Suspicious deaths of the elderly in hospital: An appeal for people to contact me

NHS-logo

Appeal for people to come forward over suspicious elderly relatives deaths in hospital

CROSS POSTED ON BYLINE.COM
For the past four years I have been a member of the Gosport War Memorial Hospital Independent Panel that concluded that at least 456 elderly people had their lives shortened as ” a direct result of the pattern of prescribing and administering opioids that had become the norm at the hospital.”

Since publication of the report the events at Gosport are now the subject of an independent police inquiry so I cannot take up any cases involving Gosport.

However since the report’s publication a number of people have contacted me on  my website with allegations of a similar nature in other parts of the country,

As a result I have started investigations into these and would welcome other people –  relatives of  former patients, NHS staff  or lawyers representing them- to contact me in confidence as I am actively looking at this issue.

The aim will be to publicise and investigate  these fresh allegations to find out what happened to their relatives  and seek explanations from the various  hospitals who were responsible for their treatment.

You can get in touch with me by clicking on the contact me heading on my website or through byline.com. I  look forward to hearing from you.

 

 

 

Fifty Shades of Child Abuse: How a brave survivor is pioneering a fight back in Cumbria

Resilience Film 2

A snapshot from the Resilience film being shown across Cumbria

CROSS POSTED ON BYLINE.COM

Cumbria is amongst the first regions in England to try and tackle the poisonous chalice of adverse childhood experiences (ACEs), including child sexual and physical abuse using medical science developed in the United States and extensively trialled in Southern California and now here in the UK.

The Cumbria community initiative, known as The Cumbria Resilience Project, comes from a 61-year-old survivor himself – a victim of the notorious paedophile and abuser John Allen – sentenced to life imprisonment on 33 counts of sexual abuse against 19 boys and one girl- aged between 7 and 15 – while running a children’s home in North Wales. Allen like so many paedophiles denied all of this and claimed the people making the allegations all wanted to make money. But the jury at Mold Crown Court disagreed.

The  anonymous survivor has just written a very readable  book – available from Amazon here for £7.99p  – Aces in the shadows – Understanding Adverse Childhood Experiences.

He thought he might call it 50 Shades of ACEs because of sadly the variety of adversity, including physical, sexual, and bullying abuse (some inflicted by other traumatised children as well as adults) which damages thousands of children in their homes, schools, places of safety and in war zones and among refugees.

ACEs science comes from a health questionnaire used in the CDC-Kaiser Permanente ACEs Study, which is one of the largest investigations of childhood abuse and neglect and later-life health and well-being in the USA, can now be used by GP’s and trained counsellors to act as a gauge on how deeply traumatised children and adults have become following adverse childhood experiences through abuse, neglect and household challenges, often caused by members of their family, teachers, children’s home staff , and priests leading to perpetual mental and physical health outcomes in later life including Cancer, Ischemic heart disease, Liver disease, Alcoholism, Chronic obstructive pulmonary disease and Depression.

The science, now accepted by the World Health Organization (WHO), shows beyond any doubt that a child’s growing brain can be arrested by such traumatic experiences, but the brain’s plasticity and the building of resilience can help people recover in later life. The book includes views from three professionals, Al Coates MBE, a social worker; Judy James, a coach-therapist; and Laura McConnell, a teacher and ADHD campaigner, on how to tackle this. The survivor adds his own views.

With a score of 10 ACEs, the anonymous survivor has endured it all – three marriages, fathered eight children, 40 sexual partners, 34 homes, two bankruptcies, copious drink and sleeping pills and a range of health conditions. Only the unconditional love of his third wife helped pull him through after years of therapy.

His psychiatrist diagnosed that he suffers from complex Post Traumatic Stress Disorder – something ( which I will return in a later blog) the authorities don’t wish to know about because of the expense of treating it. He concludes : ” I do not believe however he is likely to make a complete or rapid recovery because of the duration of his symptoms since childhood.”

The good news is that such episodes have become rarer while the work he is doing in Cumbria is growing beyond anything he could have expected.

” Cumbria might appear to be a beautiful place but behind the beauty are some of the highest numbers of sexual and domestic violence offences in the country,” he told me.

The Cumbrian Resilience Project has already attracted more than 300 members belonging to its closed social media forum. It also has free viewings of a film called RESILIENCE – The Biology of stress and the science of hope which explores the damage done to the body by the toxic trauma of  repeated adverse childhood experiences as a child and puts forward a scientific way of tackling it. Film showings this autumn will be in Carlisle, Penrith, Workington, Barrow, Eden Valley and Kendal to name but a few.

