Saturday, 30 July 2011

BLOG LAUNCH ON TWITTER

I'm launching my blog today on twitter!

Welcome to anyone who has followed the link!

Friday, 29 July 2011

McDonald Overnight Care Case

This post follows my tweet earlier this month regarding the case of Ms McDonald. After having her case heard in the Supreme Court on 6th July 2011, Ms McDonald lost her battle against Kensington and Chelsea Council to provide overnight care. Earlier this month, John Wadham, Group Director, Legal, at the Equality and Human Rights Commission, said:

'We are disappointed with [the] ruling which is a significant setback for people who receive care in their home. Ms McDonald is not incontinent, however this judgment means she will be treated as such...Local authorities will now have greater discretion in deciding how to meet a person's home care needs and will find it easier to justify withdrawing care. This means that older people's human rights to privacy, autonomy and dignity will often be put at serious risk.

Indeed, I agree that it is crucial to ensure that basic human rights to privacy, autonomy and dignity are protected, particularly with respect to elderly and vulnerable groups. It is totally unacceptable for anyone to have to, as Ms McDonald puts it, 'lie in urine for hours' when they are continent and could easily be assisted to use a commode. Age UK are correct in pointing out the "extremely adverse and devastating consequences for many thousands of older people if other councils take similar decisions to save money". (http://www.guardian.co.uk/society/2011/jul/06/care-battle-ballerina-supreme-court)

However, (to play the devil's advocate for a moment), given the governmental resource constraints is it reasonable to expect a local authority to provide overnight care for all who need it in their catchment area? Could or should alternative arrangements be made?? (We are all aware of the care homes crisis!) How do/should local authorities balance the needs of individuals with the broader needs of society as a whole? These are difficult questions. I would like to hear your thoughts...

Health Sector: New Report

The Equality and Human Rights Commission (EHRC) has recently released a new report, entitled 'The Performance of the Health Sector in Meeting Public Sector Equality Duties.' This report examines performance on the former race, disability and gender equality duties by Strategic Health Authorities and Primary Care Trusts in England. These duties were replaced by the new public sector equality duty in April 2011.

The research found that although progress was made on delivering the race, disability and gender equality duties, significant work still needs to be done by health bodies to ensure that their efforts lead to identifiable changes to health outcomes for different groups.

The report is accompanied by a policy paper with recommendations as to how health bodies can meet their obligations under the new equality duty. Effective implementation of the new duty can assist healthcare providers in reducing health inequalities, creating a more effective workforce, and improving the life chances and wellbeing of millions of people in the UK.

Taken from: http://www.equalityhumanrights.com/advice-and-guidance/public-sector-equality-duty/research-and-policy-papers-on-the-duty/#The_performance_of_the_health_sector_in_meeting_the_Public_Sector_Equality_Duties

Thursday, 28 July 2011

Interconnectedness

I have just read a good article in The Lancet which, though not strictly related to human rights in healthcare, might be of interest. It looks at the correlation between suicide rates and unemployment, thus highlighting the way in which (mental) health issues and employment are closely related.
The article is entitled 'The effects of the 2008 recession on health' and can be found at:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961079-9/fulltext

I thought I would make a note of this here as it links into a particular interest I have concerning the interconnectedness of human rights. Many human rights are mutually dependent; they are contingent on one another. I have already mentioned on the 'Right to Health' page that the right to healthcare must be understood in the wider context of the right to health itself. As this right is an inclusive right (covering access to safe food and housing, for instance) it has close links with many other social and economic rights such as the right to employment. Therefore the right to health should, where possible, be understood in this wider context. It is especially important for policy developers to acknowledge this broader context because it is difficult to address many rights, including the right to healthcare, in isolation.

Gastric Surgery: Appeal Lost

I posted on this case earlier this month (under the title 'Gastric Surgery: A Human Right'). Today, news has been released that Mr Condliff has lost his appeal against North Staffordshire Primary Care Trust. The Court of Appeal decided that the Primary Care Trust did NOT have an obligation under Article 8 of the European Convention on Human Rights to consider social / non-clinical factors when deciding whether to grant a request for exceptional funding.

