Monthly Archives: July 2017

Doctors warn Government plans for ‘brutal’ NHS cuts will cause ‘uproar’ ‘It is totally unacceptable that proposals of this scale are shrouded in such secrecy’

The implosion and downgrading of all health service standards and potential for the future continues.

Nina Massey in the Independent reports 27th July:  Doctors warn Government plans for ‘brutal’

NHS cuts will cause ‘uproar’

‘It is totally unacceptable that proposals of this scale are shrouded in such secrecy’

The British Medical Association (BMA) says health service leaders have refused to publish details of the proposals that could extend waiting times, reduce access to services, cut down on prescriptions and treatments, and even merge or close hospitals and facilities.
The proposals are being discussed under the capped expenditure process, which was introduced this year to cap NHS spending in some areas in order to meet so-called “control total” budgets in 2017-18…..

As an NHS doctor, I see lives put at risk every day

A new joke is doing the rounds in my hospital. How many doctors does it take to change a lightbulb? The answer is 11. One to do the actual changing, the other 10 invented by Department of Health spin doctors in response to the latest headlines about NHS understaffing.

This week, those headlines could not have been more stark. Data from NHS Digital revealed that there are more than 86,000 vacant posts in NHS England – a rise of 15.8% on last year, and the highest number on record. But not one of the doctors and nurses I work with was remotely surprised by the news. One day’s fleeting headlines are our everyday lived and breathed reality…..

Pulse reports: RCGP: GPs are feeling ‘let down’ by NHS support package 

Two new GPs needed for every retiree, warns report

% of GP training places unfilled after two recruitment rounds


Doctors attack plan to close children’s heart unit at the Royal Brompton hospital. Can 216 specialists be wrong?

Chris Smyth reports in the Times 28th July 2017: Doctors attack plan to close children’s heart unit at the Royal Brompton hospital

Image result for heart surgery cartoon

Doctors from around the world have condemned plans to close the biggest NHS children’s (The Brompton) heart surgery unit, in a battle that highlights how the NHS struggles to make life-saving reforms.

Thousands of children would suffer if the Royal Brompton’s congenital heart disease unit was closed and care for adults would also be put at risk, according to 216 specialists in cardiology and paediatrics.

NHS England said last year that the unit was one of three hospitals that must no longer operate on children or adults with inherited heart problems in an attempt to improve standards by centralising care.

The move dates back to the Bristol heart scandal in the 1990s and the principle of restricting complex care to a smaller number of specialist centres is widely supported. However, disputes about the evidence and which units should close have derailed such plans.

In a letter to The Times, doctors say that the Brompton’s results are excellent and “it is difficult to identify where any patient benefit would accrue” by closing the unit.

NHS England said: “We all want to ensure that patient care is as good as it can possibly be.”

Letters to the Times 28th July 2017:


Sir, As medical professionals working in cardiovascular, respiratory and paediatric care, we urge the health secretary to block plans to decommission congenital heart disease (CHD) services at Royal Brompton Hospital. This plan would affect more than 14,000 patients and 400 staff and would cost tens of millions of pounds, yet it is difficult to identify where any patient benefit would accrue. Official data show that Royal Brompton’s CHD service is the largest in the UK, with excellent patient outcomes. The Royal Brompton & Harefield NHS Foundation Trust’s adult CHD research team is independently rated as the most influential in the world.

NHS England’s plan will result in the closure of Royal Brompton’s paediatric intensive care unit (PICU), losing a sixth of London’s PICU beds at a time when there is already a widely publicised shortage in London and the south. The lack of a PICU would in turn occasion the loss of other heart and lung services treating thousands of patients, including the country’s largest paediatric cystic fibrosis and difficult asthma services.

