Why I despise the so-called system of care for vulnerable people

I’ve been fairly controlled over recent weeks, months or even years.  I suppose I’ve been waiting and hoping for a chink of light to emerge, for a culture change to emerge, for a way forward to emerge in the so-called system of care that we have allowed to be in place.

However, I am reaching screaming point.  Hardly surprising.  When someone is destroyed because of absent systems of protection, and when it then takes almost 5 years to work your way through to a full understanding of why the so-callled system of care for vulnerable people fails to provide decent care so very often – that’s when you reach screaming point.

Time and time again, the CQC comes up with yet another report as it did today, with a report into the ‘care’ afforded to people with learning disabilities.  Or rather the lack of  care.  I’ve read it all, but there’s not much hope for real change.

Week and month after week and month, our government comes up with …… not one single plan to improve things.

Year after year, the same old same old same old gets published in the press, reported on radio, featured on TV.

Still nothing changes, so I need to scream now.  It won’t change anything – but it may just help me to scream.

[Next section of this particular blog post: Deleted temporarily pending the return of sense to the world of care.]

Therewith, I will leave this one for today.  But not for long.

NMC hearings schedules – aka close to Care in the UK

I omitted to post this :  NMC Hearings Schedule – 6th to 17th February 2012 – at Euston House, London.

All in the best interests of Care in the UK.

More later, but click here for the charges.  Same as above link – but I wouldn’t want anyone to miss it.

NMC to review ‘serious cases’ before the employer does so

There’s an old saying, with many variations on the same theme:  ‘everything comes to him who waits’, and my favourite variation is  ‘all things come to him who waits – provided he knows what he’s waiting for’.  I’m not absolutely sure that this next revelation is something I knew I was waiting for – but after years of waiting for the NMC to get its act together, there’s a small chink of light appearing.

The NMC (Nursing and Midwifery Council) is to review serious cases before internal investigations are conducted by the employer of the nurse(s) in question.  According to Nursing Times –

Nurses and midwives involved in “very serious cases” that pose a risk to patients should be referred to the Nursing and Midwifery Council prior to an internal investigation, the regulator has stated.

In updated guidance on referrals, the NMC has called on employers to make referrals as quickly as possible in order for it to consider issuing an interim suspension until the case has been fully investigated.

The regulator said it had “clarified its advice as a result of cases in which employers have misunderstood their responsibility to refer quickly if patient safety is at risk”.

It states: “The revised advice specifically encourages employers to refer a nurse or midwife at an early stage in very serious cases, even before they conduct their own internal investigation.”

NMC director of fitness to practise Jackie Smith said: “We would like to remind employers that if they believe the public’s health and wellbeing is at immediate and serious risk, they should contact us straight away.

“This will give us the opportunity to issue an interim suspension or restrict the person’s practice while the case is investigated,” she added.

The revised advice and information also notes that in less serious instances cases may be referred back from the NMC to the employer to be dealt with locally.

The guidance also includes more detailed information about the existing responsibilities of employers to check references, identity and competence.”

This news is of such importance, that I’ve just given you the full content of the Nursing Times article, and I trust that will be acceptable.   It’s not so easy to find the updated guidance on the NMC website, but this is the nearest I’ve found – Urgent referrals and interim orders.

As an employer you have the power to suspend or dismiss a member of staff, but this will not prevent them from working elsewhere. Even suspensions by a local supervising authority midwifery officer (LSAMO), which would prevent a midwife from practising in that region, will not prevent a midwife from practising in other regions, or practising as a nurse if registered accordingly.

We are the only organisation with the powers to prevent nurses and midwives from practising if they present a risk to patient safety. In very serious cases it will therefore be appropriate to refer a nurse or midwife to us at an early stage, even before you conduct your own internal investigation. This allows for the possibility of issuing an interim suspension or restricting the practice of the nurse or midwife concerned until the case has been thoroughly investigated.

I am shocked to discover that this has only just been ‘clarified’ by the NMC, but it goes a long way to explain to me why I’ve had such a fight on my hands for the last 4 years now. 

Perhaps I was naive and took it for granted that the onus was already there on the employer, in my case one of the big care home providers, and that the NMC would be contacted by any employer who has serious concerns about the standards of care being provided by a registered nurse or midwife.  I didn’t know then how easy it was for the employer to allow several registered nurses to resign from their employment. 

