Monday, June 08, 2009

Scans showing possible cancer not passed on for months at scandal-hit NHS hospital trust

Scans showing possible cancer were not passed on to consultants for months at scandal-hit Mid-Staffordshire NHS Foundation Trust, MPs have heard. Forms detailing serious incidents also ended up in the waste paper bins of senior managers or in a "black hole", the Commons Health Select Committee was told.

A report from the Healthcare Commission in March condemned "appalling" and "shocking" standards of care at the trust, which led to some patients dying.

Between 400 and 1,200 more people died than would have been expected in a three-year period, with the poorest examples of care at Stafford Hospital. Families described "Third World" conditions at the trust, with some patients so thirsty they drank water from vases and others left screaming in pain.

The Mid-Staffordshire NHS Trust was awarded Foundation Trust status just before the investigation into the scandal began and Ben Bradshaw, Health Minister, told MPs that legal changes are under consideration to allow the status to be removed and thus bring failing trusts back under the control of Whitehall. Mr Bradshaw also appeared to soften the Government's opposition to a public inquiry into the scandal, saying ministers remained open to persuasion but were not currently convinced it was necessary.

Dr Peter Daggett, a consultant physician and endocrinologist at the trust, who has worked there since 1982, told the committee that a cardiologist submitted forms detailing serious incidents which were "downgraded" to minor incidents by nursing managers or were not investigated at all.

Another colleague, a gastroenterologist, warned that there was a dangerous lack of nurses on the wards but nothing was done. However Dr Daggett said although nurses had apologised over the failings, doctors had not because "they had nothing to apologise for".


UK faces backlash over 'libel tourists'

US politicians try to protect citizens from British court, claiming foreigners use law to bring expensive defamation cases

American politicians are pushing through free speech laws to protect US citizens from libel rulings in British courts that have been accused of stifling criticism of oligarchs and dictators. The development follows claims that foreigners flock to the UK to begin hugely expensive defamation cases even though they have little to do with this country.

Claimants who have indulged in so-called “libel tourism” include a Ukrainian businessman who sued a Ukrainian language website based in his homeland for £50,000, simply because its contents could be viewed in Britain. An Icelandic bank successfully sued a Danish newspaper in the British courts for publishing unflattering stories about the advice it gave to clients, despite collapsing six months later.

Now lawmakers in several American states, including New York and Illinois, have moved to block the enforcement of British libel judgments in the United States. Congress is also considering a bill that will allow defendants of foreign libel suits to counter-sue for up to three times the damages sought by a claimant if their right to free speech, enshrined in the First Amendment, has been violated.

Amnesty International, Human Rights Watch, Greenpeace, Global Witness, Index on Censorship and representatives of Oxfam and Christian Aid are all known to be alarmed by the way UK courts are being used to challenge their reports. “Our libel laws have made Britain a place where any of the world’s bullies and wealthy celebrities can wander into court 13 \ and launder their reputations,” said Mark Stephens, a partner at the law firm Finers Stephens Innocent, which advises many non-governmental organisations (NGOs). “In the US you can still be sued but claimants pay for their own lawyers, fewer spurious claims go to court and freedom of speech is enshrined in law by the First Amendment. Some NGOs are seriously considering moving their publication people out to the States to protect themselves.”

London has long been regarded as a claimant-friendly place for libel actions because defendants are deemed “guilty” until they have proved their innocence, the opposite of the usual burden of proof in criminal cases. Damages are also typically higher in the UK and the costs so expensive that defendants often feel compelled to settle out of court, even though they may be in the right. Because there is no legal aid for such cases, the government has allowed libel and privacy claimants to sue under “no win, no fee” arrangements. This enables lawyers to claim a 100% “uplift” on their normal rates. One of London’s leading libel lawyers charges up to a total of £1,200 an hour.

“The reports NGOs (write) take many months, even years, to put together and rely on anonymous sources who fear for their lives,” said Jo Glanville, of Index on Censorship. “These are not people you can just pull into a courtroom. “By contrast, many of these libel tourism claims are not about disputing factual errors, they are really about shutting up critics who have exposed serious abuses.”

Global Witness, an environmental and human rights pressure group, faced legal action in London from Denis Christel Sassou Nguesso, son of the president of Congo-Brazzaville. The NGO published a report, based on Hong Kong court papers, which suggested Sassou Nguesso had bought more than $100,000 of designer clothes and other luxury goods using a credit card paid for by public funds. Sassou Nguesso hired Schillings, a London law firm, in an attempt to suppress the report. His application for an injunction did not succeed, but Global Witness has been left with legal costs of £50,000.

