Patients struggle even to get on NHS waiting lists
Patients have told how they have struggled even to get on NHS waiting lists, forcing them to endure lengthy delays for treatment or to go private, as managers ration treatment to save money.
One woman waiting four months for a knee operation was told by a hospital that her name would drop off the list unless she replied to a letter, while a man had to pay £11,000 for a replacement hip after his doctors repeatedly refused to refer him for treatment. A multiple sclerosis sufferer claimed he had had to wait 18 months just to be added to a waiting list.
The examples emerged after The Daily Telegraph disclosed how health service funding bodies are artificially increasing waiting times as they wait for patients to die or go private.
The row prompted Andrew Lansley, the Health Secretary, to accuse the Primary Care Trusts that currently pay for treatment of “cynically” trying to “game” the system, and promise that under his reforms patients’ needs will be the priority.
But Labour and a leading medical body claimed managers are being forced into rationing treatment because of the financial pressures they are under. It now appears likely that PCTs will be forced to publish the minimum waiting times they are imposing on patients, as recommended by the watchdog that uncovered the practice.
Asked by BBC Radio 4’s Today programme if trusts should be open about artificially imposing longer waiting times, Paul Burstow, the Care Services Minister, replied: “Absolutely. Part of having effective choice is being able to compare the performance of different organisations providing these services. One of the things people should be able to make a choice on is how long they have to wait and the quality of the care they receive.”
The row began when the Co-operation and Competition Panel, which advises the Department of Health, published a report claiming that PCTs were imposing minimum waiting lists of up to 15 weeks for planned surgery, just short of the 18-week upper limit, in order to save money.
The watchdog said trusts believe that longer waits lead some patients to “remove themselves from lists”, and that this meant they either died or paid for private treatment before the NHS saw them.
One woman told this newspaper how the Royal Free Hospital in north London had tried to remove her from a waiting list after four months. The 62 year-old, who did not wish to be named, had undergone a scan on her knee late last year and told in the spring to expect a wait of three or four months before an arthroscopy operation.
But then in June she was sent a letter telling her: “We are conducting a review of our waiting lists in order to keep our records up to date. If we do not hear from you within three weeks of the above date your name will be removed from the waiting list.” She said: “My first thought was they’re waiting till I go private or die.”
Gerry Warsop, a retired City worker, started to feel pain in his hip while playing golf a year ago but said he was repeatedly fobbed off by GPs in Enfield, north London, even though one accepted that he needed replacement surgery. In May the 63 year-old decided to pay £11,000 to have the operation at a private hospital as he could no longer walk more than 150 yards. “I couldn’t possibly have got it any other way with the shortcomings in the NHS,” he said.
“I’ve paid all my taxes and 37 years of National Insurance, then the first time I want to get something out of it it’s no good.”
Benjamin Cohen, a technology correspondent for Channel 4 News who has MS, said: “From what I understand, many trusts have a system whereby people wait to get onto the waiting list.” He claimed he had once waited 18 months to get on a list, then told his appointment would be in four weeks. “The whole thing is a game,” he said.
But there were claims that the tactics have been forced on managers who need to save £20billion by 2015.
Sir Richard Thompson, president of the Royal College of Physicians, said: “The postponement of surgical procedures is a form of rationing forced on hospitals by their relatively reduced funding set against an ever increasing workload of acute care as the population ages.
“Patients should not have to wait longer than necessary as it increases anxiety and sometimes has a detrimental effect on their recovery. The Government needs to release more money for secondary care until further long term savings can be found.”
John Healey, Labour’s shadow health secretary, said: “It is a disgrace that patients in some areas are being forced to wait at least 15 weeks before being treated, as a result of deliberate local policy decisions. Far from being a justification for the Tory-led Government’s NHS reorganisation, it is evidence of the extra pressure their huge upheaval is piling on the NHS.
“Patients are already starting to see long waiting times returning as we saw under the last Tory Government. David Cameron and Andrew Lansley have to get a grip on the NHS.”
