Whistleblowing/Sources

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  • Train companies reject whistleblower safety scheme. . The Times, 22 October 1999.
  • THE callous treatment of the elderly in NHS hospitals has been exposed by a doctor who claims patients are denied life-saving treatment, are grossly neglected and are given drugs which hasten death. Rita Pal, 28, a junior doctor, was so disturbed by her experiences that she is leaving the profession. This week she will submit a dossier to the General Medical Council (GMC) detailing the cases of abuse that she saw. Sunday Times April 2 2000
  • Rita Pal was so disgusted by the maltreatment of the elderly she saw while working in 12 hospitals that she decided to leave the profession. But not before she presented a dossier to the General Medical Council earlier this month of the cases she had witnessed.
    "In every hospital I have worked there is an attitude that if people are over 65 it is often not worth bothering to treat them," said the 28-year-old junior doctor. "Doctors are unilaterally taking the decision to put 'do not resuscitate' or 'nil by mouth' orders on patients' medical notes purely based on the age of the patient. Nurses are being bullied into doing things simply because doctors want a bed freed for another patient."
    Dr Pal, from Sutton Coldfield, west Midlands, said on one occasion a doctor told her to withdraw all medication from a stroke victim who was conscious and could hear what was being said. Dr Pal decided to carry on the man's medication and held his hand, telling him: "You'll be all right." He was transferred to another unit where he died.
    "I was sickened by the whole episode," she said.
    On another occasion she was told to put a pneumonia patient on diamorphine. She injected the drug into the patient's mattress and the next day a senior doctor commented: "She is still alive. Didn't you start her on the diamorphine?"
    The patient recovered and went home.  Daily Mail, 14 April 2000. 
    For an update on the consequences for Dr Pal, leading through inappropriate legal processes to an out of court settlement in 2005 see NHS Exposed, especially http://www.nhsexposed.com/healthworkers/doctors/gmc/pal_v_general_medical_council.shtml and my article for the October 2004 edition of The Whistle
  • Six years ago I launched a campaign in this column on behalf of Pat Cooksley, a ward sister at Derriford Hospital in my home city of Plymouth. Pat was suspended for "gross misconduct" - rewriting a drugs prescription sheet for a seriously ill patient. The doctor who should have signed it had forgotten to do so. Paul Foot in Guardian 27 June 2000
  • There are a lot of nursing homes around Blackpool. It's the sort of place many elderly people imagine spending their last days - in a pleasant home, not far from the sea, with all those hazy memories of summer holidays. But not all these places offer the sort of care for their elderly residents that we might expect. In those where there is neglect and abuse, there are probably staff who don't like what they see. They are reluctant to speak out. They are frightened for their jobs. It is easier to stay silent or quietly leave. Bryan Bladon did neither. He blew the whistle and, like many before him, was sacked. But unlike his predecessors, Bladon had the law on his side - a new law that protects whistleblowers against sacking or other forms of victimisation. Guardian 3 July 2000
  • The cost of whistleblowing Even in the new culture of openness that employees are told now exists, blowing the whistle on wrongdoing can often mean suspension and blighted career prospects, writes Maggie Murray. Blowing the whistle on a colleague or raising awareness of bad practice takes courage, even in the new culture of openness that employees are told now exists.  For the individual who decides to challenge the status quo, the implications of the decision to highlight wrongdoing may mean, at best, a period of stressful suspension, and, at worst, blighted career prospects. Last year, Sian Caiach, a consultant orthopaedic surgeon, raised concerns that a fellow doctor at the Prince Philip hospital in Llanelli was using NHS time and resources to treat private patients. An audit commission investigation substantiated some of her claims and found that the hospital was subsidising private patients and had lost income of £7,500.  Since that time, Ms Caiach has not worked and has been on what is described as extended maternity leave for almost eight months. She is also the subject of an investigation by the Royal College of Surgeons after allegations were made about her clinical practice. Guardian Society Thursday March 22, 2001
  • Nurses who blow the whistle on poor standards of care run the risk of threats, intimidation and physical and mental health problems, it is claimed. Delegates at the Royal College of Nursing's annual congress in Harrogate backed a call for action to protect nurses who speak out. BBC 22 May 2001
  • Doctor who blew the whistle and suffered a reign of terror. Stoke Mandeville is one of Britain's most famous hospitals, but when a doctor in A&E warned about a consultant she was ignored - then the anonymous threats began.  David Rose. Observer Sunday January 27, 2002
  • Pick of the day.  Harold Jackson Tuesday July 23, 2002 The Guardian.  One of the constant and depressing experiences for workers who blow the whistle is that public esteem is so often followed by private retribution. Anaesthetist Stephen Bolsin, who revealed the appalling toll of child deaths at Bristol infirmary, was professionally ostracised until he sought work in Australia. The government is supposed to be backing the protection of NHS whistle-blowers but, as Allan Urry discovers in File On 4 (8pm, Radio 4), insiders say their situation is as bad as ever.
