Law in Action asks: Legal aid changes: long overdue reform or denial of justice?

Radio 4's Law in Action asks: Legal aid changes: long overdue reform or denial of justice? I listened to this programme today. There isn't an iPlayer version available unfortunately, but the programme will be repeated on Thu 23 Feb at 20.00 on BBC Radio 4. ""The single biggest attack on access to justice since the legal aid system was introduced". That's the view of the Law Society on the government's controversial proposals to reform the civil justice system. But the government argue that the legal aid system has become unaffordable and along with no win no fee has helped create a litigious society. They say the current system is a boon for lawyers, while draining resources from organisations like the NHS and leaving many small businesses in fear of legal action." It is clear that the intended changes to the legal aid system will have a disproportionately harsh effect on medical negligence victims and their families, who are already abysmally and inhumanly treated by the NHS and their scandalously futile Complaints System. I constantly wonder why Kenneth Clarke (Justice Secretary) is so astonishingly hard on medical negligence victims. I remember he was of the same mind when he was Health Secretary over 20 years ago. His bluff, faux-reasonable style cuts no ice with me.

Why does it never occur to anyone in government that the best way - incomparably the best way - to reduce the costs of medical negligence, both the financial costs to the victims and their families and to taxpayer funds, and the terrible cost in pain and suffering to the damaged victims, is to reduce the ever-increasing incidence of clinical negligence? - And the best way - incomparably the best way - to accomplish that is make health professionals ACCOUNTABLE for their negligence.

Evan Davis and The Bottom Line on Radio 4 today

I've just been listening to Evan Davis chairing The Bottom Line on Radio 4. "With protests continuing around the world against the financial sector, three guests from that industry swap candid thoughts about it. Evan puts to them a fundamental question: is their industry creating genuine wealth, or is it essentially parasitic, finding clever ways of distributing other people's wealth to its own workers? Joining Evan in the studio are Ken Olisa, chairman of boutique technology merchant bank Restoration Partners; Ian Gorham, chief executive of financial advisory firm Hargreaves Lansdown; Julian Roberts, chief executive of savings and investment group Old Mutual".

Well, give him his due, Evan Davis really homed in, again and again, on the key outrage of the rôle of the bankers in the worldwide financial woes of recent years - namely their lack of accountability. Try as he might, however, and despite his repeatedly drawing attention to the great suffering endured by so many innocent people who were taken for a ride by being allowed/persuaded/conned to borrow money they could not pay back, he could not obtain much sympathy/understanding for the victims. He pointed out that 'Heads we win, tails you (i.e. the taxpayers) lose' was not right or fair, but it was largely a dialogue with the deaf. He was informed that it was a matter of 'Caveat Emptor!' (Let the buyer beware!') and if people were stupid enough to fall for dodgy deals, they must take the consequences.

The Daily Mail reports that patients are being struck off GPs' lists just for daring to make a complaint

The Daily Mail reports that patients are being struck off GPs' lists just for daring to make a complaint. The article is commenting on a report by Health Service Ombudsman Ann Abraham.

"In one case, an elderly woman and her husband were removed after she wrote to the practice manager to complain that receptionists did not answer the phone while she was trying to book an appointment for their seasonal flu jabs. In a telephone call the practice manager warned them he would ‘get you struck off for this’. Shortly afterwards they were removed from the surgery’s list."

So making a complaint is punishable by being removed from the doctor's list... I invite you to compare this mean-spirited injustice with the way that complaints are dealt with in the commercial world. If you were to complain to Sainsburys or Tesco or M & S, I think you could be pretty sure that the complaint would be investigated and that you would receive a prompt, polite response with a detailed explanation for what had gone wrong, together with thanks for drawing the matter to their attention, apology for your inconvenience and very probably a voucher as recompense. And you could be absolutely sure that you would not be threatened with being banned from their stores! Decent businesses use complaints to improve their service to the public. Not so the NHS.

GPs are, as near as dammit, unaccountable to the public who pay their bloated salaries. (UK doctors are the highest-paid in Europe.) Even extremely grave errors routinely incur neither censure nor penalty. - Read Can you trust your doctor? The non-accountability of doctors encourages arrogance and increasing careless professional negligence. - Here is my own dreadful experience of the NHS Complaints Procedures. Why do so many doctors give such poor service? - Because they can.

Our present government claims that it is seeking to provide greater patient choice. What nonsense! Patient choice in the UK is, as ever, Like it or Lump it!

Update, Wed 19th October 2011: also see today's Daily Mail follow-up article on this subject.

Disgracefully poor care for elderly patients in some UK hospitals

Today's is but the latest of the litany of shameful reports of Britain's substandard treatment of elderly, vulnerable people in NHS hospitals. In the Telegraph we read: "Unacceptable care has become standard in some trusts, with doctors and nurses talking down to patients, ignoring their calls for assistance and failing to help them eat, drink or wash. After carrying out spot checks at geriatric wards in 100 hospitals, the commission found that 35 needed to make improvements, 18 were failing to meet legal standards and there were “major concerns” at two trusts."

This has rightly been the top news item today, both in print and on the broadcast media. There are always apologists with their ever-ready excuses of insufficient cash/time/nurses/resources, of course, but this will cut no ice with people who have experienced the routine 'uncare' for themselves, or have visited neglected elderly patients on these wards of shame. "Katherine Murphy, the chief executive of the Patients Association, said: “Yet another report to add to the plethora of other reports, all highlighting the same issues around poor care of elderly patients in hospital. "How many reports do we have to look at and how many times do the public need to hear about this before the right action is taken?”"

Why does nothing improve? - I'll tell you why: because no-one is held accountable. - Remember, despite presiding over the avoidable suffering and deaths of around 400 patients at that infamous, inhuman Stafford hospital between January 2005 and March 2009, Martin Yeates, claiming to be 'ill', was allowed to cry off even attending at the public inquiry into the scandal! Furthermore he received a golden handshake - £400,000 (that's a thousand pounds for each death!) - and has a jewel-encrusted pension to look forward to, as well as being able to apply for other obscenely-highly paid similar jobs in another area! Instead of being tried in a criminal court for the manslaughter of hundreds of his fellow-citizens, this scoundrel has been richly rewarded for his dereliction of duty.

When grave wrongdoing incurs no sanction, there will be no reform. We have read today of hospitals that are 'failing to meet legal standards'. - Very well, let's see the people responsible for this tried in court and sentenced appropriately. That would very soon result in better care for vulnerable patients.

"The Plot Against the NHS" This review has the ring of truth

Dr Richard Horton is editor in chief of the Lancet, and in this Guardian article is reviewing The Plot Against the NHS by Colin Leys and Stewart Player. I recognise the chicanery and deceptions that have been practised by politicians of all hues for many years in all aspects of the NHS. While I am certainly not a fan of the NHS, the deficiencies of which I have frequently drawn attention to and deplored, I see no redeeming features in the privatisation of parts of it. What is overwhelmingly needed is proper accountability by the medical profession, the nursing profession and other healthcare professionals, and by the bureaucracies and management that administer both public and private healthcare. - By which I mean accountability to patients, who both as taxpayers and as private patients, pay the salaries of the Healthcare Industry, but are grossly ill-served both by the futile Complaints Procedures and by the partisan legal system, when they are harmed by professional negligence, ignorance or incompetence.