Fury as British judge frees paedophile teacher and says: Teaching staff are often attracted to children
A judge has let a paedophile teacher walk free after telling him she did not criticise him for being attracted to children. Supply teacher David Armstrong had admitted hoarding more than 4,500 indecent images of children.
But handing the 63-year-old pervert a suspended sentence, Judge Mary Jane Mowat said: ‘I don’t criticise you for being a teacher who’s attracted to children. ‘Many teachers are but they keep their urges under control both when it comes to children and when it comes to images of children.’
Her extraordinary comments – recorded by a local newspaper reporter – provoked fury from campaigners who labelled them ‘outrageous’. Senior teaching representatives expressed disbelief at the remarks and said they sent the wrong message to child sex offenders.
Peter Bradley, of the children’s charity Kidscape, said schools exist to provide a safe place for children to learn. ‘This teacher should not have been in the profession and it is outrageous for the judge to say many teachers are sexually attracted to children,’ he said. ‘The message needs to be clear – if you are sexually attracted to children then you don’t work with them.’
Christine Blower, of the National Union of Teachers, said: ‘Teachers are professionals whose interest is ensuring children and young people achieve their educational potential. ‘To suggest their interest in pupils could understandably be anything else is totally unacceptable.’
Armstrong was caught after a colleague reported him at the Little Heath School in Tilehurst, near Reading. A teaching assistant noticed files on his laptop computer had names such as ‘rape wife’, ‘nude model’ and ‘gay alligator’.
Armstrong was arrested and police found the appalling catalogue of indecent images and videos on two laptops and an external hard drive. Reading Crown Court heard more than 300 were in the two most serious categories and involved victims as young as two. Some of the images were not of real children but Japanese cartoons depicting youngsters in sexual scenes.
Armstrong’s solicitor said he had worked at many schools and had an ‘impeccable record’.
The supply teacher, of Devizes, Wiltshire, was given 12-month jail sentences, suspended for two years, for each of five charges of making indecent photographs of children. He was put on the Sex Offenders’ Register for ten years, with a Sexual Prevention Order which bans him from owning a computer or device capable of connecting to the internet. He was also automatically banned from working with children.
The case is not the first time Judge Mowat has stirred controversy over sentences handed to sexual offenders. In 2008, she allowed a former headmaster to walk free from court after he said drugs he was taking for Parkinson’s disease made him a paedophile. Phillip Carmichael said the medication caused him to become ‘hypersexually active’ after he was caught with 8,000 images and videos on his computer.
The judge said the case was ‘wholly exceptional’ and gave him an absolute discharge.
Two years earlier, after paedophile Robert Prout was convicted of abusing a 12-year-old girl, the judge admitted she would normally give a suspended sentence but recent public criticism influenced her decision to jail him for ten months.
Birmingham’s historic Gun Quarter is renamed… because PC critics say it glorifies crime
It encapsulates a manufacturing heritage stretching back 250 years. During the Napoleonic Wars, almost 1.9million muskets, rifles, carbines and pistols were manufactured for the Government in the district’s numerous weapons factories.
But Birmingham’s historic Gun Quarter is now to be renamed because of concerns that it could be linked with the firearms crime which blights other parts of the city. Officials said residents no longer wanted to be associated with weapons of war.
Instead the district to the north and west of the city centre will be known as St George and St Chad in recognition of a local church and Birmingham’s catholic cathedral.
Yesterday, opponents of the rebranding exercise said the Gun Quarter had been sacrificed on the altar of political correctness, while even the Dean of St Chad’s Cathedral said the decision sounded ‘irrational’.
Tim Huxtable, Birmingham City Council’s Tory head of regeneration, said the decision had been taken after a public consultation, although one petition received by the council was signed by just 50 people objecting to Gun Quarter.
He said: ‘We listened to the local community, which is the whole point of consultation. The views of local people seem quite clear.’
