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My family's experience of abuse and mistreatment by
the NHS was in the 20th Century, and treatment received in the 21st Century
has generally, subject to resource constraints, been satisfactory. Reports
on my husband's and
son's treatment are included on this website to
update the family's experience, but they do not highlight major scope for
concern.
But while the emphasis of recent material on this website has been on policy
developments (often misguided) and on mismanagement and under-resourcing in the
NHS, there are numerous reports of wrongful actions against patients, especially
in the following pages.
Sharon Wilson drew my attention to her own experience of being denied basic
medical facilities because she was labelled without evidence a persistent and vexatious
complainant when her serious medical conditions were not correctly treated.
It is a common problem for
patients to be deregistered by general practitioners.
The following pages explore in more
detail how the national health service and other public services have served her
badly.
Paul O'Callaghan has had some similar
experiences over many years.
Some abuse is policy
led, notably the
denial of treatment on arbitrary grounds, whether they are due to short term
financial
problems or moral judgments. See
our letter
about the misuse of moral judgments. Also the following reports:
- Obese patients
should not be denied hip ops. The NHS should not deny obese patients hip
replacement surgery simply on the basis of weight. A study led by Professor
Cyrus Cooper, professor of rheumatology at the University of Southampton, found
obesity did not affect a patient's long-term outcomes after surgery, with the
severity of disease a much more important factor. The findings cast serious
doubt on the policies of some PCTs, which have sought to bar obese patients from
surgery.
Summary by
Keep our NHS Public
of Pulse 5 May 2006
- Don't operate on
smokers and the obese, says Hewitt. Patients could be denied treatment
because they smoke or are overweight, Patricia Hewitt has said. The Health
Secretary insisted it was right for those whose lifestyle choices could make
treatment ineffective to be refused care in some circumstances. It is the first
time a minister has explicitly endorsed the controversial policy, which has
already been adopted by some health trusts. Opposition MPs and some medical
experts predict the move could encourage rationing of treatment for vulnerable
groups, particularly when many NHS trusts are struggling to balance their books.
Health trusts in Suffolk were among the first to announce that obese people
would be denied hip and knee replacements on the NHS. The ruling was part of an
attempt to save money locally. Doctors say the risks of operating on obese
patients are higher and the treatment may be less effective, with replacement
joints wearing out sooner. Smokers could also be denied heart bypasses on
similar grounds. But Dr Colin Waine, chairman of the National Obesity Forum,
questioned the criteria being used to judge the appropriate weight for surgery.
He said some trusts were denying surgery to those with a body mass index of over
30 - around one in five adults. "This is nothing less than a cop-out, frankly,"
he said. "There is absolutely no evidence that people should be refused
treatment if they have a body mass index of 40 or below. Turning down hip or
knee replacements for those people has no scientific basis whatsoever. In fact,
some of them - because of their arthritis in hips or knees - can't actually
exercise to help themselves lose weight. So you are really dealing them a double
whammy by denying them an operation that would help them to get healthier." Miss
Hewitt insisted the Government wanted to see people taking greater personal
responsibility for their health. A British Medical Association spokesman said:
"We would not want to see blanket rules. What about people who diet down from a
body mass index of 40 to a BMI of 30 - would they still be denied surgery
?" Summary by
Keep our NHS Public of Mail
12 February 2007. [See also a
report
on 13 April 2007 that obesity in part is a result of the person's genes.]
- Ministers deliberately making asylum seekers destitute, say MPs.
Ministers are deliberately making vulnerable asylum seekers
destitute, a committee of MPs and peers claimed today. They accused the
government of inflicting unacceptable and inhumane treatment, and described the
asylum system as a "confusing mess". A deliberate policy of refusing benefits to
some asylum seekers combined with a ban on legal working left many would-be
refugees in "appalling" circumstances, a report by the Joint Committee on Human
Rights (JCHR) said. It highlighted one case of a destitute Rwandan asylum seeker
who suffered bowel cancer and had a colostomy bag but was
refused treatment by a hospital and could not even register with a GP. In
another, a woman was forced to live rough for three months - sitting at crowded
bus stops all night because she was terrified of being alone - but on winning
her asylum appeal was ruled entitled to immediate support. It also reported how
parents of a three-week-old baby were housed in a "filthy, bug-infested room" in
Leicester, and how a penniless Chinese asylum seeker arrived "exhausted and
distressed" at an agency after carrying her newborn baby around in a towel for a
week. Andrew Dismore, chairman of the JCHR, said: "The system of asylum seeker
support is a confusing mess, and the policy of enforced destitution must cease.
