How British doctors repeatedly missed a woman’s cancer, with fatal consequences
On a freezing November day last year, Shirley’s funeral was held near her home in Cheshire. She was 40 years old. If her death had been painful then the two years leading up to it were even more so, if only because Shirley fought so hard – against the disease and the doctors who had ignored her symptoms.
The medical profession failed her – in particular, one gynaecologist, namely Anthony Nysenbaum, who is currently under investigation by the General Medical Council (GMC). Shirley was awarded substantial compensation but, as she told friends: ‘What use to me is money? I just want my life back.’ …
At one breakfast meeting Shirley confessed she had been ill. Really ill. She ran through a catalogue of symptoms that no woman should ever put up with. There were pelvic cramps so severe that she had to crawl from bedroom to bathroom for pain-killers (up to 15 a day) and she would wrap herself in bath towels at night to stem the haemorrhaging that left her bed like a scene from a horror movie. And that was not just monthly. It was becoming the norm and had gone on for a year.
Of course she visited her doctor. Not only had Shirley diligently gone to her GP, she had kept records of appointments month after month in which she reported her debilitating symptoms. She was given a smear test but it came back as normal.
Eventually, after several visits to her GP, she insisted on seeing a private consultant, Mr Nysenbaum. He examined her womb under anaesthetic at a private hospital, told her there was nothing wrong and discharged her without any further investigations or monitoring. Her symptoms continued but her GP, reassured by Mr Nysenbaum’s view, did nothing.
Mr Tim Mould, consultant gynaecological oncologist and clinical director for Women’s Health at London’s University College Hospital, told me at a media briefing on cervical cancer that Shirley could have requested a referral to a hospital specialist for a colposcopy from her GP, which would have examined the neck of the cervix and detected any cancerous changes.
Even a recent normal cervical smear should not stop a referral for colposcopy if abnormal symptoms persist. A cervical smear may miss abnormalities and so a normal result does not exclude a problem.
I had never heard of the test and nor had Shirley. Like most women in her situation, she accepted what the doctors told her. Perhaps we should be more questioning. Out of 2,800 annual cases of cervical cancer, 900 women die from the disease, many of whom have had smears that have not identified cancer.
Dr Dawn Harper, a Gloucestershire GP involved with The Eve Appeal, a charity raising awareness of genealogical cancers, is frank. ‘If I have a patient who comes back to me three times and I can’t figure out what is going on, then I refer them,’ she says.
Even when Shirley was referred to Manchester’s Trafford General Hospital – again to Mr Nysenbaum – no examinations were undertaken and she was discharged after a blood transfusion.
Many precious months were lost before finally a long overdue examination at Trafford revealed a large cancerous growth on her cervix. It also revealed that the cancer had spread through her body and was now inoperable.
The injustice of her situation had her scouring the internet for a big-hitting medical negligence lawyer and she settled on Sarah Harman, sister of Harriet, the Deputy Leader of the Labour Party. Shirley told me of her relief when Sarah immediately agreed to take on her case. Even so, the case against her GP, Mr Nysenbaum and the Trafford General Hospital proved just as gruelling as her treatment for cancer.
By the time Shirley contacted Sarah she had already outlived the prognosis given to her by her doctors that she would survive only a few months. A sympathetic judge, realising Shirley had little time left, arranged for her to give her evidence on tape before the trial. But this meant Shirley had to sit in a room crammed with lawyers to face cross-examination. To her horror, Mr Nysenbaum also attended.
The experience, Shirley told Sarah, was worse than being given her terminal prognosis. Every physical symptom and examination was trawled through and Shirley was made to feel she was responsible for her delayed diagnosis by suggestions that she refused to attend for smear tests or be examined.
Even in her frail state, Shirley was able to stand her ground. A few months after this dreadful experience, Trafford Hospital admitted full liability on behalf of their consultant Mr Nysenbaum. But compensation was not the main objective for Shirley. She asked Sarah to report Mr Nysenbaum to the GMC, which aims to protect patients from doctors who fail them.
Shirley will not see the outcome, but knew that she did the right thing in persisting with making the medical establishment follow up the litany of neglect she suffered.