Sir Albert Bore, leader of the opposition Labour group, said: ‘What kind of nonsense is it when we replace the Gun Quarter with St George and St Chad? ‘Like it or not, and I am not into the arms trade myself, the Gun Quarter has a historical connection with this city. This is just political correctness.’
The name change was described as a ‘terrible shame’ by the owner of one of the few surviving gun makers in the district. Simon Clode, managing director of Westley Richards and Co, said: ‘This is an important part of Birmingham’s history. The area is not well occupied by gun makers now, but it’s still the Gun Quarter.’
The Very Reverend Canon Gerry Breen, Dean of St Chad’s Cathedral, said the name change was ‘almost as irrational as deciding not to call the Black Country the Black Country’.
Reverend Larry Wright, Rector of St George’s Church, however, said he was among those who had lobbied the council to change the name. ‘We wrote on behalf of our own congregation – many of whom wanted a name change to move away from any suggestion that this area was associated with gun crime,’ he said. ‘But they could have come up with something snappier (than St George and St Chad).’
A council spokesman insisted the gunsmith area would live on as a separately defined part of the new St George and St Chad quarter.
Wolf-whistling is “intimidation”?
As stereotypes go, it’s a classic. And when two young builders wolf-whistled an attractive woman as she passed by they probably imagined they were indulging in a bit of harmless fun.
The woman’s husband, however, failed to see the funny side, and following a complaint to their bosses the pair have been suspended.
Council officials in Royston, Hertfordshire, received a furious email from the husband, who has not been named. He accused the builders of harassing his wife, leaving her so uncomfortable that she was refusing to walk past the area again.
The allegation was passed on to the council’s contractors Maylim Ltd and the alleged offenders – described locally as Albanians – were taken off the job for several days.
They will now be allowed back after their accuser decided not to take matters further, although they are still facing a `discussion’ with bosses today. Maylim yesterday insisted sexist behaviour was `terrible for the company image’ and it was taking the allegations seriously.
Managing director Thomas O’Mahony said: `We acted within half-an-hour of being alerted to the complaint. It’s company policy to immediately suspend anyone who is made the subject of a complaint by the public.
`We don’t tolerate wolf-whistling or any form of sexual harassment. It’s unacceptable – we are in the public eye and our image is important.
`The two men are in their mid-20s and they have been invited in for a discussion. They denied the allegations and were frustrated to be off work. Now we know that the complainant doesn’t want to take this further the men will be allowed to go back to work.’
The incident was said to have happened last week in Fish Hill Square, where £400,000 is being spent turning the area into a `civic space’ with seating and a sculpture.
Locals – both male and female – expressed sympathy for the builders yesterday. Hairdresser Jane Westley said: `I don’t think wolf-whistling’s too much of an issue. If I got wolf-whistled I think I’d find it a compliment. It’s just what builders do.’
Another woman, who asked not to be named, said: `I guess it’s their bit of harmless fun while working – to admire girls walking past in the summer.’ A 34-year-old man added: `Everyone thinks it’s a strange complaint to make. I feel bad for the guys off work.’
Wolf-whistles originated among sailors to draw colleagues’ attention to a pretty woman. A number of building firms have now banned them as inappropriate. Workmen who repeatedly make obscene comments to passers-by can also be convicted of a breach of the peace.
Obesity war failing
Heavy-handed tactics aimed at making families seek help for overweight children are a waste of time, an obesity expert declared last night.
David Haslam, a leading GP and chairman of the UK’s National Obesity Forum, says his fellow doctors can spot overweight children the minute they walk through the door. ‘The problem isn’t identifying these people, it’s getting them motivated to lose weight and reduce their risks of disease,’ he said.
His comments came in response to a study showing that most parents who receive letters about the health risks of their children being fat do very little about it.
Dr Haslam, who is a GP in Hertfordshire, said: ‘Sending letters to parents like this is a waste of time. It’s the duty of the healthcare professional, doctor or nurse, when they see a patient whose weight is putting their health at risk to seize the moment – children’s lives are at stake.’
