5,000 Patients Sent Letters Warning They May Have Contracted Disease at Dentist

From the Daily Mail, June 1, 2009:

Thousands of people have been told they could be at risk of infections such as HIV or hepatitis because of a dentist’s poor hygiene measures.

Patients in Bristol and Bournemouth have been sent letters alerting them to the potential risk of blood-borne infections after a dentist was found to have been operating poor infection control measures.

The concerns surround the possibility that dental instruments were not adequately sterilised.

NHS South Gloucestershire, NHS Bristol and NHS Bournemouth and Poole said the risk to patients was very low but they took the precautionary measure to reassure people.

Patients will be given the opportunity to attend a special clinic and have a blood test if they wish.

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NHS: Theory vs. Reality

From the Daily Mail, May 25, 2009:

THE THEORY: Announced to a fanfare of publicity last year, Choose and Book allows you to select the time and place you have specialist treatment rather than having an appointment allotted to you.

THE REALITY: Around 90 per cent of GP surgeries are connected to the service. However, some experts argue that hospital choice is not as important as consultant choice – and that option is offered by only a few hospitals because of the fear of long waiting lists for certain specialists. The computer system is also prone to glitches.

THE THEORY: Since 2000, you have been able go to one of the 93 walk-in centres in England without a prior appointment. Although these tend to be nurse-led, there are usually doctors on hand, too.

THE REALITY: Around three million people use walk-in centres each year. ‘They provide good local care that is easily accessible,’ says Mr Summers.

However, the centres are often not manned by a doctor and so can offer only minimal treatment. As uncovered by a Daily Mail investigation, three doctors resigned from a centre in London’s Canary Wharf in 2006 after fears that nurses were operating without doctors’ supervision and were not always giving appropriate treatment.

THE THEORY: By the end of this year mothers-to-be will be able to choose to give birth either at home with a midwife, at a midwife-run centre or in hospital, the Government has promised.

THE REALITY: Currently, only a third of women are offered the option of a home birth, and with the Royal College of Midwives (RCM) claiming the NHS needs another 5,000 full-time staff to provide safe and good quality care, it seems unlikely pregnant women will get much choice.

THE THEORY: After several well-publicised battles, people who want to fund their own expensive cancer treatments can do so while still being eligible for NHS care.

THE REALITY: It’s still early days, but one concern is that the cost is prohibitive for many patients; Erbitux, for example, costs around £3,700 a month.

‘And even with these new rules people cannot have their drugs administered on an NHS ward — they also have to pay for the tests and scans associated with their treatment,’ says Dr Bill Beeby, chairman of the BMA’s clinical and prescribing sub-committee. ‘So, in effect, they are being denied NHS care.’

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Canadian Researcher Wants Dying Sent Home to Free Up Hospitals

From UPI, May 20, 2009:

As a way to help free up hospital beds, a Canadian researcher suggests people should be encouraged to die at home rather than in a hospital.

University of Alberta researcher Donna Wilson says that there’s been a dramatic change in the location of death of Canadians. Up until 1994, about 80 percent died in a hospital, but that number has dropped to 61 percent.

Wilson says she would like to see the number drop further to 40 percent as baby boomers age because this could reduce wait lists and free up hospital beds for those who need life-saving treatment or surgery.

It’s also a much more dignified death for a family member, Wilson says.

Wilson calculated that in the next 20 years the number of people dying could double and if death rates in hospital stay at 80 percent it means a potential tie-up of every single bed in Canada for three days of the year — because each person takes up a bed for an average of 10 days.

Rampant Medi-Cal Fraud May Amount to 30% of Budget

From the Daily News:

In a bustling black market trade, unscrupulous medical providers are buying Medi-Cal and Medicare patient identity numbers and using them to get reimbursed for millions of dollars in tests and other services that are never provided, authorities say.

Of $34 billion annually spent by the Medi-Cal program for health care for some 7 million poor Californians, state officials estimate that as much as 40 percent or nearly $14 billion is stolen in fraud.

The identity theft scam involves conspirators using stolen patient information purchased for as little as $100. They submit bills for up to $30,000 to cover tests, prescription medicine, wheelchairs and incontinence supplies which are either never delivered or are received and resold on the black market…

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NY Medicaid Rip Off

From the NY Post, August 4, 2008:

New York is wasting tens of millions of dollars annually by paying the medical expenses of thousands of former residents who have long since moved out of state, an explosive new audit has found.

The scathing – and still-secret – audit determined that nearly 30,000 people in New York City alone were improperly on the state’s Medicaid rolls from November 2006 to November 2007, even while they were enrolled in the Medicaid programs of other states.

Auditors from state Comptroller Thomas DiNapoli’s office, using federally developed computerized record checks in 44 states, determined that nearly 13,000 of the former city residents “should have been investigated” for violation of New York’s Medicaid regulations, according to the audit, a copy of which was obtained by The Post.

It’s not clear why the other 17,000 out-of-staters were not identified as targets for a probe.

But the city’s Human Resources Administration, which oversees the Medicaid program, investigated only 207 of the cases, the audit says. The results are not known.

The audit concludes that investigations of out-of-state residents improperly receiving Medicaid, as well as efforts to recover the cost of their medical care, are virtually nonexistent.

The audit found that in one year alone, $30 million was spent on Medicaid services for city residents living out of state – in violation of state regulations.

“There are no efforts to recover inappropriate payments,” it says.

Read the rest.

78% of British Nurses Fear Personal Reprisal for Whistleblowing

From the Guardian, May 10, 2009:

A survey of more than 5,000 nurses found 78% feared personal reprisals or a negative effect on their career if they reported concerns to their employers. It also found that 21% had been discouraged or told not to report concerns about what was going on in their workplace.