The last time I saw Shirley was a few months before she died. She needed a stick to walk, her frame was tiny but her stomach, which she rubbed as she tried to make herself comfortable on the sofa, was distended. She could no longer eat, the cancer had spread and she was angry. ‘Why did I not do more?’ she kept repeating. ‘I am so cross that I did not do more.’
If there is a lesson to be learned from Shirley it is this: unexplained, persistent symptoms – especially those you find distressing or frightening – are not to be ignored. They mean there is something wrong with your body. If your GP is at a consistent loss as to how to help then try elsewhere. You owe it to yourself and perhaps, too, to Shirley.
Tony Blair changes his tune over immigration saying it produced a ‘challenge’
Tony Blair yesterday admitted for the first time that mass immigration has produced a ‘challenge’ which causes alarm to millions. The former prime minister acknowledged there was a ‘debate’ over the impact of immigration and whether British generosity in allowing it had been abused.
Mr Blair said immigration had produced both a cultural and economic ‘challenge’. He made his admission in an article in which he accepted that ‘there is a perception of failure’ over the issue. The view contrasted strongly with his stance as prime minister. In the 2005 election campaign he insisted immigrants had made a ‘huge contribution’ to Britain and condemned opponents for ‘exploiting people’s fears’.
In his 690-page autobiography published last year he devoted only one page to the controversial subject. Yesterday, however, in Roman Catholic journal The Tablet, Mr Blair declared that immigration – 3.2million came to live in Britain during Labour’s years in power – was a matter of major importance.
He said: ‘A new type of debate is taking shape. While it can centre on immigration or protectionism, it is above all about issues to do with culture and integration – issues that are altogether more vigorous and potentially more explosive. ‘In Europe, the debate is about whether our attempt to integrate cultures has succeeded or failed and, insofar as there is a perception of failure, it is about whether our “generosity” in allowing inward migration and encouraging multiculturalism has been abused.’
Last night Douglas Carswell, MP for Clacton, said: ‘What a pity that Tony Blair waited until he left office to address an issue of concern to millions of people in this country.’
And Sir Andrew Green, of MigrationWatch, said: ‘Having ignored the development of mass immigration for 12 years, Mr Blair has now discovered that Labour’s legacy has left us with huge problems, both economic and social.’
The number one excuse: Right to a family life lets foreign convicts stay in Britain
More than 200 foreign prisoners, including killers, cheated deportation last year by claiming they have a human right to a ‘family life’ in Britain. The Home Office has confirmed that the ‘right to a family life’ has become the number one excuse used by convicts successfully blocking removal from the UK.
It has overtaken the usual claim submitted by illegal immigrants and overseas criminals that they face ill-treatment at home. MPs said it was hard proof that Article 8 of the Human Rights Act – which protects the right to a ‘family life’ – was being abused, and they are demanding changes to the law.
Tory MP Dominic Raab, who obtained the figures, said: ‘It is one thing to argue against deporting an individual into the arms of a torturing state. But it makes a mockery of British justice to allow hundreds of criminals and suspected terrorists to claim family ties to defeat a deportation order.
‘This is a novel expansion of human rights by the UK courts, and an escalating threat to our border controls. Whilst the Coalition partners may not agree on scrapping the Human Rights Act, we should look urgently at specific amendments to deal with the growing deportation problem.’
Home Office figures show a 17 per cent rise in the successful human rights claims by immigrants fighting removal from Britain between January and September 2010. There were 303 cases, compared with 258 in the first nine months of 2009. The total for 2010 is expected to be 400.
Mr Raab says the figures he uncovered made a case for immediate amendments to the law. Currently, the law says offenders jailed for 12 months or more should be deported on completing their sentence – but there is an exemption if removing them would breach their human rights.
Repealing that exception would lead to fewer criminals successfully arguing they should be allowed to stay. MPs fear judges are now going even further in interpreting Article 8. In some cases, criminals who are single with no children have won appeals to stay because their parents live in the UK.
Other beneficiaries include Aso Mohammed Ibrahim, who knocked down 12-year-old Amy Houston and left her to ‘die like a dog’ under the wheels of his car.
He was driving while disqualified and committed a string of offences after the little girl’s death, but an immigration tribunal ruled that – because Ibrahim had children while living in Britain – he had a right to a ‘family life’ here.
