Appalling: NHS delays operations ‘as it waits for patients to die or go private’
NHS managers are deliberately delaying operations as they wait for patients either to die or go private in order to save money, according to an official report. Health service trusts are “imposing pain and inconvenience” by making patients wait longer than necessary, in some cases as long as four months, the study found.
Executives believe the delays mean some people will remove themselves from lists “either by dying or by paying for their own treatment” claims the report, by an independent watchdog that advises the NHS.
The Co-operation and Competition Panel says the tactic is one of a number used by managers that “excessively constrain” patients’ rights to choose where to be operated upon, and damage hospitals’ ability to compete for planned surgery.
It claims unfair practices are “endemic” in some areas of England and pose a “serious risk” to the Government’s drive to open up the health service to competition.
But managers, who are already rationing surgery for cataracts, hips, knees and tonsils, say they must restrict treatment as the NHS is under orders to make £20 billion of efficiency savings by 2015.
Lord Carter of Coles, chairman of the panel, said: “Commissioners have a difficult job in the current financial climate, but patients’ rights are often being restricted without a valid and visible reason.”
Katherine Murphy, chief executive of the Patients Association, said: “It is outrageous that some primary care trusts are imposing minimum waiting times. The suggestion that it could save money because patients will remove themselves from the list by going private or dying is a callous and cynical manipulation of people’s lives and should not be tolerated.”
Since 2006, NHS patients who need routine elective care have had the right to choose between at least four hospitals including privately-run units. But there have been claims that trusts, the local bodies that pay for treatment, restrict choice and favour some hospitals to balance their books. The panel investigated whether the allegations were true.
It found “many examples of PCTs excessively constraining patients’ ability to choose, and providers’ ability to offer routine elective care services”. Managers restricted GPs’ ability to refer patients to some hospitals by imposing “caps” on the number a provider would be paid to treat and by imposing minimum waiting times, its report said.
Under government targets, patients should be treated within 18 weeks of referral by a GP. But even when surgeons could see them far sooner, the study found that some trusts made hospitals wait as long as 15 weeks before operating. The tactic forced private hospitals, which were more likely to be able to treat patients quickly, to operate as slowly as overcrowded NHS units in an “unfortunate levelling down”.
Some managers insisted that longer waiting times would lead to overall savings as “experience suggests that if patients wait longer then some will remove themselves from the list”.
Interpreting this statement, the panel noted: “We understand that patients will ‘remove themselves from the waiting list’ either by dying or by paying for their own treatment at private sector providers.”
It said that minimum waiting times should only be used as a “last resort” and told trusts to publish their policies on the home page of their websites.
The panel also found that trusts tended to give elective business to their local NHS hospital, rather than allowing choice, in order to ensure its other services such as casualty departments remained financially viable.
The findings come as the NHS is under pressure from increasing demand and tighter budgets. Waiting times have lengthened since last year’s general election and more trusts are increasing the number of procedures of “low clinical value” they turn down or insisting that patients’ conditions worsen before they are seen.
Labour yesterday unearthed Treasury figures that show health spending totalled £101.985 billion in 2010-11, down from £102.751 billion in the last year of Labour, despite David Cameron’s pledge that “the money going into the NHS will actually increase in real terms”. The Tories pointed out that the fall represented the last part of the previous government’s five-year spending plan.
Ministers welcomed the competition panel’s study. Paul Burstow, the care services minister, said: “This report illustrates exactly why we need to modernise the NHS and increase choice for patients. “Trusts will want to take a hard look at practices in light of this report and ensure they are always in the best interest of patients and the taxpayer.”
Under the Health and Social Care Bill, which has been watered down in the face of opposition from the medical profession and Liberal Democrats, power to buy treatment will be handed from trusts to new bodies led by GPs.
The new Clinical Commissioning Groups are intended to be more accountable to patients, while the number of sectors where choice and competition apply is being extended. David Stout, director of the NHS Confederation’s primary care trust network, said: “Today’s report rightly acknowledges that each situation will be different and the extent that any benefits outweigh the loss of choice should be considered on a case-by-case basis.”
He added: “Commissioners will still be left to decide the right course of action when faced with trade-offs between patient choice and value for money. The suggestion that many current trust decisions are not justifiable on these grounds is largely unsubstantiated by the detail in the report as the CCP has not investigated specific cases in detail.”
