£750,000 for patients left in agony by “top” NHS surgeon
Five patients have been paid a total of £750,000 compensation by an NHS hospital after they were left in agony and with permanent mobility problems following surgery by orthopaedic specialist Manjit Bhamra.
Mr Bhamra, who has advised the Government on hip replacements and fractures, is being investigated by the General Medical Council (GMC) but is still working in the NHS. There are now calls for all operations he carried out to be reviewed.
One patient, Wayne Pickering, 59, had his pelvis fractured during surgery which damaged a major nerve and left him in so much permanent pain he has been unable to work since.
Another patient, a 23-year-old woman who needed a hip replacement, was given the wrong implant which was then inserted incorrectly, leaving her needing extensive surgery to revise the problems and a lifelong disability.
A third patient in her 50s woke up after a routine hip operation with one leg longer than the other. The subsequent pain was so bad that she had to have her entire hip joint removed for nearly three months before it could be corrected.
The two other patients receiving payouts have not agreed to have details of their claims released.
All have now received substantial out-of-court settlements after Rotherham District Hospital in South Yorkshire, where the operations were carried out between 2005 and 2007, admitted liability.
The individual sums cannot be disclosed. It is understood several more complaints are awaiting investigation.
Mr Bhamra, 55, left the hospital in September 2007, before the complaints emerged. He is now employed by the nearby Pinderfields Hospital in Wakefield and also works for the private Care UK group in Southampton and London.
Mr Pickering, from Doncaster, had surgery on his hip carried out by Mr Bhamra in February 2006 and underwent a repair operation in 2009.
He said: I went into hospital expecting to come out the other side in ¬better shape. Instead, I found myself in agony and unable to work.’
Solicitor Tim Annett, from law firm Irwin Mitchell which has brought the claims by Mr Pickering and other patients, said all operations carried out by Mr Bhamra should be reviewed.
Assurances needed to be given ‘that the same situation cannot be allowed to happen again’, he added.
Walid Al-Wali, chief medical officer for Rotherham NHS Foundation Trust, said the hospital had referred Mr Bhamra to the GMC after concerns emerged.
‘We understand the investigation is still on-going,’ he added.
Scandal of the labs that refuse to check under-25s smear tests
Hundreds of young women given smear tests on the advice of GPs are having their test samples rejected by bureaucratic clinics – because they are under 25.
Patients and GPs are becoming increasingly frustrated at the zero tolerance approach by laboratories, which saw 712 women across England have tests ignored last year because of Government rules which say those under 25 do not need to be tested. This was up from 244 rejections the previous year.
GPs and patients groups are increasingly calling for a return to pre-2003 rules when the minimum age for a test was 20. Around 3,000 women in the UK each year contract cervical cancer and it accounts for more than 900 deaths.
Dr Clare Gerada, of the Royal College of GPs, told BBC Newsnight: ‘I think if a GP has made a clinical decision to give a cervical smear then that smear should be processed. ‘The decision not to process it should not be made by a lab with no details about why that smear has been done.’
The Government insist that if a woman under 25 needs a smear test they must be referred to a gynaecologist. But one consultant told Newsnight, which compiled the data using the Freedom of Information Act, that decision was crazy. Professor John Shepherd said: ‘I think that’s not sensible, It’s crazy. GPs are well trained doctors.
‘In most practices there will be partners who specialise in gynaecology. To send patients straight to a gynaecologist is actually a waste of man power, time and money, and not sensible.’
The age for cervical screening was raised to 25 because experts believed it caused more harm than good in younger women. Under 25s are more likely to present falsely positive results, meaning unnecessary treatment.
More multiculturalism in Britain
TWO police cars were set on fire overnight as hundreds of demonstrators took to the streets of north London to protest the fatal shooting of a young father by police.
Trouble flared after a crowd of around 300 gathered in the Tottenham area, with some hurling missiles and smashing shop windows as the unrest threatened to spiral into a riot.
It followed a march, involving around 120 people, from the Broadwater Farm area to Tottenham police station demanding “justice” for the shot man named locally as Mark Duggan. The black father-of-four, 29, died on Thursday, allegedly after he exchanged fire with police officers.
