous.
At yesterday’s hearing, Shankar, was found guilty of 10 of the 11 charges relating to his treatment of Miss Sams between 1999 and 2005. He was found guilty of failing to record Miss Sams’ symptoms, failing to carry out an abdominal examination, failing to keep adequate-records and failing to refer her to hospital.
GMC chairman Dr Surendra Kumar said: ‘The concerns raised by your actions are multiple and wide-ranging. The panel therefore determined that your actions amounted to misconduct and that it is serious.’
Shankar achieved an ‘ unacceptable’ rating in many simulated and knowledge tests before the hearing. In one case he failed to even consider the signs of a woman’s depression. In another he did not refer a man for prostate tests despite signs of cancer.
The GMC panel will decide what sanction to impose on the doctor’s registration. It could place conditions on his licence, suspend him or remove him from the register.
The medicalization of life marches on: Being physically inactive is ‘a disease’
Another excuse for government invasion of private life. Compulsory drill for everyone? Computer nerds taken away from their parents like fat kids now sometimes are?
The excuse is that that making people more active would pay off as preventive medicine. But, despite the popularity of the concept, preventive medicine measures are not in general cost-effective. They have very little impact and cost more than they save: “Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not”
Physical inactivity should be classed as “disease in its own right”, a pair of leading public health experts have proposed. Dr Richard Weiler and Dr Emmanuel Stamatakis have put forward the idea because they say the the link between inactivity and poor health is so strong.
Writing in the British Journal of Sports Medicine, they explained: “Given the significant associated mortality and morbidity, we propose that perhaps physical inactivity should also be considered for recognition as a disease in its own right.”
Obesity is already classed as a disease by the World Health Organisation, noted Dr Richard Weiler, a specialist registrar in sports and exercise at Imperial College Healthcare and a GP. But he said obesity was often at least partially the result of a deeper cause – not doing enough exercise.
Speaking about the article, he said: “Money is pumped at treating the symptoms of physical inactivity – at obesity, diabetes, hypertension, heart disease – but not at the root cause.”
He added: “It is neglected because of the way that modern medicine is taught and the way the NHS is run. “We need to put the health back into the NHS – we need to promote wellness as well as treat illness.” In May Dr Weiler said that the evidence showed that lack of fitness was the root cause of more illness than being fat. Despite such evidence, he said it remained the poor relation of the public health family.
He said GPs should be financially rewarded for promoting exercise through the Quality and Outcomes Framework, an action which he estimated would cost £1 million. This was “peanuts” set against the estimated cost of problems associated with lack of exercise, of £8.2 billion a year, he argued.
His comments follow those made at the weekend by Prof Steve Field, chairman of the Royal College of General Practitioners, who said many people needed to “face facts and take responsibility” for their own health.
Dr Weiler said recent studies showed only one in 20 people took the minimum amount of recommended exercise, but there was still “no co-ordinated plan” to tackle the problem.
He and Dr Stamatakis, of University College London, concluded in their paper: “Can we afford to leave physical activity promotion in primary care as the ‘would-be-nice’ preventive option, offered typically in the form of unstructured advice by inadequately trained professionals?”
Some alarming bacterial evolution
PLASTIC surgery patients have carried a new class of superbugs resistant to almost all antibiotics from South Asia to Britain and they could spread worldwide, researchers say.
Many hospital infections that were already difficult to treat have become even more impervious to drugs thanks to a recently discovered gene that can jump across different species of bacteria.
This so-called NDM-1 gene was first identified last year by Cardiff University’s Timothy Walsh in two types of bacteria – Klebsiella pneumoniae and Escherichia coli – in a Swedish patient admitted to hospital in India.
Worryingly, the new NDM-1 bacteria are resistant even to carbapenems, a group of antibiotics often reserved as a last resort for emergency treatment for multi-drug resistant bugs.
In the new study, led Walsh and Madras University’s Karthikeyan Kumarasamy, researchers set out to determine how common the NDM-1 producing bacteria were in South Asia and Britain, where several cases had turned up. Checking hospital patients with suspect symptoms, they found 44 cases – 1.5 per cent of those screened – in Chennai, and 26 (eight per cent) in Haryana, both in India.