Last night, Immigration Minister Damian Green said: ‘Convicted foreign national criminals who refuse to comply with the deportation process should not be allowed to hold the public to ransom. ‘It is not acceptable that the British taxpayer should have to pay to accommodate foreign national criminals with no right to be here. Our priority will always be to protect the public.’
The statistics will reignite the pressure on David Cameron to make meaningful changes to the Act.
The Coalition is preparing to launch a commission to consider overhauling the legislation. But it is already mired in controversy as Lord Lester, a QC who campaigned for 30 years for EU rights conventions to be incorporated in British law, will sit on the body as will Labour peer and human rights lawyer Baroness Kennedy.
Tory MP Douglas Carswell said: ‘If you put a fox in charge of the chicken coop, you have a problem for the chickens. If we put human rights lawyers in charge of human rights reviews, you still have a human rights problem.’
Bureaucracy means the end of a free handout to members of Britain’s Women’s Institute
Mostly older ladies
For 20 years the thirsty ladies in village halls have received free parcels of Yorkshire Tea. But now the complimentary cuppas, enjoyed by members in more than 6,000 branches, are to be stopped because of charity law red tape.
The decision has caused outrage among the 96-year-old organisation’s 200,000 members – who shook off their once-genteel image with stunts such as the nude calendar that inspired the 2003 film Calendar Girls. A Facebook group has been launched called ‘Reinstate our Yorkshire Tea’, on which members complain that they were not consulted by the top brass about the decision. The Facebook page also carries accusations that discussions about the tea on the WI’s own website have been ‘censored’.
Problems started when the National Federation of Women’s Institutes (NFWI) decided that to protect the WI ‘brand’ Yorkshire Tea needed a contract to supply the organisation with free tea.
But the tea’s makers, Taylor’s of Harrogate, decided the contract wasn’t for them and have now dispatched the last goody boxes.
A Yorkshire Tea spokesman explained: ‘It was a case of “we need a contractual relationship”. This wasn’t for us. There were lots of elements to it. We started conversations and we didn’t get that far. ‘It’s been difficult for everyone. We have had super letters of support and thanks from ordinary members. They’re a very vocal bunch and we hope they’ll carry on drinking Yorkshire Tea for years to come.’
The WI blamed the situation on ‘constraints and obligations on the NFWI Board as charity trustees under current charity law’. A spokesman added: ‘While members are free to accept gifts in kind, no public acknowledgement for the commercial company is allowed in return unless there is an agreed contractual relationship clearly stipulating the terms of engagement.’
The decision could provoke a backlash as fierce as the occasion when members slowclapped and heckled Tony Blair at a 10,000-strong WI conference.
On Facebook, Shirley Markham of Farmborough WI writes: ‘Please NFWI have another think! Our long association with Yorkshire Tea has done nothing but good to many causes and people, why change it if it works?’
Claire Fox, director of the Institute of Ideas, said: ‘How ironic. We have a Government that promises to get rid of red tape and nurture charities yet somehow, the ever-more elaborate, trumped-up regulations imposed on charity trustees means a genuinely altruistic act by business is scuppered. ‘If the Big Society means anything, surely it’s butting out of informal arrangements. ‘Mr Cameron promises to roll back the state to free up People Power. Maybe he could start with rolling back charity law.’
The British hunt saboteur, a loving couple and judges who dismiss Christianity
A Christian couple, Owen and Eunice Johns, were recently banned from fostering children because of their belief that homosexuality is wrong. Ten days ago, two senior judges concluded that the right of homosexuals to equality ‘should take precedence’ over the right of Christians to manifest their beliefs and moral values.
On Tuesday, David Cameron blundered into the controversy. The Prime Minister asserted that the couple had been dealt with in an ‘appropriate way’, and added that Christians must be ‘tolerant and welcoming and broad-minded’ towards homosexuality.
That same day, another judge in a different court ruled that the ‘deeply held’ beliefs of a prominent animal rights campaigner and hunt saboteur called Joe Hashman should be protected from discrimination in the same way as religion.
The two cases are obviously unalike in all sorts of ways, but they both illustrate an extraordinary new phenomenon. In the eyes of the courts, secular values have supplanted religious ones and, in the second case, have been accorded the status of a religion.