  • Secretary 'driven to quit' after revealing problems in cancer unit Martin Wainwright Guardian Tuesday August 13, 2002  
  • A hospital secretary who raised the alarm about problems in a breast cancer unit won a whistle-blowing employment tribunal case yesterday.  Saturday August 17, 2002 The Guardian
  • Ambulance staff 'feared revealing fiddled 999 data'.  John Carvel, social affairs editor Tuesday October 15, 2002 The Guardian
  • An NHS "whistleblower", sacked after speaking out about an alleged "fiddle" of statistics for cancelled operations is taking his case to an employment tribunal.  BBC News Thursday, 9 January, 2003
  • Hospital finance director 'sacked for whistleblowing'.  Sarah Hall Thursday January 9, 2003 The Guardian
  • Blowing your job. The health secretary has urged people to speak out about misconduct or mismanagement in the health service. But whistleblowers claim they do not enjoy the same protection in other parts of the public sector. Simon Parker reports. Friday January 17, 2003
  • The financial director of an NHS trust, who claims he was sacked for "telling the truth", yesterday lost the first round in his fight to be reinstated. Saturday January 18, 2003 The Guardian
  • Whistleblower lifts lid on NHS culture of secrecy.  A senior health service official who was fired after revealing his hospital's financial problems yesterday lifted the lid on what he claims is the culture of deception now endemic in the NHS.  Jo Revill, health editor Sunday January 26, 2003 The Observer
  • Online commentary: The Observer today reports on the case of NHS whistleblower Ian Perkin. Here he says that managers must be able to talk honestly about the problems which the service faces. Sunday January 26, 2003
  • Union leaders today called for an independent inquiry into allegations of serious sexual abuse of female patients at one of the UK's high security psychiatric hospitals. Thursday March 6, 2003
  • Broadmoor's cover-up.  Another brave whistleblower suffers.  Leader Saturday March 8, 2003 The Guardian
  • One of Britain's most famous teaching hospitals is in a state of unprecedented crisis and riven by internal quarrels due to government pressure to modernise, a Guardian investigation has discovered. A number of doctors and administrators at St George's in London have been suspended or sacked by the trust board after alleging mismanagement as the hospital struggles to achieve government "star" ratings. Sarah Hall Saturday April 19, 2003 The Guardian .This relates to Ian Perkin
  • Staff tell of cutbacks, quarrels and cover-ups.  Sarah Hall Saturday April 19, 2003 The Guardian
  • The hospital finance director who claimed he was sacked for "whistleblowing" was described by the trust's medical director as a "scorecard keeper" with a "can't do attitude", an industrial tribunal heard today. Wednesday April 23, 2003 .This relates to Ian Perkin
  • Finance chief 'not sacked for blocking NHS fiddle'. Rebecca Allison Thursday April 24, 2003 The Guardian .This relates to Ian Perkin
  • No crisis at our hospital. Letter Tuesday April 29, 2003 The Guardian
  • Hospital falsified figures, whistleblower says. Angelique Chrisafis Thursday May 1, 2003 The Guardian .This relates to Ian Perkin
  • A senior consultant at St George's hospital intensified pressure on the trust yesterday, accusing hospital managers of massaging waiting lists to meet government targets. Sarah Hall Thursday May 1, 2003 The Guardian
  • One in three NHS workers who has voiced concerns about bad practice in the service has faced reprisals, figures reveal. BBC News May 7, 2003
  • A famous teaching hospital has brought in a top troubleshooter to replace its chief executive, just as an employment tribunal discusses the sacking of an award-winning colleague. Sarah Hall and Rebecca Allison Thursday July 24, 2003 The Guardian
  • A hospital finance director who claimed he was sacked for blowing the whistle about fiddled figures for cancelled operations was unfairly dismissed, but not for revealing wrongdoing, an employment tribunal has found. Rebecca Allison Saturday January 31, 2004 The Guardian
  • Preventing the worst. Leader Monday October 4, 2004 The Guardian
  • A leading London hospital fiddled data about cancelled operations as it attempted to curry favour with the Department of Health to win a higher star rating. Its chief executive also improperly charged £540 towards the cost of a dinner at the Savoy to the hospital's credit card, an independent inquiry found yesterday. Inspectors upheld two of six complaints by a whistleblower against St George's hospital in Tooting, south London, concluding: "The dysfunctional state of the senior management team was severe." But the inquiry report, published by south west London strategic health authority, reserved some of its sternest criticism for the whistleblower, Ian Perkin, the hospital's former finance director, accusing him of "obsessive managerial behaviour". John Carvel Wednesday October 20, 2004 The Guardian
  • A HOSPITAL in Wolverhampton run by controversial health boss David Loughton is suffering from crippling debts. Cash-strapped Royal Wolverhampton Hospitals NHS Trust achieved just one out of three stars in the Healthcare Commission rating. New Cross Hospital would have achieved top rating in the latest health watchdog review but for the debts, according to bosses. Mr. Loughton, who was chief executive of University Hospitals Coventry and Warwickshire NHS Trust, resigned from Walsgrave Hospital in March 2002 after a vote of no confidence. His departure followed calls from seven MPs for him to leave and a vote of no confidence by 99 consultants. The Rugby Advertiser launched a well-supported campaign to see his resignation. During Mr. Loughton's ten year 'reign' over Walsgrave and Rugby's Hospital of St. Cross, the trust was criticised in a Commission for Health Improvement report for putting patients' lives at risk with unsafe practices. It also said doctors feared being victimised for voicing concerns. This report was swiftly followed by a zero-rating in the Government's star rating system. But Mr. Loughton sprung back to become chief executive of the Royal Wolverhampton Hospitals NHS a year ago. Rugby Advertiser 22 September 2005