Dr David Ross, Consultant Paediatric Cardiac Surgeon, University of Alberta Hospital; Dr Gary Webb, Consultant Cardiologist, Cincinnati Children’s Hospital; Professor Ju Le Tan, Senior Cardiology Consultant, National Heart Centre Singapore; Professor Paul Khairy, Director, Adult Congenital Heart Centre, Montreal Heart Institute; Professor Tal Geva, Professor of Paediatrics, Boston Children’s Hospital / Harvard Medical School; Dr Lisa Hornberger, Professor of Paediatrics and Consultant Cardiologist, University of Alberta / Stollery Children’s Hospital; Professor Barbara Mulder, Cardiologist, Academic Medical Centre Amsterdam; Dr Susan Etheridge, Professor of Paediatrics, University of Utah; Professor Jolien Roos-Hesselink, Consultant Cardiologist, Erasmus Medical Center Rotterdam; Professor Dipen Shah, Director, Cardiac EP, University Hospitals Geneva; Professor Wayne Tworetzky, Consultant Attending, Boston Children’s Hospital; Dr Puja Banka, Consultant Cardiologist, Boston Children’s Hospital; Dr Anne Marie Valente, Cardiologist, Boston Children’s Hospital; Dr Andrew Powell, Chief, Cardiac Imaging Division, Boston Children’s Hospital; Dr Alexander Opotowsky, Assistant Professor, Boston Children’s Hospital / Brigham and Women’s Hospital / Harvard Medical School; Professor Douglas L. Packer, Director Translational Electrophysiology / Clinical Consultant Electrophysiology, Mayo Clinic / Mayo Foundation; Professor Luc Mertens, Consultant Cardiologist, The Hospital for Sick Children, Toronto; Professor Edgar Jaeggi, Director, Fetal Cardiac Program, The Hospital for Sick Children, Toronto; Dr Elizabeth Stephenson, Consultant Cardiologist, The Hospital for Sick Children, Toronto; Professor Vivek Reddy, Director of Electrophysiology, Mount Sinai Hospital, New York; Professor Mats Mellander, Consultant Paediatric Cardiologist, Queen Silvia Children’s Hospital, Sweden; Dr Vasu Venkanna Burli, Clinical Fellow Children’s Acute Transport Service, Great Ormond Street Hospital; Dr Evangelia Papathanasiou, Clinical Fellow in Paediatric Cardiology, Great Ormond Street Hospital; Professor Peter Schwartz, Director, Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano; Dr Riyan Sukumar Shetty, Consultant Paediatric ITU and Head of ECLS, Narayana Institute of Cardiac Sciences, India; Dr Aranzazu Gonzalez Posada, PICU Consultant, 12 de Octubre Hospital, Madrid; Mr Michael Heuer, Managing Director Europe, Acutus Medical, Belgium; Dr Kelly Straka, PICU Fellow, Aghia Sophia Children’s Hospital, Greece; Professor George Giannakoulas, Consultant Cardiologist, AHEPA University Hospital, Greece; Dr Fulvio Gabbarini, Consultant Cardiologist & Chief of Grown Up Congenital Heart Center, AOU Città della Salute e della Scienza di Torino, Turin University; Dr Sumanaru Dorin, Paediatrics, AP-HP Paris; Dr Prabhat Maheshwari, Head of Paediatric Intensive Care, Artemis Hospital, Gurgaon, India; Professor Karl-Heinz Kuck, Head of Cardiology Dept., Asklepios Klinik St. Georg, Germany; Dr Michael Schlüter, Scientist, Asklepios Proreseach, Germany; Dr Hani Mahmoud, Associate Consultant Cardiologist, Aswan Heart Centre, Egypt; Dr Massimo Stefano Silvetti, Cardiologist, Bambino Gesù Children’s Hospital, Rome; Dr Fabrizio Drago, Paediatric Cardiologist & Chief of Paediatric Cardiology, Bambino Gesù Children’s Hospital, Rome; Dr Ramaratnam Ramanan, Consultant Paediatrician, Basildon Hospital; Dr Tosin Otunla, Consultant Paediatrician, Ashford & St Peter’s Hospital; Dr Anita Mittal, Consultant Paediatrician, Bedford Hospital; Mr Nimrod Hershco, Field Clinical Specialist, Belinson, Israel; Professor Cristiane Martins, Consultant Cardiologist, Biocos Hospital, Brazil; Mr Bjarne Larsen, Clinical Development Manager, Biosense Webster, Denmark; Dr Farhana Khalil, Consultant Paediatrician, Bradford Teaching Hospitals; Dr Martin Hosking, Consultant Cardiologist, British Columbia Children’s Hospital; Dr Raghavan Nair Mahesh Babu, Consultant Paediatrician, Broomfield Hospital; Mr Lars Retzlaff, Senior Field Clinical Specialist, Bsc, Germany; Professor Jia L, Professor, Capital Institute of Paediatrics, China; Dr Jelena Radojevic Liegeois, Paediatric and Adult Congenital Cardiologist, Strasbourg; Dr Junaid Zaman, Electrophysiologist, Cedars Sinai Medical Center, US; Dr Joachim Hebe, Co-Chair, Center for Electrophysiology Bremen, Germany; Professor Christos Ouzounis, formerly Professor & Chair, King’s College London, CERTH, Greece; Professor Stefan Willich, Director, Charite University Medical Center, Germany; Dr Sam Kaddoura, Consultant Cardiologist, Chelsea and Westminster Hospital; Dr Bikash Bhojnagarwala, Consultant Neonatolgist, Chelsea and Westminster Hospital; Dr Jonathan Penny, Consultant Paediatrician, Chelsea and Westminster Hospital; Dr Martin Stocker, Consultant PICU/NICU, Children’s Hospital Lucerne, Switzerland; Dr Jose Pedro Da Silva, Peadiatric Cardiothoracic Surgeon (Attending), Children’s Hospital of Pittsburgh of UPMC; Professor Gil Wernovsky, Senior Consultant in Paediatric Cardiology and Cardiac Critical Care, Children’s National Health System, US; Dr Marie Bosman, Consultant Anaesthetist, Christian Barnard Mem Hospital, South Africa; Dr Marko Gujic, Consultant Electrophysiologist, CHU Charleroi, Belgium; Professor Julian Villacastin, Director Cardiovascular Institute, Clínico San Carlos. Madrid, Spain; Dr Radu Vatasescu, Consultant Cardiologist, Head EP Lab, Clinic Emergency Hospital Bucharest; Dr Miguel Ventura, Cardiologist Electrophysiologist, Coimbra University Hospital, Portugal; Dr Theo Fenton, Consultant Paediatrician, Croydon University Hospital; Dr Dinakaran Rengan, Consultant Paediatrician, Croydon University Hospital; Dr Nazma Chowdhury, Consultant Paediatrician , Croydon University Hospital; Professor Hans-Heiner Kramer, Director, Department of Congenital Heart Disease and Paediatric Cardiology, Kiel; Professor Annalisa Angelini, Associate Professor of Cardiovascular Pathology, University of Padua, Italy; Professor Ingo Daehnert, Head of Paediatric Cardiology, Heart Center, University of Leipzig; Professor Gaetano Thiene, Professor of Cardiovascular Pathology, Università degli Studi di Padova, Italy; Dr Alexandra Galloway, Consultant Paediatrician, East and North Hertfordshire NHS Trust; Miss Elia Heraclio Doya, Internist and Cardiologist, Ernst von Bergmann Klinikum, Germany; Dr Judit Llevadias, Paediatric Cardiac Intensive Care Consultant, Freeman