The locum doctor paid £5,700 a day: Enormous sums handed to agency staff by desperate NHS managers
The NHS paid one doctor £5,700 for a day’s work under a system which sees hospitals squander millions on agency medics to stand in at understaffed hospitals. Desperate trusts are being forced to hire temporary doctors during busy times to plug holes created by drastic cut backs, redundancies and reduced working hours for junior doctors.
Stand-in consultants earn as much as £3,200 for a single shift but one was paid £5,700 for working a 24-hour shift in an A&E unit. That is equivalent to a £510,000-a-year salary and more than five times the average wage of full-time staff consultants, who typically earn £90,000 a year.
The extraordinary sums are being handed out at the same time as routine treatments such as hip operations, cataract surgery and IVF are being suspended because they are deemed too expensive.
Experts say that Whitehall-imposed cutbacks designed to save the NHS money, such as recruitment freezes, are actually resulting in hospitals wasting millions hiring locums to cover unstaffed departments.
Figures uncovered through a Freedom of Information request show that some hospitals are spending up to £15million a year on temporary doctors at peak times. Many are forced to pay locums extortionate hourly rates to cover shifts that full-time consultants refuse to do, such as nights, weekends, Christmas and the August bank holiday.
Others pay out for temporary doctors because they are desperately short-staffed due to recruitment freezes and trusts not replacing medics who leave or retire, while some have started rounds of compulsory redundancies. Demand for agency staff has also increased since controversial EU rules were brought in last summer to stop junior doctors working more than 48 hours a week.
Critics warn that millions are being wasted on the inflated salaries and it would be far better spent recruiting full-time, experienced doctors.
The highest locum rates are being paid by Mid Staffordshire NHS Foundation Trust, where up to 1,200 patients died between 2005 and 2008 due to appalling standards of care. The hospital admitted paying one doctor £399 an hour for an eight-hour shift, a total of £3,192 for the day. On a separate occasion a locum consultant was paid £5,667 for a 24-hour shift in the trust’s A&E unit. Over the last year it paid £1.4million for locum doctors and another £2.1million for agency nurses.
Other trusts which have admitted spending vast amounts on locum doctors include Barking, Havering & Redbridge University Hospitals Trust in East London, which spent £8million last year, and Pennine Acute Hospitals Trust in Greater Manchester, which spent £15million.
Critics described the rates as ‘hugely wasteful’ and warned that patient safety could be jeopardised if hospitals became overly reliant on temporary staff unfamiliar with basic procedures.
The NHS has been ordered to make £20billion of efficiency savings across the board by 2014. As a result, health trusts are making tens of thousands of staff redundant and cancelling routine, non-urgent treatment such as hip and knee replacements.
Katherine Murphy, chief executive of The Patients Association, said: ‘It is outrageous that we are paying nearly £6,000 to an agency consultant to cover a 24-hour shift – the consultant will not know the policy and procedures of that hospital and could be putting patient safety at risk. ‘We want clinical mangers within hospitals to take responsibility for managing staff rotas to ensure there are enough doctors available to treat patients effectively and that safety is not compromised.’
Dr Mark Porter, head of the BMA’s Consultant Committee, said: ‘Many departments have become increasingly understaffed as trusts impose recruitment freezes. ‘Departments will be forced to offer locum agencies higher rates as they become increasingly desperate for staff cover.’
It is not known whether doctors take home all the money, or whether some is paid to agencies.
The Department of Health said: ‘The high cost of agency staff in the NHS is unacceptable. We have asked the NHS to reduce management costs, which includes agency costs, by 45 per cent in time for 2013/14.’
Careless NHS staff kill again — and nobody’s to blame
Elderly heart patient killed after his body was accidentally drained of blood following NHS blunder
A pensioner died after his chest was bled ’empty’ when he was wrongly connected to a blood pumping machine and a hospital worker left the room. NHS staff failed to use enough clamps to disconnect 76-year-old Dr John Baines from the device after a gruelling six-hour bypass operation, on January 29. This meant his blood was pumped into the machine, which was filling in for his heart and lungs during the surgery, but not pumped back into his body.
An inquest heard how the pensioner, a former research chemist, had survived the complex procedure only to die days later due to brain damage caused by the blunder. NHS bosses in Nottingham have now apologised for the fatal error which left Dr Baines’ brain starved of oxygen.
During a bypass operation, a heart-lung machine is used to remove blood from the body, fill it with oxygen and pump it back in. But due to a catalogue of errors, Dr Baines’ blood pressure dropped dramatically after the man in charge of the machine at Nottingham City Hospital left the room. By the time hospital staff had discovered their mistake, it was already too late and his brain had been starved of oxygen.
Dr Baines, from Woodthorpe, Nottinghamshire, died in hospital 21 days later.