Interest has been shown by Cumbria Police, Cumbria NHS and across the care sector and the project founder is planning ACEs awareness training sessions for parents, social and care workers, and all frontline staff so they can understand what is needed to help children and adults affected by ACEs. Sessions this year are being held in Workington, Carlisle, Penrith and Barrow.

The project relies enormously on volunteers and survivor champions. But I hope when the Independent Inquiry into Child Sexual Abuse (IICSA) moves on to discuss how to help survivors that projects like these (they are more widespread in Scotland) are advocated on a national level. The author is a Core Participant in the inquiry and hopes to have the opportunity to raise issues of ACEs at the inquiry later in the year.

Among the supporters of the project are Graham Wilmer, who runs the Lantern Project on the Wirral :

He says: “There are people out there who are trying very hard to undermine the courageous efforts of survivors of child abuse to come forward and give their testimony. Some of these individuals claim to be survivors themselves, others include a diverse range of individuals, some professionals, others just perhaps misguided folks without much else to do, who, through the advent of social media, believe they have a right to call out and abuse anyone they want to, simply because they can.

“That will change, but, in any case, they matter not. It is the voices of those who had the courage to speak truth to power that will be remembered, not the voices of those who tried to stop them.”

Another is Dr Wendy Thorley who described the book as a ” An open and unrestricted account of the impact on ACEs for not only children but adults. The bravery of the author to put this in the public arena is not unrecognised.”

I would recommend it – the author does not go for intellectual sophism – but is direct, honest and tells the unvarnished truth – and it is all the better for that.

Race equality groups seek big changes to the mental health act to end stereotyping and over-medication

Simon_Wessely-300x300

Sir Simon Wesseley, planning to report on reviewing the mental health act later this year

CROSS POSTED ON BYLINE.COM

While Theresa May is battling to hold her line on Brexit her almost unreported initiative to reform the mental health act is leading to demands for the government to introduce radical reforms for treatment and new rights for patients.

A submission from Race on the  Agenda and the Race Equality Foundation to the review  by Sir Simon Wesseley, set up by Theresa May to look into why so many black Afro Caribbean people were being detained in mental hospitals and the need for changes to the Act. It also comes against a disturbing background of deaths in police custody.

The submission has been backed by the Runnymede Trust;Patrick Vernon OBE, Chair of the Labour Party’s Race Equality Advisory Group, writer Amy Kenyon and Professor Rachel Tribe, of the School of Psychology at the University of East London among others.

NEED FOR BIG CHANGES

The Downing Street interim report  contained many warm words but not a lot of action. It stated: “Experience of people from black African and Caribbean heritage are particularly poor and they are detained more than any other group. Too often this can result in police becoming involved at time of crisis. The causes of this disparity are complex.” The  full report  and details of its members  and terms of reference is available here.

Now the submission to the inquiry proposes major changes to tackle the problem. The link to it is here. The main proposals are:

1. The Mental Health Act (the Act) should set out principles that define human rights, anti-discriminatory practice and a commitment to combat institutional racism.
2. The Act should be amended to include a clause that states explicitly that a diagnosis for a ‘mental disorder’ must take account of the patient’s social and cultural background. And the Act should allow for appeals against diagnoses via a Tribunal, with a panel that includes experts from BAME backgrounds.
3. Patients detained under the Act should be empowered to choose which carers or family members have a say in their care and can support them during an appeals process.
4. A new system of appeal whenever a new diagnosis is applied and/or continued, to a tribunal-like body, with the right of the patient concerned to have legal representation at the hearing.
5. All mental health service providers should be set targets to reduce the use of Community Treatment Orders and minimize racial inequalities in their use. This should be monitored by the Care Quality Commission  during inspections. Specific amendments in relation to supervised treatment in the community should be made to ensure this is statutory.
6. Statutory bodies should be regularly inspected by the CQC or other appropriate body to ensure that training of professionals working in mental health services addresses issues of racial bias and cultural competence.

The  submission  says: “:We were glad to see an emphasis on the urgent need to address the disproportionate number of people from black African and Caribbean backgrounds being detained under the Mental Health Act (MHA).

Equally, we were unsurprised that Black, Asian and Minority Ethnic (BAME) focus group participants highlighted a lack of cultural awareness in staff and a need for culturally appropriate care as paramount. We would express concerns about racism, stigma, stereotyping and overmedication. We hope that these findings will guide and underpin the recommendations made in the final report ”

It is to be hoped that Sir Simon and Theresa May do take action to remedy these many faults in the system. Otherwise it will be another case of political posturing  like help for the ” just about managing” which has so far amounted to warm words and little else.

