Monday, October 06, 2008

The world's biggest computer botch-up: Take a bow NHS

Patients `at risk' from flawed $25BILLION IT system

An NHS computer system intended to revolutionise patient care has so many software flaws that seriously ill or badly injured patients are at risk of being inaccurately diagnosed, according to an internal health service document. An assessment of the system at the first hospital to launch it, the Royal Free Hampstead NHS Trust in north London, details a catalogue of software glitches and design faults. It warns that the problems pose a possible "risk to patients by underestimation of clinical condition".

According to the document, the system, which is being used in the accident and emergency department, is routinely crashing, patient information is intermittently "lost" and some staff are reverting to pen and paper. Extra staff have been drafted in to help cope.

Tony Collins, executive editor of Computer Weekly, said the document, disclosed by an NHS employee, warned that some of the problems could "continue indefinitely". He said: "This is the centrepiece of the Connecting for Health programme [the government's plan to computerise NHS records] and it isn't working properly." Hospital officials said this weekend that continuing problems were being "vigorously" pursued with the contractors while staff were being vigilant to ensure patient safety was not compromised.

The report is the latest setback for the 12 billion pound Connecting for Health programme, which was meant to provide a single nationwide IT system for the NHS containing records for every patient by 2010. While some elements of the programme have been introduced ahead of schedule, the patient record system has been beset with delays and software problems.

Last June the Royal Free became the first trust to launch the most advanced version. To protect patient confidentiality, records can be accessed only with a swipe card and a code. The launch was a key test for Connecting for Health, which has faced questions about the reliability of its systems and whether patient confidentiality could be easily compromised with computerised records. Two months after the launch there were reports of missing data and delays in booking patient appointments.

Now an assessment of the new system at the Royal Free has uncovered a series of problems, which appear to be unlikely to be fixed in the short term. The Royal Free Hampstead NHS Trust said the implementation of the new system was initially better than expected but there were continuing problems that would "take some time" to rectify.


NHS child loses out as surgeon gives liver transplant to private patient from the Gulf


A senior surgeon broke NHS guidelines by transplanting part of a donated liver into a private overseas patient instead of saving it for someone on Britain's waiting list. Professor Nigel Heaton, head of the transplant unit at King's College Hospital in London, transplanted part of the liver into a boy from one of the Gulf states.

The surgeon was the subject of a formal investigation after other doctors said that a child on the NHS organ waiting list should have been given priority. National guidelines state that, because of the acute shortage of donor organs in Britain, livers must be offered to all other NHS centres before they can be given to a patient from outside the EU. There are about 400 NHS patients on the liver transplant waiting list - 20 per cent of whom will die before a suitable organ can be found.

The incident sparked fury among surgeons at St James's University Hospital in Leeds, which first received the liver from a 40-year-old donor. After instructions from UK Transplant, which co-ordinates NHS transplant services, the Leeds surgeons sent the liver to King's for a `super-urgent' adult NHS patient on the understanding that it was to be used solely for that person. St James's only learned the following day that Prof Heaton had split the liver into two when a member of staff from King's contacted them.

Prof Heaton had used the larger right portion for an adult NHS patient and transplanted the left lobe into a seven-year-old boy who had rejected an earlier liver and was seriously ill. He later died.

A senior medical source said: `This was clearly a violation of procedure. It should have been offered back to every other hospital within the NHS and then throughout Europe before going to a non-NHS recipient. `There is no process for it to go to a non-entitled patient on compassionate grounds. It just doesn't happen.'

David Mayer, chairman of UK Transplant's Liver Advisory Group, said the Leeds doctors had been extremely concerned because they had a sick child, an NHS patient, who could have benefited if they had known the liver was to be split. He added: `If we were to provide livers for the world from the UK, then UK patients would be enormously disadvantaged.'

The procedure of splitting livers has been developed in recent years to counter the shortage of donor organs, particularly for children. Because livers are able to regenerate relatively quickly, two patients, usually an adult and a child, can be treated with one organ. Normally, livers from donors aged over 40 are considered too old to split, so UK Transplant had not expected this to happen in this case.

In a statement, King's said they had applied to have the Gulf state's child considered for priority liver transplantation on compassionate grounds and that there had been no objections. They said that the investigating panel had found that guidelines had been breached and that it had recommended that King's review its practices and ensure all staff were aware of transplant guidelines. A King's hospital spokesman confirmed that Prof Heaton had been paid for the original transplant on the private patient - which had been rejected - but had received no further fee for the second operation.