Deputy Assistant Coroner Mairin Casey said ruled that no one member of staff was to blame and his death was caused by a ‘series of collective errors’.
The inquest heard cardiac surgeon David Richens left theatre when his heart was stable, but his blood pressure then began to drop and alarms went off.
He was given fluids and his chest was reopened upon which hospital staff realised something had gone catastrophically wrong.
Anaesthetist Dr Ganapathy Muthuswamy, said: ‘The chest was empty. Just before this, my colleague walked in with results from the blood test. He was looking at the pump and quickly noticed the volume in it.’
The team began to put the blood back in, but Dr Baines’ brain had been starved of oxygen for too long.
In a bypass operation, the pumps are operated by specially trained health professionals known as ‘perfusionists’, who work with the surgical team in connecting and disconnecting the machine to the patient.
However, the perfusionist who had been involved in the discussions about the complex operation was replaced before it began by two others, who oversaw the machine during the surgery. One of them, Andrew Sutcliffe, said they clamped the line from the patient’s neck and assumed two other clamps required had been attached by other members of the team. He said: ‘I think the issue is that we had clamped the common line. But clamps hadn’t been applied where we would have expected them to.’
Mr Sutcliffe said he left the room before John’s blood pressure began to drop because he was asked by a colleague to help with another job. He added: ‘There was one of us there up to that point. It’s very unfortunate that I was asked to help with something else. I should have refused, but I didn’t.
‘It was about a test on Dr Baines and obviously you think it is going to improve his outcome. It’s quite normal for perfusionists to leave theatre at the end of a case. ‘If I had stayed, I would have noticed blood going into the reservoir.’
Mr Richens added: ‘I want to say how terribly sorry we all feel. Mine and my team’s consolations go out to the family. I cannot imagine how they feel and we are profoundly sorry.’
Miss Casey recorded a narrative verdict and said the mistake was the result of collective rather than individual error. She said: ‘I’m confident that from the earliest point the human error was acknowledged to the family and to all who needed to subsequently investigate this matter. ‘I’m also satisfied that there’s no culpability in respect of an individual in this case.’
Dr Stephen Fowlie, Medical Director at Nottingham University Hospitals NHS Trust, said: ‘We offer our deepest sympathies to Dr Baines’ family, and apologise that we so badly let down Dr Baines and his family. ‘Our immediate investigation identified that the error had been caused by a coincidence of several weaknesses in our systems and processes for removing patients from heart bypass.
‘The cardiac unit took action to considerably strengthen our safety systems, and to add checks to our procedures when we use heart bypass for these complex operations. ‘We are closely monitoring the implementation of each of our investigation’s recommendations. It is most important that we learn from our mistakes.
‘We owe Dr Baines and his family nothing less, but recognise that explanation and strengthened checks cannot compensate them for their loss.’ ‘We offer our deepest sympathies to Dr Baines’ family, and apologise that we so badly let down Dr Baines and his family.’
The health trust carried out a Serious Untoward Incident report and have made recommendations following the bungle. It also paid an undisclosed amount of compensation to Dr Baines’ family. Following this, NHS chiefs promised to alter working practices to prevent such a tragedy from occurring again.
Speaking after the inquest, his heartbroken widow Patricia said she hoped lessons had been learned from the ‘horrendous accident’. She said: ‘The coroner gave a narrative verdict, meaning they couldn’t give the blame to any one person. ‘All in all, it was a dreadful thing that happened. It’s now over a year since he died and I still have not got used to the idea. ‘I’m not going to blame anyone in particular, but hopefully they have now got things in place to ensure it will never happen again.
‘We feel very, very upset about it, but so did the hospital and they have compensated us financially up to a point. They never tried to deny that it was their fault.’
Paying tribute to her husband, who she described as her ‘soulmate’, she added: ‘If you asked any of his friends they would all describe him as a gentleman and that is what he was. ‘He was very courteous, very kind, very generous and a lovely man. We know it shouldn’t have happened, but it did and we have to cope with it. ‘We had 52 years and three months together and we had a very happy marriage. Not many people can say that. It’s just a shame that our old age together was cut short.’
Dr Baines leaves behind two sons, Martin and Iain.
Crooked British Muslim cop is made to pay just £750 of £64,500 trial costs… despite his THREE homes
Disgraced police chief Ali Dizaei was at the centre of a new storm last night after it emerged he has been forced to pay just £750 towards the prosecution costs of his corruption trial.
The Crown Prosecution Service had asked that three-times married Dizaei be ordered to pay their £64,500 bill for the four-week hearing earlier this year. But despite owning three homes worth a total of £1million, playboy Dizaei – who had expensive tastes in women, cars and clothes – said he was virtually penniless and able to pay only a tiny amount. After considering his case, Southwark Crown Court ordered that he pay £750 plus VAT towards the prosecution costs.