Hospital, Newcastle; Professor Jochen Weil, Consultant Paediatric Cardiologist, German Heart Center Munich; Professor Isabel Deisenhofer, Head of Department, German Heart Center Munich; Professor Gabriele Hessling, Consultant Paediatric Cardiologist, German Heart Center Munich; Dr Oktay Tutarel, Consultant Cardiologist, German Heart Centre Munich; Mrs Jenni Syrjaenen, Clinic Manager, German Heart Centre, United Arab Emirates; Professor Christof Stamm, Consultant Surgeon, German Heart Institute Berlin / Charite Universitaetsmedizin; Mrs Miriam García San Prudencio, Consultant Paediatrician, Gregorio Marañón Hospital, Spain; Professor Yves Ville, Professor of Obstetrics and Fetal Medicine, Hôpital Necker Enfants Malades, France; Professor Simcha Yagel, Consultant Obstetrician/Gynecologist, Hadassah-Hebrew University Medical Center, Israel; Dr Roman Gebauer, Consultant Paediatric Cardiologist, Heart Centre, University of Leipzig; Dr Fernando Moraes, Consultant Cardiac Surgeon, Heart Institute of Pernambuco, Brazil; Dr Britta Weidtmann, Consultant Cardiologist, Helios Berlin; Dr Michele Cruwys, Consultant Paediatrician, Hillingdon Hospital; Professor Mélèze Hocini, Consultant Cardiologist, Hopital Haut Leveque, France; Dr Elena Montañes, Consultant Cardiologist, Hospital 12 Octubre, Madrid; Ms Rosa Maria Calderon Checa, Consultant PICU, Hospital 12 Octubre, Madrid; Professor Cleonice de Carvalho Mota, Consultant Paediatric Cardiologist, Hospital das Clínicas/ Federal University of Minas Gerais, Brazil; Dr Patrícia Barrios, Consultant Paediatric Cardiologist, Hospital de Clínicas de Porto Alegre (UFRGS), Brazil; Dr María del Carmen Gutiérrez, Paediatric Pathologist, Hospital Pereira Rossell / University of Uruguay; Dr Joaquim Bartrons Casas, Consultant Fetal and Paediatric Cardiologist, Hospital Sant Joan de Deu, Spain; Professor Jose Luis Merino, Chief Robotic EP Laboratory, Hospital Universitario La Paz, Spain; Mrs Ana María Marcos Oltra , PICU Consultant, Hospital Virgen de la Arrixaca, Murcia, Spain; Professor Josef Kautzner, Head of Department, IKEM, Czech Republic; Dr David Inwald, Consultant Paediatrician with Expertise in Cardiology, Imperial College Healthcare NHS Trust; Dr Jayanta Banerjee, Consultant Neonatologist, Hon Consultant, Paediatric Cardiology, Hon Senior Clinical Lecturer, Imperial College Healthcare NHS Trust / Imperial College London; Dr Aubrey Cunnington, Clinical Senior Lecturer in Paediatric Infectious Diseases, Imperial College London; Dr William Aaron Kay, Medical Director, Adult Congenital Cardiology Program, Indiana University; Miss Renate Oberhoffer, Director, Institute of Preventive Paediatrics, Technical University Munich; Professor Carina Blomström Lundqvist, Consultant Cardiologist, Institution of Medical Science, Sweden; Dr Raul I. Rossi Filho, Consultant Pediátrica Cardiologist, Instituto de Cardiologia, Brazil; Dr Estela Suzana Horowitz, Consultant Cardiologist, Instituto de Cardiologia, Brazil; Professor Vera Aiello, Cardiovascular Pathologist, Instituto do Coracao (InCor), Faculdade de Medicina da Universidade de Sao Paulo; Professor Peter Schwartz, Director, Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Italy; Dr Koby Sheffy, Chief Scientist, Itamar Medical, Israel; Professor Cecilia Linde, Consultant Cardiologist, Karolinska University Hospital, Sweden; Dr Haitham Sakr, Consultant Cardiologist, King Saud Medical City, Saudi Arabia; Dr Spyridon Zidros, Echocardiography Fellow, King’s College Hospital; Dr Philip Knight, PICU fellow, King’s College Hospital; Dr Laura Vitali Serdoz, Head of the Arrhythmia and Electrophysiology, Klinikum Fuerth, Germany; Professor Alpay Celiker, Consultant Cardiologist, Koc University Hospital, Turkey; Dr Akiko Ueda, Cardiologist, Kyorin University Hospital, Japan; Dr Hamish Walker, Consultant Cardiologist, Leeds General Infirmary; Professor Katja Zeppenfeld, Prof. Cardiology, Leiden University Medical Centre, Netherlands; Dr Lyn Ventilacion, Consultant Paediatrician, Lister Hospital; Dr Jan Reiser, Consultant Paediatrician, Lister Hospital; Dr Prathiba Chandershekar, Consultant Neonatal Paediatrician, Lister Hospital; Dr Kanimozhi Tamilselvan, Consultant Paediatrician, Lister Hospital; Dr Anshoo Dhelaria, Paediatric Consultant, Lister Hospital; Dr Sharmishtha Sarkar, Consultant Community Paediatrician, Lister Hospital; Dr Amanda Williams, Consultant Paediatrician, London North West Healthcare NHS Trust; Dr Khadija Ben-Sasi, Consultant Neonatologist, London North West Healthcare NHS Trust; Dr Wolfgang Muller, Consultant Paediatrician, London North West Healthcare NHS Trust; Dr Gerald Hanson, Consultant Paediatrician with cardiology expertise, London North West Healthcare NHS Trust; Dr Nilanjana Ray, Consultant Paediatrician, London North west Hospitals NHS Trust; Dr Krishnan Balasubramanian, Consultant Paediatrician, Maidstone and Tunbridge Wells NHS Trust; Dr Burkhard Hügl, Chief of Cardiology Department, Marienhaus Neuwied, Germany; Dr Job Cyriac, Paediatric Consultant with Cardiology Interest, Mid Essex Hospitals NHS Trust; Dr Michele D’Alto, Consultant Cardiologist, Monaldi Hospital, Italy; Dr Ali Zaidi, Director of Adult Congenital Heart Disease Program, Montefiore Medical Center, Albert Einstein College of Medicine, US; Dr Peter G. Guerra, Chief of Medicine and Cardiology, Philippa and Marvin Carsley Chair in Cardiology, Montreal Heart Institute; Professor Jan Janousek, Consultant Paediatric Cardiologist, Motol University Hospital, Czech Republic; Dr Mithuna Urs, Consultant Paediatrician, Maidstone and Tunbridge Wells NHS Trust; Dr Shreesha Maiya, Consultant Paediatric Cardiologist and Electrophysiologist, Narayana Health, India; Dr Ganesh Sambandamoorthy, Consultant CICU , Narayana Institute of Cardiac Sciences, India; Professor Marek Malik, Professor of Cardiac Electrophysiology, National Heart and Lung Institute, UK; Dr Alice Maltret, Paediatric Cardiologist, Necker-Enfants Malades, France; Dr Barbara Deal, Consulting Cardiologist, Northwestern Hospital, US; Dr Kerry Day, Consultant Paediatrician, Northwick Park Hospital; Dr Sheana Wijemanne, Paediatric Consultant, Northwick Park Hospital; Dr Richard Nicholl, Consultant Paediatrician, Northwick Park Hospital; Dr Thais Lins Pedersen, Resident Cardiologist, Odense University Hospital; Dr Tom De Potter, Staff Cardiologist, OLV Hospital, Belgium; Professor Seshadri Balaji, Paediatric Cardiology, Oregon