Great grandfather died following stroke – after he waited 76 minutes for ambulance
A great grandfather died from a stroke after he waited 76 minutes for an ambulance to take him to hospital – almost 10 times longer than the national response guideline.
Ron Gibson, 78, was found collapsed and unconscious at his home by his daughter, Deborah, during the height of the snowy winter weather last December. She immediately dialled 999 and requested an ambulance but then waited more than an hour for it to arrive – when the guideline for response times to life-threatening incidents is just eight minutes.
Mr Gibson was taken to hospital but his condition deteriorated and he died two days later. His family believe he could have been saved if he had arrived at hospital sooner.
Paul Richardson, 49, his son-in-law, said: ‘The ambulance service we feel weren’t able to provide a reasonable excuse as to why it took so long. ‘The delay was simply unacceptable. All the medical professionals said the earlier you start on the treatment, the better chance you have of survival. ‘If you are going to hospital with a delay of 76 minutes we believe that chance is taken away from you.’
At an inquest into his death deputy coroner Alan Walsh said that despite the impact of the severe winter weather last December the ambulance response time was unacceptable. The tragedy happened on December 9 last year after freezing conditions and snow had brought the UK to a virtual standstill.
Mr Gibson was at his home in Withington, Manchester when he suffered a stroke. An ambulance was called to his home and the incident was classed as red, meaning it was life-threatening, and an ambulance should have arrived within eight minutes.
But at the time of the incident around 30 emergency calls were awaiting response and North West Ambulance Service (NWAS) had been forced to declare a major incident to manage a large amount of calls.
A rapid response vehicle was sent from Stockport and arrived at 5.40pm but paramedic Ian Jackson could not take Mr Gibson to hospital where he could receive potentially life-saving drugs without a larger, two-man ambulance. In a tragic turn of events, Mr Jackson told the inquest in Bolton he had been deeply upset on arrival because he realised the casualty was a man who had been his friend for 20 years.
After frantic phone calls from Mr Jackson, including one to his manager, another ambulance was sent from Stockport arriving at the house at 6.40pm.
Mr Gibson, a great-grandfather of four and part-time water bailiff, was taken to Salford Royal Infirmary, arriving at 7.04pm.
Dr Christopher Douglas, a consultant neurologist at Salford, told the inquest Mr Gibson had suffered a very severe stroke and said time was crucial in saving patients. “It can’t be said with any degree of certainty that Mr Gibson would not have died when he did if the therapy had been administered sooner.’ He said: ‘Up to two billion brain cells per minute are lost in strokes and the sooner you can save these cells the better. ‘I can’t say that he would have survived if he had started treatment sooner. It might have had an impact.’
Mr Walsh recorded a narrative verdict, ruling Mr Gibson had died from a severe stroke complicated by subsequent expansion and exacerbated by further bleeding to the brain.
He said there could be no criticism of paramedics or hospital staff but said the ambulance delay was ‘not acceptable.’
Mr Walsh said: ‘I accept that many public services, and the ambulance service is no exception, from time to time are faced with unprecedented situations as a result of circumstances beyond their control. ‘Demand upon them results in delayed allocation of resources even in life-threatening situations, I think this was one such situation.
‘It can’t be said with any degree of certainty that Mr Gibson would not have died when he did if the therapy had been administered sooner.’
A NWAS spokesman said: ‘December 9 2010, was an exceptionally busy day for the Trust impeded by the severe winter weather. ‘This meant that ambulance resources were stretched to full capacity and messages were sent out via the media to inform the public that delays may be experienced.’
UK fears migrant influx as EU bids to break down border controls
Brussels bosses want to tear up European Union immigration rules, leaving Britain vulnerable to a new influx of migrants. The European Commission plans to use human rights laws to break down border controls.
David Cameron will today go into battle to face down plans to scrap the existing rule that means illegal immigrants and asylum seekers are supposed to be sent back to the country where they first enter the EU.
Commission President Jose Manuel Barroso will use a summit in Brussels today to press for the changes. He wants the rule suspended indefinitely, opening the door to thousands of immigrants heading for Britain to claim more generous benefits than they could get elsewhere.
