INSPECT NURSING HOMES AS GROUPS

 

In October, 2014, the American departments of Justice and Health and Human Services, and state investigators, found a nursing home chain to be guilty of ‘egregious care’, that is, care that was substandard, and which seriously harmed residents. The company agreed to a $38 million settlement. It had no real choice, as it had fallen foul of an area of law called elder-justice. In some cases, misappropriation of state funds (not providing the service that the government is paying for), is treated as a federal crime, and can result in a prison sentence.

Assistant Attorney General Joyce Branda blamed Extendicare’s business model – a model that was driven more by profit and less by the quality of the care it provided: “Extendicare employed fewer skilled nurses than were needed to care for the very sick residents in those facilities and failed to properly train and supervise the staff it did have”.

Extendicare operates 146 skilled-nursing facilities across 11 states.

The investigation found:

Low staffing levels.

Improper catheter care.

Falls, fractures and head injuries unnoticed by staff.

Malnutrition, dehydration, pressure ulcers and infections.

Medicine improperly administered.

 

“Through this settlement, not only will the states and federal government be reimbursed for the millions that we believe was paid for inadequate care, but we will also make sure that residents living in every Extendicare skilled nursing facility across the country receive the quality care that they depend on and deserve,” Attorney General Mike DeWine commented.

Thank God nothing like this can happen in the UK. Proof of this is given in the mission statements of all our major (private equity owned, we take a 30% slice of the fee income), care companies. One has only to consider a statement by Four Seasons: “I would happily put my mother into my home”. That comment from one of our managers captures what quality is all about. It comes from having well trained, dedicated staff who really bring care into our homes’. We are so reassured.

So, all is well. There is not a need to inspect nursing home chains as groups, and to fine them £30 million if they are guilty of the fraudulent misuse of state funds.

Of course not, as many of the government’s business friends will wholeheartedly agree.

lenin nightingale 2014

FAKE NURSING CERTIFICATE – BUT A 24 CARAT HEART

 

My fall from grace in nursing was a slow process, as it often is for those of us who didn’t call a spade a shovel. You might first be sent to the equivalent of nursing Siberia – the staff room where everyone speaks to everyone, but not to you. This usually accompanies a stint on bed-pan alley, and subtle innuendos that your name has a thick line ruled through it. Oh my dear hearts of today, you may as well swallow the whistle and choke on it, rather than blow it!

My fall from the 36D bosom of nursing led to me being a gypsy of sorts, as nursing agencies peddled my services to a variety of private shit-holes … Oops! … that should be ‘private nursing homes and hospitals’, which ‘offer unparalleled care to our dearly beloved residents’. It was whilst I was doing a drug round at one of these (very) unparallel shit-holes that I first met Mary – a nurse doing her NMC pre-registration course for overseas nurses, as it was then. Mary wasn’t her real name, just as they are not when speaking to someone in an Indian call centre. She asked me, “Can I do one?”, dispense a medication, that is. The prescribed dose was 100mg, and the liquid strength was 50mg in 5ml – the simplest of calculations for any nurse. As I watched Mary slowly pour 10mls into a medicine pot – hovering over the 5ml mark! – I began to have certain doubts! “Is this right?”, she asked, handing me the pot. “Very nearly”, I replied, somewhat kindly, “but perhaps we can just take 2ml out”. Whatever her slight ‘failings’, she had a gentle heart of 24 carat gold, and that made me worried for her, and is why I remember her. More of Mary, soon.

As I came to the end of my nursing travels, and having had my nursing procedures hovered over by (“Can I watch?, you do it differently here”) ‘nurses’, the subject of fake certificates became of interest. Here are the results of my most recent research into this topic:

The idea that any average Joe or Joanne can buy a fake nursing degree and practise in the UK is likely to be false. Joe or Joanne would need some nursing experience before buying the degree and accompanying certificates that would allow them to practise as a registered nurse. The seven nurses recently arrested in California had nursing experience. A report in allnurses.com (June 6, 2014), sated: ‘Seven people have plead guilty to charges of forgery for using fake transcripts to become licensed as Registered Nurses. All were arrested as a result of a multi-agency probe initiated by the Board of Registered Nursing (BRN) that involved the Division of Investigation (DOI), the U.S. Immigration and Customs Enforcement (ICE), Homeland Security Investigations (HSI) and the Internal Revenue Service (IRS) … BRN licensing staff were instrumental in assisting with identifying the individuals involved and verifying they did not attend the nursing schools listed on applications for licensure. “Protecting patient safety is the Board’s top priority,” said Louise Bailey, Executive Officer of the Board of Registered Nursing. “A nurse without the proper education could be dangerous to a patient”. (In my experience, nurses with so-called ‘proper education’, and a lack of being able to convert it to good practice, have been a danger to patients).

They may have had a nursing degree and falsified their transcripts to show that they’d had all the requisite theory/clinical experiences. They may have partly gone through Nursing school. They may have been care assistants with a lot of clinical/theoretical knowledge, and I have known many of them. The end result is that they somehow managed to convince the nursing authorities that they met all the requirements for initial registration, and passed the required (NCLEX) exam. Although this is a difficult exam, enough study material exists that would allow someone to pass it. All seven people were sentenced on June 27, 2014. There are investigations into another 100 plus cases.

 

A question is: if people are willing to run the gauntlet of a very tough American regime, involving HSI, with severe penalties for offenders, how much more likely is it that they will come to the UK?, with its chocolate fireguard of a nurse regulatory organisation that performs No Meaningful Checks (NMC).

 

We are not talking about fake online degrees and transcripts from bogus colleges. My research identifies some of the premier league of forgery experts, who use the most advanced technology to replicate degrees, birth certificates, and driving and marriage licenses:

 

(http://www.superiorfakedegrees.com).’Over the years we have developed a true expertise in developing the highest quality custom replicated documents. Our expert printers have the experience and equipment to get the job done to the highest level of quality. Customer service and relationship building is another pillar in our philosophy, in that we strive to provide the most optimal level of customer service with the hopes that the customer will come back for future printing, copying and replicating business. (We supply) Replicated, Fake Degrees/Diplomas from most post-secondary institutions from around the world (we have over 3000 templates on file) all designed to look 100% identical to the original’ (Their Polish passports look extremely ‘real’).

 

(http://www.diplomareplacementservice.com). ‘Obtaining a Fake Marriage Certificate takes very little time, just click on the ‘order now’ tab on this site and fill out the easy request form to get the authentic marriage certificate you want! We have two types of marriage certificates for your needs that can be customized for almost any country, state and province. They are: The Platinum/Official Marriage Certificate: This certificate looks 100% authentic and is designed to match up equally with originals. It is created by using embossed seals, identical water markings, identical security grade transcript paper, raised ink crests and the correct card stock weight to correspond with institution specifications’.

 

(http://www.diplomareplacementservice.com). ‘Letter of Recommendation – $25.00 each. Letter of Enrolment Verification – $25.00 each’.

 

(http://www.nd-center.com). We create and customize detailed fake diplomas and college, university, and high school documents to meet any specific requirements that you may have, no matter how detailed the document might be. We are able to produce extremely genuine documents for any application from a real college degree, a completely customized college transcript, or a fictitious high school diploma. We will gladly make any type of document you may need. All of them are available at a reasonable price and we will provide them for you within a reasonable time frame’.