Health & Science University; Dr Craig Broberg, Consultant Cardiologist, Associate Professor, Oregon Health and Science University; Miss Silvia Scansani, Cardiac Physiologist Echo, Policlinico Ospedale Maggiore, Italy; Dr Deane Yim, Consultant Paediatric Cardiologist, Princess Margaret Hospital Perth; Dr Catarina Cavalcanti, Paediatric Cardiologist, PROCAPE University Hospital / University of Pernambuco, Brazil; Dr Monther Obeidat, Fellow in Paediatric Cardiology, Queen Alia Heart Institute, Jordan; Professor Stephanie Ware, Professor of Paediatrics and Medical and Molecular Genetics, Riley Hospital for Children at Indiana University; Professor Yves d’Udekem, Consultant Cardiac Surgeon, Royal Children’s Hospital, Australia; Dr Sainath Raman, Paediatric Intensive Care Fellow, Royal Children’s Hospital, Australia; Dr Safeena Afzal, Anaesthetic Registrar, Royal Free Hospital; Dr Ana Martinez Naharro, Clinical Research Fellow, Royal Free Hospital; Dr Mark Spence, Consultant Cardiologist, Royal Victoria Hospital; Dr Mariutzka Zadinello, Consultant Paediatric Cardiologist, Saúde Santa Mônica Medical Center, Brazil; Dr Fredy Prada, Consultant Cardiologist, Sant Joan de Deu Hospital, Spain; Dr Amish Vora, Senior Consultant Paediatric Intensivist, SRCC NH Children’s Hospital, India; Dr Sandeep Shetty, Consultant Neonatologist, St George’s University Hospital NHS Foundation Trust, UK; Dr Donovan Duffy, Consultant Neonatologist, St George’s University Hospital NHS Foundation Trust, UK; Dr Nasreen Aziz, Consultant Neonatologist, St George’s University Hospital NHS Foundation Trust, UK; Dr Cliona Murphy, Consultant Cardiologist and Electrophysiologist, St Luke’s Hospital, University of Missouri Kansas City, UK; Dr Alison Groves, Consultant Paediatrician & Cardiology Lead, St Peter’s Hospital, UK; Dr Anay Kulkarni, Consultant Neonatologist, St George’s University Hospital NHS Foundation Trust, UK; Dr Maxim Didenko, Head of Department, Associate Professor, St. Petersburg Paediatric State University, Russia; Professor Sanjiv Narayan, Professor of Medicine, Stanford University, Palo Alto, California, US; Dr Venkata Krishna Kishore Jayanthi, Consultant Paediatric Intensivist, Star Hospital, India; Professor Evgeny Pokushalov, Head of Arrhythmia Department and Electrophysiology Laboratory, State Research Institute of Circulation Pathology, Russia; Mr Bart Wittevrongel, Director Clinical Adoption EMEA & ROW, Stereotaxis, Belgium; Ms Dustie Butteiger, Research and Clinical Affairs Manager, Stereotaxis Inc., US; Dr Paul Brathwaite, Vice President of Research and Development, Stereotaxis, Inc., US; Mr Nathan Kastelein, Medical Systems Engineer, Stereotaxis, Inc., US; Dr Adil Dingankar, Cardiac Critical Care Research Fellow, Stollery Children’s Hospital, Canada; Dr Claire Scudder, GP, The Chelsea Practice, UK; Professor Jack Rychik, Robert and Dolores Harrington Endowed Chair in Paediatric Cardiology, The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine; Dr Andrew Davis, Paediatric Cardiologist and Electrophysiologist, The Royal Children’s Hospital, Australia; Dr Daniel Tobler, Staff Cardiologist, University Hospital Basel, Switzerland; Dr Ans Wiesfeld, Cardiologist / Electrophysiologist, University Hospital Groningen, Netherlands; Professor Gerhard-Paul Diller, Consultant Cardiologist, University Hospital of Münster, Germany; Dr Maria Grazia Bongiorni, Director of Cardiology Department, University Hospital of Pisa; Dr Matthias Greutmann, Director Congenital Heart Disease Unit, University Hospital Zurich; Dr Fernando Amaral, Consultant Adult Congenital Heart Disease, University Hospital, Ribeirão Preto, Brazil; Dr Mohammad Zoha, Consultant Paediatric Transport, University Hospitals of Leicester; Dr Julia Vujcikova, Consultant Paediatric Intensivist, University Hospitals of Leicester; Professor Isabelle Van Gelder, Cardiologist, University Medical Center Groningen, Netherlands; Professor Ian Adatia, Consultant Paediatric Pulmonary Hypertension Specialist and Paediatric Cardiologist, University of Alberta / Stollery Children’s Hospital / Glenwood Paediatric Cardiology Clinic, Canada; Dr Julia Indik, Professor of Medicine, Division of Cardiology, University of Arizona, Sarver Heart Center, US; Professor Nassir Marrouche, Professor of Medicine, University of Utah; Professor Jeanne Poole, Consultant Cardiologist-Electrophysiologist, University of Washington; Professor Haran Burri, Staff Physician, University Hospital of Geneva; Dr Ferran Rosés-Noguer, Lead of Paediatric Cardiology Department, Vall d’Hebron University Hospital, Spain; Dr Sunil Raga, Consultant Paediatrician; Professor David L Wessel, Executive Vice President and Chief Medical Officer, Washington; Dr Sankara Narayanan, Paediatrician with Cardiology Interest, Watford General Hospital; Dr Emmanuel Quist-Therson, Consultant Paediatrician/Local PEC, West Hertfordshire Hospitals NHS Trust; Dr Eleanor Hulse, Consultant Paediatrician, West Middlesex University Hospital; Trudie Lobban MBE FRCP (Edin), Expert Patient Representative, Arrhythmia Alliance, UK; Dr Anil Garg, Consultant Paediatrician – PECSIG, Western Sussex Hospitals Foundation NHS Trust; Dr Anna Mathew, Consultant Paediatrician, Western Sussex Hospitals NHS Foundation Trust; Dr Jonathan Mervis, Consultant Paediatric and Interventional Cardiologist, Westmead Children’s Hospital, Australia; Dr Rachael Cordina, Cardiologist, Royal Prince Alfred Hospital, Clinical Senior Lecturer, University of Sydney; Dr Coralie Blanche, Hôpitaux Universitaires de Genève; Dr Riikka Rydman, Karolinska Institutet, Sweden; Dr Annette Schophuus Jensen, Department of Cardiology, Rigshospitalet, Copenhagen; Professor Alex Davidson, Cardiologist, Children’s Hospital of Philadelphia; Mrs Maria Cristina Bembom, Consultant Cardiologist, Hospital de Clinicas Gaspar Vianna, Brazil; Professor Maiy El Sayed, Consultant Paediatric and Adult Congenital Cardiologist, Ain Shams University Hospitals, Egypt; Professor Lars Sondergaard, Consultant Cardiologist, Rigshospitalet, Denmark; Professor Paul Volders, Cardiologist / Professor of Genetic Cardiology, Maastricht University Medical Centre; Mr Charles E. Juvin, Cardiovascular Surgeon, Hôpital Universitaire Pitié-Salpêtrière, France; Professor William Yip, Adjunct Professor, National University of Singapore; Dr Trong Phi Le, Klinikum Links der Weser, Germany; Dr Tiffany Ng, Junior Doctor, Chelsea and Westminster Hospital