There were concerns expressed at the recent conference organised by Rota at the University of East London that little would really be done to tackle this. If little happens it will only make matters worse and there is a need for strong campaign to make sure Downing Street does really listen.

Theresa May’s risky gamble with reforming an ” institutionally racist” mental health act

Professor_Sir_Simon_Wessely

Sir Simon Wessely, chair of the mental health review

CROSS POSTED ON BYLINE.COM

With very little publicity and dwarfed by Brexit  Theresa May has committed herself to a major reform of the Mental Health Act. Last year she convened a meeting at Downing Street and appointed a former president of the Royal College of Psychiatrists, Sir Simon Wessely. to conduct a review.

This month it published an interim report with a lot of warm words, some constructive proposals and a public admission that far too many people were locked up and a disproportionate number were from  the black and ethnic minority communities. A report in the Guardian on  May 1 highlighted some of the issues.

This Friday the charity Race on the Agenda  will host a conference at the University of East London on the  Stratford campus tackling the issues head on by addressing the issue of institutional racism in the mental health service.

They will have a lot to go from the interim review report which firmly  puts the case for change by highlighting the poor  and  often inhumane treatment of people of black African and Caribbean heritage in the worse case scenarios results in deaths in police custody.

It also appears to want to redress the balance between the role of the police and the NHS.

The interim report states: “Experience of people from black African and Caribbean heritage are particularly poor and they are detained more than any other group. Too often this can result in police becoming involved at time of crisis. The causes of this disparity are complex.” The  full report  and details of its members  and terms of reference is available here.

Among some of the salient points raised include phasing out the use of police cells to detain mentally ill people and using ambulances rather than police cars to transport mentally ill  people and increasing NHS involvement by looking at NHS England taking responsibility for  commissioning of health services in police custody.

This week’s conference will  go further than the report by looking at the culture and attitudes towards black people – the stereotyping, unconscious bias  and sometimes politically incorrect racism – as well as the role psychiatry has in defining who is mentally ill.

So why should this be a risky gamble for Theresa May ? The answer is the countervailing trends in society which could mitigate against reform.

First there is austerity. The state of some mental health hospitals , including one not far from the conference in Tottenham, have to be seen to be believed because there isn’t the money to provide adequate services. Thus all the reforms in the world could fall down because there are not the staff nor proper facilities to help people.

Then there is current hostile environment which led to the Windrush scandal , the rise of Islamaphobia and the Prevent strategy  which creates a climate of fear and fuels latent racism and fear among the white community of “the other”. The fight against terrorism can morph into discrimination against  particular ethnic groups in society.

So in the worst case scenario all Theresa May will be left with is warm words and no action – which, given the hope rising from the mental health act review, could make matters worse than they are now.

That is why it is important that conferences looking at issues the report may find difficult to confront – such as institutional racism – are being held and issues thoroughly aired.

 

 

A psychiatrist’s damning indictment of 500 years of racism – now revived by Trump and 9/11

suman1

Suman Fernando. Pic credit: http://www.sumanfernando.com

CROSS POSTED ON BYLINE.COM

Suman Fernando is a gentle soft spoken  consultant psychiatrist, lecturer and honorary professor at the London Metropolitan University.    The 85 year old is not the sort of person at first sight to produce such a searing critique of racism in the UK and the US and the baleful role psychiatrists have had in treating ethnic minorities in both countries.

His book released at  the end of last year and launched by ROTA – Race on the Agenda – looks at both the history of racism which he dates from 1492 when the Spanish finally  removed the Moors from Europe and the role of psychiatry in treating ” mentally ill”  black and brown patients over a very long period.

The book is particularly relevant as Theresa May has  quietly decided to review the UK’s mental health laws  which cover some of these issues – signalling her intent by  holding a meeting of psychiatrists at Number Ten Downing Street.

It also comes at a time when the election of Donald Trump, the rise of Islamophobia in the wake of 9/11 and to an extent, the worst excesses of some people supporting Brexit, has seen a revival of popular nationalism and in the US, white supremacists.

He traces racism from the bloody Inquisition in Spain through the development of the slave trade, the rise of eugenics leading to Nazism,  the Imperialist destruction of other cultures by colonisation to the ” rivers of blood” speech of Enoch Powell as Britain faced an immigration wave in the 1960s and 1970s.

His  thesis is that – mainly because of the 1970s race relations legislation in Britain – overt racism has until recently been replaced with a form of institutional racism and psychiatry is no exception to the rule.

