Wednesday, September 24, 2008

Bureaucratic NHS control freaks quite happy to let patients die rather than lose any control

Bosses in the National Health Service have refused to administer a drug to a patient with advanced kidney cancer even though the medicine is being provided free. Barrie Clark, 61, was told in May that he could receive a free supply of a new kidney cancer drug on compassionate grounds from the pharmaceuticals company that makes it. Clark was then astonished to be told by the NHS that he could not take up the offer at his local hospital because it was against management policy. He could receive the drug, which has been approved as safe, only by paying for nurses to administer it privately.

Clark is in a similar predicament to patients being denied NHS care if they choose to pay for drugs that the health service does not fund. Campaigners are outraged that the ban on allowing NHS patients to pay for private drugs has now extended to letting them receive additional medicines for free.

In a letter of complaint to NHS Grampian, which runs Aberdeen Royal Infirmary where Clark is being treated, the father of four said: "I have been denied a free drug for a long time when there was no alternative treatment. "We find this appalling and demand that the drug be offered free of charge immediately. How many other people has this happened to? You have jeopardised my life and caused great anguish to me and my family. That is disgraceful."

The medicine, temsirolimus, which has the brand name Torisel, was granted a licence for the European Union in November. The European Medicines Agency (EMEA) has ruled that its benefits outweigh the risks. Dozens of NHS patients have received it on compassionate grounds from Wyeth, the manufacturer, in advance of its commercial launch in Britain. The National Institute of Health and Clinical Excellence (Nice) is assessing whether Torisel is cost-effective enough to be prescribed on the NHS.

Managers at NHS Grampian told Clark that he could not receive it because it was not yet on its list of prescribed drugs, known as the hospital formulary. The trust says it will not be placed on the formulary until it is assessed by Nice or the Scottish Medicines Consortium. Clark, a manager in the oil industry, has been helped by Kate Spall, a cancer drugs campaigner with the Pamela Northcott Fund. Spall said: "I have never heard such rubbish. They are saying this medicine cannot be given because it is not on a drug list, but patients elsewhere across the country are getting it. Are we now in a position where a terminally ill patient is denied a free medication?"

Cancer professors dismissed the explanation as "bureaucratic nonsense". Will Steward, a consultant oncologist at Leicester Royal Infirmary, said: "I really do not understand the decision not to allow a free drug to be administered from the hospital. We do this frequently. "Many trusts have allowed this in the past and this decision is perverse." Jonathan Waxman, a consultant oncologist at the Hammersmith hospital in London, added: "This is an effective treatment. This shows the mess we are now in."

After Clark told the hospital he was going to speak to the media, managers said he could pay to have the drug administered privately. He would need to pay about $2,000 a month as it is taken intravenously. Clark said that, although appalled at his treatment by the NHS, his own oncologist had done his best. NHS Grampian declined to comment on the individual case.

The Sunday Times has been campaigning to end the ban on NHS patients paying for private drugs that the state does not fund. Last week two patients won appeals to receive cancer drugs on the NHS after they featured in the Sunday Times Right to Pay campaign.

Sheila Norrington, 59, a cancer patient from Maidstone, Kent, was denied NHS care after paying privately for Erbitux, which costs about $6,000 a month. After the paper highlighted her case, the Peggy Wood Foundation, a charity, agreed to pick up the bills, but last week West Kent Primary Care Trust reversed its decision.

Barry Humphrey, 59, from North Walsham, Norfolk, was told that if he paid for Nexavar, the only available treatment for his advanced liver cancer, he would be billed for his NHS care. His local trust refused to fund the drug but neighbouring Suffolk Primary Care Trust has recommended that the NHS should provide it.

The British Medical Association and the NHS Confederation, which represents hospital managers, support a patient's right to co-pay for cancer drugs without losing NHS care.


NHS clinics to be built `where they are not needed'

Is anybody surprised?