Perhaps I was equally naive to expect that the Local Authority would have a duty to follow through with all the sensible procedures, in order to protect other people who could be at risk if those same registered nurses who were allowed to resign were then ’employed’ elsewhere.  But when a care provider has several 25-year contracts with the same local authority, you begin to learn how to whistle in the wind! 

Perhaps I was even more naive to expect that the local authority’s Safeguarding/Protection of Vulnerable Adults unit would be equally responsible for ….. safeguarding others.

The NMC is a Regulator.  The GMC is a Regulator.  The CQC is a Regulator.

What is being a regulator all about if it fails to regulate in the way that most of us, mere mortals that we be,  would want and expect a regulator to regulate?

A feisty band and Chai Patel and Southern Cross

Two appearances -in-word by Chai Patel over the last few days – and both seem fairly innocuous at first reading. 

A piece from Community Care on Friday 29 July 2011 begins:

Operators taking over Southern Cross homes face a long battle to earn the trust of residents and relatives, ex-Priory Group boss Dr Chai Patel has admitted as he prepares to take over one-third of the homes.

Patel told Community Care the firm he will head up to run the homes faces a “long journey” as “reputations are breached in a second and take years to build up”.

He’s referring to the reputation of Southern Cross there.  Perhaps he should remember his own reputation and the way it was sullied by the experiences of residents of Lynde House care home.

An article in the Express on Sunday 31 July 2011 refers back to the year 2000/1 when residents of Lynde House  care home were neglected and mistreated, when Lynde House was owned by Westminster Healthcare, with ….. Chai Patel as its then Chief Executive.  Patel sold Westminster Healthcare soon after the scandal emerged.  Patel was apparently interviewed on Friday 29 July 2011 and  the former government adviser on elderly care, vowed that he would protect pensioners from the kind of ­maltreatment suffered at Lynde House, in Twickenham, Middlesex.

The Express quotes him as saying “The residents felt they could get recourse only by going public which has tarnished my reputation… I have never tolerated poor care and never would ­tolerate poor care.” 

You can’t get away with that one, Chai Patel – otherwise people may be hoodwinked or even deceived by such protest!

Did Patel never bother to read the Report of the Lynde House investigation, dated May 2002 and published on 2 August 2002 – 9 years ago almost to the day? 

If the Chief Executive shoulders no ultimate responsibility for the standards of care provided – or rather the sub-standard care a.k.a. neglect provided – the Chief Executive should not share excessively in the profits made either. 

Let’s look also at 1 October 2002, when the London Evening Standard printed a neat summary of Patel’s career path.  Including these words from Vince Cable talking about the feisty woman who had the courage to stand up to Chai Patel: 

“Without Gillian Ward and her brave group of relatives, none of this would have come to light,” says MP Vincent Cable. “They have done us a major public service. The climate of denial they faced was ferocious.”  “When I first raised the issue with Chai Patel, he totally poohpoohed it. All he had to do was to care enough to acknowledge their complaints, deal with them and apologise. But he chose to deny it and that led to it becoming a national public campaign.” 

I do hope that the residents and relatives of all current Southern Cross care homes don’t have to face the same kind of ferocious denial. I also hope that in his new role, Chai Patel will accept responsibility for the care provided in his name and under his banner.

Where does the buck stop?  If it doesn’t stop with the Chief Executive of a private care provider, then the buck will be in perpetual motion. 

And here’s Gillian Ward again – also known as Deddie Davies.  Still supporting those in care. 

Commons Health Committee reports on NMC and GMC – some thoughts

The Commons Health Committee published, today, its reports on the healthcare regulators NMC and GMC.

The Annual accountability hearing with the General Medical Council is available here.

The Annual accountability hearing with the Nursing and Midwifery Council is available here.

Back in 2008, Ben Bradshaw, then Minister of State for Health Services, commissioned a report by the CHRE (C0uncil for Healthcare Regulatory Excellence) – the Regulator of the Regulators.  The report highlighted a poor level of service to complainants (sometimes insensitive or misleading information was being given to them) significant delays in communication with complainants, poor quality correspondence and long delays in fitness to practise hearings.

Nothing has changed since 2008, and the CHRE’s 2010/11 annual review still finds concerns ‘about the number and nature of the improvements that the NMC still had to make, particularly around its customer care and, its management of serious cases and the timeliness of its case progression’.

I agree wholeheartedly.  I may show bias – but after nearly 4 years of waiting for them all to get their respective acts together, who could blame me.

