A helpline in crisis and doctors who still refuse to put patients’ interests before their own
For weeks there have been many stories emerging of patients left hanging on the phone, fearful or in pain; urgent calls going unanswered; ambulances rushing off on wild goose chases; and paramedics dispatched to treat the most minor ailments.
Now we have the heart- rending saga of Kim Green, who waited on the line for the best part of an hour as she sought help for her dying husband, unable to provide pain relief as spasms racked his cancer-ridden body.
Her tragic tale highlights in the most horrendous way possible the scale of the problems caused by the botched launch of the National Health Service’s 111 helpline.
Mrs Green is right to be angry. The agony of those awful minutes must add terribly to the burden on this brave widow from Buckinghamshire as she prepares to bury her husband this week.
Sadly, her case is just one among many. For although this service has been running for only a few weeks and is still to be fully rolled out across the country, it has already emerged that three patients may have died due to its failings.
A further 19 cases involving poor care are being investigated — and there are widespread fears these are just the tip of the iceberg. Many more may emerge after this Bank Holiday weekend, with GP surgeries closed for three days.
The horror stories over the chaotic new service, largely manned by the sort of scarcely trained call centre staff who might just as easily be answering car insurance queries as matters of life and death, are the latest bad news to afflict the increasingly sickly NHS.
Indeed, this crisis encapsulates all the problems we have come to associate with our embattled health service: poor management, overstretched resources and patients desperate for competent care falling victim to bungling and topsy-turvy priorities.
The 111 call-line was intended to ease soaring pressure on Accident and Emergency units: a free 24-hour number for patients with urgent — but not life-threatening — symptoms.
Instead, the service — which is being offered by a hotchpotch of providers, including private firms, ambulance services and remnants of the old NHS Direct — has been plagued with problems.
This has caused an outcry from patients sick and tired of a system that seems designed to make seeing a doctor face-to-face ever more difficult.
Seven of the 46 services are not yet operational; others have been suspended or hastily bailed out by other parts of the NHS.
More than a quarter of the contracts for the 111 lines were awarded to a private health care provider called Harmoni, which has already been criticised by a coroner for the ‘wholly inadequate’ actions of an out-of-hours doctor in relation to a seven-week-old baby who died of pneumonia.
Others who have used Harmoni’s services have complained of being fobbed off or made to wait as they desperately tried to get medical advice.
Despite widespread concerns over the launch of the 111 service, Sir David Nicholson — the shamed NHS chief who should have been sacked over the Mid-Staffordshire scandal — ignored pleas to delay the roll-out. He later admitted he had again ‘let patients down’ by not intervening.
Astonishingly, more than eight out of ten of the people answering the phones to worried patients have no medical training, while computer systems have repeatedly crashed.
Ambulance crews in some areas say workloads have doubled because so many calls are wrongly flagged up as emergencies. One team in the South-West rushed out to be confronted by a case of hiccups; another by a cat with diarrhoea.
Such absurd incidents sound almost amusing — yet this could not be further from a laughing matter, with doctors warning that lives are being put at risk as heavily stretched services come under even greater strain.
The medical unions are right to raise the alarm over the shambolic introduction of this shockingly inept service.
Yet this is a symptom of a far deeper ailment in the health service — and doctors cannot avoid their share of the blame. For at the root of it all is the selfish zeal with which they ditched the old-fashioned approach of family practices offering round-the-clock care to patients.
The saga began with the disastrous deal Labour ministers struck with GPs nine years ago that, incredibly, saw them earning more than before in return for working fewer hours. This new contract allowed GPs to stop treating patients outside office hours, in return for a supposed £6,000 salary cut.
Nine out of ten family doctors instantly stopped providing emergency cover — yet average pay rose by one-third thanks to various simple targets they were set. As a result of this ridiculous offer, Britain has the world’s best-paid GPs, earning average salaries of more than £100,000.
Yet four million more patients are using hospital A&E services each year.
This flooding of hospital emergency units is the single biggest operational challenge for the cash-strapped NHS.
Much of the upsurge has come from worried parents who are being denied access to their GPs or who are reluctant to rely on locums who have no knowledge of their family and are possibly from abroad. Little wonder that emergency hospital admissions of under-fives jumped more than 50 per cent over the past decade.
According to one recent study, that represents a ‘systemic failure in the NHS’ — certainly, few children today enjoy the security so many of us had as youngsters of being cared for by a friendly face when sick at night.
But the biggest pressure on A&E units comes from those patients with long-term conditions associated with ageing, such as diabetes, dementia and heart problems, who account for more than two-thirds of health spending.
These are the old and disabled who always bear the brunt of failure in the health system.
They would be far better dealt with by community doctors familiar with their cases, rather than patched up in the frenetic emergency departments of hospitals — let alone relying for help on unskilled call centre workers at the end of a 111 phone line.
The harsh truth is that amid the whirlwind of health service reforms in recent years, doctors have put their own interests above those of their patients — and daily we suffer the consequences. Even the NHS’s deputy medical director admits GPs should never have given up responsibility for out-of- hours care.