Shortly after dark last night, two police cars parked around 180 metres from the police station were set on.
A spokesman for London’s Metropolitan Police said officers have been dispatched to disperse the crowd. He could not confirm that those responsible for the trouble were connected to the protest.
Local resident David Akinsanya, 46, said several store windows were smashed and a second police car was also torched. “It’s really bad,” he said. “There are two police cars on fire. I’m feeling unsafe. It looks like it’s going to get very tasty. I saw a guy getting attacked.”
The Broadwater Farm area was the site of a notorious riot in 1985 that followed the death of an African-Caribbean woman who suffered heart failure during a police search of her home.
Police Constable Keith Blakelock was brutally stabbed and beaten to death in the ensuing unrest.
Prison drug taking in Britain is so bad that even the wardens are getting stoned… on the fumes
Solution? Improved ventilation!
Prison officers have complained to the Government’s health and safety watchdog that staff are getting ‘high’ from cannabis fumes escaping from prisoners’ cells. The warders’ union says its members suffer headaches and sickness because inmates smoke pot. It raised fears that this is affecting officers’ mood and performance.
The Health and Safety Executive has asked the Prison Service to carry out a risk assessment, which might lead to improved ventilation.
The Prison Officers’ Association (POA) says the use of cannabis is widespread among the 80,000-strong population of British jails, where inmates are allowed to smoke tobacco in their cells because they are exempt from the ban on smoking in business and office premises.
The union claims that the drug is being brought into prisons more easily because of staffing cuts.
Brian Traynor, the POA’s health and safety chairman, said that while serving at Walton Jail in Liverpool he felt giddy and that night had to lie down while gardening. ‘I am convinced I was stoned because of the passive effect of the drugs smoked by prisoners,’ Mr Traynor said. He warned that officers could be driving home unaware they were under the influence of cannabis.
At Wandsworth Prison in South London, POA branch secretary Stewart McLaughlin said: ‘It is outrageous that we are exposed to cannabis smoke. We are the only members of the emergency services to have fitness tests in a smoke-filled environment. It could not be more upside-down.
He said prison officers at Wandsworth – one of Britain’s toughest jails – were complaining of vomiting and headaches. POA deputy general secretary Mark Freeman said: ‘The Government knows that this is going on in prisons all over the country but they are doing nothing about it. ‘After a 12 to 15-hour shift breathing in the fumes from cannabis, our members won’t be driving home. They’ll be flying home.’
Mr Freeman claimed that even though jails were experiencing high levels of drug use – including heroin, cocaine and cannabis – the Government planned to reduce daily cell inspections in an effort to reduce costs.
A spokeswoman for the HSE said: ‘Our expectation is that Her Majesty’s Prison Service should carry out an assessment of the risks posed to staff and, in consultation with those working in affected areas, devise some reasonably practicable control measures.
‘This might include some of the same measures identified for controlling smoke from cell fires, such as improved ventilation and mobile ventilation units.’
A Prison Service spokeswoman said yesterday: ‘We work hard to keep illicit drugs out of prison, using a range of security measures to reduce drug supply, including working closely with police forces and carrying out random mandatory drug tests. ‘Targeted cell searches are undertaken in all prisons on a risk-assessment basis, with daily searches in Category A prisons.
‘Prisoners are allowed to smoke tobacco in their own cells. No smoking is allowed in communal areas. ‘There has been no change to the staffing level during visits at HMP Wandsworth.’
First they came for the anarchists
The clipping attached comes from the City of Westminster police’s “Counter Terrorist Focus List” (PDF, H/T to Liberal Conspiracy). I’m not quite an anarchist – although some of my best friends are, and the works of people like David Friedman (PDF) and Georgetown legal philosopher John Hasnas (PDF) make me unsure. But saying that “anarchists should be reported to your local Police” is a pretty extraordinary command that should worry everybody. Disliking the state is now enough for your neighbours to report on you, and for plod to take notice.
Instead of a legitimate request for information about people who might be violent at riots (who quite incorrectly call themselves anarchists while demanding more state spending), the police have targeted people who believe something to spy on. The reason, in the police’s own words, is that anarchists:
consider the state undesirable, unnecessary, and harmful, and instead promotes a stateless society.