Indeed some of the worse psychiatric theories to treat people as seen by superior whites as ” the other” came from this profession. This was the profession that applied the concept of  ‘Drapetomania’  to slaves in the USA, the primary symptom being a persistent urge to run away.  The implication was Black Afro-Caribbeans were supposed to be happy and content as slaves  and had mental problems if they wanted their freedom.

In Britain the book provides numerous examples of how different ways of dealing what is an obvious imbalance in the number of Afro-Caribbeans being sectioned compared to white Britons. Attempts to change treatment or properly research the issue by black psychiatrists were undermined in a typical British way – their work was subsumed by more conventional psychiatrists or their findings were ignored.

He also reveals  how attempts to change matters politically were undermined. Tony Blair  appointed Paul Boateng – now Lord Boateng- as the first minister for mental health in 1997. At the time he was known to be  strident in wanting to change the treatment of black Afro Caribbeans like himself- but within months he was squashed.

Since 9/11 the danger is that racism is on the rise with Muslims rather than Afro Caribbeans as the main target. That is why the timing of this book is relevant in the context that the mental health legislation is being revised. Already psychological research is being used as a basis in the Prevent programme to decide whether teachers or NHS staff, their pupils and their patients, should be reported to the authorities if they show signs of radicalism.

The next slippery step would be to decide that these people are insane – and should be sectioned rather than prosecuted. This is not as fanciful as it sounds. Under  Labour there was a move to classify stalkers of VIPs as a mental illness and Jack Straw when he was home secretary is said to have considered whether paedophiles should be classified as insane rather than criminals.

That is why this book is so interesting because it tells how deep seated racism is among white Europeans  and how insidious the present system is in dealing with the ” other” – from stop and search to sectioning.

The one sad thing is that the book itself has been “Ghettoised” – it has been pigeon holed by the publisher  as part of ” contemporary black history ” when it is much more of an account of how contemporary British and US society has reached such a view on black and brown people.

The German publisher has created another ghetto by price – Palgrave Macmillan have priced it at a ridiculous £67.99 or £53.99 as an e-book. Amazon have a Kindle version at £45.19. So I suggest you try and get it in a public library or if you are a student make sure your university library has got one.

Institutional Racism in Psychiatry and Clinical Psychology. Suman Fernando

 

 

 

Exclusive: Are whistleblowers now too frit to reveal when NHS patients and care home residents are in danger?

dr-henrietta-hughes

Dr Henrietta Hughes, 4 day a week National Guardian Pic Credit: CQC

CROSS POSTED ON BYLINE.COM

Tucked away in a recent National Audit Office report on the NHS and social care regulator, the Care Quality Commission, is the extraordinary statistic that the number of whistleblowers who tipped off the regulator fell by a staggering 16 per cent to 7452 in 2016-17. That is one in six fewer whistleblowers than the previous year. See paragraph 2.19 of the report.

The figure compares with 153,000 members of the public – an increase of one per cent – expressing concerns about services during the same period.

I have written about this in Tribune this week.

And the latest figures come after  a report by Robert Francis QC to Jeremy Hunt, the health secretary,which was highly critical of the way some had been treated after they made a complaint.

In 2015, Francis reported widespread severe victimisation of staff by senior management when they spoke up for patients. Francis recognised that sacked whistleblowers are blacklisted and recommended a re-employment scheme but nothing seems to have come of it.

His most substantial recommendation was for a National Guardian to protect staff. This led the CQC to create a part time post with no powers. The first appointee, Dame Eileen Sills, quit before starting.

Since then Dr Henrietta Hughes . a GP has been appointed  as National Guardian, on a four day week. And according  to the CQC  yesterday marked her first year as the National Guardian for the NHS with the publication of her first case review report and her annual report highlighting the work of Freedom to Speak Up Guardians.

The one case review she published covered Southport and Ormskirk Health Trust which  has the unenviable reputation for bullying and discriminating against black and ethnic minority staff , a dodgy appointments system favouring some people against others and an attitude of not bothering when staff raise concerns about patients. This might sound familiar incidently for those who have followed my articles on staff practices at the Equality and Human Rights Commission but we should wait for the employment tribunals to see what happened there.

Dr Hughes has recommended a series of recommendations to put matters right – 22 in all – and there is promise from the interim chief executive of the trust, Karen Jackson, to act  with a new senior management team. We shall see. Also this was a trial – how many reports are we going to get from her in future?

The National Guardian has also produced a series of high flown documents which sound terribly good in theory – but again I think we should wait to see what happens.

What has happened so far is that the appointment of a national guardian has coincided with a drop in whistleblowers telling the CQC when things are going wrong.