British officials fear that suspending the rule will mean that countries on the edge of Europe make far less effort to police their borders, since they will not have to face the consequences themselves of letting in too many migrants.
The situation has been made more acute by the fighting in Libya, which has seen thousands of refugees fleeing Colonel Gaddafi’s regime to take shelter in the EU. More than one million people have fled Libya since the conflict began. Frontex, the EU border agency, estimates that 48,000 have already arrived in the EU. Italy is expecting another 50,000 to double those numbers.
Eurocrats are demanding the changes to the existing rules, enshrined in the so-called ‘Dublin regulations’, after officials lost a legal case in the European Court of Human Rights in January. On that occasion the Court ruled that Belgium and Greece had violated the rights of an asylum seeker in expelling him to Athens.
Both countries had been following EU policy by sending migrants back to the port where they first entered the EU to file their claim to refugee status. The policy was followed despite warnings from the UN refugee agency and the Council of Europe’s human rights commissioner that Greece’s system was dysfunctional.
The Afghan asylum seeker, known to the court as M.S.S., said that Belgium and Greece had subjected him to degrading treatment in returning him to Athens, and that he had been denied an ‘effective remedy’ against expulsion. The court agreed.
Last night the Prime Minister’s official spokesman said: ‘The Commission is proposing that the regulations are suspended. ‘We will be resisting that because we think it’s important to have proper border controls.’
The Prime Minister will join forces with French President Nicolas Sarkozy to block a bid by Mr Barroso to write the plans into the communiqué which will be issued at the end of the EU leader’s summit tomorrow. The French are keen to block the move because they have already fallen out with Italy after immigrants arriving from Libya crossed the border into France.
The No 10 spokesman said: ‘We do care because what happens at the border of Europe can impact on the border of the UK. ‘People who come into the EU through other countries can end up in the UK. ‘We’ve got to have the right incentives in place so countries police their borders properly.’
Burglar stabbed to death in Britain: Father and son arrested on suspicion of murder
A father and son were being questioned by detectives last night after a suspected burglar was stabbed to death as he broke into their family home. The death comes only days after David Cameron vowed to protect the rights of homeowners to defend their property.
Peter Flanagan, 59, and his son Neil, 27, were asleep upstairs when four masked men forced their way in through the back door of their terraced home. They awoke and confronted the gang and during a violent struggle one balaclava-wearing intruder was stabbed. His three accomplices helped him as he staggered 200 yards before collapsing.
Alerted by a 999 call from the Flanagan household shortly before midnight on Wednesday, police dashed to the scene to find the intruder lying in the street in a pool of blood. The 26-year-old suspected burglar, who has not been named, was taken to a nearby hospital where he was pronounced dead.
Police returned to the £120,000 two-bedroom Victorian home in Salford and arrested Mr Flanagan, a garage worker, his son, a builder, and Neil’s 21-year-old girlfriend.
They were in custody last night, being questioned by detectives on suspicion of murder. Earlier this week, Mr Cameron said: ‘My mission is to make sure families can feel safe in their homes. The first duty of government is to protect people. ‘We will put beyond doubt that homeowners and small shopkeepers who use reasonable force to defend themselves or their properties will not be prosecuted.’
But Shami Chakrabarti, director of civil rights group Liberty, said: ‘This is a problem not of law but the public understanding of it. ‘Of course people facing intruders can use reasonable force to defend themselves. ‘But saying that “burglars leave their rights at the threshold” is a recipe for vigilante execution and mistaken killings of family members returning home after dark.’
Asked about Mr Cameron’s comments, Chief Superintendent Kevin Mulligan of Greater Manchester Police said: ‘I would tell people to ring the police and use reasonable force, but I don’t want to enter into a legal debate.’
Mr Flanagan’s wife Valerie, who moved out of the home in 2000, was not at the property at the time. She said: ‘It’s such a terrible incident. How anything like this can happen to anyone I don’t know. My husband is a great man and a great father – it’s such a shock.’
One neighbour said: ‘They’re just a normal family and I would never have expected in a million years that they would have been caught up in anything like this. ‘I’ve known the young lad Neil since he was born and I’ve known the family for years.
‘If what people are saying is right then I think it’s perfectly understandable if Neil and his father stood up against a gang of burglars. I would have done the same thing to protect my own family.’