Perhaps you thought you still lived in a Christian country. I wouldn’t be so sure. In the case of Owen and Eunice Johns, Lord Justice Munby and Mr Justice Beatson opined that Britain was a ‘largely secular’, multi-cultural country in which the laws of the realm ‘do not include Christianity’.
The learned judges must know that our common law is rooted in Christian ethics. However, they believe that ‘because of enormous changes in the social and religious life of our country over the past century’ the law should be able to place secular values above Christian ones.
Of course, there are many Christians (I would include myself) who do not share the Johns’ views on homosexuality. But there are a large number, not least the Pope, who believe that the practice of homosexuality is sinful. This view is not just dreamt up out of thin air. It is based on a reading of the Bible, and would have been accepted by virtually all Christians until about 50 years ago.
The Johns, who are Pentecostal Christians and were born in Jamaica, do not hold their views in any aggressive or hectoring way. They seem to be strikingly good people, and have fostered very many children. They were simply unable to respond in the affirmative to this question posed by Derby City Council: ‘Would you tell a child that it was all right to be homosexual?’
The couple said that in all conscience they could not say this because they did not believe it. They deny they are in any way homophobic, and stress that they would treat any child with love. They are just unwilling to say something they do not believe. That seems to me brave, principled and Christian behaviour.
In fact, the Johns had applied to foster children between the ages of five and eight for whom the rights and wrongs of homosexuality are not usually a very pressing concern.
It looks to me as though, in a mood of zealotry, Derby City Council deliberately picked a fight by invoking a piece of egregious New Labour legislation, the Equality Act (Sexual Orientation) Regulations 2007.
The normally sensible Work and Pensions Secretary, Iain Duncan Smith, has argued that the judges did not rule that the Johns had no right to hold their views on homosexuality — merely that they should not make them plain to prospective foster children. But isn’t the distinction a pretty meaningless one? If you are not allowed to communicate a belief, the implication must be that the belief is in some way dangerous and wrong. It is not a very big step from being prohibited from expressing a principle to being prevented from entertaining it even in private.
And yet the belief we are speaking of does not threaten the practices of anybody. It is part of traditional Christian dogma, rejected in recent times by some Christians, but still held as a matter of conscience by others.
David Cameron’s intervention when asked about the Johns’ case during a visit to Derby was unwise. I doubt he has made much of a study of Christian attitudes towards homosexuality, and he should have kept his mouth shut. He was in a small way doing what Lord Justice Munby and Mr Justice Beatson had done — imposing fashionable secular values (I won’t accuse him of playing to the electoral gallery) on religious ones.
As a number of homosexual pundits have observed, the people who are displaying a lack of tolerance and broad mindedness, to borrow Mr Cameron’s words, are not the modest, retiring, public-spirited Johns — who merely want to be true to their beliefs, and might, incidentally, serve as a perfect advertisement for Mr Cameron’s ‘Big Society’ — but the original promoters of the Equality Act (Sexual Orientation) Regulations 2007, Derby City Council and even the learned judges.
In view of their intolerance towards the couple’s religious beliefs, it is almost farcical to find Judge Lawrence Guyer pandering to hunt saboteur Joe Hashman, and treating his purely secular beliefs as though they amounted to a religion.
Mr Hashman says he was sacked as a designer from a garden centre when his bosses discovered he was a hunt saboteur. Judge Guyer practically genuflected in front of his reputed belief ‘that people should live their lives with mindful respect for animals and we all have a moral obligation to live in a way which is kind to each other, our environment and our fellow creatures’. This is what many, probably most, people believe. It does not constitute a religion.
Moreover, bearing in mind Mr Hashman’s past as a hunt saboteur and animal rights campaigner, I doubt he has observed the ‘moral obligation to live in a way which is kind to each other’ in quite the way the woolly-headed judge suggests.
Maybe Mr Hashman has lived an unexceptionable life promoting his cause, but many animal rights campaigners have not. It is part of their credo to disrupt the livelihoods of others, and the more extreme fringes have abused, terrorised and sometimes used violence against workers in laboratories where experiments involving animals take place.