Heaven forbid that anybody think the state might be harmful. Where could they have gotten that idea from? Fortunately the police are on their way, and they’re here to help.
The thinking behind this is, at best, a misunderstanding of the police’s role. They police are supposed to protect people from harm – not the state from peaceful change. Thinking that the police should protect the state from peaceful reform is more akin to 20th century totalitarianism than modern liberal democracy. Let’s not fall for the myth that a small group of violent thugs somehow implicates other people who share some of their beliefs. Nobody should be considered a criminal because of their opinions. If the police are getting involved, actions are what count.
We should be profoundly disturbed by this development, and not because it’s people who mistrust the state that are being targeted. The police section that released this piece is probably incompetent. But they’re incompetents who have the power to throw innocent people in jail, and they’re sniffing around people who’ve had “bad” thoughts.
No, this isn’t East Germany, where you’d be thrown in jail (or worse) for holding unusual political opinions. But, when the police investigate people for thoughtcrime, it’s not the England that most people think they live in either.
British Teenagers can earn university entrance by by going trekking, diving and whale-watching
Teenagers on gap years are being given university entrance points for adventures abroad. They can put experiences such as whale watching, trekking and diving towards a Certificate of Personal Effectiveness – equivalent to an A grade at AS-level.
Those who gain a level three in the CoPE receive 70 Ucas points, which could help them secure a university place. An A* at A-level is worth 140 Ucas points. Gap-year companies are promoting the certificate as a way for teenagers to secure university places.
But critics say the inclusion of such qualifications in the Ucas tariff system is ‘crazy’ and warn that the CoPE could give students a false sense of security when applying for courses.
There are also concerns that the extra points awarded for gap-year activities could see wealthier students edging out rivals who have the same grades but cannot afford to spend a year out travelling and volunteering.
The CoPE requires students to choose challenges from six modules: global awareness, enrichment activities, work-related activities, active citizenship, career planning and extended project.
They gain five credits for 50 hours’ activity, with at least 15 credits from three different modules required to complete the qualification.
The Frontier website, which provides gap-year advice, says the CoPE ‘will appeal to potential employers or university applications’. It adds: ‘If you just missed out on a university place or just want to boost your score, a CoPE would be a good way to do it.’
Holly Taylor, from Camps International, which specialises in expeditions to Africa and Asia, said acquiring Ucas points for overseas trips was a convenient way for ‘gappers’ to kill two birds with one stone. She said: ‘As well as doing a gap year they are able to come back and better themselves at university here.’
She added that the first two students from Camps International to achieve the CoPE secured their university places with the extra Ucas points they gained.
But Professor Alison Wolf, who led a government inquiry into education qualifications, said: ‘It underlines the craziness of trying to put points on everything that moves. ‘There is a danger that people will believe that universities will treat all points as equal and a terrible danger that the most vulnerable people will be misled and make choices they shouldn’t make.’
Professor Alan Smithers, director of Buckingham University’s Centre for Education and Employment Research, said: ‘To get into Oxford or Cambridge, I’m not sure these gap-year A-level points will make any difference. They are not going to rate very highly among A*s in physics, maths and chemistry.’
Overseas volunteering is a multi-billion-pound industry, with the average gap-year traveller, aged 18 to 24, spending £3,000-£4,000 on the trip, according to analysts Mintel. But the economic downturn and next year’s tripling of the limit on tuition fees have seen the numbers planning gap years fall from 20,000 in 2010 to 6,000 this year, Ucas figures show. And students who defer their places for gap years face paying fees of up to £9,000 next September.
A spokesman for The Department for Business, Innovation and Skills said it was up to universities whether they wanted to charge those students under the current fee regime or at 2012 levels.
However, students can complete the CoPE without taking a year out or going abroad. It is aimed at anyone aged over 16 and some study for it by doing voluntary work during their A-levels.
A Ucas spokesman said it was possible to use activities gained ‘from a wide variety of experiences to inform a course of study’ and to attract tariff points.