  • Two health service employees who highlighted fire and safety breaches at a new privately financed psychiatric hospital were suspended within days of giving evidence to a council investigation into the allegations. The workers, who do not want to be identified, believe they are being victimised because they have expressed concerns to Leeds mental health NHS teaching trust over the building and design of three facilities. Their fears were vindicated in a report by NHS Estates earlier this year. It found one of the sites, the Newsam Centre at Seacroft hospital in Leeds, breached every section of the fire safety code. Laura Smith Wednesday October 26, 2005 The Guardian
  • Trust attempts to gag its staff. Cambridgeshire and Peterborough Mental Health NHS Trust has sent a letter to employees telling them not to speak to the media about "contentious" issues, following "intense media scrutiny" over the proposed £3m cut to services. Last week 27 consultant psychiatrists wrote to the Cambridge Evening News expressing their fear over the cuts, and the story was picked up by the Guardian. David Howarth MP has condemned the trust's move, saying the doctors' letter "was a legitimate exercise of the right of free speech by a group of people who know far more about the issue than anyone else." Cambridge Evening News 13 December 2005
  • A proposed ethical code for scientists would help junior staff blow the whistle on unethical behaviour and also help promote the subject in schools, the Royal Society said today. The code has been drawn up by the government's chief scientific adviser, Sir David King, with a small working group, following a meeting of science ministers and advisers from G8 countries last year. It calls for rigour, honesty and integrity among scientists, who should take steps to prevent corrupt practices and professional misconduct and declare conflicts of interest. Scientists should ensure that their work is lawful and justified, they should "minimise and justify any adverse effect" their work may have on people, animals and the natural environment. Donald MacLeod Thursday January 5, 2006
  • NHS staff told "shut up or lose your jobs". Staff at the University Hospital of North Staffordshire have been told not to whinge about their place of work in public places, for fear that any damage to the hospital's reputation could have serious consequences under Choose and Book. They were also told that patients should henceforth be known as customers. Summary by Keep our NHS Public of  Stoke Sentinel 18 January 2006
  • One of Britain's leading charities for people with severe learning disabilities has been accused of abusing some of the most vulnerable people under its care, The Observer can reveal. An employee of United Response, which runs more than 100 care homes across England looking after people with learning disabilities, turned whistle-blower to report on 'appalling' events he alleges he witnessed at the company's Gombards care home in Welwyn Garden City, Hertfordshire. Two senior members of staff at the home have been suspended, although the company claims this is unrelated to accusations of abuse. Sunday February 19, 2006 The Observer
  • Consultant quits over op delays. A gynaecologist who spoke out over claims he was left with nothing to do because his hospital delayed non-urgent surgery has resigned. David Penman faced disciplinary action after saying public money was being wasted through the delays at Kent's £1m-in-debt Medway Maritime Hospital. He resigned because he could "no longer tolerate the way the NHS is being run". Mr Penman spoke out in March after the hospital imposed minimum waiting times of nine weeks for outpatient appointments and 20 weeks for non-urgent operations. Upon resigning he said: "I come from a long line of doctors and I was brought up to act and behave to my patients with honour, honesty and respect and all I see is spin, lies and deceit from the management. I don't feel I can work in a system like that. It is an important principle not to allow organisations to effectively gag people who, for the most honourable reasons, are wishing to expose dishonourable actions to public scrutiny." The hospital is continuing with disciplinary action against him despite the fact he has resigned. Summary by Keep our NHS Public of  BBC Online 5 June 2006
  • X-ray films and scans belonging to more than 100,000 patients were dumped in cardboard boxes lining a dirty hospital corridor and lay unchecked for years. Now the senior doctor who revealed the scandal that exposes the dire state of NHS diagnostic services has been sacked. Radiologist Dr Otto Chan has spoken for the first time about the discovery that led to his dismissal. On two separate occasions, some 15,000 packets of films and scans were kept in corridors as the hospital had neither the manpower nor the money to analyse them all. It is estimated that only half of the films and scans were ever seen by a specialist meaning thousands of patients and their doctors will never know whether or not their images showed any signs of disease. At one stage in 2002, the packages of films were locked away in a storeroom shortly before an official inspection visit. On other occasions, consultants would keep patients' x-ray films in their car boots because they were so worried they would go missing. Each x-ray or scan should be read, or 'reported' by a radiologist trained to detect early signs of illness and infection, under medical royal college guidelines. But at Chan's hospital, Barts and the London NHS Trust, there was no computer system in place to count or record the images in question, so staff had no way of knowing how many images were stored or of cross-checking them with patients' records. Dr Chan, 49 and a father of six, was suspended 18 months ago, and then dismissed last month - a decision he is now fighting. 'I believe I was sacked because I was marked out as a whistleblower and a troublemaker, and that's because I refused to accept that thousand of films lying jumbled up in a corridor constituted good patient care,' he said. He revealed to The Observer that from 2000 the number of films started to accumulate in the Royal London. 'At first it was just few packets from outpatients and inpatients but gradually they built up. By 2001, it was 10,000 packets of film (each packet contains up to eight images) and by 2002, it was up to 15,000 packets. They were stuffed into boxes and kept in the corridor. 