What we do know is that staff do lose jobs are blacklisted and get the reputation of being troublemakers. There is a  website which covers 11 such cases here. All designed I suspect to cover up an NHS and care system creaking at the seams and not being adequately financed. I hope Dr Hughes does not turn out to be a convenient fig leaf for a service in trouble.

 

Gag, cover up and secret privatisation: What is the real story behind the NHS clinical correspondence scandal

archives

NHS archives. Pic credit: Health IT Central

CROSS POSTED ON BYLINE.COM

A week ago the media was full of the huge scandal of over 700,000 clinical correspondence documents – including details of sensitive patient conditions – going missing and  instead of being delivered to GPs being dumped in rooms.

The story was originally broken by the  Guardian in February this year which revealed that NHS England was secretly working on how to sort out it  without disclosing the scandal to the public. Jeremy Hunt had made a perfunctory statement to Parliament in 2016 not disclosing the full state of affairs in July 2016.

Last week the National Audit Office published a very thorough investigation into the scandal – including discovering that somehow the NHS also lost  highly confidential reports dating back to 2005 which identified children subject to child protection orders which must never be disclosed to the public without the individual’s consent. And in 1788 cases it look possible that patient treatment could have been harmed as a  result.

The mislaid and unprocessed correspondence covers GPs and now abolished Primary Care Trusts in the East Midlands, North East London and South West England .

The NHS has paid GPs £2.6m up front  to examine the mislaid documents but they have yet to complete the work so a proper picture can still not be obtained.

In one bizarre incident some 205,000 documents were kept in a room marked “ clinical notes”. The report says: “A subsequent review found that the label had been removed by an SBS general manager because “you don’t want to advertise what’s in that room”.

“ NHS SBS told us that it was important that documents were held securely and therefore not having a label on the door was appropriate as part of this.”

Now this scandal is bad enough but in the small print of the National Audit Office report there lurked another extraordinary scandal – SBS  and its auditors, BDO, decided to frustrate the National Audit Office finding out what had gone wrong.

Both the company and the auditor refused to hand over the files unless the National Audit Office signed an indemnity letter – which  could get them off the hook should enraged patients decide to sue them for their negligence.

The NAO to its credit refused to do so and in its own report says, if it had, Parliament would not have been told the full story. As the report says:

“NHS SBS and BDO felt unable to share with us their reports into the incident unless we also signed a letter (which would indemnify them). This is common practice among audit organisations.

“We declined to sign any letter that would limit our ability to report on the incident.”

Instead the NAO used its statutory powers to force NHS England, which had copies of the documents after signing the indemnity letters, to hand them over.

Now NHS Shared Business Services was set up as a joint venture with the private sector  under the Blair administration in 2004 when John ( now Lord ) Reid was health secretary. It was an equal partnership between the  Department of Health and Xansa Ltd,a British outsourcing technology company 50 per cent owned by the staff. In 2007 it was taken over by Steria, a French  rival, with British staff pocketing millions of pounds as the French paid a 70 per cent premium on the share price.

In 2014 Steria merged with another French rival Sopra creating a French owned global conglomerate. They are now planning to take over a Swedish firm

But two years before Andrew Lansley, then secretary of state for health, quietly and without any public announcement, transfered a single share to the French company, so it became the majority owner and could dictate policy. Just to make sure the Department of Health, which had civil servants on the board, declined to take up the directorships on the grounds of ” conflict of interest”.

I asked BDO and NHS Shared Business Services why they had sought to frustrate the NAO.

BDO replied putting the onus on the privatised company  saying :

“BDO was in no way obstructive or concerned about making its reports accessible to the relevant third parties.” BDO has a contractual duty of confidentiality to clients as well as an ethical duty of confidentiality under the Code of Ethics of the Institute of Chartered Accountants in England & Wales (ICAEW). Therefore, unless required by law or regulation, we cannot disclose information to third parties (such as the NAO) without the express permission of our client. 

The letters dealing with obtaining the necessary consents and agreeing the basis for access are drafted in accordance with professional guidance issued by the ICAEW. As the NAO report acknowledges in its report (paragraph 3.19), this is “common practice among audit organisations”.

 Patients of the NHS are not a party to such letters and therefore their legal rights are completely unaffected.”

NHS Business Shared Services said :

“The recent NAO report highlights a number of failings in the mail redirection service provided to NHS England. We regret this situation and have co-operated fully with the National Audit Office in its investigation. All of the correspondence backlog has now been delivered to GP surgeries for filing and NHS England has so far found no evidence of patient harm. NHS SBS no longer provides this mail redirection service.”

There appear to be contradictions in both statements.  I gather the safe delivery of clinical correspondence  is now in the hands of Capita.