• ….. the Committee remains very concerned about the existence of low standards of basic nursing care in our acute hospitals and care homes, which appear to be in  breach of the code of conduct for nurses and midwives. We are particularly concerned about this in light of the ongoing inquiry into Mid Staffordshire NHS Foundation Trust, the Winterbourne View scandal and the recent Health Service Ombudsman report into care of the elderly in hospital.
• This evidence presents a challenge to the NMC which is responsible for  professional standards in the nursing and midwifery professions. Based on its existing guidance on care of the elderly, we propose that the NMC should develop a programme of action to deliver a demonstrable improvement in outcomes for this vulnerable group.
• Furthermore, the NMC needs to send a clear signal to nurses and midwives that they are at as much risk of being investigated by their regulator for failing to report concerns about a fellow registrant as they are from poor practice on their own part.

The CQC is failing older people; the NMC is failing older people.  They are both reactive, whereas they both need to be pro-active if they are to protect people in care.  Over the last years, I’ve come to understand that systems of all shapes and sizes are sadly lacking.  The NMC report in particular confirms to me what I already suspected, in a way, but it distresses me beyond imagination.  How have we come to this?

To save you from reading the whole report, here are a few more extracts.  (The use of blue is mine.)  Make your own mind up about it all.

The report mentions the transition to an all-degree nursing profession by 2013 and the perception that nurses may have “stepped back” from basic nursing care.

• However, the Committee raised the issue that many basic nursing care tasks that used to be undertaken by registered nurses are now undertaken by healthcare assistants. The NMC estimates that there are 300,000 unregistered healthcare support workers and an unknown number of assistant practitioners currently working in the UK.  The NMC has “growing concerns” that healthcare assistants (HCAs) are increasingly working on tasks previously undertaken by registered nurses but remain unregulated. This means that there is little control over entry to employment and no final sanction of removal from a register when competence or conduct are not of a sufficiently high standard.
• The NMC commissioned a scoping review of HCA registration which found that there is evidence of HCAs taking up work having been dismissed from other roles for misconduct, and that they are undertaking tasks for which they have not been trained. Based on these findings, the report states that a strong case exists for regulating HCAs.
• They went on to tell us about assistant practitioners who undertake complex procedures such as suturing and giving drugs, but are also unregulated.
• As previously mentioned, the Committee has ongoing concerns about the care and treatment of older people both in hospitals and care homes. Of particular concern to the Committee is the lack of regulation of a range of groups who undertake many basic nursing care tasks.
• The Committee endorses mandatory statutory regulation of healthcare assistants and support workers and we believe that this is the only approach which maximises public protection. The Committee notes that the Government intends to give powers to the relevant regulators to establish voluntary registers for non-regulated professionals and workers, but would urge it to see healthcare assistants, support workers and assistant practitioners as exceptions to this approach who should be subject to mandatory statutory regulation. However, the NMC needs to make significant improvements in the conduct of its existing core functions (such as in how it manages fitness to practise cases) before powers to register these groups are handed to it.
• The current standard for re-registration—completing 450 hours of practice and 35 hours of professional development—is wholly inadequate, as this tells patients  and the public nothing about the quality of nursing and midwifery practice undertaken by the registrant. There is also no routine assessment of whether nurses and midwives have even met this minimal standard. The NMC instead relies on honesty within the profession and “whistle-blowing” when registrants are  dishonest. For many nurses and midwives this may well be adequate, but for a significant minority, including those most at risk of manifesting low professional standards, it may not be.
• Nurses and midwives from the European Economic Area and Switzerland seeking to practice in the UK cannot routinely be language and competence tested by the NMC. The NMC, along with other professional regulators and the Government is  working towards resolution of this with partner organisations across Europe. The  Committee takes the view that the current legal framework is at odds with good clinical practice, which is clearly unacceptable.
• The Government, the NMC and the other health professions regulators must now grasp this as a significant risk to patients and dramatically pick up the pace in resolving or mitigating it.

What a way to run a railway!

As for the GMC report, it’s much of a muchness and more of the same.