Amazing: Mother-of-three scarred after bungling doctors try to remove cyst which was actually her WOMB
A mother of three has been left unnecessarily scarred for life after bungling doctors mistook her womb for a potentially cancerous cyst. Sandra Cornwall, of Warrington, Cheshire, was told she needed urgent surgery to remove the 10cm ‘cyst’ from her ovary and medics performed blood tests to check whether it was cancerous.
After losing her mother and grandmother to cancer, Sandra, 43, spent two terrifying days waiting for the results before being given the all clear, but was told the growth would still have to be removed the following day.
But when she came round from the operation with a 13.5cm scar and 18 staples in her stomach, she was stunned when doctors confessed the surgery had been unnecessary as they had mistakenly thought her womb was a cyst.
Sandra, who was left in agonising pain following the operation on July 6, is still in excruciating pain, struggling to care for her children and says she’ll never be able to wear a bikini again due to her scar.
She is set to meet with hospital bosses, who have opened an investigation into the incident, and is seeking legal advice with a view to suing.
Full-time mother Sandra, of Warrington, Cheshire, said: ‘I just don’t understand how they could have been so wrong. ‘It’s been just awful. It’s been all so draining emotionally. Then you start thinking, can you even trust anyone now? It’s all been so upsetting.’
Sandra first went to Warrington Hospital’s A&E department on Sunday June 26 complaining of severe stomach cramps. She said, ‘I had extreme pain and it was getting worse. It took me five days to get an appointment with my GP. ‘She said it could be a bladder infection and gave me some tablets. But on Saturday the pain was so much worse and I went to A&E.’
Following an examination, Sandra was advised she had a lump in her stomach and was referred for an ultrasound the following day, July 3.
Sandra, who has three children aged 12, 16 and 18, said, ‘The sonographer told me I had a 10cm mass pressing against my left ovary and tube and that’s what was causing the pain. ‘Then the doctor came along and said, ‘We’ll need to do a blood test to find out if it’s cancerous.’
‘I was absolutely devastated. My mum died of lung cancer in 1999, aged 54, and my nanna died of cancer as well. I was thinking, ‘Oh no, I’m next, it’s generation by generation. ‘I’m thinking about how I’m going to tell my kids, when I’m going to tell them. They said we’ll need surgery, I’m wondering about chemo, is it terminal?
‘I was upset thinking about telling my 12-year-old daughter. We’re very close. I thought, ‘I’ll miss my 16-year-old’s prom.’ It was awful.’
Sandra, who spent part of her childhood in England then moved with her family to Perth, Australia, before returning to the UK in 2000, was admitted to the gynaecology ward and had to wait 48 hours before she was told she didn’t have cancer, but had an infection.
Sandra said, ‘I had to wait two days, it was just awful, I was crying all the time. I called my family in Australia, they were ready to take the next flight over but I told them to wait.
‘They said the cyst had to be removed, along with my left ovary and tube. It was a big operation, I filled in my consent form and on Wednesday I went down to surgery. It was so fast because they said it was quite urgent. ‘When I came to in recovery the pain was so bad. I asked the nurse if I could see the cyst. She said, ‘They didn’t take anything out’ and administered me with a morphine injection. I was in no state to ask questions at that point.’
When she awoke, she claims she overheard nurses saying, ‘That was a complete waste of time.’ She said, ‘I was really confused then. Later in the morning, I got the feeling they were all avoiding eye contact with me.
‘The consultant came to see me and his face was just a picture. He said, ‘I’m so sorry, we were just going off the sonographer’s report, we just don’t know what happened.’ There wasn’t any more explanation. ‘Later the surgeon came around and said, ‘I’m so sorry. I opened you up and there was nothing there. I even went through your bowel. I don’t know what happened’.’
She was given antibiotics for her infection, which cured her abdominal pains, and was discharged from hospital three days later, but says she suffered two panic attacks on the ward due to stress.
After complaining to the hospital, she was invited to meet with their patient liaison service on July 13 when she says she found out more shocking news. Sandra said, ‘They told me they thought my womb was the cyst, because it was a bit larger than normal. But I thought, ‘Hang on a minute, where did he think my womb was?’
‘I asked the consultant and surgeon that question and they said, ‘We’re not qualified to interpret the scans. We were going on the sonographer’s report.’