Mr Hashman’s beliefs, whether anti-social or otherwise, are not religious, and until the court establishes the truth about his sacking, it is very hard to see how he has been the victim of discrimination.
By contrast, the self-effacing Johns have not tried to impose their beliefs, which are part of this country’s religious tradition, on anyone. They are the victims of discrimination, and yet almost no one seems to care.
It is not just the law that increasingly relegates and ridicules Christianity. The BBC has steadily reduced the amount of religious broadcasting. Christian speakers have been progressively edged out on Radio Four’s daily avowedly religious Thought for Today slot at the expense of Muslim, Hindu, and Buddhist ones. Though these religions have many fewer adherents in this country, they are virtually accorded equality by the secularly-minded BBC.
Even Christians who do not agree with the Johns’ views on homosexuality should wake up and grasp that many of their values are being challenged and replaced by secular ones.
And all of us, Christian or not, should understand just how blindly intolerant and narrow-minded these forces of a new secular religion often are.
History teaching in Britain fails to give pupils proper view of the past, says watchdog
Schoolchildren fail to grasp how events in history are linked because the subject is taught in “episodes”, an official report has warned. The Ofsted report said many primary and secondary pupils are being let down by a curriculum which does not give them a “chronological understanding” of the subject – instead concentrating on individual topics from ancient Egypt to post-war Britain.
The education watchdog also said that history teaching is being marginalised in state schools, while A-levels are not adequately preparing sixth-formers for more rigorous university courses.
The verdict will be seen as further damaging Labour’s legacy on education and add weight to calls for reform of the national curriculum, which is currently being reviewed by Michael Gove, the Education Secretary, with the help of Simon Schama, the historian and television presenter.
Pupils in a typical primary school will study the Romans and Celts, Ancient Egypt, Henry VIII and the Tudors, Victorian life, World War II, the Ancient Greeks, and Britain since 1948 between years three and six – but not what order they are in.
A “fundamental weakness” in primary schools was that some teachers “did not teach to establish a clear mental map of the past for pupils”. The report said: “Some pupils found it difficult to place the historical episodes they had studied within any coherent, long-term narrative. “They knew about particular events, characters and periods but did not have an overview. Their chronological understanding was often underdeveloped and so they found it difficult to link developments together.”
Christine Gilbert, Her Majesty’s Chief Inspector of Education, said: “Pupils need to experience history as a coherent subject which develops their knowledge, thinking and understanding, especially their chronological understanding, and I hope the current review of the national curriculum will recognise the importance of this.”
In primary schools where history teaching was rated “satisfactory”, inspectors said there was “an unbalanced curriculum with too much attention paid to particular topics at the expense of others” and many teachers lacked specialist knowledge of the subject.
The report also criticised changes introduced by the previous government which allow schools to ditch history as a self-contained subject and instead incorporate it in a general humanities course alongside geography and arts subjects. “Where these developments had taken place, curriculum time for teaching had been reduced and history was becoming marginalised,” the inspectors said. “This resulted in significant gaps and encouraged an episodic understanding of the past.”
England is the only European country which does not teach compulsory history to the age of 15 or 16, with growing numbers of pupils now allowed to drop the subject at 13.
Ofsted stopped short of recommending that history should again be made compulsory at GCSE, but it did urge ministers to ensure pupils receive a “significant amount” of tuition in history to “at least the age of 14”.
Regarding history at secondary school level the report said: “One of the most serious concerns about poor provision was the tendency for teachers to try to cover too much content and ‘spoon-feed’ students.” In some cases at Key Stage Three – for pupils aged 11 to 14 – some teachers gave only cursory checks to children’s work books so that “basic errors of spelling, grammar and punctuation were uncorrected”.
The inspectors found an over-dependence on text books at sixth form level, meaning students were unprepared for studying the subject at university.
And the report detailed falling numbers of schools offering history at GCSE. In 2010, 102 maintained secondary schools entered no students at all to sit GCSE history, compared with 77 schools the year before. In State schools, only 30 per cent of pupils took history at GCSE last year – and 20 per cent at academies – compared with half in the independent [private] sector.
The most able students are being let down, the report indicated. History teaching for the brightest was good or outstanding in only 16 of 32 schools analysed, with the rest only satisfactory, it said.