Book Review of “Junk Medicine” by Theodore Dalrymple (Harriman House Ltd)
Review by Dr. Alick Dowling — review originaly prepared for the Bristol Med Chi society. The “junk” referred to is alleged drugs of addiction, principally opiates
This book will be of special interest to members of the Bristol Med Chi and the Bristol BMA. Many flocked to hear Theodore Dalrymple at the annual joint meeting in Bristol, Jan 2005. He spoke on ‘The Story of the Corruption of Britain’, summarized in The Spectator 22 Jan 2005 describing his retirement from the NHS in ‘A Doctor’s Farewell’. He has regular columns in the BMJ, Spectator and other outlets such as The Wall Street Journal. In his alter ego he is also an admired book reviewer. This book published in the UK in September appeared last year in the USA as Romancing Opiates. Theodore Dalrymple himself summarized it in the article: ‘Poppycock’ in The Wall Street Journal 25 May 2006.
His sardonic wit is famous and readers familiar with his written style could legitimately wonder how he entices patients to speak so frankly. It seems unbelievable they could actually say what he reports. Those who assume his speech resembles his written style suspect him of invention, but anyone who had the opportunity to talk to him at the Bristol meeting found him courteous, cheerful, smiling readily and listening attentively. It must be difficult for his patients to remain hostile when confronted by an engaging smiling face eager to listen to anything you say. In short, his charm disarms those patients inclined to be surly. A less sympathetic questioner would not have so soothing an effect. Dalrymple’s columns make compulsive reading because he can convey succinctly, yet with humour, their usually bleak message.
In Junk Medicine he questions the long-held belief, popular since 1822 when Thomas De Quincey published The Confessions of an English Opium Eater, that addiction to opiates is a medical problem, when it is not a medical but really a moral or social problem. This message is encapsulated in the subtitle ‘Doctors, Lies and the Addiction Bureaucracy’.
It is stated explicitly in the Introduction: “Addiction to opiates is a pretend rather than a real illness, treatment of which is pretend rather than real treatment. How and why addicts came to lie to doctors, how and why doctors came to return the compliment, and how and why society in general swallowed the lies wholesale, is explored in this book.”
At the beginning of his career as a doctor and psychiatrist in prisons Dalrymple accepted uncritically the belief – which he now knows to be a myth – that addiction was a medical problem to be treated by doctors. As the incidence of addiction increased steeply, despite and probably because of, the increasing number of drug clinics he began to think about it more.
He does not rely exclusively on medical or pharmacological sources though these are fully discussed in Chapter 1 ‘Lies! Lies! Lies!’ The title Junk Medicine is not an oxymoron but a reference to Junkie, William Burroughs’s autobiographical first book in 1953. Under the subheading ‘The Addictive Nature of Opiates’ Dalrymple dismisses Junkie in his characteristic way: “This book is a mixture of self-serving lies and exhibitionist frankness typical of the genre of opiate confessional. In one of his rare moments of truthfulness, probably accidental and certainly without realization of the moral significance of what he is saying, the psychopathic Burroughs writes: ‘You don’t wake up one morning and decide to be a drug addict. It takes at least three months’ shooting twice a day to get any habit at all.’ In other words, the establishment of an addiction requires a certain discipline or determination.”
Later in Chapter 1 under the heading ‘The Alleged Horrors of Withdrawal’ we read “But are the withdrawal symptoms from heroin (and other opiates) so very terrible? In the standard view of heroin addiction, they are. But let me quote from some of the major medical textbooks of our day: ‘Although opiate withdrawal is not life-threatening, patients can become extremely dysphoric. (Jay H. Stein, Internal Medicine, 5th edition, St Louis: C. V. Mosby, 1999, p. 2297)’. ‘Dysphoric’ means, of course, unhappy or disgruntled, though ‘dysphoric’ sounds very much more precise, technical, and medical: In other words, they are unhappy or disgruntled because they are not getting what they want. But, to adapt P. G. Wodehouse slightly, which of us is gruntled all the time?”
