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Private Eye

March 22, 2010

Dr Phil’s Private Eye Column, Issue 1258, March 17, 2010
Filed under: Private Eye — Tags: , , — Dr. Phil @ 10:02 am

 Labour’s dead babies

‘The death of a child is an unbearable sorrow that no parent should have to endure’ said Gordon Brown a year ago. And yet Labour’s record in providing safe services to critically ill babies is lamentable. Whatever cause the current inquiry finds for the deaths of four babies following heart surgery in Oxford, it’s patently clear that the unit simply isn’t fit for purpose. With just one dedicated paediatric cardiac surgeon (now departed) and one surgeon mixing adult and paediatric work, it beggars belief that – after the Bristol scandal – Labour could have allowed such a small unit to carry on performing such complex surgery.

This is not a new argument. Since exposing the Bristol scandal just 18 years ago, MD has argued ad nauseum that highly specialised healthcare must be concentrated in fewer units that are safely staffed and equipped. Hardly rocket science. The Kennedy Inquiry reached the same conclusion in 2001 and triggered an expert review, chaired by cardiac surgeon James Munro, which recommended that the number of child heart surgery centres be reduced to six. Labour ignored the recommendations. NHS Medical Director and cardiac surgeon Bruce Keogh realised that another disaster was imminent,

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March 4, 2010

Dr Phil’s Private Eye Column, Issue 1257, March 3, 2010
Filed under: Private Eye — Tags: , — Dr. Phil @ 8:56 am

Medicine Balls: A Tale of Two Scandals

What goes around, comes around. The Bristol heart scandal of 1984-1995 occurred under the Tories’ watch but it was the incoming Labour government that ordered a Public Inquiry and used the results to impose sweeping, centrist health reforms. Now the Mid Staffs scandal – which in many ways is worse than Bristol – has occurred under Labour’s watch and it’s the Tories lobbying hard for a Public Inquiry, the results of which – if they get in – will doubtless be used to force their own ideology on the NHS.

The Bristol heart surgeons at least cared deeply about their work and were trying their best, even when their results for complex heart surgery were demonstrably poor. The Francis Inquiry into Mid Staffs, held behind closed doors but published last week, is more troubling: “It was striking how many accounts related to basic nursing care as opposed to clinical errors leading to injury or death”.

The Kennedy Inquiry found that from 1991 to 1995, between 30 and 35 more children under one died after open heart surgery in Bristol compared to a typical NHS child heart surgery centre at that time. 198 recommendations

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February 18, 2010

Private Eye Column, Issue 1256, February 17, 2010
Filed under: Private Eye — Tags: , , , — Dr. Phil @ 8:18 am

THE EDITOR ASKS M.D. TO PEER REVIEW PRIVATE EYE’S MMR COVERAGE

M.D. writes: Private Eye got it wrong in its coverage of MMR. It gave undue prominence to unproven theories based on a small number of uncontrolled observations, and paid far less attention to the weight of evidence from large comparative studies that failed to find any association between MMR and autism. While the Eye cited potential conflicts of interest in many of the key supporters of MMR, it failed to point out any unethical or prejudicial behaviour by Andrew Wakefield.

The 1998 Lancet paper that started the scare has now been removed from the medical literature on ethical grounds; and Wakefield, its leading author, may soon be removed from the medical register. Clearly what precious research money there is should now be used to test more credible hypotheses for the causes of autism.

The Eye has never claimed that the link between MMR and autism or bowel disease was proven; rather that better research was needed to answer the question conclusively. And it stressed the danger of infectious disease and the importance of vaccination. M.D. twice asserted that he had no safety concerns about MMR and that both his

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February 16, 2010

Dr Phil’s Private Eye Column, Issue 1255, February 3, 2010
Filed under: Private Eye — Tags: , , , — Dr. Phil @ 10:05 pm

Very human errors

Last year, MD met an Australian surgeon who tells his junior staff: ‘Your job is to stop me killing anyone.’ Nurses, receptionists, patients and relatives are all encouraged to speak up if they think something isn’t right, and it’s looked into promptly without knee-jerk blame. As a result, his cock-ups and complaints are commendably sparse and he has no shortage of applicants for his training posts.

The NHS has been trying to develop a grown-up safety culture for over a decade, but there is still a huge reluctance for staff to comment on each other’s work. A senior nurse who helped developed the national guidelines for the safe and sterile insertion of central venous lines recently observed a junior doctor putting a central line with a clearly dirty technique. The drapes weren’t in place and there was a danger he would introduce infection directly into the patient’s blood stream. But because it wasn’t her patient and she didn’t know the doctor, she didn’t feel in a position to comment.

The reticence of some NHS staff to offer constructive criticism and the unwillingness of others to accept it is at the heart of many clinical errors. When serious

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February 1, 2010

Dr Phil’s Private Eye Column, Issue 1254, January 24, 2010
Filed under: Private Eye — Tags: , , , — Dr. Phil @ 5:29 pm

Bristol Update

 ‘Failure to reconfigure child heart surgery will be a stain on the soul of the specialty and will compromise the treatment of the most vulnerable members of the next generation.’ So says NHS Medical Director and cardiac surgeon Sir Bruce Keogh, just 18 years after the Bristol heart scandal was exposed in Private Eye. The Public Inquiry a decade ago found that as many as 35 babies had died unnecessarily, and a review in 2003 recommended the concentration of scarce expertise and equipment in fewer centres. Alas, Labour ignored it for fear of the political ramifications. Keogh admits there has ‘frankly been little progress’ since the inquiry and he can’t at present guarantee that ‘another Bristol’ won’t happen. The job of fixing it has now been handed to the National Specialised Commissioning Group (NSCG), which since 2007 has been responsible for making sure the treatment for all rare and complex conditions is ‘safe and sustainable.’ As Keogh puts it: ‘The NSCG has to flex its muscles. Politicians have to accept their recommendations and clinicians have to put aside personal conflict and institutional self interest.’ And patients and parents have to accept they may have to travel further to

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