The surgeon, who lives in a 1million pound detached house in Beckenham, Kent, gave George Best a liver transplant three years before the alcoholic ex-footballer died of multiple organ failure. Earlier this year, this newspaper revealed that King's had agreed with the Greek and Cypriot governments to treat patients from those countries privately using NHS livers, charging around 85,000 pounds per operation.

King's has given livers from UK donors to 22 private patients from Kuwait and the United Arab Emirates in the past five years. The hospital has made more than 4million from performing transplants on overseas patients in that time.


British politician who spoke the truth about Muslims is put in charge of immigration policy

Muslim groups expressed anger last night after a Labour politician who has been at the centre of a series of race controversies was made Immigration Minister. Phil Woolas, previously an Environment Minister, was handed the brief despite infuriating the Pakistani community earlier this year by warning they were fuelling birth defects by inter-marrying. He also caused anger following the Oldham race riots by calling for 'the reality of anti-white racism' to be acknowledged.

Last night, the Muslim Public Affairs Committee condemned his appointment. A spokesman said: 'Phil Woolas has a track record of insensitive, inappropriate outbursts that have verged on Islamophobia. 'He is a Minister clearly out of his depth. We will monitor his work for any more signs of his all too obvious antipathy towards British Muslims.'

His appointment was part of a raft of junior ministerial changes announced by Gordon Brown yesterday, including rewards for MPs who led the famous 'curry-house' plot against Tony Blair....

Mr Woolas, the Labour MP for Oldham East and Saddleworth, embarrassed Downing Street in February by arguing that marriages between first cousins are a factor in birth defects and inherited conditions. 'Part of the risk, I am told by the health service, is first-cousin marriages,' he said. 'If you are supportive of the Asian community then you have a duty to raise this issue.' It is estimated that 55 per cent of British Pakistanis are married to first cousins. The likelihood of unrelated couples having children with genetic disorders is about 100-1, but it rises to one in eight for first cousins. British Pakistani children account for as many as one-third of birth defects, despite making up only three per cent of all UK births.

After Muslim groups accused Mr Woolas of 'flirting with Islamophobia', Downing Street was quick to stress that he was speaking in his capacity as a constituency MP. It followed a series of outspoken remarks in defence of the white working class which began when he warned after the Oldham race riots in 2001 that Labour would lose out to the British National Party unless it did more to 'create a country at ease with itself'.

Last year, in an article for The Mail on Sunday, he said: 'Among the groups who are missing out and who suffer genuine discrimination is the white teenage underclass. 'Such people are fashionably dismissed as "chav scum" or "trailer trash". 'But to say such things is to be as guilty of stereotyping as those who say that all Muslims support terrorists.'


New British immigration boss may cap numbers

The new immigration minister has hinted that Labour may take the political risk of adopting a “balanced migration” policy to restrict population growth in Britain. In his first interview since being given the job yesterday, Phil Woolas vowed to toughen the current legislation, claiming that it was vital to “provide confidence to the indigenous population that migration is under control”.

Woolas expressed sympathy with a campaign led by Frank Field, the Labour rebel, who has called for a statutory limit on the number of foreigners allowed to settle in Britain. “On a common sense level there has to be a limit to the population,” said Woolas. “You have to have a policy that thinks about the population implication as well as the immigration implications.”

The government is introducing an Australian-style points system. This is aimed at ensuring that high-skilled migrants are welcomed while nonEuropean Union nationals with no useful job skills are barred.

Woolas said the government should be ready to go further in limiting migration: “On the one hand is the rationale that we have got to strengthen our economy. But we have got to provide reassurance to communities that the numbers coming in are not bad for us. “Community cohesion is crucial. After the economy, this is probably the biggest concern facing the population.” He also signalled that there would be new restrictions on people coming from overseas to get married.

Field has argued that successive ministers have failed to consider the way immigration has boosted population levels. According to one estimate, within 50 years Britain could become the most densely populated country in the EU except Malta. England recently overtook the population density of Holland. In the long term Field wants to see a “balanced” policy with annual immigration levels directly linked to birth rates and the numbers of Britons emmigrating.