The Government is planning to build dozens of new NHS clinics in areas where they are not required, independent research seen by The Times suggests. Ministers have told each of the 152 local health authorities in England to build at least one "GP-led health centre" in a $500 million scheme to improve patient access to doctors. The 1 million pound walk-in clinics will combine surgeries with services such as dentistry and chiropody.

Local primary care trusts (PCTs) are proposing sites for the health centres that would result in many being built in the wrong areas, analysts say. More than 1.3 million people have signed a petition against the clinics, which doctors' leaders and the Conservatives say could close hundreds of surgeries.

Demographic research by CACI, a market research firm, says that inner-city areas may need up to four health centres while rural locations might need none at all. The Department of Health said that the centres were intended to complement, not replace, existing practices.


UK forecast: 'Arctic winter with heavy snow and plummeting temperatures'

AN Arctic winter with heavy snow and plummeting temperatures lies in store for us all after one of the most miserable summers on record.
And we could even be in for a white Christmas, with the first snow due in December.
But the worst of the weather will come in the New Year, with icy storms bringing disruption to public services, roads, and schools.
The bitter cold will stretch into February, when daytime temperatures could struggle to rise above freezing point.
"It's going to be a colder than average winter," said forecaster Jonathan Powell of Positive Weather Solutions. "We can look forward to a lot of us seeing some snow throughout December, January and February, not to mention some raw temperatures."

There is a 45 per cent chance of snow on Christmas Day, particularly in the North and East, he forecast.
"In mid-February we'll see a sustained cold blast, with penetrating frosts by night, and also the threat of wintry conditions that will bring the UK to a grinding halt.
"Our daytime temperatures will struggle to get above freezing, with the wind-chill factor keeping the `real feel' temperature well below that for a period of time."

Despite the gloomy outlook, the Indian summer looks set to continue until at least the end of September. Much of the country has been enjoying the best weather in more than three months, with this week being the driest since June.
Temperatures will remain at 65F (18C), above the seasonal average, with plenty of sun and little rain.
"It's going to remain very nice indeed over the next 10 days or so," said Sarah Holland of the Met Office. "It is the belated summer eveyone has wanted."


The harmful mistakes of sex education in school

Those who can, do, according to the old saying, and those who can't, teach. That has always seemed to me unfair. However, I have come to think that those who can't teach, teach sex education. Judged by its results - not a bad way of judging - sex education has been an utter failure. The increase in sex education here in recent years has coincided with an explosion of unwanted pregnancies and sexually transmitted disease (STD) far worse than anywhere else in Europe. Since the government's teenage pregnancy strategy was introduced in 1999, the number of girls having abortions has soared. You might well be tempted to argue that sex education causes sexual delinquency.

Only two months ago the Health Protection Agency reported that a culture of promiscuity among the young had driven the rate of STDs to a record. Almost 400,000 people - half of them under 25 - were newly diagnosed, 6% more than in 2006.

When something fails, the usual procedure is to drop it and try something else. With sex education, the worse it gets, the more people cry out for more of it and earlier. Ministers are considering whether to make schools offer more sex education, offer it earlier and deny parents the right to withdraw their children from it.

Last week the Family Planning Association - now calling itself the fpa, having joined other charities in a mad rush to reduce themselves to a couple of lower-case letters - published a comic-style sex education booklet for six-year-olds to be marketed in primary schools for use in sex and relationships lessons. It has printed 50,000 copies of Let's Grow with Nisha and Joe, and tried it out in more than 50 primary schools; it hopes to encourage schools that have shied away from sex lessons to take them on with Nisha and Joe. Oh dear.

There's nothing wrong with the pamphlet itself. Admittedly it's more of a dreary workbook than a "fun" comic, but there's nothing that would startle a child or should upset even the most conservative of "family campaigners". The rudest thing is a drawing of two children, naked, with instructions to draw lines connecting interesting bits of their bodies with the appropriate words. This is all to promote discussion of sex and relationships when children are young enough not to feel self-conscious.