The research comes as experts predict two out of three children could be obese by 2050 if current trends continue. More than one in five is obese at present – so fat it threatens their health.
In the study, researchers at Bristol University contacted 285 families with children aged between five and 16 who were obese. The data came from GP records which had noted the children’s Body Mass Index (BMI) – the measure of weight and height which determines obesity – in the last two years.
The families were all sent a letter telling them their child was significantly overweight and offering them the chance to see their GP about it.
Just 47 per cent of the parents consulted doctors and barely 15 per cent of those who took up the offer ended up with a record of their child’s weight in GP records, suggesting the issue had not been thoroughly investigated. Just 25 fat children ended up in specialist clinics, according to the report in the British Journal of General Practice.
Researcher Dr Jonathan Banks, from the university’s school of social and community medicine, said one in two parents had rejected the opportunity to discuss their child’s weight problems. He said ‘Previous research has found that parents of overweight children find it difficult to seek help from a health professional and that many do not recognise overweight or obesity in their children. ‘It might be expected that parents who were unsure about how to deal with their child’s weight would be prompted by the letter, but the very low take-up suggests resistance to addressing the issue.’
Co-researcher Professor Julian Shields, professor of paediatrics at the university who runs weight management clinics, said GPs also seemed reluctant to deal with an often embarrassing subject with their patients. He said ‘It’s still a taboo area but things have got to change, this is one of the most pressing problems for our children. ‘But it’s difficult for GPs to say to parents their child is fat and something needs to be done without sounding rude, indifferent or blunt’ he added.
A scheme to measure fat children at school, and send warning letters to parents, attracted much criticism when it was launched in 2006, not least because many parents refused to give consent for their children to be screened. Heavier children were more likely to opt out.
Dr Haslam, who is a GP in Hertfordshire, said the latest research showed that better ways were necessary to motivate children and adults with weight problems into shedding the pounds. He said ‘Sending letters to parents like this is a waste of time.
‘The problem is not lack of access to obese children and adults, it’s getting them engaged and motivated into losing weight and keeping it off in the long term. ‘It’s the duty of the healthcare professional, doctor or nurse, when they see a patient whose weight is putting their health at risk to seize the moment – children’s lives are at stake.
‘If a child comes into the surgery with a thorn in a finger, take out the thorn and then ask then what they’re doing about trying to lose weight and how can we help’ he added.
Eight million animals face death to test your toothpaste and washing-up liquid
But don’t blame the manufacturers, it’s all down to “environmental” testing mandated by Europe
Clad in her customary white coat, the scientist carefully pulls the latex gloves up over her wrists and walks slowly towards the cage. Reaching in, she seizes one of the rabbits, cowering near the back and clamps it into a testing harness.
Taking it over to a sanitised laboratory bench, Dr Tamsin Decker supervises as solution is squirted into the defenceless animal’s eyes. She has done this many times before — and will watch as it’s done again until the rabbit shows some side-effects: pain, irritation, bleeding perhaps, and eventually, possibly, blindness.
For what cause must the animal endure such a wretched, tortured existence? Once upon a time, Dr Decker would have imagined it was to find a cure for cancer, or, at the very least, to test a compound which would relieve suffering.
But now the young woman knows that she is verifying the safety of a chemical contained in toothpaste — a well-established brand leader that she had used to brush her teeth that very morning.
‘I felt numb — no, guilty,’ she admits afterwards. ‘It isn’t as if the end justified the means. We weren’t researching some cancer cure here. We were testing a well-known chemical that has been used in household products for more than 100 years.’
On other days, Dr Decker might be required to inject mice, birds or rats with toxins to see how long it takes them to die, or to record what happens to their foetuses.
Contrary to popular belief, scientific testing on animals is not a thing of the past, nor is it in decline. Figures released by the Home Office last week show that 3.7 million ‘procedures’ involving individual animals were carried out in 2010 — a million more than in 2000.
And evidence is emerging that large numbers of animals are dying needlessly, simply because of a new directive from Brussels which demands that 30,000 chemicals are tested.