The Commons culture, media and sport select committee is conducting an inquiry into libel, privacy and press standards. “I have been left in no doubt that the high cost of libel claims is having a damaging effect on the good work of some NGOs,” said John Whittingdale, its chairman. Jack Straw, the justice secretary, has also admitted that no-win no-fee agreements for claimant lawyers are having a serious effect on free speech.

Mr Justice Eady, a High Court judge, has delivered a series of rulings that have bolstered privacy laws and encouraged libel tourism. He awarded Max Mosley, the Formula One president, privacy damages of £60,000 over the News of the World’s exposé of his sex life.

Most recently, Eady has been accused of “stifling” scientific debate after he ruled in favour of a trade body for chiropractors against a science writer who had accused the body of promoting “bogus treatments”. Eady said that Simon Singh, the writer, had effectively accused the body of dishonesty.

In a landmark decision five years ago Eady gave judgment for Khalid bin Mahfouz, a Saudi banker, who had sued Rachel Ehrenfeld, an American academic. She suggested in a book that the banker had links to the financing of terrorist groups. Ehrenfeld had not published or promoted the book in this country but 23 copies sold over the internet were shipped to Britain. She decided not to defend the case, but Eady ordered her to pay £130,000 in costs and damages.

He also ruled that any copies of her book must be pulped. This judgment almost single- handedly launched the American freedom of speech backlash against UK libel laws.


Women are soaring ahead of men at British universities

Women are trouncing men in British higher education, according to a new study which has found that they are more likely to go to university, do far better once they get there and win higher- quality jobs as a result. More than 49% of women now go to university, meaning they have almost reached Tony Blair’s target that half of all young people should do so. Men lag far behind, with just 37.8% studying for degrees.

The researchers at the Higher Education Policy Institute (Hepi) found that the gap between women and men is widening most quickly among the most disadvantaged social classes. They argue that the gap in performance is exacerbated by school exams, particularly GCSEs, which heavily favour girls.

They warn that plunging male performance risks creating an excluded generation of men, particularly among the working class. “The under-performance of males matters: graduates after all tend to form the elites of society,” said Bahram Bekhradnia, director of the institute and an adviser to the Commons universities select committee.

The number of women going to university overtook men in 1992-3 and they now outnumber male undergraduates in every type of university except Oxford and Cambridge, where the numbers are about equal.

The Hepi study shows they secure better degrees than men, with 63.9% achieving first or upper second class results, against 59.9% of men. They are also less likely to drop out of courses and less likely to be unemployed.


Probiotic supplements have 'no proven benefit for healthy people'

Good to see some reasonable skepticism

Probiotic drinks are of no benefit to healthy people and may harm those with low immune systems, a leading microbiologist has warned. Michael Wilson, Professor of Microbiology at University College London, said there were some cases when topping up on "good bacteria" could help recovery from illness, but understanding of the supplements is "shaky" and needs a more robust scientific investigation.

"There are certain instances when probiotics are useful but the problem is there's no regulation," Prof Wilson said. "They are regarded as food supplements not medicinal products – anyone can get a suspension of bacteria and market it as a probiotic," said Prof Wilson, speaking at the Cheltenham Science Festival. "With medicinal treatments, the pharmaceutical industry makes sure the things they produce are safe."

He said that there was some "instinctive sense" that adding to the gut flora will help with adverse events. In recent years, probiotics have been promoted as a healthy food supplements, in the form of yoghurts, drinks and capsules, and the market is worth an estimated £200 million in Britain.

Clinical trials have shown that eating live bacteria can help sufferers of certain illnesses, such as antibiotic-associated diarrhoea, and there is evidence they can help women who have recently given birth to lose weight. However, according to Prof Wilson, for people with compromised immune systems, increasing the bacterial load could lead to health problems.

"No bacterium is totally innocuous. If you are healthy there is probably no harm in taking probiotics, but there is also no benefit. But to increase the bacterial burden if you are immuno-compromised is asking for trouble," he said.

A spokesman for Yakult, one of the leading probiotic brands, disputed Prof Wilson's warning. "We have 75 years of studies, carried out by independent scientific research bodies in the UK, Europe and Japan, including human trials, which have all demonstrated the health benefits of supporting the gut flora with Yakult."

A spokesman for Danone, the company which produces Actimel and Activia probiotic yoghurts, added: "The efficacy of these products has been shown in many studies and the results have been published in highly reputed scientific journals. "Most recently an independent study, published in the British Medical Journal, showed a significant reduction in the incidence of C difficile-associated diarrhoea in hospitalised patients who drank Actimel twice a day."


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