NHS hospital at centre of cancer misdiagnosis scandals makes secret payouts to patients
And the managers responsible for the dangerous blunders just waltz away
A hospital has made secret compensation payouts to victims of misdiagnosis in a scandal over “botched” cancer care. An NHS inquiry is examining thousands of tissue samples after four doctors from different hospitals in Bristol expressed fears that repeated blunders were being made by a laboratory at Bristol Royal Infirmary.
Doctors raised concerns about 26 separate cases, including that of a woman who died three years after an NHS biopsy failed to detect breast cancer. Since the inquiry began, three new cases of alleged misdiagnosis have been referred to it, raising concerns that failings are continuing.
An investigation by The Sunday Telegraph has uncovered critical errors made by the hospital, and secret payments of thousands of pounds to patients who were harmed as a result of incorrect diagnoses.
Cases include a woman paid £12,000 last year after needlessly undergoing an operation to remove part of her breast, following a false diagnosis of cancer.
Iris Nicks, 72, from Gloucestershire, was told that the error was made because a laboratory doctor was on holiday, so that a decision was taken to operate without the results of her biopsy being checked. The blunder was only detected after the pensioner had undergone a lumpectomy, removing part of her breast, and was about to start radiotherapy.
None of the 26 patients or bereaved relatives have been alerted to the existence of the inquiry, being held behind closed doors, or been told that alleged blunders in their care have triggered the major investigation.
Jane Hopes, a senior NHS manager who died in 2004, was never told that doctors at the hospital where she worked believed a lump in her breast had been wrongly diagnosed as benign, at a point when she might have been saved. Until this newspaper uncovered her case in April, her bereaved family knew nothing about her doctors’ concerns, or that it formed part of an investigation.
Last night her brother expressed anger that even now, the inquiry by University Hospitals Bristol Foundation Trust, which began more than a year ago, and is due to report this autumn, has not informed any of those whose cases sparked it, or their bereaved families, about its existence.
Patients’ groups last night said the revelations displayed “a staggering degree of arrogance” on the part of the trust, and illustrated a “culture of denial and cover up” which permeated parts of the NHS.
A spokesman for the inquiry said patients had not been told their cases were being probed, in order to “protect patient confidentiality”. But Mrs Hopes’ bereaved family said the tactics looked like an underhand attempt to cover up failings, and deny justice to those who had suffered as a result of errors.
Mrs Nicks said she had been stunned by the blunders in her care, and was shocked to learn about the inquiry, which has made no contact with her.
Peter Walsh, chief executive of charity Action Against Medical Accidents, said he was appalled that the NHS could treat any patients with such little regard, let alone those who had been harmed by blunders, or bereaved by them. Mr Walsh said: “The lack of transparency and arrogance with which is quite staggering, and is an example of the worst aspects of NHS culture.”
The charity is calling for changes to the law to introduce a statutory Duty of Candour, to end what it describes as a “culture of denial and cover up” permeating parts of the NHS. The change would mean NHS bodies would be obliged to disclose any medical errors to patients who were affected.
The inquiry in Bristol, which began in June 2009, is examining 3,500 random tissue samples, to establish whether the error rate at Bristol Royal Infirmary is higher than elsewhere. But doctors who blew the whistle on their concerns are fearful that high numbers of errors in specialist areas might not be identified by such a broad trawl.
The trust has also ordered a review of the specific 26 cases where blunders were alleged, which forms part of the inquiry.
Documents seen by this newspaper reveal that the trust has already made payouts to two patients. One of the cases is that of Mrs Nicks, who was paid £12,000 in January of last year.
A letter by Robert Woolley, the trust’s acting chief executive, written on 15 April – less than a week after the trust refused to disclose whether it had compensated any patients – describes “two cases of misdiagnosis leading to patient harm where the Trust admitted liability and a settlement was reached”.
It says the trust believes that in 22 of the cases involving “diagnostic discrepancy or disagreement,” problems were resolved without patients being harmed. Another case – known to be that of Mrs Hopes – is described as “unresolved” while one case had not been located, but is now understood to have been passed to the inquiry.
All 26 cases are now being reviewed by pathologists for the inquiry, which was ordered by University Hospitals Bristol Foundation trust after Bristol GP Phil Hammond went public about the concerns of local consultants.