One in four British state schools flouts duty to teach RE
Hundreds of state schools are killing off religious education by ignoring their legal obligation to teach the subject, it was claimed yesterday.
Since 1944 it has been enshrined in law that all five to 16-year-olds must study the subject at school. Typically, guidelines state it should comprise at least 5 per cent of their curriculum – equivalent to one hour every week – and all 14 to 16-year-olds must take at least half a GCSE in religious studies.
But research published yesterday shows one in four comprehensive and academy schools do not teach religious studies at GSCE. And some 31 per cent of grammars are now shirking the obligation.
The findings come as the Government seeks to leave the subject out of the new GCSE performance measure, the English Baccalaureate. And the Coalition has removed the onus from schools watchdog Ofsted to police take-up of the subject.
As a result, schools have less incentive to teach the subject and increasingly think they can get away with breaking the law, it is claimed. And religious experts fear RE is now at serious risk of completely disappearing in many schools.
Religious education has been integral to schooling in Britain since the Church of England first provided schools for the masses in 1812.
In 1870, when the State opened schools, it remained a core component. And with the Education Act of 1944 it became law for pupils aged five to 16 to be taught RE. Initially the law simply required schools to give ‘religious instruction’.
This remained unchanged to 1988 when the Education Reform Act established a mandatory National Curriculum of ten subjects, including RE. Over time the subject has broadened to include all major world religions and atheism.
Ed Pawson, chairman of the National Association of Teachers of Religious Education, said: ‘There has been a dramatic slump in the take-up of RE in secondary schools. ‘Once it dies out at GCSE level, it will die right across the board. ‘Nobody is policing the teaching of RE and the Government offers no incentive for it to be taught. It would be an absolute tragedy if it died out. ‘The subject is more relevant today than ever and gives pupils an understanding of their culture and heritage, and the culture of others.’
The association conducted a poll of almost 2,000 secondary schools and found more than 500 are breaking the law by failing to teach RE to children aged between 14 and 16.
It predicts this trend will surge by at least 10 per cent next year – and says the introduction of the English Baccalaureate is the key reason.
The English Baccalaureate is given to teenagers who score at least a C at GCSE in English, maths, science, a foreign language and a humanities subject, which is limited to history and geography.
But campaigners said that RE should have been included and its exclusion sparked a wave of protest.
A Department for Education spokesman said: ‘RE remains a vital part of the school curriculum. That’s why it remains compulsory for every single student up to 16.’
New spelling test for British 11-year-olds in primary school exam overhaul
All 11-year-olds will be forced to sit a new-style test in spelling, grammar, punctuation, handwriting and vocabulary to drive up poor standards of English, it emerged today.
Some 600,000 pupils will take the toughen-up literacy exam at the end of primary school as part of a major overhaul of Sats tests, it was disclosed.
It will replace an existing exam in writing composition which has been branded “pointless” by teachers because of inconsistent marking and fears young children struggle to come up with creative prose in formal test conditions.
An independent review of assessment in English primary schools said a more focused exam based on fundamental literacy skills would “raise attainment” in these areas and give teachers more freedom to monitor children’s composition throughout the year.
The review – led by Lord Bew, the crossbench peer – also recommended:
* Maintaining existing tests in maths and reading;
* Keeping the current system in which teachers informally monitor children’s speaking and listening skills;
* Introducing three year “rolling average” results for schools alongside annual scores to stop small primaries being penalised by sudden dips in grades;
* Giving children at least a week to sit tests if they are ill on exam day – replacing the current system in which absences are marked down as “failures”;
* Investigating the possible use of on-line testing and marking as a long-term replacement for traditional pen and paper exams.
The conclusions come amid claims from teachers and academics that Sats promote a culture of “teaching to the test” and lead to a narrowing of the curriculum.
Last year, a quarter of state primaries boycotted the exams as part of industrial action staged by the National Union of Teachers and the National Association of Head Teachers. Today, both unions welcomed the reforms, saying they appeared to mark a “step in the right direction”.
But the NASUWT union branded the report a “fudge”. Chris Keates, general secretary, said: “The simple and straightforward question Lord Bew was asked to look at was the relative merits of teacher assessments versus externally marked testing, whilst ensuring public confidence. “However, he has ducked the issue and come up with a fudge.”