Press Association
Friday March 30, 2007 Guardian Unlimited
- Deny surgery to obese, says poll. A majority of the public wants the
NHS to deny obese people surgery until they lose weight but allow smokers an
automatic right to treatment even if their condition stems from the use of
tobacco, an ICM opinion poll reveals. The poll, based on a random sample of
1,077 people last month, was commissioned by the journal Nursing Standard, which
said it disagreed with the views. The results in the journal, published by the
Royal College of Nursing, show 66% of those questioned thought obese patients
should be made to lose weight before any operation for a weight-related illness.
Restrictions on treating the seriously overweight were introduced in parts of
England last year. They were widely seen as an economy measure to ration care,
but NHS chiefs said slimming before surgery could bring medical benefits,
including reduced pressure on joints and organs. There are similar arguments for
making smokers quit before heart or lung surgery, but more than two-thirds in
the poll said smokers should not be required to alter their behaviour before an
NHS operation for smoking-related illness. Lindsey Hayes, RCN public health
adviser, said: "Nurses would want to treat all patients equally,
regardless of whether or not they had a behaviour-related condition."
John Carvel, social affairs editor
Wednesday
May 30, 2007 The Guardian
- Smokers who won't
quit denied surgery. Smokers could be denied routine operations on the NHS
unless they quit a month before surgery. Although emergency surgery would not be
affected, smokers awaiting routine operations such as hip and knee replacements
could be refused treatment until they kick the habit. The proposals, which have
been drawn up by
Leicester City West Primary Care Trust, could be extended to other areas.
The patients would have to give a blood sample to prove they had quit before
being put on the waiting list and admitted for elective non-emergency surgery.
Doctors would decide whether to operate if the patient failed to give up. The
plans were condemned by smoking groups which said they were part of a drive to
save money and turn England's 10m smokers into pariahs.
Norfolk Primary Care Trust has already taken the radical step of removing
smokers from waiting lists because it claims they are more expensive to treat.
The Government's medicine advisory agency has previously ruled that smokers
should be denied treatment if their habit meant the treatment was likely to
fail. Michael Summers, from the Patients Association, said: "These measures are
clearly being driven by finance and not by clinical need. It's a way for
hospitals to save money and it's very wrong." Summary by
Keep our NHS Public of Telegraph
4 June 2007
- Hormone linked to obesity and asthma. Study suggests common
process in combined cases. Rise in weight problems and respiratory
condition. Polly Curtis and Ian Sample
Tuesday
July 17, 2007 The Guardian
- Selective medical
care is a very slippery slope. Many people will feel sympathy for
57-year-old John Nuttall. Two years ago he broke his ankle in three places. A
plastercast failed to set the break, and ever since then he has felt only the
ghastly grinding of bone on bone. So grisly is the pain, we learned, that Mr
Nuttall is prescribed daily doses of morphine. And now the Hippocrateses of the
Royal Cornwall Hospital in Truro, are refusing to enter him for an operation to
set his ankle. The reason for this, they explain, is that Mr Nuttall is a
smoker. "Smoking has a very big influence on the outcome of this type of surgery
and the healing process would be hindered significantly," a spokesman for the
health trust told this newspaper. No one seems to be claiming that smoking will
render the attempt to rebuild the ankle entirely ineffective. We are told only
that it would "reduce the chance of a full recovery". The reasoning behind their
refusal to operate is, presumably, that before you know it Nuttall will be
hopping back into outpatients, demanding more morphine and further expensive
surgery, and making the whole place smell like an ashtray while he's about it.