'One day I turned up and they had all disappeared. I tracked them down to a storeroom which had been locked, and it transpired that the inspectors from the Commission for Health Improvement [now the Healthcare commission] were coming round on a visit.' Managers at the time said that the move was taken to protect safety of patient records. These films were finally read at the end of 2002 after Chan demanded action, and threatened to go public with it. But the hospital administration then allowed a second backlog of another 15,000 packets of film to build up between 2003 and 2004. This time, there was no agreement to read all of them. Apart from chest X-rays the second pile of films was never checked by radiologists. The scandal may now be investigated by the Healthcare Commission, which looks at issues of patient safety. Charles Blakeney, a radiologist at the Royal London who worked for years with Chan, said: 'The way in which he [Chan] has been victimised is to my mind, disgraceful. He raised the issue of the unread films because it mattered to him that patient safety was being compromised. I was shocked beyond belief, as were many others, when he was dismissed.'  In January 2005, Chan was suspended and accused of professional misconduct. The trust, under threat of legal proceedings from Chan, appointed an internal investigation panel headed by a QC which took 12 days of evidence about the saga, and which included other doctors' accounts of the piles of films. The findings of the panel remain confidential but it is understood that in April this year, they concluded that although there were 'serious deficiencies' in his behaviour towards managers, he had made a 'very substantial contribution' to the trust, and they should consider re-employing him under a different structure. Chan was therefore shocked to be told on 7 June that he was 'summarily dismissed'. His suspension and dismissal has cost the NHS some £1.5m but the amount will rise if the case goes to appeal. In a statement last night, Dr Charles Gutteridge, medical director of the trust, said: 'It is true that at times in the past our radiology service experienced considerable pressure, due to the volume of films and a national shortage of qualified radiologists and radiographers. It should be emphasised that the images concerned were from patients with the lowest clinical risk. Patients with the highest clinical risk have always been reported urgently.' He said that robust new protocols for reporting were introduced in 2004. 'The introduction of state-of-the-art digital imaging this summer will radically transform the way we capture, store and distribute images and reports.' The trust management said that the recent dismissal of a consultant for gross misconduct followed a 19-month investigation, which included a formal hearing by an independent panel. 'The panel concluded that there were grounds for dismissal. The dismissal was in no way connected with issues with our radiology processes in the past.' Jo Revill, health editor Sunday July 30, 2006 The Observer
  • GPs blow whistle on walk-in centre. A GP has resigned from his job at a walk-in centre run by a private company over his concerns about patient safety because of the Government's "slapdash" introduction of the private sector centres. Dr Anila Reddy has written to Patricia Hewitt about his concern that nurses at a privately-run NHS walk-in centre were not working to protocols and that the area was "dangerously under-regulated". "There appears to be a two-tier system whereby validated safety netting is being thrown out of the window to promote an expansion of the private sector," he said. The rushed introduction of the private sector centres meant that companies like Atos Origin, an international IT company which ran the centre for the NHS, were not setting up the same safeguards used at NHS-run walk-in centres, Dr Reddy claimed. He said Atos had been told by the DoH that nurses did not need to use protocols but should rely on Prodigy and NICE treatment guidelines instead. The situation had led to nurses working outside their competency, he added. Dr Reddy said nurses of varying qualifications and experience were expected to carry out clinical assessments of untriaged patients with no requirement to involve a doctor at any stage unless they chose to. He resigned from his post as lead GP at the centre - one of four new privately run NHS commuter walk-in centres - four months after it opened at Canary Wharf in London. He said: "Nurses who are of variable experience and training are being allowed to see patients without the usual compulsory protocols necessary for patient safety, and are being encouraged to see as many types of patients as they can to ensure waiting time targets are attained, when these patients are outside their scope of practice." Other doctors who have worked at the centre expressed similar concerns. Locum Dr Nadeem Bhatti said he was shocked that nurses were in charge of clinical decisions. He said: "Unless there is more regulation of these centres, they will remain dangerous." A DoH spokesman said it had asked Atos to investigate the issue "as a matter of urgency". Summary by Keep our NHS Public of Doctor Update 22 August 2006
  • Doctors expose 'crisis' at TV hospital. Blunders by bosses have endangered lives at one of Britain's busiest casualty departments, the hospital's own doctors claimed. Six senior consultants at the Royal London claimed management decisions at the hospital had led to serious lapses in patient care. An orthopaedic surgeon said: "Specialists from every department have written letters to management that we can't do without certain services like radiology. But managers are deaf and are obsessed with targets." Some of the doctors claimed that two patients died because equipment that could have saved them was not ordered; patients with minor injuries are treated before seriously ill ones just to keep government waiting time targets; bosses refuse to provide cover for doctors who are on holiday, ill or suspended, with serious consequences to treatment; 15,000 packets of X-rays were found lying in a corridor, meaning some serious illness may not have been spotted. One orthopaedic surgeon was concerned that some patients at high risk of carrying MRSA were shuttled into general wards to fulfill government four-hour waiting time targets. Senior radiologist Dr Otto Chan was suspended last year. He was summarily dismissed despite an investigation panel recommending his reinstatement. Astonishingly half the £1.5million legal costs of his suspension and dismissal were taken from the £7million radiology budget. He discovered the numbers used to identify files were being reused after three months for different patients "to save a few hundred pounds". "It meant some patients with life threatening conditions were given the all clear because someone else's report found its way onto their file. I told managers it was unsafe but they threatened to discipline me." Summary by Keep our NHS Public of Mirror 1 September 2006