Yet the Mail can reveal that Dizaei owns homes in Acton and Chiswick in West London, and co-owns a property in Henley-on-Thames with his former wife Natalie.
Before his corruption conviction, Dizaei won a substantial five-figure libel payout from a Sunday newspaper. It is not known where the money went.
The decision to make the former Met Commander pay so little has staggered his former colleagues in the Metropolitan Police. One said: ‘A lot of people find it very hard to believe he is only worth £750. Many people will think he’s played the system and won.’
According to publicly available Land Registry documents, each of Dizaei’s homes is mortgaged. It is not known how much equity is in each.
Dizaei, 47, was jailed for four years in February for abusing his police position to bully a young businessman. He assaulted and falsely arrested Iraqi Waad al-Baghdadi, 24, after the businessman asked for £600 he was owed for creating a website showcasing Dizaei’s career.
He was sacked from his £90,000-a-year job at Scotland Yard in March but, despite his dismissal, will still be able to claim at least a third of his gold-plated police pension in the future.
A former president of the militant National Black Police Association, he has endured a torrid time since being jailed, including an attack in which he was knocked out and had a slop bucket poured over him.
The Iranian-born former officer, who spent thousands of pounds on a hair transplant, has also been goaded about the colour of his hair after it turned grey without lashings of black dye. Dizaei is now in Leyhill open prison in Gloucestershire.
In August, it emerged Dizaei plans to sue the prison service for failing to protect him from a brawl in which he allegedly attacked another cellmate at a previous jail in South Wales. He is demanding damages from prison authorities – even though he is being investigated by police for allegedly assaulting another inmate.
Southwark Court confirmed that Dizaei has been ordered to pay just £750 plus VAT for the prosecution costs of his trial. The CPS refused to comment.
Nutty British prisons boss says inmates should have choice of FIVE dishes for dinner
Prisoners must be given a choice of at least five different dishes for dinner, it emerged last night. Under new rules – quickly dubbed ‘Porridge à la Carte’ – inmates will be presented with a menu from which to select their desired meal from the five on offer.
Governors must change the menu regularly to ensure the same options do not appear more than once a month. The order dictating the changes even insists that prisoners are ‘consulted’ about the quality of meals served. Prisons minister Crispin Blunt, who previously gave the go-ahead for Halloween and Christmas parties for inmates, is responsible for prisoner food rules.
Critics described the regulations as ‘lunacy’. The rules, issued by the Ministry of Justice and sent to every jail in England and Wales, came into force on October 1 but were only published yesterday.
Diktats include that drug addicts trying to get clean should be given hot chocolate because it is ‘comforting’. New inmates must be given an arrival pack containing tea and coffee, sweets and cigarettes. And late arrivals – such as newly-sentenced prisoners – must be given a hot meal even if they arrive at the prison after all the other inmates have eaten.
Fiona McEvoy, campaign manager at the Taxpayers’ Alliance, said: ‘While many ordinary, law-abiding taxpayers struggle for cash and brace themselves for cuts in services, these convicts are getting five-star treatment on the public purse. ‘The amount of effort and planning going into these menus is just insulting – it seems criminals are being fed better than patients, school children and the elderly in many cases. ‘No one would deny inmates a decent meal, but this is just ridiculous.’
Tory MP Douglas Carswell added: ‘Surely we should be giving individual prison governors control over meals and letting them see what works and what gets results? ‘Why are we trying to micro-manage the prison service from the centre, right down to the amount of gravy and type of vegetables prisoners have for their meals? It’s lunacy.’
The edict follows a bizarre speech by Mr Blunt last month in which he said inmates should be served perfectly-sized and shaped apples to prevent ‘fruit riots’. He told the House of Commons that ‘undersize’ fruit handed out at jail canteens could create ‘issues of order and control’.
‘It is worth remembering that discontent about the quality of food, changes to menus and failure to deliver what was previously promised have been known to be the catalyst for serious disturbances,’ he said.
‘An undersize apple handed out at the servery will create issues of order and control, so we use suppliers that are sensitive to that need and that use their sourcing ability to maintain consistency from their supply base.’
Mr Blunt provoked outrage within weeks of his appointment by lifting a ban on taxpayer-funded prisoner parties and comedy workshops for high security inmates. The MP for Reigate – who is the uncle of actress Emily Blunt – was swiftly slapped down by Downing Street, and the decision reversed the following day. He was slapped down again after he said criminals could get their jail sentences slashed if they said sorry.
And there was further outrage when it emerged that newly-released prisoners are being offered free mobile phones in a taxpayer-funded ‘welcome pack’ when they arrive at bail hostels.
The ‘Catering – Meals for Prisoners’ section in Prison Service Instruction number 44/2010 states: ‘A multi-choice minimum five choices, pre-select menu including a minimum of one substantial hot meal choice per day will be provided for the lunch time or evening meal.’ Food must meet the ‘cultural, nutritional and diversity needs’ of inmates, the order states.