‘They escalated it to a formal complaint and are going to do an investigation into what happened. I’ve been speaking with lawyers to see about getting compensation. ‘It hurts to do anything, to sit, to stand, to turn over in bed. I can’t even tie my own shoes.
‘I’m never going to be able to wear a bikini again. I used to sunbathe in a bikini with my daughter, but I won’t be able to do that anymore. ‘I’m at an age where things aren’t that great and now I’m even more self-conscious.’
A spokesman for Warrington and Halton Hospitals said: ‘Any decision to undertake surgery is based around thorough assessment of the patient and the results of diagnostic tests. ‘It is not a decision that is taken lightly but with the best interests of the patient in mind based on the clinical evidence available.
‘If there has been a diagnosis that might have led to any surgery taking place when it has not been fully necessary we will investigate thoroughly to find out why this has happened. ‘However, in some cases the tests and assessment might indicate a potential problem and it only becomes clear as the surgery takes place that there is an alternative reason for the results looking as they did. [Utter bullsh*t! If their sonographer doesn’t know what and where a womb is, they should be moved to lighter duties — like cleaning]
‘We have already made arrangements to meet with Mrs Cornwall to discuss her case and to ensure she receives the aftercare, support and information that she requires from us.’
Don’t write off British State schools just yet, Lord Jones
The education system is still potentially the best place to teach youngsters about the world of work
For decades, the entire thrust of Britain’s education policy has been to get as many children as possible into school – and to keep them there. Whether it was setting a target for half of the population to go to university, raising the school leaving age, or even bribing children to stay in school, the secret to success in life was simply “education, education, education”.
Yet there were always those who argued the opposite. Schools, claimed Sir Richard Branson, can stunt entrepreneurship – better for budding tycoons to leave at 15, as he did, and make their own way in the world. Lord Sugar, too, left school at 16. And now Lord Jones, the former trade minister and another early leaver, has said that children should be allowed out of school to work at age 14.
The basic idea here is that, while studious children should still pursue schooling, those who are less academically inclined – whether because they’re too brilliant, too disruptive, or just too bored – should join the workforce, or start vocational training, as soon as possible. “There are loads of kids in school today who at 14 are more mature,” said Lord Jones this week, “and so many of them are disruptive… This isn’t about saying ‘School’s out, away you go, kids’, this is about going into a technical college, doing a couple of days a week on a vocational course and going into a business, or indeed a public sector employer, and getting the link in their mind, in their DNA, that if you get better skilled, you make more money.”
Lord Jones grew up in his parents’ corner shop, learning all about customer care at a young age. He claims that while modern employers – especially manufacturers – want to hire skilled British workers, they simply can’t find them, so have to resort to recruiting Poles or Indians instead.
The ambition here is a noble one. But it rests on false assumptions. It is true that many skilled workers here will likely be from Eastern Europe. But what does being “more skilled” mean? Restaurant owners will tell you that they employ Eastern Europeans because they know how to be professional: they turn up on time, look people in the eye, shake hands when necessary, listen attentively, take an interest, sit properly, stand properly, and take pride in their work. Restaurants don’t employ Poles because they are “skilled” waiters, or even experienced ones. The difference is that unlike their British rivals, most have stayed in school until the age of 18, where they have learnt the skills that are necessary for success in the workplace – whatever workplace that might be.
The qualities that Lord Jones and others are looking for are, ironically, the very ones that our schools used to be good at inculcating: how to be professional, how to wear a uniform with pride, how to meet deadlines that count, how to complete homework and do as one was asked. In short, they encouraged students to have a real sense of ownership of their lives.
What the advocates of vocational training are suggesting is, in effect, that the workplace should make up for the failings of the education system. In fact, this is already happening: McDonald’s offers 4,000 of its employees coaching towards Level 1 Literacy, the equivalent of a grade D-G at GCSE, because so many fail to reach the literacy levels expected of an 11 year-old.
In his interview, Lord Jones pointed to the fact that nearly half of our children fail to reach grade C in maths and English. Common sense would suggest that if these children aren’t capable of reaching the required standards, why waste everyone’s time by keeping them in school?