 

(http://masterpassport.blogspot.co.uk). ‘We are unique producer of quality fake documents. We offer only original high-quality fake passports, driver’s licenses, ID cards, stamps and other products for following countries: Australia, Belgium, Mexico, Spain, Brazil, Canada, Finland, France, Ireland, Portugal, Sweden, Germany, Italy, Netherlands, UK, USA, and so many other countries. We are the best producers of quality documents, with over 1 million of our documents circulating over the world. We offer only original high-quality real and fake passports, driver’s licenses, ID cards, Visas, Birth certificate, stamps etc.’. (Over 1 million!).

 

(http://www.buydiplomaonline.com/schooluk.html). ‘Many universities, and colleges use either embossing or gold seal. It can be multiple colors as well. Some schools combine different methods to make it look as good as possible, eg. thermographic plus gold foil, or gold foil embossed. Other schools stick with their tradition for many decades, eg. University of London using relief type embossing. For relief type embossing and in case we don’t have the die sets ready, it may take up to three weeks to get it done’. (They also offer an A-Z of UK ‘degrees’, from: Aberystwyth University, American Intercontinental University, Anglia Ruskin University (Cambridge), Anglia Ruskin University (Chelmsford),Aston University, Bangor University, Belfast Royal Hospitals, Birmingham City University (UCE), Boston University, Bournemouth University, British College of Osteopathic Medicine, British School of Osteopathy, Brunel University … (Lincoln University ‘degrees’ look particularly authentic).

 

(http://www.diplomasandtranscripts.com). ‘Realistic fake diplomas, degrees, and transcripts with authentic seals from the college or university of your choice shipped quick and starting under $60! At DiplomasAndTranscripts.com we also offer genuine looking GED certificates and General Equivalency score sheets at prices our competitors cannot beat! Our novelty college and university diplomas are printed on premium heavyweight ivory paper stock, and they are also available with metallic gold, raised foil, and replica school seals! Our fake transcripts and GED score sheets are printed on genuine anti-tamper security paper, and are available with embossed registrar seals, and we have over one hundred fake degrees and majors on file for you to select from to complete your college or university transcript’.

 

(http://www.fakediplomanow.com).’Fake College Degrees and Transcripts offers quality diploma replication and fake college degrees and transcripts, Our quality cannot be match because we use the same exact printing equipment as every major university including the same transcripts security paper. What ever the reason your looking for a fake diploma, novelty degree or university transcripts, choose us. We are not only the best quality, but we can match the same design to 100% accuracy, with no difference in quality and authenticity of our fake degrees. 100% exact as the original. If you look at our samples page you will notice the effort we put into creating a quality degree, everything from raised lettering to embossed foil seals. Our fake degrees are truly amazing. We even use the same exact registrar signatures as the date of graduation you request. Remember that using these for job interviews and other professional matters are illegal in many countries. Be careful of how you use these products … However our products are guaranteed not to be exposed, so there is no fear in using them. They have passed rigorous scrutiny from many experts in the field and passed with flying colors. You have no fear in buying one from us … Our largest market is in the Asian Region where our products are seen as great novelty items or as great show pieces. The laws in these countries are less stringent against novelty item so they can purchase them without and fear of recrimination from the authorities … For added authenticity, our fake diplomas are printed on high-quality parchment paper to match the original documents. Original seals of the school are also raised embossed on the diploma. We use the school real seal and not replacement seal that other faked diploma website offers … We also use customized safe-security paper on each of our fake transcripts in order to match the original. Why bother with generic looking fake diploma, why not go for the real deal and get yourself fake degrees that have been painstakingly created with the utmost care and even if subjected to close examination our fake diplomas will pass any quality check, so why take a risk with low quality alternatives, when we are here to create authentic fake university diplomas for you! As a matter of fact, we operate much of the same printing and embossing equipment actual universities use to print their own diplomas. Through our years of experience in the diploma printing business, we have also amassed the largest stock of real college & university diploma templates found anywhere. When printing replica diplomas for our customers, in many cases, We uses the exact color and weight parchment and printing techniques that the specific college or university of your choice would use to print their own diplomas. In addition to producing the most authentic quality replica diplomas available, Underground Documents also produces extremely realistic, replica transcripts that can be customized to your exact specifications. Our replica academic transcripts include and allow you to customize everything from classes, grades, and grade point average (GPA) to your graduation date, dates of attendance, student ID number and much more‘.

 

Thus, a choice of entry into UK nursing is offered: use forged documents to enter a UK university and enrol on its nursing degree course. UK universities use derisory checks, if a document looks kosher, that will do, just cough up the cash. You do not have to be particularly academic, either, just keep stumping up the cash. (http://www.ukessays.com. ‘Every year we deliver over 10,000 custom written pieces of work to students, just like you, who are looking for a little extra help to boost their grade. With the cost of university study increasing in the UK, we know how important it is to make the most of your studies and get the grade you need to kick-start your career … Our passionate team is dedicated to improving your university learning experience by helping you achieve more with your essays, dissertations and coursework. We offer a wide range of services, including our premier custom essay and dissertation writing services, a comprehensive marking service and a wide variety of other services to help you succeed in your studies. We know it’s vital that your order is delivered on time and to the correct standard, which is where our Aftercare team come in. Our Aftercare quality checkers need to eat, sleep and breathe quality – we won’t tolerate anything but the best. This commitment to quality is why we’ve been the UK’s leading writing service for over a decade. All orders are written ‘on request’, which means we guarantee it will be 100% original. In fact, we promise that if your essay is plagiarised, we will give you £5,000 in compensation’.

 

Alternatively, for those choosing the fast-track and less expensive route, just go and knock on the NMC door. There will always be room in their stable if their various tests on an applicants bona fides are anything to go by.

 

  1. Pass an eligibility assessment. Translation = Does the information on your forged documents meet our criteria? Of course it does!

 

  1. Take a competence test. Translation = Take a computer-based, multi-choice test at a centre in your own country. Anyone with some nursing experience and a little revision will almost certainly pass this test. Anyone who could pass the tests taken by the seven arrested nurses would sail through this.

 

  1. Take the objective-structured clinical examination (OSCE) at the University of Northampton. Translation = In the simulated environment perform a task that you have probably done many times before (most ‘foreign’ nursing is more hands-on), to a level ‘based on current UK pre-registration standards’! This takes the proverbial! The reason why many UK nurse students can not get their first hospital job is because managers can not waste money bringing them up to an up-and-ready level of competence, which their university course did not provide.

 

  1. Identification check. Applicants are required to attend a face to face identification check at our office in London. At the ID interview you must produce the original versions of the documents you sent photocopies of. We will undertake final checks on your previous registration, and take a photograph for our records. Translation = Show us the original fakes.

 

  1. English language requirements. All applicants also meet our English language requirements, with an international English language test (IELTS) score of 7.0. The seven nurses who were arrested spoke competent English. Applicants know the height of the bar they have to jump over.