It adds: ‘The menu provides information which enables prisoners to make decisions about their menu choice. The menu cycle will be for a minimum of four weeks. ‘Prisoners are consulted about and can make comments on the catering provision.’ Officials said each menu would include a hot meal, a cold meal, a vegetarian option and one that is free of dairy products.
Every menu must also include a halal meal that complies with the Islamic code on how animals should be slaughtered.
Tory MP Philip Davies said: ‘At a time when the Government is looking for ways to save money it’s quite extraordinary that the only people who look like they are going to be better off are prisoners. As far as I’m concerned it’s absolutely unacceptable and I think the public will be outraged.’
Although many prisons already offer a wide choice at mealtimes, it is thought to be the first time the five choices have been set in stone by ministers.
A Prison Service spokesman said: ‘The choice of meals that are available to prisoners reflect both religious and medical requirements, including halal, dairy free and vegetarian options. In practice this means a number of prisoners only have one choice.’
British school trips to be freed from health and safety red tape as Lord Young promises to roll back compensation culture
Red tape surrounding school trips is to be slashed as part of a Government drive to inject ‘common sense’ into Britain’s health and safety laws. Former Cabinet minister Lord Young said the regulation surrounding school trips was now so onerous that many teachers no longer bothered to organise them – leading millions of children to miss out on a vital part of their education.
Launching a Government report on health and safety laws today Lord Young criticised the ‘enormous bureaucracy’ currently surrounding school trips. He said ministers would cut back the 12-page risk assessment that currently has to be completed by teachers for each trip. Parents will also be able to sign a single consent form which covers a child’s entire time at the school, to prevent the wasteful practice of seeking consent for every visit.
Lord Young, who was appointed by David Cameron to roll back Britain’s compensation culture, said: ‘The simple truth is that filling in a form doesn’t make a trip more safe. ‘Children are potentially missing out on vital education because schools just do not have the time and resource to carry out the process. ‘If they do, they are too concerned about the threat of legal action should an accident happen.’
The report also calls for risk assessments of children’s play areas to consider the benefits of giving youngsters somewhere to play rather than focusing solely on the potential risks.
Lord Young said health and safety laws originally designed for dangerous industries were now being applied to a range of jobs and everyday activities that are ‘non-hazardous’.
He also hit out at no-win, no-fee lawyers for fuelling the compensation culture, saying: ‘I started out as a lawyer and I am frankly ashamed of some of the things that I have seen.’ The new report calls for a crackdown on adverts encouraging people to launch a compensation claim for even the most trivial accident.
Lord Young said the Government would ban the practice of law firms and claims handlers offering people up to £500 up front in return for lodging a compensation claim. Lord Young said the growth of the compensation culture led to higher insurance premiums for millions of businesses and individuals, and persuaded many organisations to adopt an unnecessarily risk-averse approach.
He said the insurance industry was also ‘part of the problem’. He added: ‘Businesses now operate their health and safety policies in a climate of fear. The advent of ‘no win, no fee’ claims and the all-pervasive advertising by claims management companies have significantly added to the belief that there is a nationwide compensation culture.’
Two years ago teachers at the John F. Kennedy Primary School in Washington, Tyne and Wear, scrapped the sports day sack race fearing children will fall over
The report ‘Common Sense, Common Safety’, which was accepted in its entirety by the Government, also calls for the introduction in law of a ‘Good Samaritan clause’ to make it clear that volunteers cannot be sued unless they have clearly acted recklessly or maliciously.
Lord Young said the move would prevent a repeat of the farce last winter when people were warned they could be sued for clearing the snow in front of their home if someone then slipped on the pavement.
A separate legislative move will make it clear that members of the emergency services will not risk prosecution on health and safety grounds in circumstances where they have acted heroically – a move immediately welcomed by the Association of Chief Police Officers.
The Prime Minister said he hoped Lord Young’s report would prove to be a ‘turning point’ which would ‘help stop the creep of unnecessary health and safety culture that we have’.
Other changes include requiring killjoy councils that want to ban community events such as pancake races to put their reasons in writing. Organisers will be able to challenge any ruling and councils could be fined if they are found to have acted wrongly.
A new fixed-cost system for resolving compensation in road traffic accidents will be extended to cover straightforward personal injury claims.
Simpler guidance on health and safety will be published for offices and other low-risk workplaces, and employers will not have to conduct a full health and safety assessment for staff who work from home.
Lord Young insisted that his reforms, which will be rolled out over the next 18 months, would have no impact on important health and safety laws in hazardous workplaces.
But TUC general secretary Brendan Barber described the report as a ‘grave disappointment’ which could throw safety improvements into reverse. Mr Barber said: ‘The report contains not a single proposal that will reduce the high levels of workplace death, injuries and illness.’