Professional Theft – PIP Breast Implants
It has been reported that Prof Sir Bruce Keogh, the NHS medical director has looked in to the sub-standard breast implants supplied by French company PIP and has said that despite their double-than-normal failure rate, they did not appear to be linked with increased levels of cancer.
It would appear that where the NHS is concerned, the organisation has offered to remove any implants it made, but the problem in England lies with the 95 % of women, who had the operation done privately.
I’ll give an example here. Suppose I had taken my Jaguar to an approved dealer after the air-conditioning pump had failed and it had been replaced by a sub-standard import, non-approved part. If I’d have noticed this, I’d have asked the dealer to replace it with the approved part at no charge and I suspect that Jaguar would have backed up my demand.
The NHS seems to be fulfilling its similar obligations, but many private clinics seem to be washing their hands of the whole thing. Surely, to use a sub-standard part and probably charge for the kosher one is theft. I call this professional theft, where the customer is milked by a professional, who should know better.
And when the report from Professor Keogh doesn’t take a robust attitude to those of his profession, who didn’t put the best interest of the patients first and insist they replace the offending implants, some might think he is putting the doctors before the patients.
In my view these women should have their implants removed and replaced and those done outside the NHS, should be paid for by the skimping clinics and doctors involved.
How to Cut Down Strokes and Their Effects
The more I learn about strokes the more I know that the one I had in Hong Kong might well have been avoided.
my stroke was caused by atrial fibrillation. This was detected hen I had a small stroke in March 2010. I now feel that I should have been put on Warfarin, but why the doctors didn’t take this route, I do not not know. Could it be that my previous surgery in Suffolk, wouldn’t use a simple hand-held instrument, but still relied on expensive weekly blood tests? I don’t know, but having been on a system based on a machine since moving to London, I can honestly say that the the system is better from a patient’s point of view. My previous cardiologist, who has an International reputation assured me that if I kept my Warfarin regime, I would not have another stroke.
I am now under the care of University College Hospital in London. I happened to tell the nurse doing my electro-cardiogram there, that twenty or so years ago, I had had one that missed a beat in a flying medical. She said that that should have been followed up as it was indicative of atrial fibrillation. Instead over the past twenty years, I’ve had the odd cholesterol and blood pressure tests and that is about all.
It strikes me that, if I had had a proper heart medical, twenty years ago, then my stroke might have been avoided.
But I didn’t even see a cardiologist after my first stroke.
It strikes me that GPs either need to be better trained with regard to heart problems or less reluctant to refer patients to cardiologists.
I was also lucky in that I had my major stroke in Hong Kong.
There I was given a drip of a clot-busting drug, that provably mitigated my lasting problems. It is common place in some countries and regions of the UK. A BBC London report, showed that it saved money against conventional treatment, by avoiding lots of expensive after care. Additionally, in London, you are always taken to a specialist stroke unit.
So it does look like things are improving in the treatment of strokes.
The NHS Gets Gluten-Free Food Spectacularly Wrong
According to a report to be broadcast on Newsnight tonight, the NHS pays things like £17 a go for a gluten-free pizza base. If I remember correctly, that buys more than one gluten-free pizza with a topping from somewhere like Sainsburys. i don’t as I like to buy my pizzas made in a proper oven, by someone who knows what he is doing. The last time I ate a pizza was in Naples.
Apparently, the NHS spent £27 million on gluten-free prescriptions last year and say it helps people stick to their gluten free diet.
I don’t get anything on prescription. I used to until I went through the boring list available with a pharmacist and I decided that as I liked food with taste, I’d pass. For instance on the NHS approved list there are no chocolate biscuits. A couple occasionally would liven things up.
I’ve just returned from the shops and for my lunch today and tomorrow, I’ve bought some gluten-free rolls, some smoked salmon, an egg and potato salad and some melon. I could have bought the salad and fruit unprepared, but with my gammy hand, I’d prefer to let someone else do it.
It is much easier to buy it in the local supermarket, in this case Waitrose, than get the bread delivered by post.
At the moment, I’m not cooking, as my cooker has gone and the new one is not delivered until Monday, so a couple of days a week, I live on gluten-free ready meals from somewhere like M & S. But when I get cooking again, there are so many simple things to cook that are naturally gluten-free, like fish, meat, vegetables and fruit.
So in some ways the solution to the NHS’s £27million bill for gluten-free food, is to get everybody to eat healthily. We already have a pasty tax, so why not have a super-tax on burgers, unhealthy sandwiches and other foods, that cause obesity. I would be pleased, as every day, someone has dumped the old fast food packaging on my front patio, sometimes with the burger remains in it.
