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Private Eye

October 25, 2010

NHS Rationing in Warwickshire
Filed under: Private Eye — Dr. Phil @ 8:39 am

Explicit rationing in the NHS is no bad thing. When he was shadow health secretary, I made Andrew Lansley stand on stage at the NICE conference and say: ‘There is and has to be rationing in the NHS.’ He’s now hoping GP Consortia will do it for him, but NHS Warwickshire is ahead of the game, announcing a list of treatment restictions ‘to manage demand in the acute sector.’ However, there’s no mention of any patient consultation in drawing up this list. Whatever happened to no decision about me without me?

Westgate House
Market Street
Warwick
CV34 4DE

Tel: 01926 493491

Fax: 01926 495074
8th October 2010

Birmingham & West Birmingham NHST
Management Centre
Dudley Road
Birmingham
B18 7QH

Dear Chief Executive

As you know, throughout this year we have seen continual and significant increases in the demand
for acute services across Warwickshire. In response we have taken action to refresh treatment
policies, remind clinicians of their content and extend the range of services in the community. This
has not had a significant enough impact to reduce the capacity problems that your Trust

[…..] Read More





October 18, 2010

Dr Phil’s Private Eye Column, Issue 1273 October 13
Filed under: Private Eye — Tags: , , , , — Dr. Phil @ 10:23 am

Preventing another Mid Staffs?

Who can say with any confidence that a similar disaster to Mid Staffs isn’t happening now in the NHS? When MD asked for a show of hands at a Tory Fringe meeting that included the Health Secretary, the president of the Royal College of Surgeons, the chief execs of the GMC and the NMC and a host of senior NHS managers and clinicians, not one arm was raised. A decade after the Bristol Inquiry and with thirty bodies supposedly scrutinising the quality and safety of NHS care, we still can’t spot and stop avoidable, repeated harm to patients occurring over a prolonged period.

Anyone doubting the scale of harm to patients at Mid Staffs between January 2005 and March 2009 needs to read the Francis Inquiry report. The debate about how useful and accurate Hospital Standardised Mortality Ratios continues, but the fact is that just about every early warning light flashed brightly in Mid Staffs for months, and yet nothing was done. The Inquiry has thus far has looked at failures within the hospital but now sets its sights on the plethora of regulatory and commissioning bodies that also failed to act. It’s likely to

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September 29, 2010

Dr Phil’s Private Eye Column, Issue 1272 September 29
Filed under: Private Eye — Tags: — Dr. Phil @ 3:58 pm

The European Working Time Directive again.

Is it possible to train doctors properly in a 48-hour working week? The European Working Time Directive (EWTD), which enforced its final hours’ restriction last year, was agreed in 1999, giving the NHS ten years to prepare. The rationale was sound – there is overwhelming evidence that sleep deprivation and unnatural sleep cycles contribute to thought and movement impairments, injuries and error – but there were obvious dangers too. Halving the working hours of junior doctors could – unless cleverly executed – have a disastrous effect on both training and patient care.

The widespread training failures and alarming drop-out rates publicised in The Times suggests that the NHS, and the Labour government, buried its collective head in the sand over the EWTD. This was hardly new to Eye readers. Back in 2002, MD argued that specialties such as heart surgery needed to merge into fewer units, with a minimum of 4 surgeons, to allow proper training and supervision of those whose hours were restricted. Labour was ‘not persuaded’ by centralisation and we ended up with Oxford heart scandal, where an inexperienced consultant had no senior support or supervision in the hospital when

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September 20, 2010

Dr Phil’s Private Eye Column, Issue 1271 September 15

PFI at all costs….

In 2003 Dr Peter Brambleby, then director of public health for Norwich Primary Care Trust (PCT), received requests from senior clinicians at the PFI flagship Norfolk and Norwich Hospital hospital (Eyes passim) to look into their concerns about changes to the design and build that they believed put patients at risk. The ventilation system and isolation facilities were top of their list, but so were a lack of management response and a culture of secrecy.

When his preliminary inquiries confirmed cause for concern, evidence of covering up and a lack of proper supervision by Norfolk, Suffolk and Cambridgeshire Strategic Health Authority (SHA), Brambleby put the matter in the hands of the National Audit Office (NAO) on 31 March 2004. The NAO, led by Sir John Bourn [Eyes passim], referred it straight back to the SHA and hospital to investigate.

External scrutiny did at least prompt some remedial building work (at the NHS’s expense), a belated clinical risk assessment (from which Dr Brambleby was barred), an internal inquiry (which omitted key witness testimony and declined to track down critical records on changes to design specification), and a flurry of press interest. Much was at stake.

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September 1, 2010

Dr Phil’s Private Eye Column, Issue 1270 September 1

A solicitor writes…

MD has received a disturbing e mail Huw Morgan, a Medical Protection Society solicitor representing a pathologist who has given evidence to the University Hospitals Bristol (UHB) Pathology Inquiry: ‘It has been alleged that it was he who provided you and/or Private Eye with the information regarding such services which appeared in the 2009 issue(s) of that magazine, shortly before the Inquiry was set up. This is not the case; however he is concerned that such any such mistaken belief on the part of Panel members might be an adverse factor in their assessment of the evidence which he has given to them.’

MD has never had any contact with the pathologist, and the public money used to fund the Inquiry (£464,000 to the end of June 2010) would be better spent focusing on the specific allegations of misdiagnosis in specialist adult and paediatric pathology. Equally important is to ascertain whether appropriate action was taken to investigate the allegations. Concerns about the lack of specialist paediatric pathologists date back to 2001: ‘Over the next 2 years paediatric work was done by adult pathologists with disastrous results, particularly in the fields of childrens’ cancers and Hirschsprung disease.’ An

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