In the middle Chapter 2 –‘The Literature of Exaggeration and Self-Dramatisation’ The author uses his literary knowledge to explore the historical reasons why such a widely held false belief, including the impossibility that heroin or opiate addicts can stop without unbearable suffering, can be traced back to the mass credulity in descriptions by such writers as De Quincey and Coleridge on opiate addiction. Theodore Dalrymple with his interest in English and foreign literature and writing is akin to another much admired medical writer of the last century, Richard Asher (1912-1969) now out of fashion but well worth reading. The latter was also eager to espouse unpopular causes and was a champion of common sense.
In Chapter 3 ‘The Show Must Go On’ the recurring theme is the influence of bureaucracy. When a ‘Drugs Tsar’ was appointed in the UK, it was only to be expected that there would be an ‘Empire’ for him to administer. And so it was: bureaucrats built the appropriate house of cards that took over the whole edifice of drug treatment clinics. The doctors and ancillary staff who work in them accept the assumptions on which they are run, including the idea, quite contrary to common sense, of substituting methadone for opiates. Though it is a house of cards, it will be difficult to dismantle: the bureaucrats have fixed the cards with glue, and the inmates have no incentive to destroy their place of employment – and has anyone heard of bureaucrats being defeated on their chosen pitch?
In ‘Auxiliary Workers’ Need for Addicts’ Dr Dalrymple tells of how he once pointed out that there was no ‘evidence-based medicine’ to support methadone substitution for opiates; a medical colleague “reacted with something akin to a cry of panic: You’re challenging the consensus, he said, as if to do so were automatically to be wrong, or worse still, wicked. The apparatchik mentality is far from unique to the former Soviet Union.”
Under his final subheading ‘What Is To Be Done?’ the author discusses whether opiates should be legalized. We might expect Theodore Dalrymple, with a reputation for dogmatic statements, to have a decided view, but he puts the alternatives clearly and with moderation, and comes to a conclusion with some reluctance that “on balance, therefore, I think that the arguments against legalization, however formulated, are stronger than those in favour.”
At the end of this section he writes: “I would suggest the closure of all clinics claiming to treat drug addicts, the modern bureaucratic institutionalization of Romantic ideas. This would put an end to the harmful pretence that addicts are ill and in need of treatment. In the former Soviet Union, there was a saying of the workers that ‘We pretend to work, and they pretend to pay us.’ Drug addicts could say something similar to capture the reality of the current system: ‘We pretend to be ill, and they pretend to cure us.’ Henceforth, instead, doctors should treat addicts only for the serious physical complications of drug addiction: abscesses, viral infections and the like. Addicts would then have to face the truth. Whatever their background, they are as responsible for their actions as anyone else. The truth will not necessarily set them free, but neither will it enchain them in ‘mind-forg’d manacles’.”
The Appendix ‘A Short Anthology of Nonsense’ provides examples to show how the influence of De Quincey and his followers still underlies the view that opiate withdrawal is so difficult and painful that no victim should be expected to undergo something so dreadful. These examples make melancholy reading. It is depressing to realise how many of the young are still wilfully misled by literary traditions that persist in books like Trainspotting, (1993) – later a popular film.
Junk Medicine is a well presented, and well produced book; even its index is worth reading, with many literary references, including Wodehouse and Violet Elizabeth. (Somerset Maugham gets one page reference, though he appears in the Appendix as well as Chapter 3). My only regret is that the impressive structure of the overall argument is not displayed in the list of Contents. That parsimoniously lists only the Introduction, the three Chapters, and the Appendix and Index. To omit the very relevant, witty and instructive subheadings, hidden in the text of the three Chapters, is a shame. These subheadings divide the logical argument into short essays typical of Theodore Dalrymple’s style, a master of concision. They are like a series of gems joined into the three necklaces that constitute the three main Chapters – a total of twenty-seven essays. For example, Chapter 1 has eleven essays distinguished by subheadings such as: The Misconception of the Problem, The Standard or Orthodox View, The Alleged Horrors of Withdrawal, The Alleged Need for Treatment, The New Methadone.
It is a pity that all eleven are not set out in full in the list of Contents as that would help the reader to find gems he wants to re-read. All will bear re-reading. And of course the same is true of Chapter 2, devoted to The Literary Tradition, and of Chapter 3 bringing the argument to its conclusion, divided respectively into seven and nine no less compact and forceful essays.