If people need help to cope with the expense of a gluten-free diet, then they should get the help directly, not with food parcels, where the administration is the major cost.
There also might be a virtuous circle here, in that if the NHS stopped prescribing gluten-free food, the supermarkets would feel it was a market worth developing.
One interesting development over the last couple of years, is the Marks & Spencer’s widower’s range of ready meals. They call it Fuller Longer and the range contains very few allergens, with perhaps a third of the dishes being gluten-free. Probably the most common allergen is fish! I can live with that!
With food like that who needs the hassle of collecting a prescription of a load of cardboard-flavoured rubbish.
The only problem is probably bread, but then all supermarkets and many other stores, these days have a selection of gluten-free bread and rolls.
Perhaps the £27 million would be better spent on education. Let’s face it, the most expensive gluten-free products are things like biscuits and cakes. I wasn’t a coeliac, when I lived with my mother, but some of the biscuits and cakes she used to make in those days, are well within the skills of the average eight-year-old. There is always the old staple of a chocolate rice crisp, made from Rice Krispies or a gluten-free equivalence. Kelloggs also have an interesting alternative here. Just search Google for chocolate rice crisp.
Let’s assume that in the UK, one in a hundred are coeliacs, which means every coeliac costs the country £43.50 a year for gluten-free food.
London Hospitals Write Off Millions
According to this report from the BBC, the NHS in London is owed £26m by those who because they are not British or EU citizens, don’t get free healthcare. Of this a large proportion has been written off.
This is not a new phenomenon.
When my mother-in-law had her new heart valve fitted in Barts in the early 1970s, some of the patients there could be be described as health tourists from the USA. They needed a new heart valve and had come to the UK, where they then got admitted to the hospital through A & E.
I guess the system is still the same.
It Isn’t Just the PIP Implants To Blame
The third leader in The Times yesterday was a reasoned one on the scandal of the PIP implants.
It started by saying that those hospitals and clinics that fitted them should rectify the problem. It also said that the NHS and eight cosmetic surgery groups would replace the implants without charge.
The leader then said this.
But even in this mire, one private clinic stands out for the audacity with which it is abdicating its responsibility to its patients. The Harley Medical Group, which was responsible for fitting PIP implants to almost 14,000 of the 40,000 British women who received them, is refusing to replace the now banned implants without further charge. Doing so, it says, would put it out of business.
But what is Harley doing? Absolutely nothing except protesting it wasn’t their fault, but one of the regulatory authorities. I should say, that I’ve heard of the Harley Medical Group, as has everybody who uses escalators on the London Underground. I should say, that their adverts haven’t been there for some months.
It would be interesting to see a report on finances of the Harley Medical Group, by a reputable forensic accountant.
As an aside here, according to a doctor on BBC Breakfast, a proper breast implant costs £16,000. So if Harley fitted implants to 14,000 women, that works out at £448 million pounds to sort out the problem. The Times has a lesser figure of £40 million, bt also states that Harley only made a small profit last year.
So why should the NHS and ultimately the taxpayer pay for the patient’s vanity? And stupidity for going to Harley?
Lord Winston says nurses need good English
He’s absolutely right here, but it also applies to lots of other professions as well.
I also think, that a couple of hundred years ago, others were complaining about Lord Winston’s ancestors in the same way, when they first came to the UK!
The solution is simple. People should not be allowed to practice in many professions, without a proper knowledge of English. I rarely use taxis and never use mini-cabs. With the latter, you never know what or who you are going to get. In the case of taxis and minicabs, all drivers should be subject to various tests and checks.
Perhaps black cab drivers could also have proficiency tests in other languages they know. So let’s say a Spanish fsmily staying in Londonwanted a Spanish-speaking taxi, this could be booked over the phone. I suspect that in London, there are quite a good few taxi drivers with pretty good Spanish, French, Polish and Russian for a start. I did have a Chinese driver once somewhere in the UK.
NHS Waiting Times
There was a report yesterday that said that some NHS Trusts are imposing a minimum and maximum waiting time for some operations and treatment to save money.
If they are they, they are breaking the First Law of Scheduling, which is you maximise your efficiency by agreeing dates between both parties as soon as you can.
I first came across this, when I worked in the Research Department of ICI at Runcorn. We had a small workshop that would make equipment you needed. Everybody used to put a delivery date of ASAP on everything, even if they didn’t want it for a month or so. The outcome was that nothing got delivered in a reasonable time.