  • Whistle blower wins enquiry into GP cover. Urgent Care 24, the company which runs out-of-hours GP cover across Merseyside, is being investigated after a former executive, Roy McNally, raised concerns about its standards. Mr McNally has claimed among other things that patients with life-threatening illnesses were not identified quickly enough and performance figures were falsified. The company's call centre in Wavertree is contracted to find doctors for the 800,000 patients in Liverpool, Knowsley and south Sefton if they fall ill after working hours. The three area's health bosses are now reviewing a dossier of allegations handed in by Mr McNully after he resigned as the service's head of IT in March. Mr McNully says he signed a three month gagging order stopping him speaking about the service until now. Mr McNally said: "I am concerned for patient safety. The risk of life-threatening cases being missed, particularly among vulnerable groups and the elderly, is a real worry if it leads to even the smallest delay in their treatment." Mr McNally and other current and former employees took a long list of concerns to Liverpool PCT. These concerns included a figure of only 9% of calls from patients with "immediately life-threatening conditions" being referred to the ambulance service within three minutes changing to 94% by the time it reached the service's clinical monitoring board. The three PCTs have all confirmed that they are reviewing the company's contract. A spokesperson for Urgent Care 24 said the allegations were untrue and that the company did not wish to comment. Summary by Keep our NHS Public of Liverpool Daily Post 18 December 2006
  • Woman wrongly given breast scan all-clear dies. A woman wrongly given the all-clear by a consultant radiologist who misread her breast cancer scan results has died from the disease, it emerged last night. The patient, who has not been named, was one of 28 women whose mammograms were misreported at a hospital in Greater Manchester. She died after the mistake went unnoticed for at least three months. Another woman's breast cancer was only noticed two years after she was given the all-clear, it emerged. The mistakes by a consultant radiologist sparked a review of nearly 2,500 mammograms by bosses at the Trafford General hospital and North Manchester General hospital. A total of 176 women had to be recalled and re-tested after the mistake was identified in April 2005. Of the 28 wrongly given the all-clear, 18 were told that their chances of surviving were "significantly" worsened because the delay in spotting the error was more than three months. The details came to light as the NHS North West published a report into the scandal, criticising hospital procedures and saying that errors could have been spotted earlier if a clinical audit of the radiologist's work had been ordered after his colleagues raised concerns to their bosses in November 2003. Alex Kumi Friday February 2, 2007 The Guardian
  • Watchdog condemns deal behind health choice scheme. A groundbreaking deal with the private sector to provide millions of patients with information on the best hospitals and GPs in Britain is condemned today by a parliamentary watchdog as poor value for money and breaking almost every rule designed to protect the taxpayer. The National Audit Office has lambasted the Department for Health for signing an exclusive joint venture with the Dr Foster partnership - the organisation behind the Good Hospital Guide - without putting out the proposal to competitors and paying millions of pounds to the company to develop the ministry's own data. The scheme, personally endorsed by the health secretary, Patricia Hewitt, and former health minister Lord Warner, could, according to advice taken by the NAO, leave Britain facing a court case for giving illegal aid to a private company. The new system was seen as essential to Tony Blair's plan for every patient to be offered a choice of four hospitals for operations. The joint venture company, known as Dr Foster Intelligence, would sell the latest data to health trusts so they could help patients make an informed choice. According to the NAO some £12m of taxpayer's money was sunk into the project with a further £1.7m spent on consultants to evaluate it. This included a £50,000 payment to Dr Foster's partnership, headed by Tim Kelsey and Jake Arnold Foster, to advise them on setting up their own centre. The NAO says the £12m included a strategic premium of up to £4m - which was higher than the financial advisers told the ministry it was worth. Edward Leigh, chairman of the Commons public accounts committee, said: "Taxpayers should be grateful to the anonymous whistleblower who first alerted the NAO to the Department of Health's hole-and-corner deal with Dr Foster." "The department simply paid no heed whatsoever to the rules that are set to protect taxpayer's money ... there was an unseemly urgency to complete the deal ... the truth is that the department and its information centre cannot demonstrate how investment in one company, Dr Foster, rather than any other providing similar services, is to the benefit of the NHS." David Hencke, Westminster correspondent Tuesday February 6, 2007 The Guardian
