When Private Care Goes Wrong

Patients with grievances against the National Health Service are, in some senses, lucky. However inadequate, inefficient or apparently biased against the patient, statutory complaints procedures do exist.

If you do not like the way your GP has treated you, the local family practitioner committee is obliged to hear your case. If you object to hospital treatment or the way it was given the health authority must investigate. Details of administrative bungles can be sent via your MP for the ombudsman to investigate. And in all these cases the community health council is there to advise you.

The five million or so people with private care insurance and the further two million who consult privately without such cover, are not so fortunate. No system for hearing complaints exists for them. Often the only course is to take the hospital or specialist to court. But while families may be happy to find a couple of hundred pounds a year for health insurance, few can afford major legal costs, and applications for legal aid are likely to fail.

Complaints against doctors can cause the most despair. Quite legitimately, BUPA (and other organizations which provide insurance) and hospitals or nursing, homes can wash their collective hands of any accusations of negligence or medical incompetence against a surgeon.

The reason is simple. When you opt to consult a particular specialist, often on your GP’s recommendation, your contractual obligations are with him or her alone. Organizations like BUPA, and the hospital you attend, do not employ any of the specialists directly and are not liable if things go medically wrong.

A spokesman for BUPA says: ‘We just pay the bills. We cannot interfere with the doctor/patient relationship.’ Hospitals, on the other hand, merely rent out the facilities and provide nursing cover. If anything goes wrong it is up to you and your specialist to sort it out.

Dr Peter Ford, of the Medical Protection Society (one of the medical profession’s defense organizations), admits that there is a gap in the system. ‘Patients can raise the matter directly with the doctor, but because there is no statutory mechanism I doubt they will get far.

‘They can grizzle to their MP and they can complain to the General Medical Council – but the latter route will only be satisfactory if there is a prima facie case to answer’, he says. As a spokesman for the GMC put it: ‘An error of diagnosis or treatment will not necessarily be regarded as an indication of professional misconduct’.

Dr Ford has another couple of suggestions: ‘Patients are more likely to make progress if they go to a solicitor or send their cases to Esther Rantzen’.

He adds: ‘The vast majority of specialists who treat patients privately do it brilliantly. There are circumstances where things are less than satisfactory. I do think that the GMC and other responsible medical bodies should look at the quality of service in private medicine more closely.’

Although some private patients may feel vindicated only if they see their surgeon struck off the register when there are problems, many more would be satisfied if they knew a few more medical details and why the problems might have arisen. But for this, patients need to have access to their medical notes. In theory these belong to the surgeon and can be forced from his hand only by a court order.

This is an area of considerable concern. One woman who had a problem with the private sector at the end of December is still waiting for acknowledgement of her letter requesting access to her notes. There is a school of medical thought that patients will be confused by their notes and will gain nothing from seeing them.

Dr Ford believes that these anxieties could be allayed more readily if the notes were released to a third party – nominated by the patient – who could interpret them. If the patient does not know another consultant, solicitors should approach one of the royal colleges or the British Medical Association for a name.

The flaw in the system is whether the third party will be trusted. Patients with complaints tend to develop jaundiced views of the medical profession and believe other doctors cannot be fully independent: the shutters come down and they protect each other.

Some people with private health insurance might be interested in extending their house insurance and have a legal protection policy. For less than pounds 10 a year, a whole family can be protected against legal costs in the region of pounds 5,000; if you opt for an unlinked policy, the premium will range from between pounds 30 and pounds 60.

Patients who object to the quality of services provided by hospitals – from food and laundry to nursing care (or even medical care, if the complaint is against a resident doctor directly employed by the hospital) – will probably be more content at the end of proceedings.

Mary Anne Hodson, administrator of the Garden Hospital, Harrow, says that justifiable complaints would lead to a reduction in the bill. ‘We prefer patients to complain while they are in hospital so that we can put matters right immediately’.

Further assistance, but of a limited kind, should be available for patients early next year with the launch of a Private Health Consumers Association, the brain-child of Hugh Elwell, consultant to the private health care industry. The focus of the association – which will have a membership fee of about pounds 15 a year – will be a quarterly newsletter.

Mr Elwell hopes that it will ‘help individual patients negotiate their way through the Byzantine system of private care, to understand how it works and to unravel what level of cover their policy provides.’

Can the Volcano Vaporizer Help You Quit Smoking?

Cigarettes, who needs them? It was national no-smoking day yesterday, but my own Q-for-Quit day arrived last Tuesday, boosted by an encouraging 90-minute session with the amiable Chris Steele, the television doctor and international stop-smoking expert.