This is the second false assumption: that these children are not gifted enough to get these GCSEs. It is a reasonable enough one to make – until you realise the extent of the chaos that exists in many classrooms, the low level of expectation fostered by the system (and resisted by most teachers), and the lack of proper leadership in some of our schools. There are some children who simply aren’t bright enough, and should be encouraged to attend colleges and get work experience: but they are a small minority.
On the homepage of his website, Lord Jones is quoted as saying: “In a fiercely competitive world, we should not compete on cost alone, but on our ingenuity.” Isn’t that what school is meant to be all about? Sure, it’s good to know who Churchill was and how to speak some French – but it’s better to lead the brain through a variety of complex subjects and train it to develop that very ingenuity.
As a child, Lord Jones won a scholarship to Bromsgrove, a public school. He played rugby and hockey for the school, and was even made head boy. A few days before he was due to graduate, he was expelled – with what would have been an excellent record – after streaking around the quadrangle to win a bet.
The irony here is that what taught the young Digby to take risks and go out on a limb was his traditional education. His school inspired him to push the boundaries; when he did so inappropriately, it made sure he paid the price. It is by keeping our standards high in school that children will learn how to succeed in the workplace later. Lord Jones and Sir Richard Branson (who attended Stowe) are the perfect examples.
Looking around at the state of our schools, it’s easy to understand why some people want to throw up their hands and turn to the workplace instead. But before we give up, it’s worth trying to fix the system first.
Thalidomide approved for use across the NHS half a century after it was banned
A victory for sanity after many years. It was always an interesting and useful molecule but its grievous side-effects in one particular application has until now largely stopped its use
Thalidomide has been approved for use on the NHS – half a century after it caused one of the biggest medical scandals in history. The National Institute for Clinical Excellence have recommended that the drug can be used to treat myeloma – a cancer which hits the bone marrow.
An estimated 10,000 children had defects at birth after pregnant women were prescribed the drug to prevent morning sickness.
After the government finally apologised last year, the drug is today again approved for use across the NHS, the Independent revealed.
Thalidomide was withdrawn from sale in 1961 after it was revealed that it was causing birth defects. It led to wholesale reforms in the drug licensing process, with much tighter regulations put in place.
A component of the drug prevents the growth of new blood vessels in developing embryos, stunting limb growth, researchers discovered.
The drug’s UK manufacturer, Distillers Biochemicals, paid around £28million compensation in the 1970s following a legal battle by the families of those affected. Last year Health Minister Mike O’Brien said there were 466 thalidomiders – as victims of the drug are known – supported by the Thalidomide Trust.
As thalidomide makes its return half a century after it was banned, another drug, Velcade, has also been approved for use in treating myeloma. Drugs like thalidomide which are approved by Nice should be made available to patients across the UK.
Eric Low, Myeloma UK chief executive, said: ‘It is vital that doctors have various effective treatment options in their toolbox to treat myeloma patients. ‘Today’s recommendation confirms the significant role that both thalidomide and Velcade have to play as initial treatment options.’
Thalidomide has been used on the NHS in recent years to treat brain cancer in a limited number of cases, although it is the first time it’s use has been formally recommended by Nice.
In the 1990s the drug began to make a return after [Israeli] research showed that it could be used to treat leprosy. There have been suggestions it could also be used to halt the development of prostate cancer.
Prescribing thalidomide is expected to cost £2,100 per treatment cycle and up to 2,000 patients each year could be given it now it has been recommended for use. Myeloma cannot be cured but drugs can be used to reduce the symptoms and stop the spread of cancerous cells.
Nature editorial hits IPCC hard: ‘It’s time for the influential body to uphold its own neutrality standards’
An editorial by Greenie heretic Mark Lynas published in the August 2011 edition of Nature Climate Change is highly critical of the IPCC’s use of non-peer-reviewed “grey” literature [such as propaganda from Greenpeace] and that “a Greenpeace campaigner was put in charge of reviewing and highlighting his own work within Working Group III…” leading to the embarrassing and widely debunked claim that 80% of the world’s energy could be supplied by renewable energy by 2050.
A second editorial in the same issue states regarding this same conflict of interest, “For a body that represents the state of understanding on one of the most complex and important issues of our time, repeating previously acknowledged mistakes is completely unacceptable.”
That such a Green organ as “Nature” has become a platform for Mark Lynas is undoubtedly a big retreat.
The full article is paywall protected but a graphic of the first article below gives you an idea of it.