Three recent cases of alleged misdiagnosis have been passed to the inquiry. Two cases from this year include a patient incorrectly diagnosed with malignant mesothelioma, a cancer which is normally fatal, and a missed case of tuberculosis later detected by doctors from another hospital. A dispute about a case of breast cancer last year has also been referred to the inquiry.
A spokesman for the inquiry said its terms of reference required it to take a “broad look” at pathology services across the trust, not just specific cases where errors had been alleged.
He said the panel, which is chaired by a barrister, had “encouraged as many people as possible” to give evidence but that the inquiry had not contacted any of those involved in cases where blunders were alleged in order to protect “patient confidentiality”. No patients have given evidence to the inquiry.
The trust’s former chief executive Graham Rich resigned in December, to take a job reorganising local NHS services, which he left this month to take a job with the private sector.
Its medical director, Dr Jonathan Sheffield, last month announced that he will leave the trust in October to lead a research institute in Leeds.
Crazy legal verdict on vaccine damage
This is just doctors feeling sorry for a disabled kid and coming to a crazy conclusion in order to help him. Where to start?
* His condition is NOT of the kind usually blamed on the vaccine (autism)
* The vaccine has repeatedly been found to be safe in large trials of it
* His problems developed 10 days after the vaccination, which is a common time-frame for MMR side-effects (hence the verdict) but the side effects concerned are very short lived, akin to the flu. Epilepsy is NOT such a side effect.
Logical conclusion: His problems were completely outside what has otherwise been associated with the vaccine so the timing is a coincidence and the vaccine did not cause the effects observed
A mother whose son suffered severe brain damage after he was given the controversial MMR vaccine as a baby has been awarded £90,000 compensation. The judgment is the first of its kind to be revealed since concerns were raised about the safety of the triple jab.
Robert Fletcher, 18, is unable to talk, stand unaided or feed himself.
He endures frequent epileptic fits and requires round-the-clock care from his parents Jackie and John, though he is not autistic. He suffered the devastating effects after being given the combined measles, mumps and rubella vaccine when he was 13 months old.
The Department of Health had always denied that the jab was the cause of Robert’s disability.
But now, in a judgment which will give hope to hundreds of other parents whose children have been severely affected by routine vaccinations, a medical assessment panel consisting of two doctors and a barrister has concluded that MMR was to blame.
Robert’s mother Jackie said the money would help with his care, though she described the amount as ‘derisory’.
Her first application for compensation under the Government’s Vaccine Damage Payment Scheme was rejected in 1997 on the grounds that it was impossible to prove beyond reasonable doubt what had caused Robert’s illness.
But Mrs Fletcher appealed and in a ruling delivered last week, a new panel of experts came to a different conclusion.
In a six-page judgment, they said: ‘Robert was a more or less fit boy who, within the period usually considered relevant to immunisation, developed a severe convulsion… and he then went on to be epileptic and severely retarded.
‘The seizure occurred ten days after the vaccination. In our view, this cannot be put down to coincidence. ‘It is this temporal association that provides the link. It is this that has shown on the balance of probabilities that the vaccination triggered the epilepsy. ‘On this basis, we find that Robert is severely disabled as a result of vaccination and this is why we allowed the appeal.’
The ruling will reignite the debate over the safety of common childhood vaccines, although it makes clear that Robert’s case does not involve autism.
There is one other reported case of a family being given compensation as a result of an MMR jab.
But Mrs Fletcher said she believed the compensation award to Robert was the first to a surviving MMR-damaged person since controversy erupted in 1998 when the now discredited Dr Andrew Wakefield raised concerns about a possible link between the combined MMR injection and autism. He has since been struck off the medical register….
The controversy over a suggested link between MMR and autism erupted in 1998 when Dr Wakefield published a paper in The Lancet medical journal.
His work has since been discredited and earlier this year Dr Wakefield, who has moved to America, was struck off the medical register after the General Medical Council ruled that he had acted against the interests of patients and ‘failed in his duties as a responsible consultant’.
Robert Fletcher does not suffer from autism. But Mrs Fletcher, from Warrington, Cheshire, said the ruling would give hope to hundreds of other parents fighting to prove that their children’s disabilities were caused by the MMR injection….
The first doctor who assessed Robert under the compensation scheme in 1996 concluded that he had suffered a ‘simple febrile convulsion with no long-lasting consequences’. Although he agreed that Robert had a degree of disability, he refused to accept that the MMR vaccine was to blame.