They likewise found the superbug in Bangladesh and Pakistan, as well 37 cases in Britain, where several patients had recently travelled to India or Pakistan for cosmetic surgery. “India also provides cosmetic surgery for other Europeans and Americans, and it is likely that NDM-1 will spread worldwide,” said the study, published in the British medical journal The Lancet.
NDM-1 was mostly found in E. coli, a common source of community-acquired urinary tract infections, and K. pneumoniae, and was impervious to all antibiotics except two, tigecycline and colistin. In some cases, even these drugs did not beat back the infection.
Crucially, the NDM-1 gene was found on DNA structures, called plasmids, that can be easily copied and transferred between bacteria, giving the bug “an alarming potential to spread and diversify,” the authors said.
“Unprecedented air travel and migration allow bacterial plasmids and clones to be transported rapidly between countries and continents,” mostly undetected, they said.
The emergence of these new drug-resistant strains could become a serious global public health problem as the major threat shifts toward a broad class of bacteria – including those armed with the NDM-1 gene – known as “Gram-negative”, the researchers warn.
“There are few new anti-Gram-negative antibiotics in development, and none that are effective against NDM-1,” the study said. NDM-1 stands for New Delhi metallo-beta-lactamase-1.
Johann Pitout from the University of Calgary in Canada said patients who have medical procedures in India should be screened for multi-resistant bacteria before they receive care in their home country.
Welfare housing in Britain: Migrants given one in 15 new houses
While Brits wait. Britain is much more heavily dependent on welfare housing than is the USA
The number of council houses given to immigrants has increased by 10 per cent in only a year to nearly 10,000. Official figures show nearly one in every 15 newly-available homes let by a council or housing association went to a foreign national.
The revelations highlight the pressure immigration has put on housing and public services. They have also prompted calls for a review of the rules on how social housing is allocated amid fears long-standing UK residents could be losing out.
Tory MP James Clappison, who uncovered the statistics, said: ‘This is one more aspect of the pressures created by immigration, at a time when people are waiting many years on a waiting list for tenancy. ‘The system surely must be ripe for review. I think it will strike a lot of people as strange when UK citizens are waiting up to ten years for a home.
According to research by the House of Commons Library, foreign nationals were given the keys to 9,979 social houses in 2008/9. That is up 905 from the 2007/8 figure of 9,074. A total of 147,739 new social lettings were made in 2008/9. That means nearly 7 per cent of homes went to migrants.
Nearly three quarters of the increase was attributed to houses let to immigrants from EU countries. The total is made up of houses and flats let by councils and housing associations. Rents in such properties are subsidised by taxpayers.
It is estimated the cost of providing social housing averages £133,941 a home. The Government contributes £62,000 with the rest coming from developers or social landlords. Taxpayer-subsidised housing is in short supply nationwide with nearly two million people on the waiting list.
EU immigrants who are working can apply for social housing immediately. Other foreign nationals are legally entitled to social housing after spending more than four years in the UK or successfully claiming asylum.
Once immigrants are on the list, they are considered at the same time as long-standing residents on the basis of who has the greatest ‘need’.
Labour pledged to introduce new powers to allow local families to be given preference, but then backed down from changing the law amid fears that it could breach human rights laws.
A spokesman for the Communities and Local Government Department said: ‘Over 90 per cent of foreign nationals who arrived in the UK over the past two years were living in the private rented sector, and most of those who have recently come to England are not eligible for social housing.
‘Councils are responsible for deciding their own housing allocation schemes, but migrants who are eligible for council housing are given no special priority and must have their needs considered against the needs of all other eligible applicants.’
The spokesman said the Government aimed ‘to reduce net migration back to 1990s levels – tens of thousands each year, not hundreds of thousands’. It had already introduced limits on immigrant numbers, he added.
Evil British social workers again
Couple who had son removed by social workers cleared of neglect
A couple who had their son taken away by social workers who accused them of starving him have been cleared. Lisa and Paul Hessey have spent 12 months in a battle for Zak, two, who was taken into care for four months last year when doctors raised concerns over his “failure to thrive”.
The couple, of Bolsover, near Chesterfield, who are expecting their sixth child, suspected that he was autistic but said they were ignored. Experts have now confirmed Zak’s eating problems were caused by the disorder and the case has been dropped.
Mrs Hessey, 28, and her 48-year-old husband became worried last May over the fussy eating of Zak, then 18 months. Their GP referred him to Chesterfield Royal Hospital. Doctors said he showed “autistic tendencies” and health workers would be in touch.