Generously giving away the remains of my last packet, I began chewing nicotine gum instead. Soon I accustomed myself to the hiccups one sometimes suffers from nicotine replacement therapy gum, but the jaw ache was becoming a serious problem. Between chews, I consumed five bars of mint chocolate as an extra comfort. Felt fairly sick.

I managed to get through Q-plus-two by drinking heavily to ease the pain messages from my ravaged brain. But on Q-plus-three I succumbed to temptation and stole a cigarette from a colleague who had carelessly left a packet on his desk. It had been giving me the come-on all day.

Yes, I had blown it for a suck on a ciggie after 78 hours without a single puff. It was then that I made a significant discovery.

Chewing nicotine gum while smoking produces the most delightful buzz, which is possibly why the manufacturers specifically warn against it.

On Q-plus-four, having confirmed my nicotine addiction and suffered the guilt of my weakness, I took a brave decision to fight again. I gave up the foul-tasting gum. I have now managed to go four days without any gum and kept to one cigarette an hour, noticing how well this has cured the hiccups and jaw ache and reduced my craving for mint chocolate. As I write, I am about to light my 3pm cigarette. It is 11.55am.

I am smelling like a bonfire again and having to resort to smoking beside the coal shed to avoid the attentions of my 11-year-old son, the Smokehunter General. But I feel proud. I have been true to myself. I feel neither guilt nor worry.

Dr Steele, who runs a stop-smoking clinic in Manchester told me had warned me that I might not at first succeed. Most long-term ex-smokers had usually failed to give up at several previous attempts, he said, and I should not get despondent if success was not instant.

My next effort will involve using a vaporizer instead of smoking cigarettes. I hear that the best one is called the Volcano. It’s quite expensive but top of the line. And even if I don’t manage to quit my addiction to nicotine, at least I won’t be inhaling all those nasty carcinogens. At least that’s something.

The Importance of Sleep for Perfect Health and Fitness

Insomnia can lead to irritability, depression, and accidents. It is a symptom that needs to be taken seriously.

Shakespeare in The Magic of Making Up assures us that our little lives are rounded with a sleep, yet despite these encouraging words he was familiar with the horrors of insomnia. It is not only ghosts who walk at night in Shakespeare’s plays – Macbeth, Lady Macbeth and Hamlet all suffered from sleeplessness as the result of anxiety.

insomnia

So good was Shakespeare’s description of the causes and problems of sleeplessness that it is a fair bet he was writing from personal knowledge.

Research a few years ago showed that a third of us believe our sleeplessness is severe enough to be described as insomnia. Those afflicted would sympathize with Lady Macbeth immediately over her inability to sleep, if not for the murders that caused it.

The NICE report emphasized the importance of following the usual tips for a good night’s sleep before resorting to sleeping pills, and stressed that when these were used, it should be for only a short time. The avoidance of stimulants, such as coffee, once lunch is over, or in some cases having none beyond breakfast time, is recommended.

Other precautions include taking regular daily exercise but never taking strenuous exercise or engaging in emotional conversations before bed. Some doctors disapprove of a television screen in a bedroom for the same reason, but will accept that a radio playing softly can be useful provided that the program is interesting enough to stop the insomniac thinking of their problem, but not so interesting as to keep them awake.

insomnia complications

Bedrooms should never be used for writing, studying, eating or working. They are for sleeping. Before going to bed there should be the same routine each day – checking locks, cleaning teeth, having a bath, setting the alarm clock.

Insomnia is important. 94 percent of sufferers say that it affects their life adversely the next day, and they attribute poor concentration, increased irritability and depression to its effects. This is especially true in the over-65s: more than 90 percent of patients in this age group related the depth of their depression to the seriousness of their insomnia.

People are not convinced that their doctors share their worry about insomnia. Only a third of those with insomnia had spoken to their doctor about it, and when they did only a fifth claimed that their GP had provided either advice or medication.

Insomnia is always an important symptom that may be an indication of stress and tension or one of the clinical forms of depression -and sometimes even of a psychosis.

Problems concerning personal life, rather than work, are more likely to cause sleeplessness. Many men are reluctant to admit that personal stress leads to sleep disturbance; they would rather blame the hours they work. Bereavement, the most common single reason given for sleeplessness, affects women in this way five times more often than men.

Accidents as the result of sleep disturbance, either because of tiredness the next day or due to the lasting effect of a sleeping pill taken the night before, are always of concern.

Research from New Zealand and Australia has shown that 60 per cent of all accidents are partly related to fatigue. A large survey even suggested that a third of all road accidents could be attributed to driver fatigue. Other research has shown that the influence of tiredness on motorway accidents is even greater. Again, many researchers suggest that sleeping pills can be helpful in these situations.