  • Hospitals told not to operate until patients have waited 20 weeks. An NHS surgeon has exposed how cash-strapped hospitals are being barred from operating on cancer patients who have not waited long enough. In a withering assessment of the financial management of the health service, Mr Jaffe said that doctors were being restricted in getting waiting lists down by financial limitations and ever-changing targets. The consultant plastic and reconstructive surgeon said he and his colleagues are being prohibited from operating in non-urgent cases unless the patient has been waiting for a minimum of 20 weeks. This is because the hospital would not get paid - even if the patient and staff were ready for the operation. Mr Jaffe said the Prime Minister's pledge to have patients waiting no longer than 18 weeks between referral and treatment would be "impossible" unless more money was made available to primary care trusts. Mr Jaffe, who works at the University Hospital of North Staffordshire NHS Trust, said the 20-week ruling was a "global issue" within the NHS and not just a problem at UHNS. He claimed that he was unable to fill his evening lists because of the 20-week constraint, and that patients were having to wait longer to be seen than necessary. He said: "It's not the hospitals - these rules are being put in place by the PCTs to take them over the April 1 threshold, when the new financial year begins and they get their money from the Government. The way things stand, waiting lists will grow, not shorten, if operations have to be put back because of a lack of money. It's clearly a ridiculous way of doing business." His candid remarks come on the same day that radiotherapists reveal how other cancer patients are having to wait months beyond their recommended dates for treatment that can prevent the disease returning. Channel 4's Dispatches programme found that the waiting gap between operations to remove cancerous growths and radiotherapy treatment is at least three months in Kent, breaching the Royal College of Radiologists' guidelines. Three patients have seen the disease return during the long gap between their operation and radiotherapy. The programme found that five UK radiotherapy units have an average wait of 28 days, which means that many patients are waiting longer. In two centres, more than three-quarters of patients were not treated within 28 days. Mr Jaffe said Government proposals to increase operating hours into the night were "laudable". But he added: "We would need more doctors, more nurses, more staff. More, in fact, of all the people they keep making redundant. They are getting rid of people yet trying to impose regulations on us that mean we need more people. Nurses are qualifying yet no trusts are employing them because they have no money." Summary by Keep our NHS Public of Telegraph 26 February 2007
  • NHS doctors 'gagged by a culture of fear'.  BMA survey of consultants finds many under pressure. · More than half say cuts or targets halting treatments. The British Medical Association accused the government yesterday of instilling "a culture of fear" across the NHS to stop doctors revealing how health service reforms are putting patients' lives at risk. The BMA surveyed senior consultants in hospitals throughout England and found 56% knew of clinically effective treatments being withdrawn by their NHS trust to save money or comply with policy directives. John Carvel, social affairs editor Wednesday March 7, 2007 The Guardian
  • NHS 'reforms' are not helping patients, say hospital doctors. Senior hospital doctors believe that major NHS reforms, such as payment by results and Patient Choice, will fail to improve the service patients receive, according to a British Medical Association survey. The poll of 265 consultants in England will be worrying for the government, coming at a time when ministers hoped to regain clinicians' backing for their reform programme. The survey showed they have much work to do to reduce doctors' scepticism - 53% said PBR would worsen or considerably worsen patient care. Only 11% said choice would improve patient care, while a third believed moving care out of hospitals and into the community would result in better services. Independent sector provision would make patient care poorer, according to 72%, while 58% said they had examples of patients being adversely affected by a national initiative. More than half (56%) said they or their colleagues had experienced problems because clinically effective treatments or procedures were no longer available or restricted. BMA consultants' leader Jonathan Fielden said senior doctors were implementing better services for their patients - 81% of respondents had initiated service improvements in the past year. However, their efforts were being hampered by funding constraints and poorly thought through government policies. 'The government is wasting millions of pounds on health reforms that have not adequately involved senior doctors and consequently fail to benefit patients,' he said. 'Consultants are going the extra mile to bring down waiting lists only to be told to slow down and be less productive. Meanwhile, work continues to be diverted away from NHS hospitals to under-performing independent sector providers at greater cost. Plans to increase recruitment or buy new, modern equipment are being put on hold or abandoned because of a lack of money.' He added that many of the doctors who took part in this survey felt unable to speak out openly. 'There is a culture of fear in the NHS and doctors are under severe pressure to meet targets and keep their mouths shut. Doctors want to be at the forefront of health reforms, both locally and nationally, to ensure government policy has clear benefits for patients.' Summary by Keep our NHS Public of Public Finance 9 March 2007
  • Warning for GPs call-out service. The company which runs Merseyside's largest GP out-of-hours service has been given three weeks to bring its operation up to basic national standards. An investigation was launched into the Urgent Care 24 call centre last year after its former IT director raised concerns lives may be at risk. Roy McNally claimed patients with life-threatening illnesses were not being identified fast enough by call operators and accused managers of falsifying performance figures. One GP, who regularly worked evening and weekend shifts for UC24, revealed he is about to raise further concerns about the service. Dr Srinivas Dharmana is meeting officials at Liverpool PCT this week to ask them to consider commissioning two or three companies to run the service. He claims he has encountered several problems working for UC24, including: Basic medical supplies like painkillers, pregnancy tests and swabs were not available for doctors working at the Urgent Care centre next to Aintree hospital's A& E department; Criteria used by non-clinical call handlers meant one of Dr Dharmana's patients, a 19-year-old with mild chest pain, was thought to be more urgent than a middle-aged man with a hernia who needed emergency life-saving surgery; Non-medical staff often failing to provide basic details, like GPs' names, whether drugs were prescribed, or what time a patient died, in written reports passed to patients' regular doctors. Dr Dharmana said he believed doctors across the region felt constrained by only having one option for out-of-hours care. Summary by Keep our NHS Public of Liverpool Daily Post 12 March 2007