 

Although many newly qualified UK nurses can not get their first hospital job (I have monitored ten Hospital Trusts’ vacancy boards for 6 months, and 80% of them require applicants to have ‘previous experience’), the NMC actively assist foreign nurses to work in the NHS! Don’t tell UKIP! ‘We have been working closely with UK Immigration and Visas (formally the UK Border Agency) to ensure that there are appropriate provisions in place for applicants taking the Test of Competence: Part 2 – the Objective Structure Clinical Examination (OSCE).

 

For those sponsored by an employer, it is anticipated the sponsorship will formally start from the date of the scheduled OSCE, with arrival permitted up to 14 days ahead of that date. The sponsor may choose to continue to offer sponsorship in cases where the individual needs to re-sit the OSCE. For those without sponsorship who wish to travel to the UK to take the examination, a visitor visa provision is being put in place. This will allow nurses and midwives to enter the UK on a six-month visitor visa specifically to take the OSCE‘. What cost advantages accrue to a sponsoring employer? Who are they? Is it in their interests to insist on rigorous, American-style certificate validation processes? Why are three-quarters of hospital Trusts recruiting from overseas, when their job vacancy adverts clearly debar newly qualified nurses, without the necessary experience, from applying? Answer: There is no shortage of nurses, just a shortage of adequately trained ones. Those who ignore this fact are hiding behind the skirts of the truth. This situation is mirrored in America and Australia, where many newly qualified nurses can not find work.

 

That the NMC testing system is fat on words but anorexic in effect is suggested by their advice to employers who find that foreign nurse the NMC have registered are not competent – report them to us! It’s like a supermarket saying to customers, if you find our beef products contain horse meat, just let us know, it must have slipped through our very fine net! A cart-horse could jump through the NMC’s net!

 

The situation with EU nurses is even more Brian Rixish. There is either ‘automatic recognition’, or acquired rights. The NMC assess your training programme directly against the relevant United Kingdom (UK) educational requirements. To do this we need a complete transcript of your training, which must show the number of hours of theoretical and clinical study, and number of deliveries if you are a midwife. Certifying copies of your documents: We accept documents that have been certified by: A legal practitioner (solicitor, lawyer). A notary public. The competent authority in your country of training.  An official who is authorised to certify documents from an embassy or consulate. A police officer. A justice of the peace. The office of mayor (when authorised to do so). The certifying authority must confirm they have seen the original document. They must state their full name, profession and stamp and sign the document. We cannot accept faxes and subsequent photocopies of certified documents’. All this can be expertly forged, faxes are superfluous, as most forgery vendors offer a bespoke service –  anyone’s signature or stamp of office. It is quite meaningless to have applicants turn up at the Post Office and have passport, birth, and marriage certificates checked, for these documents can be genuine.

 

The NMC have not been given the resources of their American counterparts. They will not phone a police station in Poland or Bulgaria and ask questions (in Polish or Bulgarian), about nursing applicants. The nurse training programmes in some EU countries are not equivalent to UK levels, which are, themselves, not high enough to guarantee students a job. The level of nursing technologies employed in these countries is inferior. This is the word on the street, away from the cloud-cuckoo tower of the NMC, away from government which declares the NMC is independent of them, but which gives them so little resources that their pitiful defence of UK nursing is in this way directly controlled by government. It is as if an open door policy of nurse recruitment is the aim of the British government, which sends ten troops to guard a border fort against an army of thousands, and only wants these troops to offer meaningless words and useless drills. The British equivalent of the American Homeland Security Service are not asked to investigate potential fraud relating to fake nursing certificates. What does that tell us? By way of answer, it can be explained that the top council members of the NMC are appointed by the Privy Council, that is, by the British Establishment. The NMC are nothing but a branch of the British government. They protect the government and not the public.

 

That the RCN now remonstrates against the use of off-the-peg foreign nurses, and highlights that it costs £70,000 to train a UK nurse, is laudable, but less so when it refuses to investigate exactly how many of these nursing students get a full time, long term NHS job. It is as if they do not want to bring attention to the poor cost effectiveness and training outcomes of the nurse lecturer industry, which many of their members feed off. If you attack Jack, my dears, you must also attack Jill, or else you will find yourselves falling arse over heels down the slope of the government’s hill, which they are busily greasing for you. Governments are starting to muse over the advantages of one year nursing courses in specialist areas, to create a cheap form of nurse specialist, i.e. surgery/A&E nurses, rather than fund a three year degree course based on the ‘Jack of all trades and the master of none’ principle. A salient question to the RCN ‘top brass’ is: Why do you complain about the increased use of overseas nurses by the NHS, when you are starkly silent about the NMC’s complicity in their recruitment? Is it merely a coincidence that most of the NMC’s ruling committee are RCN members?

 

The number of ‘fake’ nurses in the UK would fill Wembley Stadium. I came to this conclusion as I recently lay on a hospital ward, ignored by the nurses I repeatedly requested assistance from. It was then that I thought of Mary, who I had once observed holding the hand of an elderly lady patient who was dying. This was after her shift had ended. She explained: “I can’t bear anyone ending this life without a hand to hold”. Remembering Mary, I came to this conclusion: I could not give ‘Jack Shit’ whether the person caring for me had forged documents or not, for I would rather be cared for by someone with a fake certificate and genuine heart than someone with a genuine certificate and a fake heart. Most of us would make this choice, I think, especially as the seven arrested nurses were probably more competent than most UK nursing graduates, and may also have had, like Mary, 24 carat hearts.

 

lenin nightingale 2014

Empathy or Bust : “These ‘Shoes’ are Made For Walking”

The term empathy is understood to mean feeling as though you are standing in the shoes of the other, experiencing how they feel, and thus better care for them – or with them.
Is this possible in reality? How can I know how someone feels after the death of their loved one – even though I have experienced such loss myself? Almost like an actor trying to get into the role so he or she can play it better, we attempt to feel another’s loss, but can we really imagine another’s personal experience of horror? Even if we think we can can, we all have different coping mechanisms and abilities to deal with what has hurt us. One person’s depth may be more shallow to another.

The response “how dare you say you know how I feel” is all too accurate.

Can we deal with another’s loss by a training programme. Does learning theory make a caring heart?

Does a man in a luxury home in India or the USA, surrounded by homeless people, not care for them because he has no experience of how they feel? – cold, hungry, and depressed. Is it understanding he lacks? Or does his understanding make him indifferent, and ready to condemn the homeless as unworthy.

‘Politicians dress themselves in Christian robes, but are nakedly amoral. They preach that those downtrodden by mental and physical illness can be saved from the sin of idleness by waiting by their phones to hear if they are needed that day to clean toilets or subway walls. Such work is meant to liberate, and amoral politicians pitch this at the great army of low paid, resentful losers, who must be given people even weaker than themselves to kick, lest they start attacking the mansions of their masters. The downtrodden are not seen as part of humanity, they are nothing more than lumps of clay to be shaped by these plastic (it’s a sin to be idle) Christians, who use religion to justify the mental stoning of of the weak. They do what they must (to manipulate others), and call it by a different name, and, yes, people are fooled, and are so blinded that they can not see that but for fortune they too might be the downtrodden of tomorrow'(l.n.).

C.B. Macpherson describing 17th century attitudes to poverty relief: The Puritan doctrine of the poor,treating poverty as a mark of moral shortcoming, added moral obloquy to the political disregard in which the poor had always been held. The poor might deserve to be helped, but it must be done from a superior moral footing. Objects of solicitude or pity or scorn, and sometimes of fear, the poor were not full members of a moral community (The political theory of possessive individualism, p. 226-7).