The confidence of nurses was shaken last month when the Nursing and Midwifery Council, their regulator, struck Margaret Haywood off the professional register for exposing poor care in a film for the BBC programme Panorama. Her attempt to reveal the substandard care experienced by her patients was interpreted as an intrusion into their privacy.

The RCN will respond today by setting up a dedicated line to allow members to talk in confidence about “serious and immediate worries that patient safety is being put at risk in their workplace”.

The union said it would use the information to help the nurses raise concerns and, if needed, to step in swiftly to investigate problems directly with the employers.

The move came as nurses assembled for the RCN’s annual conference in Harrogate. The general secretary, Peter Carter, said the Healthcare Commission last month exposed a scandal of what it described as “appalling” care for patients admitted in an emergency to Stafford hospital.

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Hard Questions About “Universal Care” in Canada

From the Recrod, August 9, 2007:

The story in The Record this week about a Walkerton-area woman’s desperate attempt to overcome the lung cancer that threatened her cannot help but evoke sympathy and understanding.

Catherine Cooke, 49, is spending $41,000 to go to a private hospital in India. For many Canadians, the thought that a patient in this country feels she must travel to a Third World country for treatment will come as a shock. Canadians expect their government health plans to cover their medical expenses. Cooke is paying this bill by using an inheritance from her mother.

Cooke was surprised at what she has learned about the level of service available to her in Ontario. As her husband, Dave Cooke, explained, she was told she had two months to live, and it took those two months for her just to get a biopsy and appointment with a cancer specialist in Owen Sound.

That specialist did not express much hope but offered to set up an appointment with an oncologist in London, Ont., two weeks later.


These cases raise troubling questions. Why couldn’t the Canadian medical system treat these two patients in a timely manner? Is the world such a global community now that treatment in foreign countries will become routine? How can Canada’s universal health programs adjust to this new world? Can the Canadian medical system be described as “universal” when patients feel the need to go to private hospitals, despite the cost?

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Flying to India for Cancer Treatment

From the Record, September 2007:

A few weeks ago, Walkerton-area beef farmer Dave Cooke was intense, almost angry, and rarely laughed.

His 49-year-old wife, Catherine, was in India getting chemotherapy for advanced lung cancer. She travelled overseas because doctors here said she would not likely survive, and the wait to see specialists was long.

Today, Dave is relaxed and laughs often. Catherine is home after five months in India and clear of cancer symptoms.

The couple figure Catherine’s trip and treatment cost them $60,000 but Dave is almost floating with relief and joy. He beams in Catherine’s presence, moving close to his wife for a fond touch.

“We’re a great team,” Catherine says.

Catherine has praise for another team as well — the doctors and nurses who treated her at the Apollo Hospital in Chennai, India.

“They were some of the most incredible doctors,” she said.

The Cookes learned about Surgical Tourism Canada, the Apollo group hospitals and health care available in India through television and Internet research.

There were no promises of a miracle cure in India. Catherine was told she had a 40 per cent chance of living for a year.

“I thought ‘Am I a dumb blond?’ ” she recalls. “I came halfway around the world for a 40-per-cent chance?” She wondered briefly if she was “a sucker” by signing up for out-of-country treatment.

But doctors in India were willing to try a different formula of chemotherapy than Ontario doctors advocated. They used positron emission tomography imaging to track the cancer and assess treatment — a technology Catherine was told she didn’t qualify for at home.

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To Avoid Year Long Wait, Canadian Patient Flies to India for Hip Resurfacing

From the National Post, October 26, 2007:

Jeff Dolinsky, a dentist in Golden, B.C., travelled to India in the spring — and he didn’t go to sightsee, meditate or contort his body in front of a yoga master. Dolinsky’s goal was more prosaic — hip surgery.

When Mr. Dolinsky went under the knife in a hospital in Chennai (formerly Madras), he felt reasonably confident he had made the right decision.

After all, six other residents from the Rocky Mountain town of Golden also had undergone successful hip surgery in the same hospital with the same physician during the previous three years.

The patients from Golden are among the small but slowly growing number of Canadians flying to foreign countries for treatment — a for-profit phenomenon known as medical tourism.

Frustration over the long list of 875,000 Canadians awaiting for surgery and other procedures is what is driving people to “outsource” their treatment overseas.

Mr. Dolinsky, 48, had spent many months in severe pain from osteoarthritis. He sought treatment and was told that hip resurfacing — a less invasive alternative to hip replacement surgery — was his best option. He also was told he might have to wait a year if he wanted the procedure performed in B.C.

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Patient Wait Times Cost Canada $15 Billion a Year

From CTV, January 15, 2008:

It cost Canada’s economy $14.8 billion in 2007 to have patients waiting longer than needed for medical procedures, estimates a new analysis commissioned for the Canadian Medical Association.

The analysis, conducted by The Centre for Spatial Economics, focused on just four key medical procedures:

  • Total joint replacement surgery,
  • Cataract surgery,
  • Coronary artery bypass graft surgery
  • Magnetic resonance imaging (MRI) scans

It found that having patients wait for these procedures cost federal and provincial government revenues a combined $4.4 billion in 2007.

The analysis focused on the costs of “excess waits” — that is: the cost of waiting for treatment beyond maximum recommended wait times as assessed by the Wait Time Alliance for Timely Access to Health Care.

The study found that “excess waits” rob the economy of workers — both the patients and their caregivers. They also lead to increased costs on the health care system, as patients need extra appointments, tests and medication. And they cost governments through disability pensions and welfare costs, as well as in lost tax revenue.

Read the rest.