At this month’s appeal, evidence was given by a leading expert on vaccine-damaged children, paediatric neurologist Dr Marcel Kinsbourne. He explained the biological changes which had occurred in Robert’s brain following the vaccination.
The one-day hearing was chaired by a barrister sitting with two doctors, Professor Sundara Lingam, a former consultant at Great Ormond Street Hospital for Children, and Dr Adrian Allaway.
In a dissenting judgment, Professor Lingam said he believed Robert was ‘genetically predisposed to epilepsy and that the vaccination triggered it rather than caused it. ‘Robert would have developed epilepsy in any event, even if he had not had the vaccination’.
But Professor Lingam was overruled by his two colleagues. In their final judgment, they accepted that MMR had caused Robert’s illness but added: ‘We would stress that this decision is fact-specific and it should not be seen as a precedent for any other case. ‘In particular, it has no relevance to the issue… as to whether there is a link between the MMR vaccine and autism.’
Dr Michael Fitzpatrick, a London GP whose own son is autistic, said: ‘It is a very important principle that parents should be compensated in cases of this kind. ‘But although a causal link has been established in law in this instance, exhaustive scientific research has failed to establish any link between MMR and brain damage. ‘This case should not make parents feel any different about the safety of the vaccine.’
The Department of Health said: ‘This decision reflects the opinion of a tribunal on the specific facts of the case and they were clear that it should not be seen as a precedent for any other case. ‘The safety of MMR has been endorsed through numerous studies in many countries.’
Evil British bureaucrats again
They love using their little bit of power to hurt people: Army hero who lost a leg in Afghanistan denied a disabled parking permit by council bosses ‘because he might get better’
A hero soldier who lost a leg in Afghanistan has been denied a disabled parking badge three times by council bosses.
Lance Corporal Johno Lee has clocked up £800 in fines for parking in disabled bays in his home town of Newark, Nottinghamshire, on days when he uses a wheelchair or feels unable to walk very far.
When he first applied to Nottinghamshire County Council for a blue badge, he was advised he was young and ‘may get better’.
Wounded veteran Johno Lee has racked up over £800 in parking fines because council officials refuse to grant him a disabled persons parking permit
Wounded veteran Johno Lee has racked up over £800 in parking fines because council officials refuse to grant him a disabled persons parking permit
His right leg was amputated below the knee after he was caught up in an explosion in Helmand Province in 2008 and was catapulted into a minefield.
He said yesterday: ‘I replied that they possibly did not quite understand the situation and that I thought it unlikely my leg would grow back.
‘Sometimes the leg swells so badly I can’t even get the prosthetic leg on. I then have to park in disabled bays otherwise I can’t get into town, but then I get a ticket. ‘If I live for another 60 years, am I expected to continue to have to struggle for all of that time?’
Lance Corporal Lee’s applications are being supported by the British Limbless Ex-Servicemen’s’ Association.
In a statement, the Council’s Service Director Mr Paul McKay said: ‘We are looking into the matter and have arranged for a member of staff to meet Mr Lee to review the situation. We will urgently assess whether he meets the criteria for a disabled parking badge as laid down by the Department of Transport.’
Mr Lee, a charity worker for the Armed Forces, added: ‘A lot of people are coming home from Afghanistan severely wounded and are deserving of recognition rather than to be disrespected by the bureaucrats.’
When he was blown up, his heart stopped twice, once on the helicopter taking him to Camp Bastion and once on the operating table, but he was revived each time.
British High School exama are ‘so boring’ says top school’s head who wants a tougher exam for her students
A school where pupils passed 51 per cent of A-levels with A* grades may abandon the ‘methodical’ exam in favour of a rival qualification. Cynthia Hall, head of £29,250-a-year all-girls boarding school Wycombe Abbey, warned that pupils risk being penalised for showing originality and intelligence in their A-levels.
She said her school – which tops the national league tables for A* grades – was ‘keeping an eye’ on the rival Cambridge Pre-U exam, brought in two years ago to encourage more in-depth studies.
Earlier this week Gary Lineker blamed the Pre-U for the failure of his son George, a pupil at Charterhouse, to get into university. The TV presenter said it ‘seemed to have been marked much harder’ than A-level papers.