This belief is what politicans in many countries have brainwashed people with for many years – the “me, myself, and I syndrome”, or “I’m alright Jack”- driven by capitalist materialism. One’s value is measured by some according to how much wealth one has accumulated. Is this part of a new man-made evolution? The species that will survive will be Homo Etonius, and their close cousins, Homo Bankerius. The one they replace will be Homo Empathicus, and their dependent species, Homo Peasantius.

In effect, we have two types of people- one caring, one materialistic. They with wealth will survive.

Carol Dimon and Lenin Nightingale

Volcanic Complaints

 

There are many cases regarding questionable practice within healthcare in all countries and fields. Some of these cases are unpublished by main news  but may be found on blogs or web sites , put there by people in desperation. Some of these cases have “festered” for 20 plus years . People react in different ways – some may have the inner strength to continue to battle , others may choose not to battle believing it cannot be won, or they are unable to carry on. Whatever the reaction, all cases , especially of unexpected death , affect the whole family and individuals for the remainder of their lives.

Some may chose to campaign as a group, or alone. Some may select a relevant field within their career , such as law, to represent or to assist others. Some people combine to form resource and support networks  for others.

Campaigning groups in the UK include, amongst others,  Patients Association, Cure the NHS, Patients First, Compassion in Care, and phsothefacts . The Patients Association has existed for 50 years and published  several reports . CuretheNHS campaign lead to the development of the Francis Report for example. Phsothefacts are contributing towards changes in policy .Patients First protects whistleblowers, and campaigns to change policies. Links to some of these organisations to others  with vested interests may be questionable because it would determine their action.

Some relatives battle as individuals. One of the earliest cases is that of Robbie Powell.  “In 1990, a ten year old boy called Robert Powell [Robbie] lost his life in hospital. “Within months, the father (Will Powell) began to suspect that somebody was tampering with his son’s medical records. He filed more complaints, and spent 15 years fighting for the truth [currently 24 years]. Now, finally, he has it – and he was right” (Davies 2006). The family had not been informed that Addisons disease was suspected and tests had not been done (nursebloginternational 2014). If this situation had occurred in the USA, Will Powell could have instigated an injunction to stop medical records being “altered”, called a Conspiracy to Commit Fraud.

The care of  Robert Bird’s son (2006)  also involved  a failure to undertake  a test, because  an appropriate  staff member was unavailable; the test was an endoscopy. As  a consequence, Robert’s son, Garry, aged 22, lost 90% of his bowel, and other errors followed. Records again were missing (phsothetruestory.com 2013).This case is described by the pressure group phsothefacts, which consists of many members with similar cases.  In both cases, as in all , relatives had a horrific time trying to raise the issues and ensure full investigatons and action were undertaken. Both Will Powell  and Robert  Bird’s cases  involve negligence – the failure to undertake tests  and occurrence of missing records, plus lack of communication between professionals.

An earlier case, in 1979, concerned the death of Helenor Bye, age 12, after she was involved in a  drugs trial without her parents consent and given epilim for epilepsy that she did not have. Her parents were lied to by staff and informed  that  Helenor was still alive and she was not, whilst her organs were removed, so they could not undertake  full examination (Dr. Rima). This case again involved “missing records”; Helenor’s parents were not given access to the records  until many years later. Other factors included staff lying, as in other cases

Will Powell fought for a Duty of Candour which ,  known as ‘Robbie’s Law’,  commenced in 2014 and requires staff and care providers to be honest to patients. This law requires NHS or FT hospitals in England to tell the truth to patients and relatives if there is significant harm to the patient. Debates will remain concerning what is significant harm – is this physical or psychological?   Also, care by healthcare assistants may cause harm in some cases. It is, however, a move in the right direction (qualityofnursingcare.webs.com 2014) . There are two versions of this duty held by CQC and regulatory bodies ;  “Regulation 5: Fit and proper persons: directors and Regulation 20: Duty of candour come into force for NHS bodies in November 2014. ‘NHS bodies’ means NHS trusts, NHS foundation trusts and special health authorities. The fit and proper persons requirement outlines what providers should do to make clear that directors are responsible for the overall quality and safety of care. The duty of candour explains what they should do to make sure they are open and honest with people when something goes wrong with their care and treatment” (cqc.org.uk 2014) .

All UK Healthcare regulators (2014) joint statement: “Every healthcare professional must be open and honest with patients when something goes wrong with their treatment or care which causes, or has the potential to cause, harm or distress”. http://www.nmc-uk.org/media/Latest-news/Regulators-pledge-to-do-more-to-put-openness-and-honesty-at-heart-of-healthcare/ 12.10 14 including GMC and NMC

A major underlying issue is that of missing records. Why are missing tax records prosecuted more often and easily than missing healthcare records ? -http://www.hmrc.gov.uk/record-keeping/. An accountant who destroyed evidence would be considered to be a criminal. . They in power have the ability to masquerade mistakes.

Loss of records should incur a very hefty fine for negligence. In the USA, it is mandatory for any person witnessing abuse to report it, but legislation differs between the 50 states (Nightingale 2014). However, stern action is taken, such as hefty fines and imprisonment if  a person fails to do this, for example -http://www.newyorknursinghomeabuselawyerblog.com/ . This web site gives several examples of nurses who falsified records “Many cases of complaint, both in America and the UK, are hindered by claims that records have gone missing. Should not the loss of medical records attract a very hefty fine? – perhaps to an amount of 30% of the cost of an award which may have been granted if records had not been ‘lost’” (Nightingale 2014).

Describing the NHS ombudsman as a “diversionary tactic” Nightingale (2014) very clearly describes the situation “The Ombudsman (more accurate if called Ambushman) will close a case if the smallest of details are not submitted, and if the slightest inference is given that legal action is being considered, which, of course, could mean the Trust paying compensation”. “Trusts have enormouse influence within the GMC and NMC” (ibid.), and  “no regulatory bodies are truly independent “ (Dimon 2014).” The GMC, NMC, RCN, and CQC are all complicit in covering up the abject failure of the ‘marketisation’ of the NHS, that is, failure to patients, not to their ‘fingers-in-the-pie’ political masters” (Nightingale 2014). Other groups, such as the RCN, may rule by infiltrating other committees, even if they seemingly oppose RCN aims (Nightingale 2014).

One must remember also the vast number of staff, including nurses, care assistants, doctors and radiographers, who have raised issues and are termed “whistleblowers,” and as a consequence  have lost their job . For example Sharmila Chowdbury a radiographer, lists and describes many cases on her web site regarding the NHS.

Some opt to campaign alone, to run blogs, or form campaigning groups. Their plight may be regarded as a separate issue to that of relatives; whilst the case may still involve missing records, it also involves employment issues.

Other relevant factors which may hinder campaigning, may include group adherence, brought about by leadership that seeks it’s own self-interest. . This is illustrated within all spheres – including that of campaigning groups  from where people may be excluded if they do not adhere to “group” opinions. The nature of poor care or good care is, however, an individual matter when considering such aspects as attitudes, personal aims, or culture (Dimon 2014).