The project, entitled the Registration, Evaluation, Authorisation and Restriction of Chemical substances — or REACH — has at its heart a noble desire to safeguard the environment and limit our exposure to hazardous substances.
But, as a Daily Mail investigation has uncovered, many of these chemicals are already found in household products which we have been using for generations — brands such as Colgate toothpaste, Ajax cleaner, Gillette shaving foam and Fairy washing-up liquid.
Yet, as a consequence of the European Commission diktat, animal welfare groups claim that millions of creatures will die needlessly to test chemicals in products which have already been deemed safe.
Not only that, the European regulations are so far-reaching that it is slowly becoming impossible for consumers to buy ‘ethical’ products whose ingredients have not been tested on animals.
‘I’m from the generation that was determined to do as little harm as we could to animals, and we have come a long way in finding alternative testing methods,’ says Dr Decker. ‘But for some tests you can only use animals — and many of us think that we shouldn’t be using them to test chemicals that we already feel are safe.’
Decker is not her real name, and we cannot disclose exactly what she was testing for fear of identifying her employers. In addition, scientists are being gagged by their employers, who don’t want to be seen to be complaining about REACH in case it makes them look unwilling to do their bit for the environment.
REACH was launched in 2007 and required companies to produce dossiers on all the chemicals in the products that they manufactured, including evidence of their safety — no matter how long they had been in production. The more of the chemical they produced, the more detailed the evidence required.
After lobbying from animal welfare groups such as the RSPCA, which predicted wholesale destruction of animals, companies were encouraged to share information to prevent unnecessary testing, and to find alternatives to animal testing wherever possible.
Earlier this month, the European Chemicals Agency (ECHA), which oversees the REACH project, published its first progress report which said that of almost 25,000 dossiers that had been submitted by companies on chemicals that they used, ‘only’ 1,849 had involved new animal test results.
Geert Dancet, the ECHA’s executive director, argued that this was good news. ‘This report clearly shows that companies have shared data or made extensive use of alternative [testing] methods available so as to avoid the need to test chemicals on animals, which is positive,’ he said.
However, when animal welfare scientists trawled through the long and minutely-detailed report, they came to the conclusion that even though only a small proportion of the data on chemicals had been garnered from animal testing, no fewer than 87 per cent of the animals in those tests had died.
Assuming internationally accepted models for animal studies had been observed, the British Union for the Abolition of Vivisection (BUAV) claims this amounts to more than 231,000 pointless deaths. ‘It is a completely unnecessary waste of life,’ says Dr Katy Taylor, BUAV’s senior scientific adviser.
Among these ‘unnecessary’ tests were 188 studies on eye irritation carried out on rabbits; 336 skin sensitisation studies on guinea pigs or mice; 254 short-term toxicity tests on fish; and 33 genetic toxicity tests on mice. The number of animals in each study is thought to range from one to 500.
Dr Taylor argues that instead of testing animals to destruction, there are computer models that can predict reactions, while chemicals can be tested on cell cultures and artificially grown skin in the lab.
Under REACH, where companies do need to test on animals, they must first announce their intentions to the European Chemicals Agency to see if any other company or academic centre has already carried out such tests. If no one has, then they are given a licence to test.
So, does this mean that you are buying products with ingredients that have been freshly tested on animals? Probably, yes. I looked at just eight chemicals that had been tested on animals under REACH, and they led to some nasty surprises.
Even though animal testing on cosmetics was banned in the UK in 1997 and across Europe in 2009, I found that Colgate toothpaste and Gillette shaving foam contained ingredients that were tested on animals only recently. This is no poor reflection on these companies, as they may have played no direct part in the testing.
In Colgate’s case, calcium carbonate — a substance used for hundreds of years and found naturally in rocks, eggshells and pearls — had to be tested under REACH. In the case of Gillette, the substance was triethanolamine, a compound used for generations in household cleaners, polishers, paints, inks and detergents.