It is impossible to turn back the clock to the days of Dr Finlay, when a single phone call would have seen a GP arriving at your door.
But — despite presiding over the present shambles — the Coalition Government does seem determined to force doctors to resume having overall responsibility for their patients at all times. This, after all, is in keeping with the logic of its controversial reforms of NHS bureaucracy, which hand GPs more control over health spending.
The Government has already begun the process of reversing Labour’s bungling with the launch of a review into out-of-hours services.
Ministers tell me they can’t afford to cave in on this issue because otherwise hospitals will simply be swamped with patients — most of whom should be dealt with at community level — when they do not have the resources to deal with them.
In the meantime, the Government must move fast to fix the lamentable launch of the 111 helpline and to make sure that the NHS is never again shamed by someone left hanging on the phone for help while their dying spouse suffers in agony.
Paramedics: Patients are killed by a shortage of ambulances and long delays
Patients are coming to serious harm and even dying because of long ambulance delays and a shortage of vehicles, a paramedic has warned. He said some ‘lone-response’ paramedics had been stranded for several hours as they waited for fully crewed ambulances to arrive.
At the same time, doctors revealed that A&E closures across England and Wales will lead to even longer waiting times as ambulance crews are forced to queue to offload their patients.
The warnings come as emergency departments across the country are expected to be inundated over the Bank Holiday weekend and serious concerns are raised about the new 111 out-of-hours number.
The paramedic at East of England Ambulance Service, who did not wish to be named, said he had experienced two occasions when patients had died because a vehicle was not immediately available.
The paramedic – who was in a ‘rapid response vehicle’ that often arrives first but is not capable of dealing with the most serious emergencies – said: ‘It’s happened to me with a patient who was having severe breathing difficulties. ‘I had to wait for an ambulance to come from 50 miles away. Regrettably she passed away before it arrived.’
Although Department of Health targets state that ambulances should respond to the most urgent 999 calls within eight minutes, the paramedic said he had once waited ‘a couple of hours’ for one to arrive while colleagues had waited even longer.
Last month an inquest heard how Isabel Carter, 74, died after being forced to wait four hours for an ambulance after her 999 operators failed to upgrade her initial call.
The grandmother, from Wymondham, Norfolk, died of bowel ischaemia – inadequate blood supply to the organ – within ten minutes of arriving at Norfolk and Norwich University Hospital.
Yesterday, Dr Andrew Mason, an experienced emergency doctor, also warned that A&E closures would lead to long queues outside remaining emergency departments. ‘It’s not just a case of chucking more ambulances at it: that’s just a sticking plaster on the wound,’ he said. ‘If A&Es are full, it doesn’t matter how many ambulances there are.
‘At Norwich, West Suffolk and Ipswich hospitals, crews are waiting an hour, two hours, and sometimes even longer just to get rid of their patients, which has a huge impact on the ambulance service.’
New strain of superbug C. Diff kills three hospital patients in Scotland
And the health service seems completely complacent about it
Three hospital patients have died after contracting a new strain of the superbug Clostridium difficile (C. diff).
Doctors in Scotland have been alerted to the strain, named ribotype 332, which has been reported for the first time by Health Protection Scotland (HPS).
HPS said two patients being cared for at the same hospital died – one in December and the second in January. A third patient within the same health board area died last month. All were seriously ill with underlying conditions. HPS did not disclose the hospital locations due to patient confidentiality.
A statement said: ‘All three cases were severely ill due to other underlying conditions and died following their episode of CDI. ‘HPS has alerted clinicians and laboratory staff throughout Scotland.
‘The identification of a novel ribotype does not require any immediate changes to surveillance or in the antibiotics used to treat CDI.’
A CDI is a type of bacterial infection that can affect the digestive system. It most commonly affects people who are staying in hospital.
Symptoms include diarrhoea and abdominal cramps and it can also cause life-threatening complications such as severe swelling of the bowel.
HPS said new ribotypes have emerged ‘frequently’ over the last decade. A ribotype is the pattern of DNA fragments particular to a bacterial strain. Ribotyping is the name given to the process of identifying this pattern which allows scientists to differentiate between different strains.
Camilla Wiuff, strategic lead for microbiology at HPS, said the cases were not classed as an outbreak because the third case had not been linked to the first two.
She told The Scotsman: ‘But it is an interesting finding that we have this same ribotype and we are doing further investigations to see if there are more patients with this ribotype.’
Past samples are now being re-examined to see if the 332 strain could be present and may have been missed. She said the 332 strain had occurred on one occasion previously somewhere in Europe, but this had not been the subject of an official report.
“It is quite a common event that new strains develop all the time. It is a natural evolution of genetics in the bacteria,” she added.
More hateful British bureaucracy
Some stories make my blood boil. You won’t always find them on the front pages or leading the television news bulletins. But they tell you more about the condition of modern Britain than most of what passes for ‘news’ these days.
Take the case of 19-year-old Kurtis Green, from Dersingham in Norfolk. For the past 12 years he has been lovingly tending the war memorial opposite his parents’ fish and chip shop.
It began when he was just seven. Kurtis saved up his pocket money to buy gardening tools and started clearing litter and planting bulbs.