The situation couldn’t go on and the manager of the workshop decided that no work would be accepted without an agreed delivery date.
The outcome was harmony and everybody was happy. One interesting side effect of this method, was that when the workshop could see a high peak of future work, they would sub-contract some jobs to an external firm.
I must admit that I stole this technique when I wrote the task scheduler for Artemis, but of course this was a legitimate steal and it made the task scheduler very good.
Some NHS Trusts do use this agreeing of appointments method. Addenbrooke’s in Cambridge do and I’ve negotiated a suitable date and time on the phone several times.
I know too of a farmer, who needed a hip replacement and got the operation done at one of the quietest times in the farming year and a slack time for Ipswich Hospital.
Now most of us have e-mail or can use SMS, surely this negotiation can be an almost painless and automatic process.
It oviously won’t work for emergencies, but say you need something like a hip replacement, a mutually convenient date is best for all parties and in my view will probably add a few percentage points to hospital capacity.
How many NHS Trusts still manage appointments and waiting lists on a non-scientific basis.
NHS Ill-Prepared for the Obese
This is a headline on a story on the BBC’s web site. Surely, the headline should be something like “Obese Ill-Prepared for the NHS”.
The High Cost Of Gluten Free Food to the NHS
The Times yesterday had a piece about the high cost of gluten free food to the NHS. They quoted an NHS gluten-free loaf at 32.27 and I know I pay a lot less than that for acceptable ones in Marks and Spencer, Waitrose or Tesco. They also said that you could buy gluten-free afternoon tea in Fortnum and Mason for £34 a person. I think I’ll try the latter out one day!
Anyway I was moved to write to the paper and here’s what I said.
As a diagnosed coeliac, I am entitled to various gluten-free prescriptions. But I don’t exercise my right, as most gluten free products available that way are inferior to products bought in normal shops and supermarkets. I do buy bread from a well-known chain twice a week and if I feel like some pasta I go to a chain of Italian cafes, where the penne is as good as any.
It would be much better if all of those entitled to gluten-free products were given vouchers that could be redeemed in shops against suitable products. That way we could eat quality rather than processed cardboard. Some might blow the vouchers on gluten-free chocolate biscuits, which are not available on the NHS, but then having coeliac disease, doesn’t mean you have to be miserable!
But innovation is the real solution. My local pub has a chef who is a coeliac. He made an alternative muffin from slices of grilled aubergine, a sliced tomato and some spinach. It was much better than any gluten-free bread I’ve ever tasted and complimented the Eggs Royale superbly.
Last night, I cooked one of Lindsey Bareham’s simple gluten-free creations; a chorizo, chicken and chickpea stew, all cooked in one pot. Delicious!
I do think though there is a much more cost effective way of getting coeliacs, gluten-free products. Why should we be subsidised so heavily, when there are people in a much worse state than we are? I would happily give up my right to gluten-free food on the NHS, which I don’t exercise, for a monthly voucher to be spent on something gluten free. I would probably use it to buy a gluten free pasta dish in Carluccio’s or some chocolate chip cookies or Damm Daura in Waitrose!
I do remember going through the gluten-free list with a pharamcist once. There is nothing there with any excitement at all.
Repeat Prescriptions
I have several drugs on repeat prescriptions from my doctor.
Having once been caught out, on Wednesday, I took the form in to get some more. I wanted to pick the actual prescription up at lunchtime today, but it looks like I won’t be able to get it, without a special trip today, until Monday. The surgery is shut on Saturday.
At my previous surgery, I just e-mailed the dispensary and 48 hours later I just went in and picked up the drugs. I could even do that on a Saturday.
It’s not important and I’m not complaining, as I have enough until the end of next week anyway, but it makes me wonder if some of the problems in the NHS are caused by simple procedural problems.
If we had a central drugs database, then on production of suitable identification, I should just be able to walk into any pharmacy and pick up the drugs I need. Obviously, the system would make sure, I wasn’t taking out more drugs than I was entitled too or needed!
One point that should be said, is that I’ve had some drugs on visits to private hospitals. Where the drugs only cost a few pence, they often give you three months supply, rather than the 28 days that seems to be normal in the NHS.
Another is that the repeat prescription form doesn’t say what the drugs are for, so in one case I ticked the wrong box and got the wrong ones.
It strikes me that we could have a much more customer-friendly system, that improved the efficiency of the NHS.
But then I’m not a doctor or a pharmacist, so what do I know about healthcare?
I’m only a patient and our needs are at the bottom of the NHS’s priorities.
The Anonymous Widower 