• Some of the decisions made by fitness to practise panels of the GMC defy logic and go against the core task of the GMC in maintaining the confidence of its stakeholders. Furthermore, they put the public at risk of poor medical practice.
• The GMC holds the dual but potentially conflicting roles of prosecutor and adjudicator in fitness to practise cases.
• The GMC has told us that between 120 to 150 doctors must have known something  was going badly wrong at Stafford Hospital yet few raised concerns through the proper channels.
• A clear signal needs to be sent by the GMC to doctors that they are at as much risk of being investigated by their regulator for failing to report concerns about a fellow registrant as they are from poor practice on their own part.
• However, in principle, we believe that it is right that regulatory authorities should not merely react to poor practice but should, where possible, pre-empt it.
• For example, a higher proportion of overseas qualified doctors work in peripatetic locum situations. In moving around within the NHS and not belonging to one organisation, the threshold for referral might be lower because there is no local governance around that doctor when they move on.

After nearly 4 years of ongoing investigations into the circumstances surrounding the death of my own relative in care, I understand more of the pathetic systems of regulation in place.  I had no idea then of the way in which so many of our Regulators are failing to regulate. 

The one thing I omitted to take on board, when I placed my complaints before the GMC and the NMC, is the fact that you cease to be the concerned complainant once you hand over all of the supporting evidence you can think they might need.  You become a witness.

You spend hours, days, weeks putting together your evidence.  You spend more weeks, running into months, which then turn into years ‘assisting’ the legal team working on behalf of the Regulator in question.  You chase, you correct, you supply further information. 

Then the drawbridge is pulled upright.  Silence reigns.  The weeks pass by, the months pass by, the years pass by.  You make polite enquiries as to progress.  Obfuscation and downright untruths come your way, all disguised as ‘business’, but all masking inefficiency.  That’s where you started – with the inefficency of those charged with the duty of care. 

They failed to care, and the Regulators fail to care either. 

On it goes – on and on and on. 

They hold meetings to ‘facilitate’ the investigation and then the planned ‘hearings’.  The Registrants and their legal team are allowed to attend the ‘meetings to facilitate’. 

You, the nuisance complainant turned witness, are not allowed to attend.  You are not allowed to see one single shred of their evidence submitted, but they are allowed to see everything you submitted. 

On it goes – on and on and on.  Slowly progressing – or regressing?  Towards the hearings.  Perhaps.  Perhaps not.

 

Who guards the guardians? Oh yes! Good question.

So, Lord Justice Leveson has one simple question at the heart of the public inquiry he is to oversee.

Who guards the guardians?

If only that same question could be asked about those who are charged with guarding our mature relatives in need of care at the most vulnerable stage of their lives.

It would require Lord Justice Leveson to ensure that his inquiry would encompass not only the toothless Care Quality Commission, but also the care providers, the local authority commissioning departments,  local authority facilitators (for want of a better word), the whole network of careless care that so often destroys the lives of those who deserve better care.

The ethics and culture of the care system need a thorough examination also.

“The terms of reference raise complex and wide-ranging legal and ethical issues  of enormous public concern,” said Justice Leveson in a statement released this afternoon.”

The same should be said about the way in which we have allowed a care system to develop that raises equally complex and wide-ranging legal and ethical issues of enormous public concern.

I’m not talking about phone-hacking.  I’m talking about the preservation of life.

Southern Cross builds another brick wall of silence

You take a break – switch off – relax.

You come back and discover that  Southern Cross is to close and then, within hours, our  wonderful government publishes its Open Public Services White Paper.

The ‘brick wall of silence’ is distressing Southern Cross care staff – so goodness knows how the residents and their families must be feeling.

To add insult to injury, of Southern Cross’s  752 homes, according to Community Care, 250 ‘will return to landlords who are themselves operators or have close links to operators, while the others are finalising arrangements.

The larger group includes landlords NHP and Loyds Properties, which between them own more than 300 Southern Cross homes. Separately, Loyds has gone into administration, a process overseen by Grant Thornton.

NHP and Grant Thornton are thought to be working to bring an experienced operator into their portfolio of homes with former Priory owner Chai Patel tipped.  Last week Patel was brought in as an adviser to NHP on a possible shake-up of its homes, according to the Guardian.  However it is unclear what will happen to the remaining homes.’

You remember, suddenly, Lynde House care home from May 2002 – owned then by Westminster Care under the ‘guidance’ of Chai Patel.  ‘Lynde House is a nursing home owned by Westminster Health Care and has been operating since 1996. Westminster Health Care was registered by the Kingston and Richmond Health Authority to provide general nursing care only to seventy-two elderly frail residents. In May 1999 Dr C Patel and Mr Tony Heywood bought Westminster Health Care from the previous owners.’

The Investigation Report from May 2002 is available here .