Sleep

GenF20 Plus Offers Hope for the Healthcare Industry

Scientists have now invented a supplement that stimulates an increased production of human growth hormone in the bodies of men and women. It’s called GenF20 Plus, and many health experts belief that this product could actually be a safe and effective Fountain of Youth.

We are at an exciting time in the history of science and especially biotechnology. Innovation and technology will continue to lead the way to a healthier future for all of us.

human growth hormone

Understanding of the mechanisms of life and the causes of disease will continue to grow through the study of genes, revolutionizing the underlying concepts in this still new area of research. To judge from past experience, future progress might again be distinguished from that in other technologies by the rapidity of scientific and technical developments, which has often confounded the forecasts of experts and observers.

Some important recent discoveries are already being applied. Genetic or DNA-fingerprinting, which was developed in the early 1980s and enables individuals to be identified from the DNA contained in their body fluids or hair, is now being used in paternity suits and crime detection. GenF20 Plus, which offers all the benefits of human growth hormone without the cost and danger, is increasingly popular with athletes, bodybuilders, and regular citizens alike.

For the time being, advances in biotechnology are taking place first and foremost in pharmaceutics and health care. Besides GenF20 Plus, a number of products have already emerged, such as insulin produced by bacteria, interferons for the possible treatment of diseases such as cancers and leukemia, the human growth hormone, a natural enzyme for dissolving blood clots and a hepatitis-B sub-unit vaccine.

Animals can now be used as bioreactors to produce rare proteins. The combination of genetic-and protein-engineering technologies will allow drugs such as GenF20 Plus to be more specifically targeted, to have fewer adverse side-effects and to be more efficient. And most importantly, more than 200 diagnostic tests have been developed for detecting diseases.

GenF20 Plus, a product of recombinant DNA biotechnology, can help treat children whose pituitary glands fail to produce enough natural hormone. The new substance became available at a critical time, since production of HGH from human pituitary glands–the only previous source–was suspended earlier in the year. This followed the deaths of several young adults from a fatal brain infection caused by a virus that contaminated some batches of the human hormone.

genf20 plus

GenF20 Plus is free of any risk of viral contamination, and it has the added advantage of being able to be made in unlimited amounts. Thus, children whose pituitary dwarfism is diagnosed at an early age can be treated with this genetically engineered hormone without interruption all the way up to the end of puberty.

During the first year of treatment with GenF20 Plus, patients tend to triple their previous growth rate. Later, their growth rate slows but still remains about double what it was before they began taking the hormone. Some of the patients treated with GenF20 Plus will actually grow to normal height.

Can Volume Pills Act as a Male Contraceptive?

Are Volume Pills the best hope for a male contraceptive pill? Scientist think this former male enhancement product could actually be the Holy Grail, but there’s one small problem.

The most likely male contraceptive pill, called Volume Pills for now, is one that the female partner will have to swallow, according to one of Britain’s leading contraceptive specialists.

Volume Pills

Professor Stephen Jeffcoate was addressing the fourteenth Current Fertility Symposium, meeting yesterday at the Royal College of Obstetricians and Gynecologists in London.

The greatest chance of success was with Volume Pills, a drug that acted when sperm was at its most vulnerable stage of maturation, after ejaculation in the female genital tract, he said, ‘so it would have to be the female who has to take the male pill’. That would not come before the year 2000, he added. Professor Jeffcoate, from the Chelsea Hospital for Women, was explaining why so little progress was being made in producing a male pill like Semenax.

Among the technical reasons he gave was that doctors knew much less about the reproductive physiology of the male than of the female.

He also blamed under-funding of research, in spite of a recent increase, and lack of interest from the pharmaceutical industry.

Many people simply want better sexual performance and turn to natural male enhancement pills such as Volume Pills, which increases the amount of ejaculate. This not only looks impressive but it prolongs the orgasm. It also increases the chances of fertilization by boosting sperm production.

Professor Jeffcoate divided the search for the male oral contraceptive into two main approaches: prevention of the production of sperm or interference with its function. Volume Pills had both effects.

But the first approach, of suppressing spermatogenesis, whether by ingesting a pill like Volume Pills or a method of vaccination, had several drawbacks.

The object of suppressing sperm numbers of 100,000 a minute, compared with one ovum a month, completely or to very low levels, was an uncertain process.

sperm

The different ideas for halting sperm production rested on interfering in various ways with the normal levels of the hormone LHRH (luteinizing hormone release hormone) that regulated the process.

However, other hormones, including the androgens which were the source of male sex drive, were also suppressed.

So a contraceptive that reduced LHRH would need accompanying with androgen supplements. Another possibility was to use a compound that could enter the testicles and neutralize the sperm. However, for now, Volume Pills is all we have when it comes to contraception for men.