Consider the many groups of people who - through more or less elective
circumstance - find themselves in need of medical treatment and - through more
or less elective circumstance - are in a position where that treatment is
likely, in the long run, to be only partially effective or need repeating. If
old ladies fail to live in bungalows, should we refuse to patch them up when
they fall down the stairs on the grounds that they're very likely to do it again
? If professional footballers will insist on continuing to run around in
branded carpet slippers stamping on each other's feet, what price yet another
operation on a metatarsal ? Think of
all those rugby players and their collarbones. Don't let's even get started on
hang-gliding enthusiasts, human cannonballs, violent sadomasochists and bikers.
We ought not to forget, incidentally, that Mr Nuttall was offered surgery when
first he broke the ankle. He refused to let them operate at that point because
he was worried about catching MRSA. I hope, in any case, most of us would take
the view that, "tough - you've had your chance", isn't the attitude we'd hope
for in the caring institution for which we all pay. This seems to indicate that
at least at one point in the last two years, the same hospital took the view
that a smoker's cough was not an insuperable obstacle to the setting of a bone
in the ankle. When we start refusing to perform operations on the basis of
implied moral censure - no new liver for the alcoholic, no heart operation for
the obese man - we enter very deep water indeed. "Free at the point of need,"
runs the mantra. It seems to me that if you have all sorts of bone fragments
grinding around in your leg, causing you most terrible pain, you are at the
point of need. You need whatever help medicine can give you. Partial recovery
from this surgery is surely better than no recovery at all.
Summary by
Keep our NHS Public of Telegraph
15 September 2007
- Smokers and obese
'denied NHS ops'. One in ten trusts restrict operations for the obese or
smokers, according to an ITV1 programme called
Too Fat for Treatment. The programme's investigation found that 16 of the
152 trusts in England have policies restricting treatment, one of them for
smokers, eight for weight only and seven for both problems. The programme
examines whether the restrictions are being introduced for medical or financial
reasons. Some also say that weight restrictions based on BMI indexes are unfair.
Guidance from the General Medical Council says that treatment should not be
withheld due to a patient's lifestyle, but critics say this is exactly what is
happening. Michael Summers, chairman of The Patients Association, tells the
programme: "It's absolutely clear that many of the decisions have been made
whereby patients are deprived of treatment, are made on financial grounds and
not clinical grounds, and that is never acceptable in our view ... merely to
send patients away because they are smokers is morally wrong and again, contrary
to the rules which I think are set by the General Medical Council." Summary by
Keep our NHS Public of Chester
Chronicle 1 October 2007
- Patients denied
help. Patients who smoke or are obese are denied operations by one in ten
NHS trusts, according to a survey for ITV1's Tonight programme. It indicates
that 16 out of the 152 Primary Care Trusts in England have policies refusing
non-emergency surgery such as hip implants to smokers or those classified as
obese. Summary by
Keep our NHS Public of Times
2 October 2007
-
- We the undersigned
petition the Prime Minister to Ban a GP's right to deregister patients without
just cause. Remove the ability of GPs to remove patients without just
cause. Often following a complaint GPs will remove a patient, the is no right
of appeal, this cannot be a just system, they are paid from the public purse!
- We the undersigned
petition the Prime Minister to introduce legal protection for overweight
people who are being discriminated against. Obesity is a horrible ordeal..
Yet they suffer in silence as society accepts, even encourages, this
discrimination. The lean are not superior persons because their weight appears
"under control." They received a biology which has kept their bodies within a
range of weight our society regards as "normal.". We need to finally accept
that the obese (as well as the lean) are powerlessness in voluntarily
controlling their own weight. They are truly powerless because we do not know
the exact details, the "secrets," of how our biology controls our weight. The
obese are victims of their own biology. How can they, in all honesty, be more
"guilty" than the lung cancer victim who smokes heavily, the heart attack
victim who chronically consumes a high fat diet or others who acquire sexually
transmitted diseases? How can our society dare to deny the obese a share in
this victimhood? All of these other victims may likewise possess genes which
promote a specifically compulsive lifestyle which our exceptionally bountiful,
permissive environment promotes. Our Society must understand that the obese
deserve the same compassion and understanding as do other disease victims.
- Petition to: stop
discriminating against the overweight.
(updated 9 October 2007)
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