Yet along the way, there may be expressions of sheer frustration, anger, and disbelief.Lack of responses to communication does not help. Responses may be needed from MPs, or journalists, for example. If this does not happen somebody may ask “Is there anybody there?”, or  more rudely, “Are you going to reply?” Some may well shout and appear to lack appreciation of certain points. Surely this is understandable? This is not about making allowances for people; it all comes down to listening. If people were heard in the first place cases would not erupt.

 

References

Dimon C (2014) The Myth Of Independence nursebloginternaional.wordpress.com

Duty of Candour information ack A Dignified Revolution.

DrRima ( nd ) Helenor Bye- Dead at 12, Murdered By The State http://drrimatruthreports.com/helenor-bye-murdered-by-the-national-health-service/

Nightingale L (2014) Regulatory Sham nursebloginternational.wordpress.com

Nightingale L (2013)  http://lenin2u.wordpress.com/2013/12/21/18/

Robert Bird’s Nightmare (2013) http://phsothetruestory.com/2013/08/25/robert-birds-nightmare/

With acknowledgements to Will Powell

Author: anon. 16.12.14

Postscript

“Comrades!” cried Squealer, making little nervous skips, “a most terrible thing has been discovered. Snowball has sold himself to Frederick of Pinchfield Farm, who is even now plotting to attack us and take our farm away from us! Snowball is to act as his guide when the attack begins. But there is worse than that. We had thought that Snowball’s rebellion was caused simply by his vanity and ambition. But we were wrong, comrades. Do you know what the real reason was? Snowball was in league with Jones from the very start! He was Jones’s secret agent all the time. It has all been proved by documents which he left behind him and which we have only just discovered. To my mind this explains a great deal, comrades. Did we not see for ourselves how he attempted–fortunately without success–to get us defeated and destroyed at the Battle of the Cowshed?” George Orwell Animal Farm

https://www.marxists.org/subject/art/literature/children/texts/orwell/animal-farm/ch07.htm

VOLCANIC

REPORTING HEALTHCARE ABUSE IN AMERICA AND THE UK

When considering the mandatory reporting of patient abuse in the UK, it may help to consult the American system, as the dilemmas and legal considerations are similar in both jurisdictions. A caveat to this is that although there is an office of Adult Protective Services (“APS”) in all 50 states, each state’s legislation may differ. In Colorado, on and after July 1, 2014, for instance, a very comprehensive list is given of those who have a mandatory duty to report serious harm or injuries. Indiana: An individual who believes or has reason to believe that another individual is an endangered adult shall make a report under this chapter. Ind. Code Ann. §12-10-3-9(a) (West 2013). Texas: A person having cause to believe that an elderly or disabled person is in the state of abuse, neglect, or exploitation. Tex. Hum. Res. Code Ann. § 48.051(b) (West 2013). Utah: A person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect, or exploitation. Utah Code Ann. § 62A-3-305(1) (West 2013). Some states specify where an initial complaint is to be lodged. Delaware: Any person having reasonable cause to believe that an adult person is impaired or incapacitated as defined in § 3902 of this title and is in need of protective services as defined in § 3904 of this title shall report such information to the Department of Health and Social Services. Del. Code. Ann. tit.31, §3910(a) (West 2013). North Carolina: Any person having reasonable cause to believe that a disabled adult is in need of protective services shall report such information to the director. N.C. Gen. Stat. § 108A-102(a) (West 2013). APS are not necessarily a state run service, North Carolina defining them as: services provided by the State or other government or private organizations or individuals which are necessary to protect the disabled adult from abuse, neglect, or exploitation. They shall consist of evaluation of the need for service and mobilization of essential services on behalf of the disabled adult. N.C. Gen. Stat §108A-101(n) (West 2013). Much might depend on what is deemed reasonable.

Generally, those with a mandatory duty of reporting serious harm or injury are given variations of the following legal advice. The Wisconsin Caregiver Law (WI Caregiver Law Ch. DHS 13), defines serious harm or injury as:

  1. ‘An act or repeated acts by a caregiver or nonclient resident, including but not limited to restraint, isolation or confinement, that, when contrary to the entity’s policies and procedures, not a part of the client’s treatment plan and done intentionally to cause harm, does any of the following:
  2. Causes or could be reasonably expected to cause pain or injury to a client or the death of a client, and the act does not constitute self–defense as defined in s. 939.48, Stats.
  3. Substantially disregards a client’s rights under ch. 50 or 51, Stats., or a caregiver’s duties and obligations to a client.
  4. Causes or could reasonably expected to cause mental or emotional damage to a client, including harm to the client’s psychological or intellectual functioning that is exhibited by anxiety, depression, withdrawal, regression, outward aggressive behavior, agitation, or a fear of harm or death, or a combination of these behaviors. This subdivision does not apply to permissible restraint, isolation, or confinement implemented by order of a court or as permitted by statute.
  5. An act or acts of sexual intercourse or sexual contact under s. 940.225, Stats., by a caregiver and involving a client.
  6. The forcible administration of medication or the performance of psychosurgery, electroconvulsive therapy or experimental research on a client with the knowledge that no lawful authority exists for the administration or performance.
  7. A course of conduct or repeated acts by a caregiver which serve no legitimate purpose and which, when done with intent to harass, intimidate, humiliate, threaten or frighten a client, causes or could be reasonably expected to cause the client to be harassed, intimidated, humiliated, threatened or frightened.

Abuse does not include an act or acts of mere inefficiency, unsatisfactory conduct or failure in good performance as the result of inability, incapacity, inadvertency, or ordinary negligence in isolated instances, or good faith errors in judgment or discretion.

Nursing homes must immediately report all incidents of alleged mistreatment, abuse and neglect of residents, misappropriation of resident property and injuries of unknown source to the DQA. (Division of Quality Assurance). CMS defines “immediately” to be as soon as possible but not to exceed 24 hours after discovery of the incident. Failure to provide the information to DQA within 24 hours of discovering an incident may result in a citation under federal or state codes.

In addition to federal and state reporting requirements, providers should notify local law enforcement authorities (immediately) of any situation where there is a potential criminal offence.

One (Oregon) county’s District Attorney gives a simplified list of offences which should result in immediate notification to the police:

Abuse may include:

Physical harm or injury.

Failure to provide basic care. (Would less UK care homes provide poor care if their owners were liable to prosecution and serious consequence, i.e. prison?).

Financial exploitation, theft or misuse of money or property.

Verbal/emotional abuse, threat, cursing, or blaming.

Confinement or Isolating from family & friends.

Wrongful restraint.

Unwanted sexual touching.

Withholding medicine.

Over medicating.

Advice which is common to most American states:

If the abused is in a Skilled Nursing facility, call the Department of Health Services (DHS), Licensing and Certification Program for your county. Submit a complaint, which can be done anonymously. The DHS is charged with giving complaints of serious harm and abuse the highest priority. An example of a timeframe for an investigation is 30 days to complete an investigation unless extenuating circumstances require an extension. The investigation must begin within 24 hours. The DHS are the parent body of the APS.

If the abused is in a Residential Care Facility for the Elderly (RCFE), contact your county’s Community Care Licensing Division. Like the DHS, the CCLD will conduct an investigation.