Until now Labour ministers have tended to duck any discussions of “population policy”, preferring to empha-sise the economic benefits of “controlled migration”. Woolas’s appointment in the ministerial reshuffle heralds a change in direction.


Transgender students force restroom change in British university

No privacy at the University of Manchester. I wonder how many sexual assaults it will take before they reverse this policy?

The ladies' lavatory is now simply labelled "toilet" while the mens' has become "toilets with urinals". The student union decided to change the signs during a meeting of its executive in the summer following a number of complaints from transgender students. Women's officer Jennie Killip refused to say how many people had complained, and there are no figures for how many transgender people there are among the university's 35,000 population. She said: "If you were born female, still presently quite feminine, but defined as a man you should be able to go into the men's toilets.

"You don't necessarily have to have had gender reassignment surgery, but you could just define yourself as a man, feel very masculine in yourself, feel that in fact being a woman is not who you are. "Transgender people can face violence and abuse when they go into toilets and we wanted to provide a place where they can feel comfortable. "I have had complaints from people who said we didn't have any facilities for them."

But the switch has caused consternation among many of the students returning from their summer break. Second-year student Jane McConnell, 19, a news editor on the Student Direct student newspaper, said: "While these signs might be appropriate for people with different sexualities, I also think that many people from different religious and ethnic groups are going to feel uncomfortable using these facilities. "Even though they're just two signs, at the end of the day, toilets should be for women and for men specifically, not for both." Another student said: "This is ridiculous. It is just too much political correctness".


Scotland: Infant pupils to get "free" meals

"There aint no such thing as a free lunch" -- just something somebody else pays for

All pupils will receive free meals in the first three years of primary school, the Scottish Government has announced. The service will begin in 2010 after a pilot in several areas, which saw the take-up of meals rise from 53% to 75%. Council umbrella group Cosla denied claims from some authorities that services would have to be cut to pay for the move.

Ministers said helping children in their early years was a priority. The Scottish Government said councils would be expected to find the money for the scheme from the funding settlement already agreed. Scottish Education Secretary Fiona Hyslop said the year-long, $10m pilot scheme, involving 35,000 pupils in Glasgow, West Dunbartonshire, East Ayrshire, Fife and the Borders, was a success. The pilot also reported that parents and teachers were positive about the scheme, while some pupils enjoyed trying new foods. "This government has made it a priority to help children in their early years and this initiative does just that, providing every child with a free school meal in their first years at primary school," said Ms Hyslop.

The Scottish Government has already published guidance to help school catering staff produce healthy meals. According to Labour, the education conveners of several local authorities - including North Lanarkshire, East Dunbartonshire, Edinburgh and the leader of Inverclyde Council - raised concern over whether they could pay for the service, with some saying they would have to make cuts to fund it. But Cosla president Pat Watters told BBC Scotland there was $80m in the budget to provide free school meals to primaries one, two and three. He added: "There is no reason why anyone should have to cut anything to fund this. This is a government funded project."

Labour education spokeswoman Rhona Brankin also raised concerns about the funding, adding: "Local authorities are already struggling to employ newly qualified teachers and reduce class sizes, but some schools can't even afford photocopying."

Liz Smith, of the Scottish Tories, questioned whether a blanket free meals policy would target the right pupils, while the Liberal Democrats' Margaret Smith said ministers had "failed to make the case" that the plan was the best way to tackle poor diets.

But John Dickie, head of the Child Poverty Action Group in Scotland, said the announcement was "a massive step forward" in the campaign to ensure healthy meals for children, whatever their home circumstances. "It will help boost children's health, education and wellbeing and provide a really welcome benefit to hard pressed families across Scotland," he said.

A two-year free school meals pilot in primaries is due to start in England next year, while the Welsh Assembly administration said it was currently focussing on improving nutritional standards.


UK Beach 2 Miles Inland in 43 AD

So much for sea level rise:

The `lost' beach where the Romans landed 2,000 years ago to begin their invasion of Britain has been uncovered by archaeologists. The remains of the shingle harbour were buried beneath 6ft of soil nearly two miles inland from the modern Kent coast. It lies close to the remains of the Roman fort of Richborough near Sandwich, one of the most important Roman sites in England and once the gateway to the British Isles.

Daily Mail: `Uncovered, the `lost' beach where the Romans got a toehold on Britain'


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