  • Ambulance row worker quits. Steve Jetley, an ambulance worker involved in a dispute over leaked documents, has resigned from the service claiming that bosses are more concerned with targets and image than patient care. He also warned that sending ambulances to deal with calls in the West Midlands was "recklessly" putting Shropshire patients at risk. Service chiefs have denied the claims, releasing figures which they say show "no significant drain" on Shropshire resources in such circumstances. Summary by Keep our NHS Public of Shropshire Star 15 August 2007
  • Nurses loth to report abuse of the elderly. More than half of nurses would not report the abuse of an elderly person in their care, according to a survey published today. The poll of NHS and private sector nurses, conducted for Help the Aged, found that a lack of training, heavy workloads and fear of confrontation or of upsetting the victim all prevent nurses taking action. The findings come amid growing evidence that elder abuse is a widespread problem in families, care homes and hospitals. A study by the National Centre for Social Research and Kings College London suggested that 342,000 older people living in private households are subject to some form of mistreatment every year in the UK. A report by the parliamentary joint committee on human rights this month highlighted significant levels of abuse and neglect suffered by older people in care homes and hospitals. Its latest study, based on 848 responses from readers of Nursing Standard and Nursing Older People, found that 58% of nurses would not report abuse of an older person because they fear having got it wrong. The poll revealed that 68% of nurses felt a lack of training in how to deal with elder abuse was a barrier to them providing decent care. Lucy Ward, social affairs correspondent Wednesday August 29, 2007 The Guardian
  • Finance chiefs confess to burying bad news. A survey of NHS finance professionals by the Chartered Institute of Management Accountants has found that finance directors are reluctant to publish poor forecasts for fear of being fired. The survey found nearly a third had given different figures to their boards than their SHA or Monitor. The report, which also drew on previous research, calls for greater "honesty" in forecasting. "Understandably, they may delay bad news for as long as possible, ignoring worsening overspends to date and hoping for miracles," it says. The institute says that forecasting is vital, but that it can be tactical or dogged by politics. More than a quarter of the 100 surveyed said that their predictions made in December 2005 were more than half a million pounds of the eventual figure. In-year Forecasting in the NHS says: "The NHS financial regime and the way strategic health authorities and the Department of Health manage the NHS don't always encourage accurate forecasting." Steven Bliss, chair of CIMA's NHS group, said there were suggestions that NHS finance professionals were under pressure to forecast what people wanted to hear, and former NHS finance director Noel Plumridge said it had happened to him. "It's quite common for any forecast that doesn't show break-even to be returned to an organization with a question on what they are going to about it," he said. Mr Bliss pointed out that some of the issues highlighted had been acted upon by the Department of Health. Keith Wood, chair of the Healthcare Financial Management Association's financial management and research committee, said there had been major improvements, adding: "Forecasting is not a precise science and is impacted by a number of external factors." Mr Plumridge said he feared there was still pressure due to the need to break even to qualify for foundation status. Summary by Keep our NHS Public of Health Service Journal 30 August 2007
  • No dignity for older patients on NHS wards, says report. Health inspectors are to mount spot checks on NHS hospitals after finding hundreds of older people being treated without dignity or adequate privacy on wards across England. In a report today on conditions in 23 hospitals, the Healthcare Commission said only five complied with all the government's core standards for dignity in care. Others were found to provide degrading treatment, including making incontinent patients wear nappies and placing older women in mixed-sex bays shielded by skimpy curtains on insecure rails. The commission included Barts and the London NHS trust among eight hospitals that failed the dignity test and were issued with a formal warning. Another 10 trusts were told to make improvements, including seven of the government's flagship foundation hospitals, which were supposed to be among the best in the country. The commission appealed to patients, carers and relatives to blow the whistle whenever they have concerns about the treatment of vulnerable older people. John Carvel, social affairs editor Thursday September 27, 2007 The Guardian
  • Trust tries to gag consultants. Hospital doctors in Cumbria have been told they could be reported to the GMC if they speak out about controversial proposals to change hospital services. The revelation stems from an email sent to consultants working at the West Cumberland Hospital, Whitehaven, which warns that they could be in breach of their contract if unauthorised statements are made. The email, sent by North Cumbria Acute Hospitals NHS Trust, also points out that consultants could be reported to the GMC if they provide factually inaccurate information that causes unnecessary panic. It follows concerns voiced by consultants over Cumbria Primary Care Trust's 'Closer to Home' consultation document, which suggests cutting bed numbers at the West Cumberland Hospital from 350 to 172. Summary by Keep our NHS Public of Doctor 14 November 2007