But Mrs Hall said her school was considering the Pre-U to stretch her high-achieving pupils. ‘We are interested in something that provides stimulus and challenge,’ she added. She said reforms to A-levels ten years ago, which broke up courses into bite-size chunks, meant pupils faced exams after just two terms of sixth-form study.
The Pre-U, in contrast, involves all exams being taken at the end of a two-year course. ‘One of the things it gives is the opportunity to restore to the lower-sixth that opportunity to research,’ she said. ‘We’re going to keep an eye on the Pre-U. We want to see what teething troubles there are,’ she added.
Mrs Hall said A-levels offered limited opportunities for pupils to show ‘originality and creativity’. She also claimed some of the marking was ‘inadequate’. Mrs Hall added: ‘You have got some markers who are not really subject specialists and are not able to recognise more individual work.
‘From time to time, you look at an answer which is clearly very intelligent but the specialist knowledge of the marker is not adequate to understand.’ Pupils were advised not to ‘take risks’ in the exam room, she added.
Her remarks came as the head of Charterhouse, the Reverend John Witheridge, made an outspoken attack on A-levels. In what was seen as a riposte to Mr Lineker, he defended his switch to the Pre-U.
‘Here are syllabuses that engage and stretch sixth-formers. They require deep delving, rigorous research and wider reading,’ he said, writing in the Spectator. ‘Pupils are encouraged to take intellectual risks by developing their own ideas and arguments, and are rewarded for academic flair. ‘All this will ring bells with those us who sat A-levels 30 or 40 years ago, but not with those who sat today’s A-levels, with their “accessible”, prescriptive and frankly boring curricula.’
The results for more than 400 independent schools, published today, show that fee-paying pupils passed 18.17 per cent of A-levels at A* this year – more than double the national average of 8.1 per cent. Some 2,108 pupils gained at least three A* grades. Boys were slightly more likely than girls to achieve a hat-trick of A*s.
Some 1,485 pupils at 43 schools took the International Baccalaureate, while 552 pupils at 23 schools took the Pre-U in at least one subject.
More than 80 schools including Eton refused to allow their results to be used in league tables, claiming the lists damage education.
Magdalen College School, in Oxford, topped the Mail’s table after gaining the most top A*, A and B grades overall – 99.38 per cent. Its head, Dr Tim Hands, insisted most schools still favoured A-levels but said there had been ‘change after change’ and now a period of ‘consolidation’ was needed.
Politically correct British politicians lose sight of what makes a “good” school
It’s heavily influenced by the quality of the kids attending it. If you let in a lot of dumb and unruly kids, educational standards go down to cope with them and the school soon ceases to be a “good” one. “Banding” will just degrade ALL schools
Middle-class parents would be unable to guarantee their children places at the best state schools by buying houses nearby under admissions rules backed by the Schools Secretary.
The Coalition is planning to allow hundreds of secondary schools to control their own entry policies and Michael Gove warmly praised the system, which allocates places according to academic ability and reserves many places for children with the weakest performance.
“Fair-banding” admissions schemes are often seen as a way of breaking the middle-class dominance in the best-performing state secondaries since they prevent affluent parents from monopolising places by paying a premium to live in their catchment areas.
Banding generally means that 11 year-olds applying for school places sit an IQ-based “attainment test” and are then divided into seven or nine ability groups. The same number of children from each ability group are then given places at the school.
Advocates say that reserving some places for children with the lowest scores ensures that children from poorer homes are more likely to get places at the best schools. Critics say it unfairly discriminates against children with the best results.
The Conservatives have not previously spoken out in favour of the practice, but Mr Gove told the BBC that fair banding had “a role to play” and could make schools “truly socially comprehensive”. It prevented better-off parents boosting their children’s chances by buying homes near better schools.
“You can make sure that if your school is located in an area which may well be relatively privileged, by dint of house prices and background and so on, that you are spreading the load academically,” he said.
There is no official record of how many schools use fair banding, but a Daily Telegraph survey last year identified at least 22 local authority areas where the rules were in place.
The Schools Department estimates that only around 100 local authority-controlled secondary schools in England admit students on a fair-banding basis.
But almost half the 200 academies currently operating, which set their own admissions policies, are estimated to use some sort of fair-banding policy.
Mr Gove has claimed that hundreds of schools are considering opting out of council control under his plan to allow all schools to become academies. If that prediction is accurate, there could be a dramatic expansion in the use of banding policies.