The following persons are mandatorily required to immediately report abuse and suspected abuse to the Division or law enforcement agency: physicians, licensed practical nurse or registered nurse, nursing facility employee or any individual who contracts to provide services, licensed social worker; physical, speech or occupational therapist; and family member of a resident or guardian or legal counsel for a resident. The local law enforcement agency shall be called first when the suspected abuse is believed to be a crime (for example: rape, murder, assault, burglary, kidnapping, theft of controlled substances). The local law enforcement agency shall be called if the offices of the Division or designee are closed and there are no arrangements for after hours investigation.

Contact your local Ombudsman’s Office – the patient advocate for the facilities. The involvment of the Ombudsman’s office in America is seen as a subsiduary, and not a primary course of action, when reporting suspected serious abuse. They tend to become involved if investigations by DHS and CCLD are the subject of unsatisfactory (to the complainant) outcomes. The UK Ombudsman will not investigate a complaint if it has proof, or infers that, the complaint is to take a legal course. That is, they do not involve themselves in a legal process which may result in a business interest being fined. They steer people toward complaining about failures in the UK healthcare system, and away from complaining about the system.

Despite clearly defined guidelines, the New York State Elder Abuse Prevalence Study (2011), found that for every case known to programs and agencies, 24 were unknown. This is because although the American Nurses Association (ANA) Code of Ethics for Nurses stipulates that nurses must act for the public benefit, whistleblowing about abuses in the nursing workplace can harm employment prospects. Also, given the severity of punishments in America, to both organisations and individuals involved in proven abuse, it may be that whilst the American system is like a shark with sharp teeth, because of this, fewer people are willing to throw a colleague or employer its way. The obvious solution to this problem is the mandatory instillation of cameras in all areas of all healthcare facilities. This meets with obvious opposition from care providers in the social care market, although the use of cameras is becoming more acceptable to regulators. Guidance for people who install hidden cameras to check on standards of their own or a relative’s care has been approved by the UK’s Care Quality Commission (CQC). The guidance is expected to be published in the new year. A BBC report (November 19, 2014), states: The care regulator says it neither encourages nor discourages camera use. It added that it does look at footage which is brought to its attention. Information is also being published for care providers on what they need to take into account if they are thinking of installing hidden or visible cameras in their homes … That hidden camera showed Yvonne calling for a nurse 321 times when she needed the toilet. It was over an hour before anyone came to check on her. Once the home was presented with that evidence change happened. “The information we will publish for providers makes clear the issues we expect them to take into account – for example, consulting with people using the services and staff – if they are considering installing hidden or public cameras”. Nadra Ahmed, chairman of the National Care Association, which represents care providers, said it was “quite sad” that covert surveillance was being discussed and it was “really disappointing” that the CQC had “pursued this course”. Of course, most employers would find mandatory cameras “really disappointing” – the would be able to record staff shortages. The point is, surely, change needs to happen. Healthcare businesses in America are also against the use of cameras in their facilities, disguising their real worry by claiming concern about the ethical issues surrounding the use of surveillance cameras.

Whistleblowers should be aware that not meeting best practice guidelines does not constitute abuse. In June, 2014, the New Jersey Supreme Court found against a nurse who claimed he was fired for reporting allegedly improper patient care to government agencies. He had claimed that his dismissal was in violation of the Conscientious Employee Protection Act (CEPA), designed to protect whistle-blowers. He had also claimed that his professional code of ethics for nurses was the basis of his reporting his employer. The judges, by a majority verdict, found that justices found that this code “does not govern” (his former employer’s) patient care”. Thus, nursing guidelines of best practice are not binding on an employer.

In another case (Lark v. Montgomery Hospice),a nurse complained to her supervisor about the mishandling of narcotics. The nurse was fired, she then filed a complaint against the employer for wrongful dismissal, alleging that the employer violated Maryland’s Health Care Worker Whistleblower Protection Act. The court found that the employer’s failure to correct the procedures for narcotics (employ best practice) was not covered by law, and the law only required the employee to file an internal complaint.

It is clear that what a healthcare professional deems best practice is not binding on an employer, who is only required to operate within the law. Best practice and law are separate entities.

The advice to anyone involved in healthcare, who is considering reporting an incident to external authorities, is to ask themselves: How serious is the problem? Is your nursing license in legal jeopardy if you do not report? Was a law violated? Have you exhausted your employer’s procedures for reporting problem? In most cases, you meet the advocacy duty with a routine report, and have no duty to go outside this chain of authority. If a problem is not resolved, some American states employ a ‘practice specialist’, to whom you can relay a scenario in a hypothetical manner. The ‘practice specialist is a service provided by the National Council of State Boards of Nursing.

In the UK, whilst such as the Royal College of Nursing (RCN), offer guidelines of good practice, the Nursing and Midwifery Council (NMC), do not give ‘practice specialist’ advice. There seems to be a reluctance to commit to any position which may be legally challenged. Understandably so, yet the question arises – which is as pertinent to the UK as it is to America – why are best practice guidelines not legally applicable to healthcare providers? Why are healthcare providers allowed more leeway than proprietors of abattoirs?

The RCN do offer a whistleblowing hotline: ‘This is an additional service for RCN members who have urgent concerns over clinical and staff safety in the workplace. It is important that health care professionals raise concerns directly with their employer. Registered nurses have a duty under the NMC to report concerns where patient care may be affected’.

The Whistleblowing Helpline also ‘offers a free-phone service for employees, and organisations working within the NHS and social care sector’. They give: ‘Free, confidential advice to NHS and Social Care staff that witness wrongdoing and are unsure whether or how to raise their concern … and also give: ‘Advice and support to managers or those responsible for matters of policy development and best practice within the health and social care market’. It is noticeable that staff who may raise a ‘concern’ might work under a manager who is given advice on how to deal with the ‘concern’, and that such ‘concerns’ exist within the social care market – a creation of free-market capitalism, which, ironically, may have given rise to the ‘concern’ (in its use of low staffing levels, etc.).

My impression is, in both cases, whistleblowers are advised to keep their concerns in-house, which, indeed, may be stipulated in their contract. The UK experience is more akin to containing a fire than putting it out. There seems to be little written about some forms of abuse being prosecutable under The Human Rights Act or British law, and, therefore, reportable to the police. This is not a stricture which the social care market wishes to be subjected to.

The American experience is that those who whistleblow are strongly advised to seek legal opinion before they act, and contacting media outlets without full redaction of patient’s details is likely to be detrimental to their case.

It is vital to keep a full record of time, place, person, and witnesses (if any), when making a complaint. Lack of detail will be picked open in court. It is noticeable that hospitals and other nursing facilities are not required by law to keep a back-up of their medical records on an external computer. Many cases of complaint, both in America and the UK are hindered by claims that records have gone missing. Should not the loss of medical records attract a very hefty fine? – perhaps to an amount of 30% of the cost of an award which may have been granted if records had not been ‘lost’.

There are non-profit organisations in America that assist whistleblowers and those furthering their case.’The Whistleblower Support Center and Archive is (an) organization that was founded to provide support to whistleblowers. The center’s Web site provides helpful information, including the 10 steps for effective whistleblowing … A major focus of the effort here to support whistleblowers is the International Whistleblower Archive, an extensive online search engine that provides thousands of articles related to whistleblowing. Attorneys, journalists, whistleblowers, and others can tag almost any aspect of the process and then gain access to a vast array of online resources. Former whistleblowers are available to provide peer-support to future whistleblowers’.