Currently, children take three exams in reading, writing and maths during the final May of primary education. Results are published in national league tables.
At the same time, teachers informally assess pupils’ progress in all three areas – alongside speaking and listening – and these results are released at the same time. In today’s report, Lord Bew proposed beefing up the role of teacher assessment by publishing results before formal exam scores.
He also criticised the existing writing test, which asks pupils to pen a piece of prose, verse or a formal letter. It is then marked for composition, spelling, grammar, punctuation and handwriting.
The review said composition should now be assessed informally by teachers throughout the final year of primary school. The other elements “where there are clear ‘right’ and ‘wrong’ answers” should be subjected to a new externally-marked test, it said.
The changes – which are likely to be accepted in full by the Government – are set to be introduced as early as next year.
Michael Gove, the Education Secretary, welcomed the review team’s report, adding: “Their recommendations represent an educationally sound approach while taking account of different opinions. They are fair for teachers and schools.
“They give an opportunity for pupils to showcase their abilities. They still give parents the vital information they need about how their school is performing, in a range of new and different ways.”
Could a 2-month low-calorie diet defeat diabetes? Trial patients were able to throw away tablets
A very tiny study but promising
The form of diabetes that blights the lives of millions of middle-aged Britons could be wiped out by cutting calories severely for just two months, research suggests. After a small-scale trial, diabetics who consumed just 600 calories a day – the amount many people would eat at lunch alone – were able to throw away their tablets.
Eighteen months on, some are still free of type 2 diabetes, which is linked to obesity and usually occurs in middle age.
The Newcastle University researchers described the result as remarkable and said it proves that the condition that affects 2.5million Britons need not be a life sentence. It also paves the way for new treatments for those who cannot stick to the drastic diet.
Professor Roy Taylor, the study’s lead author, said: ‘This is a radical change in our understanding of type 2 diabetes. ‘While it has long been believed that the disease will steadily get worse, we have shown that we can reverse it.’
In type 2 diabetes, the pancreas does not make enough insulin – a hormone key in the conversion of sugar into energy – and the insulin that is made does not work properly.
The condition is often controlled initially with a stringent diet and exercise regime. But many sufferers see their health worsen and eventually need tablets or insulin injections.
Diabetics are more likely to develop heart disease, blindness, kidney disease and nerve and circulatory damage, which at its worst can lead to amputations. Reversing the condition could therefore improve long-term health and quality of life.
The researchers put 11 men and women with type 2 diabetes on a diet of 600 calories a day for eight weeks. After just a week, some of their blood sugar readings had returned to normal, the journal Diabetologia reports.
After two months, fat levels in the pancreas had returned to normal and the organ was able to pump out insulin without any problems. Some patients no longer needed tablets to control high blood pressure.
The researchers believe that a strict diet melts away fat clogging up the pancreas, allowing it to operate normally.
Three months after the end of the diet, seven of the 11 men and women were still diabetes-free. Now, 18 months on, four of the five that have been in touch with the researchers still have no signs of diabetes.
Dr Iain Frame, of Diabetes UK, which funded the study, warned that no one should go on such a drastic diet without speaking to his or her doctor.
Fatal cocktail of common drugs putting elderly at risk
It’s no news to hear that the elderly take pills by the shovelful but it is interesting to see evidence of harm from that. Being epidemiological however, the evidence can be taken only as a straw in the wind. That people who take more pills might be less healthy is not exactly a surprise
Hundreds of thousands of older people are being put at increased risk of death or developing dementia by taking combinations of common medicines to treat routine illnesses, according to a new study.
Well-known brands of hay fever tablets, painkillers and sleeping pills pose a previously unknown threat to people’s health when taken together, British scientists claim. Many are available over the counter at pharmacies as well as being prescribed by GPs, nurses and chemists.
Today the scientists behind the study call for doctors to recognise how dangerous these drug combinations can be and to prescribe harmless alternatives instead. [Like what?]
Researchers from the University of East Anglia and the University of Kent identified 80 widely used medications that, when used in combination, were found to increase the risk of serious health problems.