It seems to me highly unrealistic (given that 25% of children leave primary school struggling to read and write) to assume that many six-year-olds could begin to read the labels "testicles" or "vagina". And it is infuriating, given that medical-style euphemism has triumphed over plain English, that the authors have chosen one that's wrong. "Vagina" does not mean the external genital organs, commonly referred to as "front bottom". It comes from the Latin for sheath or scabbard and means what that suggests. The correct word would be "vulva", but the ill-educated educationists blithely impose inaccuracy on our tiny children. However, that is not what I most object to.

What I object to about the book is what I object to about sex education as a whole (quite apart from its failures). Sex education - particularly compulsory and standardised sex education - is based on mistaken assumptions. The first is the pervasive assumption of equality - that is, that all six-year-olds or all 11-year-olds or 15-year-olds can discuss the complexities of sex in the same form in the same way. That's nonsense. Children vary in intelligence and progress. Some young children can easily decipher words such as "urethra"; others may never be able to read them.

More importantly, children and teenagers mature at different ages and come from different backgrounds with different family expectations. You cannot talk the same way to a shy 13-year-old who hasn't had her first period to another who is well acquainted with the darker recesses of the school bike shed. Some boys are men at 11 and 12, physically; others are children until much later. Some children's parents find it acceptable that their sons and daughters are having sex at 13, while others would be shocked: you cannot talk to all these children together. It would puzzle and offend them and might do them serious damage. And it undermines the authority of those parents who do not share the values of the teacher, or of the majority of the other pupils. It is wrong to assume that people want equality in such matters. They want differences.

Children and families and moral values are not equal, neither within schools nor outside them. They simply aren't the same.A sensitive teacher will try to make allowances, but there is a shortage in this country of good and sensitive teachers - hence the crisis in education.

Another mistaken assumption is that sex education ought, necessarily, to be entrusted to teachers, given how wildly they vary in ability and in moral attitudes. The thought that the government is considering making sex and relationship education compulsory in schools is terrifying. I can hardly imagine anything worse than subjecting a sensitive child to guidance on such matters from an inexperienced and politically correct teacher, who is neither well informed nor self-critical.

The relationships between sex, love, babies, crime and disease are too explosive to be left primarily to such a person, or to any person apart from the parents. Of course where parents can't, or won't, guide their children on such matters, the duty falls on teachers. Some may do a good job, although the evidence isn't encouraging. But none should take it on without parental consent.

It always amazes me when people complain that people don't talk about sex and there's not enough information about it. The truth is, you can hardly avoid it. Newspapers, magazines, chat shows, blogs, internet information sites, doctors' surgeries and all the rest are groaning under the weight of information about sex, contraception and relationships. Some of it I think is good; some of it you might think is better. And that's the point. Schools shouldn't be required to impose sex education, still less a standard sex curriculum on us. We should be able to pick and choose for our children among the infinity of information out there.

Channel 4's The Sex Education Show, for instance, strikes me as informative and helpful but depressingly vulgar. Others might find it tastefully frank. It's up to us to choose. Teacher, leave that child alone.


Inquest into British police shooting: Police ruled victim out as suspect 20 mins before they shot him! "Jean Charles de Menezes was ruled out as a suspected suicide bomber just 20 minutes before he was shot dead by police, an inquest into his death has heard. The innocent Brazilian was killed on a Tube train at Stockwell Underground station on July 22, 2005 after being mistaken for one of the four terrorists who had tried to blow themselves up on London's transport system the previous day. Two firearms officers who shot him in the head a total of seven times at point blank range have said they were "convinced" Mr de Menezes was about to detonate a suicide bomb and that "an instant killing was the only option" otherwise "everyone in the carriage was going to die". Yet an officer in the Metropolitan Police control room directing the surveillance teams who followed Mr de Menezes made a note which said: "Not identical male as above discounted. Surveillance to withdraw to original positions."

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