A general sense arising from court cases in America is that ‘justice’ favours business interests. The UK follows this lead. It is the lead of the social care market, which may as well read cattle market.

I recommend:

Install surveillance cameras in all areas of all healthcare facilities.

Institute draconian punishments for those found committing abuse, whether workers, managers, or business owners.

Make it mandatory for all healthcare workers to report serious abuse, failure to do so to result in prosecution.

Make losing medical records a criminal offence.

Make the use of best practice guidelines mandatory.

All serious cases of serious abuse to be immediately reported to the police as crimes.

All complaints to be submitted to a regional authority charged with conducting a vigorous, impartial inquiry.

The regional authority to be responsible for all healthcare and social servives, whether private or public.

All complaints to receive a regional authority response within 30 days.

Abolish the Healthcare Ombudsman.

Abolish the CQC.

Establish a regional authority inspectorate unit, with a 24 hotline, and a remit to investigate complaints within 48 hours.

 

lenin nightingale 2014

 

 

THE PRIVATISATION OF THE NHS – A RING OF YELLOW METAL

Deception is sometimes a slow process, not achieved by a sudden, outright lie, but by gradual increments that subtly lead the deceived to a point from which they can not return. In this way, the British public are being prepared for the complete privatisation of the NHS by whichever political party runs the country on behalf of their corporate paymasters. Politics is nothing but a game of language manipulation, and all politicians have a PhD in its art.

It is naeve to claim that the British public would not tolerate the full privatisation of the NHS, for it is easy for a thief to take away something held in great value if he can convince enough people that he has replaced it with its equivalent. (“Give me your gold ring, and I’ll give you one of yellow metal”).

The rejection of State funding of healthcare by political elites, such as politicians and their corporate masters, is the stuff of fact. The dice have landed, and it is just a case of gradually unwinding the plan.

The Privatisation of the NHS – Stages of Deception:

  1. Publically owned hospitals. Some sevices franchised to private corporations operating under the NHS logo. The present situation.
  2. Hospitals owned by private corporations. Medical staff to work for private corporations on zero-hour contracts. The situation in ten years.
  3. Access to healthcare to be paid for by private insurance policies. The situation in 15 years.

The American year-on-year experience of private insurance policies (my research, 2007-2013), is that 25% of people do not visit a doctor because they can not afford to. The same percentage miss tests, treatment, or follow-ups recommended by a doctor. The number of Americans spending more than £400 a year on prescriptions is the highest in the world. 40% percent of Americans with chronic conditions report not paying for prescriptions or doctor’s appointments due to cost, preferring to pay for food and rent.

This final stage of the Americanisation of the NHS will also be a gradual process, with the State and corporate media apparatus extolling the virtues of ‘individual responsibility’ and ‘choice’. The State will initially fund the medical insurance of the working and non-working poor. The principle of individual responsibility will be repeatedly invoked, however, and this support will be gradually withdrawn, for the ‘undeserving’ poor are such because they do not work, or work hard enough – failures in the Great Market of Life, who “should not be stealing from your pocket”. Those prone to grandiose delusions will readily accept such propaganda – they will always have a well-payed job, and will never have a serious medical condition which insurance will not cover. Politics is nothing but a game of language manipulation which targets the ‘unthinking class’.

The New (free market-shackled) Labour Party will offer tweeks of the system to the equally gullible – doctors and nurses must be guaranteed a minimum number of hours, etc. – but it is an affront to the history of Labour Movement to call this a socialist alternative. It is nothing other than a craftily disguised neocon alternative – different package, slight variations of the same substance. This rumour is sadly believable – that those in the Labour Party HQ await the next Conservative Party policy announcement and ask: “by how little can we tweek it to make it look as if it is our policy?”. “Will the voters of the Home Counties like it?”.

The dice landed many years ago, and the plan of a fully privatised UK health care system is being advanced so gradually as to deceive, for too many, as history informs, are easily lured by a ring of yellow metal.

lenin nightingale 2014

 

 

 

 

 

 

Drug Companies and Children- An Insane World

A British Medical Journal survey of 2002 found that 50% of children were presribed drugs that were unlicensed for use with children. A similar study in American hospitals in 2007 found that nearly 80% of children were prescribed drugs which were not FDA approved. These drugs were not tested on children, and, more worryingly, were not tested for safety in combination with other drugs. It is like assuming that if an adult drinks 10 Budweisers, then a child should be unharmed by one or two, and if an adult parties on Budweiser, wine and whisky, then appropriately smaller doses of the same mix are safe for children – not exactly ‘scientific medicine’, but assumptions profitable to the big pharma companies.

Are parents informed of the possible side effects of untested drugs? Do they seek to enquire, or do not want to know?, being blinded by the perceived advantage of the drug. The question of harmful side effects should be fully explored. Horen’s 2002 study of American paediatric outpatients found a tripling of adverse reactions in those prescribed drugs that were untested on children, when compared with those that were tested.
Are such drugs even needed? The medical profession obviously assumes they are. The ‘attention-deficit disorder’ (ADD) drugs Ritalin and Adderall were prescribed to three million American children in 2012. Adderall is essentially an amphetimine which is used to stimulate the brain. Its (potential) adverse side effects (according to its manufacturer), include slowing of growth, headache, stomach ache, disturbed sleep, decreased appetite, nervousness, dizziness, aggressive behavior, and bipolar illness. Children may also begin to hear voices, become delusional, or become paranoid.

Where America leads, the UK follows: ‘There has been a 50% rise in England in the use of drugs for attention deficit hyperactivity disorder in six years. NHS prescriptions for methylphenidate drugs, including Ritalin, rose from 420,000 in 2007 to 657,000 last year, the Care Quality Commission said. The watchdog warned health workers to “carefully monitor” their use as they have the potential to be “abused” (bbc.co.uk, August 2013). This report quoted a consultant psychiatrist, Professor Tim Kendall: “If you take Ritalin for a year, it’s likely to reduce your growth by about three-quarters of an inch. I think there’s also increasing evidence that it precipitates self-harming behaviour in children and in the long term we have absolutely no evidence that the use of of Ritalin reduces the long-term problems associated with ADHD’.

Yet, for many parents, such drugs are vital to their child’s functioning, and they become extremely anxious if they are not prescribed, even though there is convincing evidence that such drugs do not reduce behavioural problems or add to school achievement when given over a prolonged period.  Such a view was given by L. Alan Sroufe (emeritus professor of psychology at the University of Minnesota’s Institute of Child Development), in an article appearing in the New York Times, 2012: ‘Sadly, few physicians and parents seem to be aware of what we have been learning about the lack of effectiveness of these drugs. What gets publicized are short-term results and studies on brain differences among children. This spurred an increase in drug treatment and led many to conclude that the ‘brain deficit’ hypothesis had been confirmed’. What is meant here is ‘attention deficit’ is assumed to be the result of an inherited condition; the brains of children needing drugs are different from those that do not – they have a different brain chemistry. This hypothesis is sacred to the big pharma companies, for it supplies them with a conveyor belt of consumers.