Peers from across political spectrum unite to support our CHD service

Thousands march to save Royal Brompton services from closure … (March 2017)

and The Guardian: Why is this children’s heart unit facing closure? A day on the NHS …Jessica Elgot

For our last appointment of the day, we meet Robert Craig, the chief operating officer at Royal Brompton. NHS England’s plans to close the unit might be emotionally distressing for staff and patients, but if giving other hospitals more consultants, doing regular complex work in bigger hospitals and closing smaller ones improves outcomes, isn’t that the best way to “future-proof” the NHS?

Craig firmly disagrees with that proposition. Instead, he says he believes there are clear-headed clinical arguments against closure.

Yes it’s an emotional, almost visceral thing for people who work here,” he says. “It was the first adult congenital unit in the country; it’s one of the biggest in the country; our outcomes are among the best and they compare well with the rest of the world. But no, it isn’t just an emotional issue. It’s a logical, clinical question too. Why seek to fragment the biggest centre in the country?”
The Guardian asked Craig to read arguments made earlier on the blog by Prof Huon Gray, the NHS national clinical director for heart disease – and respond directly to his case forclosing the unit.

NHS surgeons … must perform between them at least 500 operations a year, which is about three each every week. That is a minimum.”

.We absolutely agree with that, we do more than the standards require,” says Craig.
“There is an argument being made that small, specialist hospitals are outdated. The argument I always make is that there used to be a hospital specifically for skin diseases, which got taken over by St Thomas’s and became a dermatology ward. And we don’t yet have a cure for psoriasis. I’m not saying that’s cause and effect, but I don’t know if something might have been different if we still had a specialist skin hospital. Because you lose the focus that clinicians can identify. Our services are different to the cardiac wards at Hammersmith or or St George’s hospital.

Their services, as judged by mortality data, are safe … [But] that is a different argument from saying do we think in the future we could do better when children are born with a complex cardiac disease where treatment previously would not have been thought feasible?

Craig says things are already improving. “The number of people now surviving through to adulthood is vastly more than 20 years ago,” he said.

“The challenge now is thinking of this as a predominantly adult service to manage, because of survival rates. And we’re in the perfect position to do that. We see people transition through. There is a risk as a teenager, and frankly getting fed up with treatment plans and hospitals. And at that exact moment, they have to be taken away from the team they’ve known all their lives to a new adult hospital. Lots of US evidence suggests that people get lost to follow-up, and our setup enables that to be much rarer.”

Co-location is Gray and NHS England’s key argument:

If I were a parent sitting beside the bed with a child who needed other specialist input, I would feel much more comfortable knowing that it was two floors down.

“I would say, has he asked the patient or parents?” Craig responds. “Surgeons are timetabled to work at both hospitals, they have to be flexible but that is what doctors do.

“Gastroenterologists are here when we need them, surgeons are here when we need them. They can be here every half an hour, they can be here every day of the week. So it does become a bit emotional yes, because it’s like, ‘why don’t you get this?’ This feels like such a matter of an interpretation of standard, the paranoid among us think there’s something else going on.

“The number of people you need for a 1,000 bed hospital means it can be impersonal. You pick up the phone to talk to the labs here and you know who they are. Would it be better to build a brand new hospital with everything under one roof? Where’s the money to do that? And what’s the benefit? It’s the theoretical risk, which hasn’t happened, that the surgeon might not be there when we want him. What actually happens is one of his colleagues covers. Even in bigger hospitals, there’s no guarantee the paediatric surgeon is immediately available either. We have done this for decades with outcomes which are the envy of the world.”

That’s all from today’s liveblog. A huge thank you goes out to the staff and patients at Royal Brompton hospital, and to you of course for reading.

Now comes the winter of our discontent – and civil unrest may well follow the expansion of covert post code rationing

The signs are ominous. The runes are clear that we live in an unhappy nation. Recent anecdotes from friends report patients from West Wales moving as soon as a diagnosis of cancer is made, or as soon as a critical investigation is not available.

Now comes the winter of our discontent – and civil unrest may well follow as the reality of differing life expectancy, safety net provision, palliative and hospice care, neonatal care, dementia care and treatment, physiotherapy and clot busting treatments after strokes, just to name some examples, comes home.

Lets get rid of a red herring. Drugs are not that important. New drugs incur vast sums and investment in research, and there are the failures to take into account as well. When PharmExec prints: Will UK Industry Show a United Front on Pricing? it is concerned about business and profits rather than patients.

…..”It has become evident that not of those represented by the ABPI necessarily agree with the stance the Board as a collective has taken. The Telegraph has suggested that one of the main differences between those in favour and those against legal action is their homeland. A headline on the ABPI JR on the 15 July 2017 said “Foreign drug giants behind challenge to NHS rationing.” They report that British board members – GSK and AstraZeneca – see legal action as unconstructive and aggressive. 

It’s also not clear that those representing industry though different industry associations agree either including the BioIndustry Association (BIA) and the Ethical Medicines Industry Group (EMIG).

The ABPI represents more than 80 per cent of all branded medicines used by the NHS, yet that is a fall from the over 90 per cent at the time that the 2014 PPRS was finalized……”

When Professor Sir Mike Richards opines on the NHSexecutive site: CQC chief: There’s a lot trusts can do to improve care without extra cash don’t take much notice. This is false news and is designed to keep his reputation with politicians (his employers) and not to lose his knighthood by speaking honestly. The BBC also covered this: NHS ‘does not need more money to improve’

When the health services are understaffed due to rationing of medical, midwifery and nursing places, and we have to import on an “industrial scale” the rhetoric is vacuous and the Emperor has no clothes.

Image result for emperor no clothes cartoon

Rosemary Bennett reports in the Times 27th July: Care homes demand top-up fees from families and this even from the poorest families. The safety net is badly holed….

….The study found that 48,400 elderly people in care homes — about one in four — were being charged “top-up fees”, even though they met the conditions for their costs to be paid entirely by their council…..

James Kirkup rightly speaks out “for” a dementia tax, With growing cross-party support for a progressive way of funding care, those who inherit should foot more of the bill and says “The children of wealthy parents should pay more from their windfall. ”

Read the whole article about progressive taxation: The children of wealthy parents should pay more for their windfall.

Rationing is covertly expanding:

There is, according to the Week and other media sources: “A surge in exceptional funding requests”. Exceptional by the way is defined differently depending on your post code… and if you live in Wales it has to be more exceptional than in England….Gareth Iacobucci reports in the BMJ: Exceptional requests for care surge as rationing deepens (BMJ 2017;358:j3188 ) and “Pressure on NHS finances drives new wave of postcode rationing” (BMJ 2017;358:j3190 )

There is no good news here. Trust Board Executives could by lynched…. Who will volunteer when they know the job is unsustainable, they cannot change the rules or make a difference, and the whole health edifice is based on lies..

