Return to Our Comments
Excellent Care .................for
SIN claims the right to 'excellent'
care for all , and that includes the iatrogenic patient - the innocent victim
of a serious medical error who is blacklisted and deliberately and persistently
On Wednesday, 16th october 2002 on
BBC1 at 10.40 pm under the title ' The Golden Hour' there was an extraordinary
documentary that showed the British Medical Profession at its best. This
documentary followed the efforts of the emergency services as they battled
to save the life of a car-crash victim in the vital first 60 minutes after
The accident was no ordinary accident! A young man had been travelling
along a country road when his car overturned several times. The car
finished upside down on its bonnet with the young man trapped inside. The
horror was that the vehicle had landed on top of a thick wooden stave that
had formed part of a fence. The stave had not only penetrated the car roof,
it had gone right through the left side of the man's chest, re-appearing
through his back.
Obviously, it was vital to get the man to hospital as rapidly as possible.
An ambulance helicopter was called and the para-medics and the doctor attended
to the man as best they could at the site of the accident. They were horrified
at the situation they had to cope with, but because of their professional
training they managed to remove the man from the car, complete with the stave
still in the man's chest. They transported him as best they could in the helicopter
to the hospital which had been put on full alert and where the theatre staff
were waiting to take him straight into the operating theatre.
The young surgeon on duty was faced with possibly the worst scenario of
his life. He realised that the last thing he must do was to try to dislodge
the stave - the stave might have cut through a major artery and whilst it
was in place it was acting as a tourniquet- to remove it could cause a fatal
haemorrhage. Since the stave had penetrated the man's left side of his chest,
the surgeon decided to enter the left thoracic cavity using the standard
operation procedure used to remove the left lung. The young man was put on
all vital support systems whilst the surgery lasted.
The surgeon was relieved to find that the stave had missed a major artery
by a few millimetres, so it was carefully removed. The next important procedure
was to clean the chest cavity of all foreign bodies - to leave any piece
of wood, even a small splinter; to leave any soil or grass - all could cause
the patient to develop a fatal internal septicaemia. Painstakingly the surgeon
cleaned the wound, sewed together tissue and muscle which had been torn.
Eventually, the operation was over and the patient was taken into the Intensive
Care Unit. The next few days would be vital - careful monitoring the patient
for any type of infection.
Miraculously, the young man survived and went back to his normal life after
a few months spent recuperating. The whole cost to save just this one patient
had amounted to almost £1million . This was the NHS at its best. The
speed and professionalism of all the health professionals, and particularly
the young surgeon, when faced with an extremely stressful and horrific accident,
Victimisation of damage patients must
cease - iatrogenic patients are entitled to the truth and should have access
to clinical care - to blacklist patients and to deny them care must
surely a be a criminal offence.?
Return to Our
Return to Our Comments
The smallest cog in
the wheel?..............the GP
It is arguable that the smallest cog
in the patient's personal health care plan is the General Practitioner. Like
all 'small cogs' in any system, these cogs may be small, but are absolutely
vital to the workings of the whole system. Failure on the part of a 'small
cog' can cause a
complete seizure of the the whole system. Failure of a GP to function
adequately can have a dire effect on the health care consequences of any patient
as many of our members have discovered ( see 'Your Comments: "
Nothing has changed....nothing has changed....)
The GP is the first point of call for most medical
care, and if he/she gets it wrong by mis-diagnosis or wrong prescription
etc., and if these errors cause very serious damage, then the patient is
in real trouble. The patient usually tries to see another GP at the practice
or will try to move to other practices. However, the GP who has made the
serious error can usually rely on all his colleague GPs not to let him/her
down, and they will 'sing to the same tune' or they will simply refuse to
see or take on their list an iatrogenic patient. Patients have reported that
they have been told that they can only see their normal GP. Others
have reported that although they manage to change to another GP practice,
after about 70 days they are then struck off and have to try another practice.
They become the 'wandering patient' who can find no one to look after them.
Other patients have recorded that GPs to whom they have moved become
so distressed because they are unable to obtain genuine specialist care for
them, that they literally beg the patient to go else where, some GPs are in
tears and explain how powerless they are.