Over the years he has devoted hundreds of hours of unpaid time to his task. When he was 15, he mounted a successful campaign to persuade councillors to spend £20,000 restoring the memorial with new flowerbeds, railings, seating and block paving.
Kurtis won a Norfolk Young People’s Role Model of the Year award and was congratulated by the Queen.
Thanks to his efforts, the local branch of the British Legion collected a prize for Norfolk’s most improved war memorial.
But Kurtis wasn’t content to rest on his laurels. Deciding the plants and flowers could do with more irrigation, he tapped into a nearby water supply, which had been installed as part of the restoration programme.
Together with a fellow villager, 65-year-old John Houston, he went about the work in a professional manner. At the insistence of the council, he took out public liability insurance and coned off the area where the trench was being dug.
Once the work was complete, the trench was filled in and new grass seed planted. ‘It actually looked better than when we started,’ said Kurtis proudly.
But this is where it all began to unravel. No good deed, as they say, ever goes unpunished.
While Kurtis and John were carrying out the work, along came a councillor and started taking photographs on his mobile phone. ‘The next thing we knew we were reported to the police.’
Dersingham parish council claimed the work had been undertaken without permission and accused them of theft and causing criminal damage.
As a result, Kurtis and John were interrogated for two hours by police. ‘All we have been doing is to help the community and we are being treated as if we are criminals,’ Kurtis complained.
‘The policewoman was trying to trap us. She kept asking us the same questions in different ways.’
Sounds about right. No doubt some dopey WPC who fancies herself as Helen Mirren in Prime Suspect.
Kurtis went on: ‘We were accused of causing criminal damage by digging up earth to see if the existing pipe was OK, but we left the area just as we found it.
‘I can’t understand what the theft is supposed to have been. All the soil we dug up was replaced and the only thing we took away was the dirt under our fingernails.’
A spokesman for Norfolk Police said: ‘The circumstances are now being considered by the Crown Prosecution Service. Police are aware of Kurtis’s efforts in cleaning up the memorial and we will work with all concerned to try to reach an acceptable resolution.’
If they are trying to reach an ‘acceptable resolution’, then why the hell has the file been referred to the CPS?
I’m only surprised that the Old Bill didn’t raid Kurtis’s house at 6am and then ransack the place for eight hours, confiscating his computers and carting off dozens of bin liners full of ‘evidence’.
Of course, in the days when Dersingham had a proper police presence, a resident bobby who knew everyone in the village, it would never have come to this.
PC Plod would have told any jumped-up parish councillor who wanted a young man prosecuted for tidying up the war memorial to take a running jump: ‘Push off, Fred, or I’ll nick you for wasting police time.’
These days, Dersingham villagers who want to talk face-to-face with a real live copper are requested to report to a ‘surgery’ in Budgens supermarket on a Friday morning, between 10.30am and 11.30am.
Turn left at the fish counter, second aisle down. Mind how you go. Time was, too, that most parish councillors saw themselves as servants, not masters, of their community.
Today, the majority of those who work in every level of ‘public service’ seem to regard the public, at best, as an inconvenience and, at worst, as the enemy.
OK, admittedly the Jobsworth mentality has always been with us, but the ubiquitous urge on the part of so-called ‘public servants’ to bully and punish their fellow citizens has never been more prevalent.
Dersingham council refused to identify the councillor who made the complaint. Tony Bubb, the council’s Lib Dem chairman, resigned on Monday, but we are told his decision had nothing to do with the dispute over the memorial.
Parish clerk Sarah Bristow said she couldn’t comment because the incident was being investigated by police, but added: ‘The parish council did not give anyone permission to do anything.’
That’s odd, because Kurtis says he took out liability insurance at the council’s insistence.
Even so, why should he need the council’s permission? He’d been tending the memorial for over a decade. His grandfather served in World War II and Kurtis says he started his clean-up campaign because it ‘was not in a fit state’ to honour those who had fought for their country.
‘In those days, it was a complete disgrace. I just decided to do something to help.’
Precisely. In a sane world, the council would have made the upkeep of the memorial one of its priorities, not fobbed off the responsibility to a teenager.
The real disgrace is that so many war memorials remain neglected. As memory of the two world wars fades, respect for those who made the ultimate sacrifice has faded with it.
Last year, a man in Hartlepool was fined for using a war memorial as a public urinal. So the idea that a young volunteer can face prosecution for cleaning up a memorial is beyond monstrous.
David Cameron used to bang on about the Big Society, though we haven’t heard all that much about it lately.
Surely Kurtis Green is a classic example of the Big Society in action, a welcome reminder of the millions of good people out there willing to give something back to the community.
Kurtis takes the idea of genuine public service seriously. In his chosen career he’s a chef in a care home.
As his mum, Sandra, says: ‘All he is trying to do is some good. He is a kind, hard-working boy. He’s got a heart of gold.’
Yet what thanks does he get for it? He’s accused of criminal damage and theft by a vindictive, self-important creep with a mobile phone camera and then treated like a criminal by the police, who try to trap him into a ‘confession’.
Makes you proud to be British.