Image result for health lies cartoon

Image result for health lies cartoon


Multi-tasking GPs give Google glasses new lease of life

Kat Lay in the Times July 22nd reports: Multi-tasking GPs give Google glasses new lease of life
and since I am always looking for what could be good news, NHSreality has posted.

My mother always demanded her GP to turn the screen away from him/her and look at my Mum when they consulted. Google’s glasses seem to be able to address her concerns, without reducing the efficiency of the GP consultation. I suspect GPs are dubious and the overstretched majority will reject even attempting to work with a camera next to their eyes..

Image result for healthy glasses cartoon

It’s a familiar scenario: you go to see your GP but they spend more time looking at their computer than at you. Now a futuristic solution could mean more than one pair of eyes looking at you in the consulting room.
Doctors complain that they need to start typing while their patient is still talking, because consultations last only ten minutes and the next patient is waiting.
The electronic systems favoured by NHS bodies are inefficient, they say, making it harder to have a real, human interaction with the person seeking their advice. Patients too, complain, feeling they are not being listened to.
Doctors in the United States have started wearing Google Glass, the computer built into spectacle frames with cameras, while examining patients to get round the problem.
The consultation is watched in “real time” by a medical scribe working remotely — often in India or Bangladesh — using a platform developed by Augmedix. They type up the notes for the doctor to later amend or approve.

The glasses can also display information from a patient’s notes.

Google Glass was launched in 2013 as a consumer device but failed to take off and production stopped in 2015.

Google has now quietly reinvented it for business use. Glass Enterprise Edition has longer battery life and is said to be more comfortable. Ian Shakil, the chief executive and co-founder of Augmedix, told Wired magazine that the new use was the polar opposite of Glass’s original launch.

He said: “When you hear the word Glass, you think dehumanisation, social disruption. We’re the opposite — being close to the patient; being able to put your hand on his or her shoulder to comfort them.”

Davin Lundquist, chief medical officer at Dignity Health, uses Augmedix when he sees patients. He said that it had cut the time spent typing up notes from 33 per cent of the day to 10 per cent and that interaction with patients had risen from 35 to 70 per cent.

In an interview with Popular Science Mr Shakil said that 98 per cent of patients consented to the use of Glass, and the device displayed a green light when it was recording and could switch to audio-only mode.

As well as doctors’ consulting rooms, the technology is being used on factory production lines.

NHS doctors and nurses do not yet use the devices. The technology is not completely alien to the UK, however. Queen Mary University of London’s medical school started using Google Glass in 2014. Its surgeons wore the devices as they removed cancerous tissue from the liver and bowel of a 78-year-old man in a teaching session watched live by 13,000 people around the world.

10% increase in vacancies. “Industrial scale” recruitment from overseas is a clear admission of recurrent cross party political failure.

Smitha Mundasad for the BBC reports a 10% increase in vacancies in health services posts. It would be interesting to see where in the 4 health systems there were most vacancies, By definition it also excludes GPs who are self employed, or their staff. Shortages have actually been present since the health service started… hence the numbers of imported staff from countries who need them more than we do. We may have the best system compared to many others, but not the best outcomes! If we cannot tempt doctors into Paediatrics something has seriously gone wrong.. with recruitment, retention, and gender balance. What a pity that the “industrial scale” recruitment of GPs cannot be from our own youngsters, and that the new recruits will once again block our own from a place in Med School. It is a clear admission of recurrent cross party political failure.

More than 86,000 NHS posts vacant, says report

Statistics from NHS Digital, which collates data, shows the number of vacancies climbed by almost 8,000 compared to the same period in 2016.

Nurses and midwives accounted for the highest proportion of shortages, with 11,400 vacant posts in March 2017.

The Department of Health said staffing was a priority and that more money was being invested in frontline staff.

The data includes job adverts published on the NHS Jobs website between February 2015 and March 2017.

‘Nurse shortages’

There are currently an estimated 1m full time jobs across the NHS in England.

The latest figures suggest in March 2017 alone there were 30,613 full-time equivalent vacancies advertised on the NHS Jobs website – the highest total for a month since this type of data was first collected in February 2015.

And nursing and midwifery vacancies have topped the list since these figures have been collated.

The data includes adverts for doctors, dentists, administrative, clerical staff and technical and scientific staff. The figures do not include vacancies for GPs or practice staff.

But as other ways of advertising NHS jobs – including adverts seeking overseas applicants – exist, NHS officials say caution must be used when interpreting the results.

Meanwhile, a Department of Health spokesperson said: “We expect all parts of the NHS to make sure they have the right staff, in the right place, at the right time to provide safe care – which is why there are almost 32,400 more professionally qualified clinical staff including almost 11,800 more doctors, and over 12,500 more nurses on our wards since May 2010.”

‘Low wages’

Janet Davies, general secretary of the Royal College of Nursing, said low pay and “relentless pressure” meant many nursing were leaving the profession.”At the very moment the NHS needs to be recruiting more nursing staff, we learn the number is falling and the NHS finds itself advertising for more jobs we know it cannot fill,” she said.
“A lethal cocktail of factors is resulting in too few nurses and patient care is suffering.
“More people are leaving nursing than joining – deterred by low pay, relentless pressure and new training costs. ….

The outgoing chief inspector of hospitals in England, Prof Sir Mike Richards, told the BBC’s Today Programme that Brexit posed a threat to recruitment which had to be addressed.

And a recent report by the Health Foundation found that the number of EU nurses registering to work in England had dropped since the vote to leave the EU.

Commenting on the report, Dr Mark Holland, of the Society for Acute Medicine, said extra pressure on “overworked frontline staff” to meet targets needed to be eased.
He added: “This data shows it is high time we saw steps taken to stop disincentivizing staff – salaries must be fair, working conditions must be safe and sustainable and clear career pathways must be in place.”