Then you remember, from your last visit to the Nursing and Midwifery Council Hearings listings, that Lynette Maggs and Sarah Johnson are both scheduled to be ‘heard’ on 25 July 2011.  Lynette Maggs was the Matron of Lynde House; Sarah Johnson was the Manager of Lynde House.  Both cases have been ongoing for years now, so may not reach a conclusion in July.

 The Lynde House Relatives Support Group have surely waited more than long enough.  They tried their utmost to alert Chai Patel’s enterprise to the problems.  This was the response:

“When concerns were raised with Westminster Health Care about this £800-a-week  nursing home – which promised round the clock care for the elderly (many of whom  were incapable of even feeding themselves) – one relative was told to ‘look  elsewhere’. Margaret Jones, Regional Manager of WHC dismissed us, declaring that  Lynde House was ‘as good as a Travel Lodge’. Sheila Roy, Group Director of Healthcare Services, told us that ‘pressure sores are inevitable’.”

Today, The Guardian reports that Southern Cross ‘was forced into announcing its wind-up this week by its former sister company and largest landlord, shareholders were told on Tuesday.

Southern Cross chairman Christopher Fisher told an investors’ meeting that NHP – itself controlled by a string of banks – “pulled the rug” from under its tenant causing the firm to conclude last weekend that it would have to be broken up.’

Which brings us back to Chai Patel!

NHP has now hired Chai Patel and he is is expected to play a leading role in the NHP-owned properties.  No surprises there!!

We are reminded constantly that ‘lessons will be learned’.  Will they?

 

 

 

The time has come ….. e’en though I’m no walrus!!!

I’ve ben fairly restrained thus far in my adulterated vitriol …. which otherwise would have been sent hurling and spitting towards those so-called support services that came my way over the last few years.

The last few years, that is,  of my own life when I forded the shallow waters between an otherwise normal life and the abnormal life across the shallow water of someone needing care and support.  The indescribable chasm ‘twixt the normal world of most of us and the abnormal world of dementia.     So different are those two ‘worlds’ that I cannot even begin to find the words to talk about it all.   Yet.   
But I am hoping to find a way, a route map, the Ordinance Survey Map, if you will, of my own personal walkings through the world of dementia and dementia-care.

We’re all in this together, are we?

So, we’re all in this together, David Cameron, are we?

That phrase must be on page 1 of the Conservative dictionary – Cameron used it in 2008, then to his party faithful.

Fast forward, to the 2009 Tory Conference, and the then shadow chancellor George Osborne clings to the same phrase:

“The shadow chancellor also outlined plans to target Whitehall costs and axe child trust funds for the better off.  He told the Tory conference “we’re all in this together” and said that the measures would save £7bn a year.”

And Cameron’s doing likewise, at the same Tory Conference.

Since 2008, things have moved on, changes to the welfare state are now falling like leaves in Autumn.  Seems that some of us really have been more in it than others:

“More than 150 peers have been claiming a £174 tax-free overnight allowance for staying in London, despite owning a property there, a report says.”

The detail is published in a report on implementing changes to the Lords expenses system.  It says 326 members who replied to a survey claim the “overnight subsistence allowance”.  Of those 167 own accommodation in London and 113 own their properties outright – making them mortgage-free.

None of the peers were breaking the rules, which until recently did not specify which property was a “main home”.

The findings come as the government has outlined plans to pay peers a flat rate of £300 a day to attend the House of Lords.

The regime, due to take effect in October, compares with a current maximum daily limit of £334.

And ‘we’ have somehow or other given permission to our brand new Coalition Government to spend £18,000 on topping up the wine cellar since the election.  Foreign Office minister Henry Bellingham revealed that Government Hospitality, which manages the cellar, had spent £17,698 on new stock since May 6 – bringing the total value to £864,000 – though he insisted the standard practice of buying wines young saved money for the taxpayer.

That’s all right then!  We’re saving money after all.

Iain Duncan Smith is now doing a Norman Tebbitt, twenty years after he first came out with his abusive phrase ‘On Yer Bike’.   Perhaps it’s something to do with being the MP for Chingford!  I am finding it very difficult to understand what kind of mentality you need to be able to consider forcing longterm unemployed people from their secure tenancies to another part of the country, in order to create a more flexible workforce.   It’s only people living in council housing, though, that will be ‘encouraged’ to be flexible.  Not the unemployed living in mortgaged property, of course.  The proposed scheme would allow them to go to the top of the housing list in another area rather than lose their right to a home if they moved.  That will be enormously welcomed by the people who are already on the housing waiting list in the area they are moved to!