Mr Gove praised schools including Dunraven School and Mossbourne Academy, in south and east London respectively, as high-performing schools that use banding.
Dunraven school in the south London borough of Lambeth introduced fair banding in 1992. It puts children in five different bands and gives priority to those children who are in care or in foster care.
David Boyle, the school principal, said results had improved dramatically since the system was introduced. The number of GCSEs at grade C or above had increased from 30 per cent in 1992 to 82 per cent this year.
He said that Dunraven was now more aspirational. “Our mission is to try to ensure a service for the whole community,” he added.
A source close to Mr Gove said: “We are not telling any school to use fair banding nor are we telling them not to. We want all parents to be able to send their children to a good school. That’s why we are expanding the number of academies.”
Some experts say the schools with the greatest incentive to adopt banding are those in the poorest areas, because they often struggle to attract brighter children.
But supporters of the policy say all schools can benefit from becoming more socially and academically inclusive.
The charity Barnardo’s this week called for the widespread use of fair banding. But David Green, the director of the think tank Civitas, described it as “a kind of social engineering based on animosity to middle-class parents.”
Prof Stephen Gorard from Birmingham University warned that Mr Gove’s voluntary approach to admissions had risks. “If banding is implemented partially and voluntarily, it sounds like the outcome will be all pain and no gain.”
John Bangs of the National Union of Teachers said banding was right in principle, but should be implemented uniformly. “Banding only works if you do it in a geographical area,” he added. “If every school has its own admissions policy and sets its own banding system, you’re going to get real unevenness.”
Nick Seaton, of the Campaign for Real Education, attacked fair banding as an unfair policy that denied places to the brightest. He added: “I’m not saying we shouldn’t help the worse-off, but it I don’t think the best way to do that is to disadvantage the better-off.”
My Holiday is Being Ruined by Global Cooling. Try Telling That to the ‘Scientists’
From James Delingpole in Britain
I’m writing this in Salcombe, Devon on a rainy, miserable summer’s day which, I fear, may be all too symptomatic of the climatic rubbish we can all expect for the next 30 years as – thanks to changes in the Pacific Decadal Oscillation combined with a solar minimum – we enter a period of global cooling. Let’s hope I’m wrong, eh?
Well, among those who seems to be hoping just that is an amiable fellow called Sir Paul Nurse, the Nobel prize winning geneticist and president-to-be of the Royal Society, who came round to my house last week to film part of a BBC Horizon documentary on why it is that people are losing their faith in scientists.
I told him people aren’t losing their faith in “scientists”. Just the “scientists” who are behind the junk science being advanced in the Intergovernmental Panel on Climate Change’s four increasingly tendentious and misleading assessment reports.
Over the next three hours, Sir Paul and I had a long, friendly, on-camera argument in which he tried to make a distinction between “skepticism” [good] and “denialism” [bad] – an entirely specious distinction, in my book – while I tried to focus on the details of the Climategate emails because it’s only on details that an arts graduate journalist is ever going to win a debate like this with a (feisty, bright, delightful but not a little combative) Nobel genetics laureate.
A trick I noticed Sir Paul trying to perform throughout our debate was to move away from specifics to the general. So, for example, he would keenly assert that “the majority” of the world’s scientists agreed with a thing called a “consensus” on man-made global warming, and whenever I got down to grimy and tedious detail suggestive of the contrary – eg Ben Santer’s outrageous rewriting of the Summary for Policy Makers in the Second Assessment Report, which seriously exaggerated the unanimity of scientific opinion on AGW – he’d either politely brush it off as if it were far too involved to be of much interest or he’d airily cite the three whitewash enquiries into Climategate as “proof” that the scientists had done nothing wrong.
Perhaps he was just playing devil’s advocate. The impression I got that Sir Paul is a thoroughly decent, very clever man who wants to be as open-minded as possible on the whole AGW debate. But the impression I also got is that, as you would entirely expect of a future president of the Royal Society (which for years has been one of the great cheerleaders for AGW theory, even to the point of writing an official letter to Exxon demanding that it cease funding “deniers”) is that Sir Paul’s view of what is reasonable and balanced has been heavily colored by that of the scientific Establishment. And, unfortunately, the scientific Establishment’s views on AGW are about as neutral and unbiased and reliable as, say, the BBC’s are about Israel. Or the European Union. Or, indeed, “Man Made Global Warming.”