BMJ: UK has best health system in developed world, US analysis concludes

Junior doctor contract is making paediatric rotas more difficult to fill, finds survey

Zosia Kmietowicz

who also wrote in 2007: Record investment in NHS fails to improve productivity, Wanless finds

Scrapped training programme was helping to increase GP numbers, review finds

Abi Rimmer and on 22nd July: GP recruitment drive fails to deliver. Simon Stevens , chief executive of NHS England said that the scheme to recruit overseas GPs needed to expand on an “industrial scale”. (Not on line as I post)
Jane Kirkby in the Independent 17th July: NHS will recruit 2,000 foreign GPs to meet staff targets, says health chief

Targeting staff abroad ‘a clear admission of failure from Government,’ says chairman of the BMA’s GP committee

The Many Failures of Britain’s National Health Service – examples from last 2 days

nhs2.PNG“The National Health Service is the closest thing the English have to a religion,” Margaret Thatcher’s Chancellor Nigel Lawson famously once observed. However, given the swivel-eyed fanaticism with which its supporters will defend it, even from the overwhelming evidence of its shortcomings, at this point it might be more accurate to describe the NHS as Britain’s national cult.

The utterly unparalleled degree of moral outrage which greets any criticism of the NHS bespeaks the decades of propaganda — in the state’s schools, from the state’s politicians, and on the state’s news and media outlets — which have taught the British people to believe that the only alternative to a state-controlled healthcare monopoly is for the poor to die in the streets. So pervasive has this myth become that the Labour party has been able to base its entire electoral strategy, for decades, on painting themselves as the only party that truly cares about ‘our NHS’, and a recent survey found that, when asked ‘What makes you proud to be British’, the NHS was the nation’s most common answer by a considerable margin. All this has led to a situation wherein the desperately needed reforms to Britain’s healthcare system cannot even be discussed, due to the irrational overflowing of blind rage and uncomprehending contempt that greets any criticism of Britain’s ultimate sacred cow.

This baseless self-satisfaction and refusal to consider change is in no way helped by studies such as one which has recently made headlines across the British press, which placed the NHS as “the number one health system”. The study in question ranked the healthcare systems of 11 countries, and found that Britain’s NHS fulfilled the study’s criteria of success most adequately, followed by Australia and the Netherlands, with Canada, France, and the United States languishing at the bottom of its rankings. This positive result might come as a surprise even to those who usually accept the mainstream narrative surrounding the NHS. Indeed, even at the bottom of the BBC’s own triumphalist article on the study in question, they link to related stories with headlines such as “NHS rationing leaves patients in pain”, and “Long waits for surgery have tripled in four years”!

These two headlines hint at the perennial problem of shortages due to price controls which must inevitably exist in a system such as the NHS. For as long as the price of healthcare services is held artificially low (or free) by state intervention, individual consumers will no longer have an incentive to economise and question whether they really need a given service, or whether those scarce resources should go to others in more desperate need. This inevitably leads to a greater number of people clamouring to extract services than the supply can handle, leading to the shortages, long waiting times, and rationing which have characterised the piteous state of NHS services throughout its history. So immutable is the economic law that price controls lead to shortages that, in the words of Ludwig von Mises, “even capital punishment could not make price control work, in the days of Emperor Diocletian and the French Revolution.” The fact that public support for the NHS remains so high, despite these major problems inherent in the nature of the system itself, provides a stark real-life example of the dangers of choosing to ignore the insights of economics.

Unfortunately however, price controls and shortages are far from the only problems which stem from Britain’s state monopoly of healthcare. As Kristian Niemietz of the Institute of Economic Affairs highlighted in an excellent recent article, the characteristics of the NHS which Britons mistakenly believe to be a unique source of pride, are actually present in almost every other healthcare system in the developed world; yet these other systems lack the NHS’s hostility to innovation in medicines and practices. Furthermore, the high number of avoidable infant deaths in some of its trusts led to the NHS being brought under government investigation in April for standards of maternal care which regulators described as “truly shocking”. I eagerly await the fundamental reforms that will surely result from the state regulators’ suggestion of a state investigation into the wrongdoings of the state’s own healthcare system.

How is it possible, then, that the NHS should have ranked so highly in this recent study by the influential Commonwealth Fund health think tank, despite all these major problems? The answer is in the study’s careful selection of the criteria used as metrics of success, in order to give the most weight to the few areas in which the NHS actually does succeed. Indeed, the study stands out considerably from all other healthcare system comparisons by the great weight it places on procedure and general system characteristics, with relatively little weight given to the actual outcomes. One might think that the NHS’s place in the bottom 20% for both cancer survival rates and medically avoidable death rates would be seen as a statistic too important to be swept under the rug by the technicalities of this study’s method. The Commonwealth Fund also gives surprisingly little weight to the NHS’s dismally low efficiency in terms of healthcare bang per buck, a fact which undermines those who claim that simply throwing more taxpayers’ money at the system would solve its problems.

In terms of its health outcomes across most common ailments, Britain’s NHS ranks closer to former communist bloc countries like Slovenia than to its Western European neighbours. Even a country like Spain, whose GDP per capita is fully 25% lower than Britain’s, has healthcare outcomes so much higher than those of the NHS that, if the British system were able to improve even to the point that it was merely equal with Spain, 10,000 fewer Britons would die of medically preventable causes every single year. Even the Commonwealth Fund study in question concedes that, while they ranked the NHS as the number one health system overall, its competence in the small matter of actually keeping its patients alive was the second-worst of any country under consideration.

The boundaries of socially acceptable debate still have a considerable distance to shift in Britain before the desperate need for fundamental NHS reform can be calmly acknowledged and reasonably discussed. Until such time, no amount of minor tweaking or extra funding will be able to address the rot at the heart of the system, from which so many of its avoidable failures stem: namely its status as a taxpayer-funded state monopoly. Until this fundamental aspect of British healthcare can be criticised without incurring excommunication from public life, the NHS will continue to fail the British people, just as Britain’s state monopolies in coal, shipbuilding, automobiles, and other industries failed in the 1970s.

In the words of the great Chicago economist Thomas Sowell, “You will never understand bureaucracies until you understand that, for bureaucrats, procedure is everything and outcomes are nothing.” Indeed, you can never understand the NHS until you understand that, for as long as British healthcare continues to be run as a government bureaucracy rather than a consumer-facing business, the very lives of British people will continue to be just another ‘outcome’ for the state to ignore.

July 24th in the Times: Patients waiting a week to see GP ‘are at genuine risk’

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Currently in 21 clinical commissioning group areas, covering 5.6 million patients, they are waiting at least a week for a GP or practice nurse appointment on more than a quarter of occasions. The RCGP said that this could present a genuine risk to patients if the situation did not improve and that even in the areas with best access about a tenth of patients were still unable to get an appointment within a week.
Professor Helen Stokes-Lampard, RCGP chairwoman, said she was highly concerned about the risk to patient safety. “If these patients can’t secure an appointment with their GP when they need one it’s probable that they will return at some point to another area of the NHS, when their condition may have worsened,” she said.
The RCGP called on the government to ensure that more than 100 pledges made in NHS England’s GP Forward View, published last year, were delivered more rapidly.