This book is one to be welcomed wholeheartedly, and needs to be read widely both by doctors, who will enjoy the education it gives so refreshingly, and by the ‘drug-treating community’ who perhaps will not.
Received via email from the author
Device designed to beat obesity helps cure diabetes
Very interesting. Obesity is sometimes held to CAUSE Diabetes but note below that the diabetes remits BEFORE weight loss. It’s consistent with the view that obesity challenges diabetes but does not cause it
An implanted sleeve that looks like a giant sausage skin is being used to tackle the most common form of diabetes. The 2ft-long device, developed as an incision-less alternative to a type of weight-loss surgery known as a duodenal switch, can reverse the disease within weeks.
The duodenum is the name for the first 10 to 12in of the small intestine, which attaches to the stomach. A duodenal switch is a keyhole procedure that involves making two incisions at the start and end of the duodenum. The lower part of the intestine is attached to the stomach, forming a new pathway.
Food then bypasses most of the duodenum, which limits absorption.
Long-term risks include hernia and bowel obstruction.
The device, the EndoBarrier, is designed to have the same effects as surgery but is far safer. It is a plastic sleeve that lines the duodenum, meaning food can only be absorbed lower down the intestine.
The procedure is performed under anaesthetic in less than an hour. The sleeve – made from a thin plastic – is inserted via the mouth and passed into the digestive tract using a thin tube. Once in place, a sprung titanium anchor prevents it slipping out. It is removed after a year.
During trials researchers found that in obese patients who also suffered diabetes, the disease went into remission. Initially experts believed it was a result of weight loss – but many patients were able to stop taking their diabetes medication before they began to lose weight.
The discovery has led to clinical trials at three hospitals, which found the implant also seems to lower cholesterol levels and blood pressure.
Type 2 diabetes is a chronic condition caused by too much sugar in the blood. Initial symptoms include extreme thirst, tiredness and blurred vision. Sufferers are five times more likely to suffer from heart disease and strokes and can suffer sight loss, nerve damage and kidney disease. Ten per cent of all NHS spending – £9 billion a year – goes on treating diabetes, and £130 million is spent on tablets alone.
Type 2 diabetes occurs due to problems with the way the body handles insulin, a hormone that controls the amount of glucose in the blood.
When we eat, the digestive system breaks down food to release the nutrients from it. These nutrients, including glucose, enter your bloodstream. Normally, insulin is produced by the pancreas to move glucose from the blood into the cells, where it is broken down to produce energy.
It is thought that type 2 diabetes is a result of the body being unable to produce enough insulin or because the cells in the body do not react properly to insulin.
Affecting 2.8 million Britons, poor diet, lack of exercise, carrying excess weight as well as a family history contribute to the development of the disease. The condition is treated with drugs designed to increase insulin production or reduce insulin resistance, but these do not stop the progression of diabetes, and some can also have side effects such as nausea, weight gain or liver damage.
With the EndoBarrier, the duodenum is bypassed, altering the balance of hormones in the body leading to a reversal in diabetes symptoms. ‘Food passing through the intestine triggers the release of hormones in the body,’ says Dr John Mason, consultant gastroenterologist at Trafford Healthcare NHS Trust, who implanted the first EndoBarrier in the UK. ‘These hormones have different functions, including signalling that the pancreas gland should release insulin.’
Results from a new study at Musgrove Park Hospital, Taunton, Somerset, show that in 72 per cent of cases, diabetic patients went into remission after the EndoBarrier was fitted, and after a year all had no need for medication.
‘The operation is available only privately,’ says Dr Mason. ‘The NHS has yet to decide on whether it should be a treatment.’ The operation costs £8,000. One patient to benefit is Jason McCullen, 39, an IT consultant from Sale, Manchester. He developed diabetes in 2009. He had the EndoBarrier implanted at Trafford Hospital, Manchester this year. ‘I didn’t feel any pain afterwards. My waist over the past three months has gone from 42in to 38in. And I don’t need medication.’