  • You can't go round telling people you've been sacked. Comedian and political activist Mark Steel writes: Until recently, no one seemed to have worked out how to apply budget cuts and privatisation to the field of care for the mentally ill. But then the Manchester Mental Health and Social Care Trust, in an effort to cut its budget by £5m, began transferring patients to the voluntary sector, where staff were paid much less than by the Trust. So one nurse, Karen Reissman, who campaigned against this tactic, was suspended and then sacked, on a magnificent set of surreal charges. The first was that she was "interviewed for an article opposing the transfer of NHS care ... affecting the reputation of the Trust." For example, she mentioned that because of cuts, there were 24 patients being kept in 20 beds. An elderly ward has been closed, and a thousand patients have had to change the nurse assigned to them, so obviously the person who affects the reputation of the Trust is the person who mentions this in an interview. The next reason for her sacking was that, having been suspended, "she told people she had been suspended". No wonder they've got more mentally ill people than they can cope with if that's considered sane. How are you supposed to not tell people you've been suspended ? What a wonderfully chaotic world if this rule applied everywhere, with no one allowed to tell anyone they'd been suspended or sacked. Charles Clarke and Blunkett would have to turn up every day at the Home Office, pretend to deport someone and come home again. But the next charge went further - she was also sacked because "she told people she was innocent". This takes the matter beyond the issue of industrial relations and creates a philosophical puzzle. Maybe the Trust could come up with extra charges along these lines, such as "she contemplated the nature of innocence", or "she offended the concept of perfection by considering human innocence despite our essentially flawed soul".And the fourth charge was "she allowed the press to print misleading statements about her case". What a test case that would be if they get away with it. Every time someone has a pack of lies written about them in the press, they'll be arrested for it. It would be quite a twist for the McCanns - the Daily Express headline would be, "Yesterday we said they were guilty. Today they're to be charged with allowing us to lie that they're guilty. Have they NO shame ?" The people of Manchester don't appear to have followed this logic, which is why the 180 staff of the Trust have gone on strike to demand Karen's reinstatement, and the campaign to support them is growing. Maybe that's because the sacking seems like an attempt to intimidate all health workers against speaking about budget cuts. Or maybe because the Manchester Mental Health Trust is officially rated 173rd out of 175 in the country, which is terrifying. Because it means somewhere there's two other Trusts even worse than the one run by these idiots. Summary by Keep our NHS Public of Independent 14 November 2007
  • NHS staff strike in support of 'whistleblower'. Thousands of NHS staff are expected to take part in protests today in support of a nurse who was sacked after speaking out against privatisation of services. Health union Unison said it expected workers to join a day of action wearing gags to symbolise the plight of psychiatric nurse Karen Reissmann. An indefinite strike is already underway by 160 of her colleagues. Reissman was dismissed last month after being found guilty of gross misconduct by Manchester mental health and social care trust for giving an interview to a local magazine. In it she expressed concern at moves to privatise NHS services. She wrote on a campaign blog: "I am a mental health nurse who has been sacked for being a whistleblower - for speaking out against cuts in services and their privatisation." Sara Gaines and agencies Society Guardian, Wednesday December 5 2007
  • NHS in Scotland 'not reporting mistakes'. The NHS in Scotland is failing to do enough to deal with mistakes and near-misses which could harm patients and staff, a report revealed yesterday. A survey of almost 4,000 NHS workers found 54 per cent said some incidents in the health service which should have been reported were not. Experts said a blame culture in the NHS and fears that admitting mistakes could affect people's careers were partly to blame for the problem. Incidents which should be reported in the NHS include mistakes which have led to disability, injury, disease, suffering or even death. The latest report, by NHS Quality Improvement Scotland, found that no health board had achieved a desirable score in their measure of incident reporting.  Care & Health 13 December 2007
  • Health ministry faces 'scapegoat' claim. The Department of Health made a "scapegoat" of a top statistician who raised the alarm with senior officials about a contentious public-private venture to provide data to the National Health Service, an employment tribunal heard. Prof Denise Lievesley, former chief executive of the Information Centre, the NHS's data factory, says she consistently highlighted concerns about the joint venture's worth and its handling of information. Prof Lievesley's claims are the latest in a series of questions raised about the joint venture, known as Dr Foster Intelligence, which a committee of MPs last year said had been set up in a "backroom deal" at a cost of £12m to the taxpayer. In an affidavit lodged at Leeds employment tribunal, Prof Lievesley, a former Royal Statistical Society president, claims the health department let her become a scapegoat for the deal. Stuart Ritchie, for Prof Lievesley, said she had "consistently complained about the joint venture and its operation" throughout her two-year tenure at the Information Centre. Professor Lievesley says she felt she had no alternative but to sign off in January 2006 on the creation of Dr Foster Intelligence, as talks on it were far advanced by the time she arrived at the Information Centre in July 2005. She claims she helped the public sector secure better terms for the joint venture, which is 50-50 owned by the Information Centre and Dr Foster LLP, a successful private health data company. Prof Lievesley, who was a non-executive board member of Dr Foster Intelligence, says some data processed by the joint venture was not, in her view, "fit for purpose". She says she high-lighted a "wholly inappropriate" use of statistics in letters to senior officials including David Nicholson, chief executive of the NHS. The Dr Foster deal first came under fire in a National Audit Office report in February last year, which rebuked the health department for failing to follow a proper tendering process and for paying too much for its half of the joint venture. In July the Commons public accounts committee unveiled a stinging report on the deal, in which the Information Centre paid £7.6m to Dr Foster LLP and sank another £4.4m into the joint venture company. Summary by Keep our NHS Public of Financial Times 15 January 2008
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