Sroufe put forward the old ‘anti-psychiatry movement’ argument – social causes lead to depression and anxiety, which, in turn, alter brain chemistry: ‘While the technological sophistication of … studies may impress parents and nonprofessionals, they can be misleading. Of course the brains of children with behavior problems will show anomalies on brain scans. It could not be otherwise. Behavior and the brain are intertwined. Depression also waxes and wanes in many people, and as it does so, parallel changes in brain functioning occur, regardless of medication’.
If the theory of different brain chemistry fails to convince everyone, waiverers might be won over by a recent study conducted by Columbia University reserachers (see http://www.drugs.com, November, 2014), which suggests: ‘Pregnant women exposed to air pollution are five times more likely to have children who develop … ADHD’. The causal factor is claimed to be polycyclic aromatic hydrocarbons (PAHs). This sounds reassuringly ‘scientific’, and may result in pregnant women walking around in masks containing chemical filters, made by the big pharma companies, of course.

In The Divided Self: An Existential Study in Sanity and Madness,1960, R. D. Laing noted that a patient with psychosis could be viewed in one of two ways: ‘One may see his behaviour as ‘signs’ of a ‘disease’ (or) one may see his behaviour as expressive of his existence’. For Laing, such as schitzophrenia was not a sign of a physical illness but an understandable reaction to an inescapable and persecutory social order. He believed that society puts stresses on families to make their children conform to social norms and (often academic) expectations, dividing them from their ‘authentic self’, and substituting a ‘false self’ they come to despise. Laing believed that mental illness was a sane response to an insane world.

ADD is placed in the same context by Sroufe: ‘One of the most profound findings in behavioral neuroscience in recent years has been the clear evidence that the developing brain is shaped by experience. Other large-scale epidemiological studies confirm such trends in the general population of disadvantaged children … (and) Plenty of affluent children are also diagnosed with ADD. Behavior problems in children have many possible sources. Among them are family stresses like domestic violence, lack of social support from friends or relatives, chaotic living situations … and a parent (that) taunts or ridicules’.

The National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services, gives the parents of children diagnosed with ADD an alternative (pharma-friendly) perspective – parents are not to blame: ‘Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood brain disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). These symptoms can make it difficult for a child with ADHD to succeed in school, get along with other children or adults, or finish tasks at home’.

It can be seen that children with such a ‘disorder’ experience a wide range of symptoms, from ‘not paying attention’ (ADD – drowsiness, hence the need for amphetemines), to hyperactivity (ADHD), making this ‘disorder’ as inclusive as so-called (bipolar) manic-depression. Either way the big pharma companies win. Although these stimulants act on certain neurotransmitters in children’s brains to make them better focused, the downside of amphetamines is, paradoxically, increased activity, and addiction. They were given to GIs in World War II. to help them combat fatigue and exhaustion, and became notorious as ‘mothers’s little helpers’. Some hyperactive children are, alternatively, prescribed antidepressants, which, in many cases, are also both ineffective and untested on children. The results of drug trials are manipulated so as to deceive parents and doctors, exaggerating the benefits of drugs and suppressing negative information. The prescription of such drugs to children is another exercise in marketing and profiteering. Better that, some think, than face the main causes of children’s anxiety – their stressed-out, taunting and ridiculing family; their disadvantaged family; their insane world.

NIMH reassuringly explain to parents the role of brain structure in their child’s ADHD ‘disorder’ – ‘Brain imaging studies have revealed that, in youth with ADHD, the brain matures in a normal pattern but is delayed, on average, by about 3 years. The delay is most pronounced in brain regions involved in thinking, paying attention, and planning. More recent studies have found that the outermost layer of the brain, the cortex, shows delayed maturation overall, and a brain structure important for proper communications between the two halves of the brain shows an abnormal growth pattern. These delays and abnormalities may underlie the hallmark symptoms of ADHD and help to explain how the disorder may develop. Treatments can relieve many symptoms of ADHD, but there is currently no cure for the disorder. With treatment, most people with ADHD can be successful in school and lead productive lives’ (nimh.nih.gov, 2014). That nothing is mentioned about happy lives is as deafening as it is damning. We live in an insane world, which knows the price of everything and the value of nothing.

This is the dark heart of the matter. The overuse of prescriptions is linked to perceived improvements in school performance. A recent report (consumer.healthday.com, October 17, 2014) shows Yale School of Management researchers finding: ‘American children’s use of stimulant medications is 30 percent higher during the school year than in the Summer’. Medication is as much about parental anxiety as anything. Children are given drugs by parents as a passport into the debt-ridden world of the graduate, who desperately seeks a graduate-type job, but who may end up flipping burgers. Our insane world bars the use of steroids by adult athletes seeking to boost their performance, but allows the pumping of their mental equivalent into children.

The ‘pushy parent’ syndrome is probably being repeated in Australia. Verity Leatherdale (medicalxpress.com, 2014), reports that: ‘More Australians, particularly children and adolescents, are using psychotropic drugs, a University of Sydney study examining prescribing patterns shows. The study examined trends across a four-year period from the start of 2009. Its results show Australia has one of the highest rates of psychotropic medication use in the world. In addition, very few of these drugs are comprehensively studied for their effects in children and adolescents before coming onto the market’.

R. D. Laing descibed this type of parental pushiness as hate disguised as love, which often leads to mental illness in children attempting to fulfil their parents’ expectations. The child is weaned on amphetamines, fails, and ends up on antidepressants. This is a form of child abuse, aided and abetted by the big pharma companies.
If only we had the big pharma companies to help us back then, you can almost hear past generations sigh. If only they could have helped little Jimmy and Jane to be successful at school and lead productive lives.
Drugs to treat high cholesterol, another condition associated with society, are also widely used on American children. An article (consumerreports.org, 2010) informed: ‘Most statin drugs are FDA-approved for children and teens under age 18, but only if they have a genetic condition that cause extremely high levels of LDL (bad) cholesterol. Yet in 2009, pediatricians wrote children in the U.S. at least 2.8 million prescriptions for drugs to lower cholesterol; nearly 2.3 million of them were for statins … Skyrocketing obesity rates … have more than tripled in the U.S. to 18 percent of the people between 12 and 19 in the last 30 years … There is also concern over the long-term potential risk for children … who use these medications for years or decades, particularly the effects on the developing central nervous system, hormone levels, immune function, and organs. Lipids play a role in brain development, and at least two statins, simvastatin (Zocor and generics) and lovastatin (Altoprev, Mevacor, and generics) can cross the blood-brain barrier and could have a direct and negative impact on such development, according to a recent editorial in the Canadian Medical Association Journal’.

Where America leads, the UK follows: In 2008, the UK National Institute for Health and Clinical Excellence (NICE) backed the American Academy of Paediatrics, by suggesting that obese children (as young as 8 years old), should receive cholesterol-lowering drugs, despite the lack of information available about the safety of long-term use of these drugs on children.

Pity the child who is both obese and hyperactive. This is not to infer that some children do not benefit from drug therapies, it is to infer that many do not.

Our binge-on-burgers society is as much welcome by the big pharma companies as its parallel one, called stress-your-kids-then-drug-them.

It is our insane world, run for the benefit of corporations, that is sick, and which needs a political enema.
lenin nightingale 2014