Last June Zak became very ill. Hospital doctors suggested a dairy-free diet. When this did not work, the couple said, doctors asked that he undergo a two-week assessment. Social workers then told the couple Zak was being taken into care as doctors were worried they were not feeding him.
Derbyshire County Council refused to hand Zak back to them until November 17 last year. It continued to battle over Zak but has now withdrawn a court application, effectively clearing the couple, who are planning to sue.
Mr Hessey said: “We have been through hell for no reason at all.” Derbyshire County Council said workers acted in “the best interests of the child”.
Weird British prosecutors again
A British drunk cost taxpayers thousands of pounds when he opened a beer in the street.
The London Evening Standard reported that Stephen Geddes, 42, was banned from possessing alcohol in public after a series of drunken incidents at Turnham Green, in western London. However, in June he was caught near his home with a can of Heineken beer.
He was sentenced to an 18-month behaviour order, ordered to undergo alcohol treatment, and told to do 40 hours of community work. But his case was still sent to the Old Bailey court – normally used to try the most serious criminal cases – for sentencing over a breach to an earlier suspended sentence.
The decision to send the case to court surprised the judge, Recorder William Clegg. “The only thing he’s done is to open a can of beer. It is rather a brave order to make for an alcoholic. It’s not exactly stealing the crown jewels,” he said. “Who would have thought a can of beer would have cost so much public money?”
The judge said it would be “unjust” to impose any further sentence on Geddes because he was still subject to the community order. He added, “I do not propose to implement the suspended sentence. Indeed you have made good progress. I am pleased to see you seem to be getting on top of the problems that you had.”
British Primary school results ‘inflated’ by teachers
The extent to which children’s grasp of core subjects is being “artificially inflated” by schools is laid bare in damning figures which have been published for the first time. New-style tests show that results in science are up to a third lower at the end of primary school than previous scores suggested.
The figures – based on a small-scale “sample” designed to give a more accurate picture of national achievement – will fuel fears that pupils have been “taught to the test” to boost schools’ positions in league tables at the expense of a proper understanding of the subject.
It will also cast fresh doubts over Labour’s education record and raise questions over standards in other core subjects such as English and mathematics.
In the past, all children in England took Sats tests in science at the end of primary school. Last year, almost nine-in-10 reached the standard expected for their age and 43 per cent exceeded national targets.
But the science test was scrapped following complaints that schools drilled children to pass by repeatedly forcing them to sit practice papers, undermining their education. It was replaced with a sample test taken by just one-in-20 pupils nationally. Under the new system, individual schools are not identified and results do not contribute towards league tables.
Figures published by the Department for Education show that 81 per cent of 11-year-olds reached the national target for their age group – Level 4 – in the sample test. This compared with 88 per cent of those who took Sats last year.
It means fewer children can use tables and bar charts to record measurements, identify organs in the human body and understand the difference between solids, liquids and gases. At the same time, only 28 per cent gained an elite Level 5 in the sample test, compared with 43 per cent last year – a drop of around a third.
Prof Alan Smithers, professor of education at Buckingham University, said: “With these sampling tests, the schools are not individually identified so there isn’t the same pressure to artificially inflate the result.
“When rewards and sanctions are attached to the test, teachers can push up results simply by training children in the sort of questions that will come up and scores quickly get out of line with the actual understanding of the children. In a sense, sampling provides a more accurate picture. “If we want to discover how well the education system is going, this is the way to do it.”
Statisticians from the Department for Education admitted that the results this year could not be compared with those of the past because previous tests “fed the school accountability framework”.
Ministers have refused to axe Sats tests in English and maths and the latest results will fuel speculation that results in those subjects are also artificially higher. Michael Gove, the Education Secretary, has already announced a review of the way primary school pupils are assessed.
Christine Blower, general secretary of the National Union of Teachers, said: “The sample tests point the way forward and I urge the Secretary of State to conduct his review of national curriculum assessment with a view to putting the sampling system in place for both English and mathematics.”
The sample science test results are also lower than teachers’ own assessments of pupils’ abilities in the classroom. Teachers informally assess children’s grasp of English, maths and science throughout the final year of primary education, with results being published alongside Sats scores. Assessment scores released last week suggested 85 per cent of children were at Level 4 and 37 per cent were at Level 5.