NHS schemes to divert patients away from accident and emergency departments are to be put under review after the death of a man during the first days of a pilot scheme.

The £1 million review, ordered by NHS England, will report back next summer, six months after “streaming” begins across the country in an attempt to reduce stress on health services.

One of the measures is to have GPs located within A&Es to treat the least sick patients, but opponents fear patients are being put at risk.

The most recent review comes after David Birtwistle, 44, died of a pulmonary embolism after being sent home by a pilot scheme in Bristol, six days after its launch last November. Instead of being seen by A&E doctors he was seen by the GP service, which sent him home. He returned six days later when his health worsened and was diverted to “streaming”, where staff failed to carry out basic tests.

A coroner wrote to the health service, calling for an urgent review of “serious incidents” and “near misses”. The Daily Telegraph revealed that researchers believe evidence in favour of having GPs in A&Es is weak and it is unclear whether the schemes are safe.

Initial documents from Cardiff University state: “The emergency care system is in crisis and evidence is needed urgently to understand how to manage workload and demand to safely achieve the highest standards of clinical and operational care, and whether the recommended addition of co-located GPs adds value. The evidence base to support service models of general practitioners working within EDs [emergency departments] is weak.”

An NHS England spokesman said: “Guidance to hospitals on making sure patients get the level of clinical care they need has been specifically updated in the light of this, so as to make sure that people who need GP care can get it, and people needing specialist assessment can quickly do so.”

Last week the Royal College of Surgeons (RCS) criticised another cost-saving measure — the “unprecedented” bans on treatment imposed on obese people and those who smoke.

Derek Alderson, the RCS president, told The Sunday Times that the denial of surgery in the face of a £791 million funding crisis was “illogical and prejudicial”. He said: “Hip and knee replacements are two of the most cost-effective interventions known.”

Sarah Kate-Templeton the day before (Sunday): NHS units impose surgery ban on obese and smokers

The NHS has introduced “unprecedented” bans on surgery including an end to the routine funding of hip and knee operations for patients with osteoarthritis.
In one area of England obese patients must wait two years for hip and knee replacements while another area plans to deny surgery for smokers, including heart and brain operations.
The Royal College of Surgeons, which uncovered the restrictions, says they are “illogical and prejudicial”. Professor Derek Alderson, its president, said: “Hip and knee replacements are two of the most cost-effective interventions known. They markedly improve quality of life. Patients can return to work and often have no need to take powerful anti-inflammatory drugs.”
The NHS in East Berkshire now requires patients with osteoarthritis to make a special application through their GP for hip and knee replacements for approval by NHS managers before a referral can be made.
In Coventry and Rugby, obese patients are being required to wait two years before being referred for hip or knee surgery unless their condition is very serious.

Herts Valleys and East and North Hertfordshire clinical commissioning groups are proposing smokers must have stopped the habit for at least eight weeks before being referred for non-urgent surgery.
NHS England said: “There are enormous efficiency differences between surgical units so if the Royal College of Surgeons helped with that, it would free up hundreds of millions of pounds to reinvest in additional operations.”

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Charlie Gard lives on: but will Trusts and Commissioners take on board that they need policies for the way they handle SIPGs?

Update 28th July 2017. NHSreality has to link to this piece of rubbish from Richard Kocur in the Greeneville Sun on 27th July in a country with a worse perinatal mortality than Cuba, and where the “utilitarian principle” for government decisions on health has been abandoned! (The Life Of Charlie Gard: Whose Decision Is It Anyway?) It is countered nicely by David Sokol in the BMJ: Charlie Gard case: an ethicist in the courtroom (BMJ 2017;358) 

Read the whole article: Charlie Gard – An ethicist in the courtroom

Whether he lives a week or a month or a year or two longer, his case will live on. The threatening behaviour of a few may influence the future, just as the Taliban are influencing the future of Afghanistan. Most of us want a quiet life, and that includes making difficult ethical decisions. A dominant minority is a minority group that has overwhelming political, economic, or cultural dominance in a country, despite representing a small fraction of the overall population (a demographic minority).

The way the Gard family has faced up to this is similar to the way we all face the future of our 4 different UK health services. Denial of the need to ration services pragmatically. The case is an allegory for the UK approach to health in general. Dominant minorities need to be dealt with openly and fairly, which is why Trusts and Commissioning Groups need a policy for dealing with all Single Interest Pressure Groups. (SIPGs) and Pressure Groups in general.

Image result for allegory image cartoon

Billy Kember reports in the Times 24th June: Charlie Gard parents suffer backlash over death threats

Charlie Gard’s parents say they have faced a backlash after Great Ormond Street staff were reported to have received death threats and abuse over the treatment of the 11-month-old boy.
The hospital has attracted criticism because of doctors’ plans to remove life support from Charlie, who suffers from a rare genetic condition and has brain damage. His parents have waged a five-month legal battle against the decision and the case is due back in the High Court today.
The police were alerted after the hospital’s staff received thousands of abusive messages. The hospital said that families visiting sick children had been harassed and discomfited.
Mary MacLeod, chairwoman of the hospital, said that doctors and nurses had been “subjected to a shocking and disgraceful tide of hostility and disturbance” by those who opposed its stance that it would be in the baby’s best interests to be allowed to die with dignity.
“Staff have received abuse both in the street and online,” she said. “Thousands of abusive messages have been sent to doctors and nurses whose life’s work is to care for sick children. Many of these messages are menacing, including death threats.”

Ms MacLeod said the hospital recognised that the case had provoked “intense public interest and that emotions run high”, but added that there was no excuse for patients’ families and staff to suffer abuse. Complaints of unacceptable behaviour inside the hospital had also been made, she added.
Connie Yates and Chris Gard said that they had suffered “the most hurtful comments from the public”, but praised doctors at Great Ormond Street. “We do not, and have not ever, condoned any threatening or abusive remarks,” Ms Yates said.
Mr Justice Francis will begin analysing evidence today, with a decision expected tomorrow. Charlie’s parents want their son to be treated by a specialist in the United States. Michio Hirano, a professor of neurology at Columbia University Medical Centre in New York, was given permission to examine Charlie and speak to hospital staff last week. Great Ormond Street doctors believe that the experimental therapy will not help. The couple have lost several challenges and were unable to persuade the European Court of Human Rights to intervene.

Child mortality matters, but there are limited resources.. Charlie Gard.. Is this denial an allegory of our whole attitude to the Health Services?