Call me a cynic, but if there’s already a housing waiting list in the ‘new area’, that waiting list is going to get longer, so how long is that list likely to keep the new arrivals waiting?  It’s a non-starter.  Or am I missing something?

And IDS mentioned people living in East London who couldn’t at present work in West London.  It would be too much of a risk for them.  What planet do you live on, IDS?  I used to live in East London, and while living there,  I worked in West London.  I didn’t need to get on my bike either.  I got on the bus and tube!  There and back each day.  Since then, transport in London has changed dramatically – for the better.  It shows how out of  touch you are, IDS, with the world.  Why not provide those needing to travel from East London to West London in the interests of gainful employment with a little bit of ‘transport-support-funding’?  Better than uprooting them, from their family, friends and their existing support network.  But you would possibly know little of the consequences of that vicious uprooting.  It wouldn’t need to happen to you, would it, Ian Duncan Smith?  You are protected and secure.

If ‘sink estates’ exist, Iain Duncan Smith would do better to create employment by improving those sink estates, and the life chances of the people living in them.  Are ‘tons of elderly people’ (!! where did that one come from??) only allowed to live in a house with a spare bedroom if they live in a mortgaged property?

That reminds me: which of our esteemed political parties was responsible for the abolition, in effect, of much council housing in the first place?  Which political party was in power when the Right-To-Buy scheme was introduced, thus depleting the existing stock even further?  Which political party did Shirley Porter represent, when she used council funds to rig the vote, and moved council tenants out of marginal wards in Westminster to make space for owner-occupiers, presumed to be Tory voters.  Did she ever pay back the £37million she owed to Westminster Council?

Social cleansing and/or engineering is unacceptable.  Or has Shirley Porter smuggled her way back into the country, with the promise of a new job?

Count me out, Coalition Government.  I’m not in this with you at all.

I can’t resist editing this to add Outside Left’s  Wonky wheels on Iain Duncan Smith’s ‘bike-lite’.

Baby Peter doctor ‘missed unique opportunity’

The GP who saw Baby Peter missed a “unique opportunity” to send him to hospital just eight days before his death, a hearing has been told.

Peter’s mother, her boyfriend, Steven Barker, and his brother, Jason Owen, were jailed in May last year for causing or allowing his death.

Dr Ikwueke is the second doctor to face GMC allegations over Peter’s care.

Consultant paediatrician Sabah Al-Zayyat is accused of failing to spot that he was suffering abuse two days before his death.

She was due to face a GMC disciplinary panel in February but did not turn up.

The hearing was adjourned until a later date after she was said to be “suicidal”.

The above is reported via BBC News.

…… …. ….. …..

I’ve mentioned little Baby P, Baby Peter before, and I’ve also mentioned GPs and the GMC.  But what I may not have mentioned is the almost-equivalent situation of a GP missing a ‘unique’ opportunity.  My 83-year old was unable to breathe, unable to swallow, unable to move, unable to call for help.  Eventually, but about 3 days too late, the care home was asked to call a doctor immediately, when another relative visited, by pure chance, at the care home.

Two hours later, the staff managed to call a GP, who arrived another hour later, and diagnosed a suspected UTI (urinary tract infection).  The GP issued a prescription for Trimethoprim.  The GP departed, having spent a grand total of approximately 12 minutes in the building, from signing in to signing out.

The GP failed to ask the care home nurses about the past medical history of a patient she had never met before, never seen before.  As a result the GP failed to discover that the person she was now visiting was a Diabetic.  If that GP had bothered to ask questions about the medications being given to a patient they had never met before, then that GP would have realised that the patient was on the brink of a diabetic coma.

My relative may have lived.

But she was admitted to hospital less than 24 hours later, in a diabetic coma.  And she died there, 3 weeks later.

The GMC?  I have complained, and I am still considering my options.  But it strikes me that the GMC is protecting the GP.  I am not allowed to view the ‘supporting evidence’ submitted to the GMC as a result of my complaint.  And yet, the documentation that the GMC has already allowed me to see indicates the extent to which the GMC has been misled, hoodwinked.  Call it whatever you will.

Justice will never be justice-seen-to-be-done as long as systems of protection are in place to protect the guilty.  Or at least, those who are prepared to ‘bend the truth’.  In their own ‘best interests’, of course, rather than in the best interests of their patients and their family.