The drugs, including common allergy treatments Piriton and Zantac, as well as Seroxat, an anti-depressant, are thought to be used by half of the 10 million over-65s in Britain. Many of the drugs, when taken in combination, were found to more than treble an elderly patient’s chance of dying within two years.
Common bladder medications, heart drugs, eye drops and asthma treatments were also among those found to pose a risk.
All the drugs work by blocking a key chemical in the nervous system called acetylcholine.
The researchers placed each of the drugs into one of three groups based on how effectively they blocked acetylcholine. The more effective the drug was in blocking the chemical, the more dangerous it was in high doses.
The most dangerous included the antihistamines chlorphenamine (used in the brand Piriton) and promethazine (used in Phenergan), the anti-depressant paroxetine (used in Seroxat) and the incontinence drug oxybutynin (used in Ditropan).
The heartburn drug ranitidine (used in Zantac), beta blocker Atenolol, the painkiller codeine and some eye drops were among the drugs in the mildest category.
Low-risk drugs were graded one point while high-risk drugs were graded three. The study found that patients who took a combination of drugs that added up to four points or more — such as a high-risk antihistamine combined with low-risk eye drops — had a 20 per cent chance of dying within two years, compared with just seven per cent for over-65s who did not take anything.
The risk of dying increased by a further 25 per cent for each additional point accumulated, the study published in the Journal of the American Geriatrics Society, concluded.
The scientists suggest that the combination of treatments could also exacerbate dementia. In patients showing early signs of mental impairment high doses could “tip them over” into a more confused state, they said.
Previous research has shown that acetylcholine-blocking drugs could have a harmful impact on the brain.
But the new study, which looked at data collected over 20 years, is the first to examine the cumulative effect of the medications. It shows for the first time that mixing drugs has a significant impact on a patient’s chance of death.
The study also identified the risk in a far greater range of drugs than had previously been documented, meaning that GPs may have been prescribing pills to patients without knowing the potentially deadly side-effects of combining medication. Ian Maidment, one of the researchers and a pharmacist at Kent University, said: “What is really the problem is the additive effect. It is the cumulative burden which is very damaging.
“It is not just the obvious medicines, it is things like heart drugs and antihistamines, and lots of doctors and nurses and pharmacists may not be aware that these medicines have this problem.”
Researchers examined the medication records of more than 13,000 people aged 65 or older over two decades and found 48 per cent were using at least one of the drugs on the list.
Dr Chris Fox, of the University of East Anglia, said: “In the future doctors may use this tool to reduce their patient’s score below four and that’s fine, but above that is the danger area.”
The risk, the scientists said, was that patients, particularly those with dementia, may be regularly taking over-the-counter drugs that their doctor is unaware of, or which they do not really need, bringing their dosage up to a dangerous level.
Mr Maidment added: “With dementia, these drugs are particularly risky in the early stages, which we call mild cognitive impairment, where the brain is just at a tipping point. This extra insult can tip people over or worsen dementia.”
All medications, including those that are available over the counter, should be reviewed regularly by expert clinicians to prevent potential risks, he added.
Dr Fox said “hundreds of thousands” of elderly people in Britain could be putting themselves at risk from the drugs but that more research was needed to explain the exact cause.
Instead of stopping their medication or rushing to the doctor, patients should seek their doctor’s advice at their next routine appointment, he said.
Rebecca Wood, the chief executive of Alzheimer’s Research UK, said: “Further investigation needs to establish exactly how and why (these) drugs are increasing mortality, which might offer clues to safer drug design.”
Dr Tim Chico, an honorary consultant cardiologist at the University of Sheffield, said: “All drugs have possible side-effects, but the results of this study should not lead anyone to stop current medications without discussing this with their doctor first … it is important to balance the proven benefits against the risk of side-effects.”
The report said that an increase in the use of medication in recent years meant the number of people affected could be even higher than estimated.
A spokesman for the Medicines and Healthcare products Regulatory Agency said: “Our priority is to ensure that patients are taking acceptably safe medicines. All medicines have side-effects — no effective medicine is without risk.
“It is important for people taking anticholinergic medicines not to stop taking them. If they have any questions or concerns then they should contact their doctor in the first instance.”