Again, this doesn’t mean that Gillette commissioned testing on the substance. It just raises questions over why the new testing on animals was necessary at all.
I also found recently tested ingredients in Persil 2in1 With Comfort (triethanolamine); Ajax cleanser with bleach (pentasodium triphosphate and calcium carbonate); Turtle Wax leather cleaner & conditioner (triethanolamine); and Fairy Liquid Green Apple & Lime Blossom (geraniol, a fragrance).
So I asked Wim De Coen, head of unit evaluation at the European Chemicals Agency, why animals are dying to test such apparently commonplace and harmless ingredients. ‘REACH comes historically from the realisation that substances were on the European market that consumers and the environment were exposed to daily, but very little information was known about them,’ he told me. ‘The intention is to protect consumers and the environment from these substances. So manufacturers and importers must now demonstrate their safety.’
Asked whether he understands the frustration felt by some scientists over testing ingredients already agreed to be ‘safe’, he says: ‘If you look at it from a lab or single company’s point of view, to their way of thinking it may be frustrating, but to the broader benefit of all of us there is much to be gained by collecting the information. Animal testing is the last resort.’
I asked Unilever, Procter & Gamble, Colgate and the Turtle Wax Corporations, manufacturers of the affected items, how they felt about their ingredients being tested under REACH.
Only Procter & Gamble replied, saying it tests on animals only where required to by law and when all other options have been exhausted. Diplomatically, it pointed out that it has spent £275 million developing alternatives to animal testing, but it didn’t address my direct questioning about the frustrations of animal testing under REACH.
However, I was able to gain an insight into how the chemical companies view the legislation through the eyes of a scientific consultant who advises them on how to comply with it. Fearful of speaking out openly against the European Chemicals Agency, he refused to be named, but branded REACH ‘an expensive nuisance’.
‘Companies have been producing some products for more than 50 years without any harmful side-effects, and then they have to provide data under REACH,’ my source told me. ‘My clients don’t want to carry out these tests on animals, but they have no choice. They are time-consuming and they can be staggeringly expensive — as much as one million euros over two or three years. It’s a huge responsibility that’s been put on the shoulders of the chemical industry.’ As a result of REACH the animal death toll figure could rise to 50 million
According to Andrew Butler, founder of Lush, the ethical cosmetics company, it is a responsibility that is spilling over into the retail sector and undermining the founding principles of his business. ‘Since our inception, it has been our aim that none of our customers’ money goes to any company involved in any animal testing whatsoever,’ he tells me.
‘Thanks to REACH, it’s impossible to buy ingredients from anyone who hasn’t been involved in animal testing. Every manufacturer is being forced into a position where they are having to pay directly or indirectly for those tests.
‘We have to rethink our policy and come up with a way of campaigning against animal testing in the light of REACH. But it isn’t going to be easy.’
No one is denying that the aims of REACH are admirable, and that it could provide a vital resource in safeguarding the environment and the health of all Europeans. At present, however, it is the health of millions of animals that is exercising campaigners.
‘We want chemicals that are safe for people and our environment, just like everyone else, but animal tests are not required to achieve this goal,’ says Alistair Currie, policy adviser at People for the Ethical Treatment of Animals (PETA). ‘There are lots of ways that companies can avoid using animals: the scandal is that those testing alternatives aren’t being used.
‘Fine words in the legislation about using animals as a last resort are meaningless if companies ignore them. Unless companies are compelled to exploit every opportunity to use alternatives to animal testing, there will be millions of completely avoidable deaths in the future.’
Millions? Surely that’s an exaggeration. Sadly, no. The RSPCA, a calm head in the middle of a heated debate, told me this week that its experts predict an animal death toll of around eight million as a result of REACH. And when unborn foetuses carried by those animals are taken into account, that figure could rise to 50 million.
As Dr Decker says: ‘You might understand it if there was a cure for cancer at the end of all the suffering. There won’t be — but at least you’ll be safe in the knowledge that your Fairy Liquid won’t do you any harm.’ But perhaps your grandmother could have told you that.