GPs who inadvertently cause a serious Adverse Medical Incident,
can rely, not only on their fellow GPs to 'cover-up' for them,
but they can usually rely on consultants to do the same. Once consultants
have become involved with a 'cover-up' then the patient is in even more trouble
and at great risk. It will not matter how many consultants to whom the
damaged patient is referred, they will not got the truth, nor will they receive
genuine medical care and further more they are probably very likely to get
'crap' letters written to go in their Medical File that will further frustrate
them in obtaining the medical care to which they have a right.
If the consultants refuse to 'play ball' - there is
absolutely nothing that the GP can do! This is why it is futile
and even irresponsible for civil servants at the D.o.H. to tell a patient
that their health care is the responsibility of the GP, when a a victim of
a medical error reports that they are unable to obtain specialist care
What should GPs do who discover that a fellow GP as caused serious damage
to a patient - or consultants are refusing to give genuine speicalsit care,
they should, of course, report the matter to their professional regulatory
body, the GMC.
What Does the GMC 'Good Medical Practice
22.If a patient under your care has suffered harm, through misdaventure
or for any other reason, you should act immediately to put matters right,
if that is possible. You must explain fully and promptly to the patient
what has happened and the likey long-and short- term effects. [ How often does thsi happen? Unfortunately by this time
the patient has become a potential litigant which is why SIN has been advocating
a Victim's Compensation Fund - see publication: " Balancing the Scales"]
Conduct or performance of colleagues:
26You must protect patients from risk of harm posed
by another doctor's or other health care professional's conduct, performance
or health, including problems arising from alcohol or others substance
abuse. The safety of patients must come first at all times.
27. If you have grounds to believe that a doctor or
other healthcare professional may be putting patients at risk, you must give
an honest exlanation of your concerns to an appropriate person from the employing
authority [Do you think they will be pleased
to hear it? They will simply see legal liablility and money for compensation
- they will not wish the truth to be given to the patient - and that means
genuine medical care]. If ......you remain concerned about
the safety of patients, you should inform the relvant regulatory body ( GMC
Has anyone heard of a GP reporting a consultant to the GMC? We all know
what is likely to happen to such a GP, don't we? He would most likely be
ostracised by his other colleagues for 'breaking ranks' - after all
who would then be safe if such behaviour became common place?- and in particular
he could well be ostracised by other consultants. This could result in
him having difficulty in obtaining genuine specialist care for his other
patients. Remember it is estiomated that 34,000 patients die needlessly and
45,000 are seriously and permanently damaged every year in our NHS. Remember
that 55% of medical errors are misdiagnoses! How many patients get to hear
the truth? How many errors are covered up? Mr Alan Milburn, former Sec. State
for Health admitted ".....mistakes are hidden and cover-ups can
occur" ( D.o.H website 10th July 2001)
On the other hand, if the GP maintained his/her professional allegiance,
it is more likely that his /her career will prosper. He/she would be given
access to prestigious committees, and perhaps obtain promotion or gain work
on lucrative hospital clinics. Certainly if he/she broke ranks and spoke out
on behalf of the iatrogenic patient, he /she would not receive any accolades
from his/her colleagues.
The setting up of the Primary Care Trusts, where several GP Practices amalgamate
together under the Trust, will surely make it more difficult for a damaged
patient to move to an impartial GP and so get the truth about their condition?
This is why SIN advocates that
it should be a statutory offence not to report an Adverse Medical Incident
(AMI) if a health professional has caused it, or has witnessed it, or anyone
who has become aware that such an incident has occurred. The aim is to find
out the cause of the AMI, to help the health professional involved and most
important of all to ensure the the damaged patient receives the specialist
care to which they have a right. Who has an ethical argument against this?
Would anyone condone a person who caused a car accident that seriously
damaged or killed a passenger or pedestrian, and any witness of this
event - to say nothing - to turn a blind eye? read SIN's recent publication:
" The case for the Removal of Anonymity in the Recording of Adverse Medical
Incidents ( AMIs in the Interest of Patient Safety"