It is interesting to ask (given the trend that is emerging) whether this is another decision influenced by the general reluctance of the judiciary to intervene in cases which concern the allocation of limited public resources. Adam Wagner, of the UK Human Rights Blogs, certainly suggests so.
For a detailed discussion of the ruling please see: 'Public Purse stays closed for Morbidly Obese Man' http://ukhumanrightsblog.com/2011/07/28/public-purse-stays-closed-for-morbidly-obese-man/#more-9995

Saturday, 23 July 2011

Tied to Chairs, Sedated or Locked Up: Dementia Sufferers

This story ran on Thursday in the DM. The article opened with:

"Thousands of restraining orders are being taken out on dementia patients and the alarming practice appears to be increasing, official figures have revealed....This can include locking residents in their rooms overnight, sedating them or even tying them to chairs – all of which, critics said, denies them their basic human rights."

I agree with the critics. Such treatment is indeed an infringement of human rights and I am appalled by the extent of such practices. While some may protest against this, arguing that it can be extremely difficult to look after patients with dementia (and somehow attempt to justify such approaches), it is important to stress that the right to be free from inhuman or degrading treatment or punishment is an absolute right which means that it cannot, under any circumstances, be justified. Precisely because of the difficulties and complications in caring for people with dementia, is is extremely important to ensure that they are treated with dignity and their right to autonomy is respected. This blog has noted in the past that under staffing in care homes is often a root cause of poor care provision but we must continue to stress that it is absolutely unacceptable that patients/residents should suffer due to failings in the system.

http://www.dailymail.co.uk/news/article-2017079/Hospital-staff-tie-sedate-2-700-frail-patients-alarming-restraining-order-rise.html#ixzz1Sv76ikRZ

The DM, (despite its lack of support for the HRA), has actually been doing some good work to highlight the widespread neglect and maltreatment of the elderly in hospitals and care homes through its Dignity for Elderly Campaign (See link above for more info).

It is also worth mentioning an article in today's Telegraph which links directly into the above story, entitled, 'five dementia sufferers die everyday from 'chemical cosh' drugs. According to Beckford, the Health Correspondent, "[m]any more hospital patients and care home residents suffer strokes triggered by the antipsychotic medications they are given to keep them sedated." The data used in this report is from 2009; I wonder if statistics are higher today given the recent rapid decline in the care system...

 Full story can be read at: http://www.telegraph.co.uk/health/healthnews/8652593/Five-dementia-sufferers-die-every-day-from-chemical-cosh-drugs.html

Wednesday, 20 July 2011

NHS Reforms

http://www.guardian.co.uk/society/2011/jul/13/nhs-reforms-local-solutions

Health Tourism

An article in the Daily Mail highlights an interesting phenomenon they call 'health tourism'. Earlier this month they ran a story on a Nigerian mother who flew to Britain when she learned she was pregnant and had quintuplets which cost taxpayers an estimated £200,000. More recently they have run a similar story in which they ask:
When the NHS is hard pushed to pay for chemotherapy for cancer patients and is struggling to provide decent maternity services, why on earth should it have to ...deliver the babies of mothers with no connection with this country?

I would be interested to know the opinion of the DM on the UN  Millenium Development Goal 5, to improve maternal health. Every year more than half a million women die due to complications in pregnancy and childbirth - 99% of which are in developing countries. In light of this, I wonder whether they would still object to the delivery of this Nigerian woman's quintuplets in the UK?

Tuesday, 19 July 2011

Hidden Human Rights Crisis of Medical Pain

It appears some extremely commendable research into the hidden human rights crisis of medical pain has been undertaken by student of journalism in the University of British Columbia. Graduate students travelled to India, Ukraine and Uganda to investigate how countries around the world deal with suffering patients. Their findings show that "more than half the countries in the world have little to no access to morphine, the gold standard for treating medical pain." What is more, they have discovered that  "[u]nlike so many global health problems, pain treatment is not about money or a lack of drugs, since morphine costs pennies per dose and is readily available." Rather it is due to "bureaucratic hurdles, and the chilling effect of the global war on drugs" which are the main impediments to access to morphine.
The full story can be read at http://www.publicaffairs.ubc.ca/2011/07/18/ubc-documentary-shows-hidden-human-rights-crisis-of-medical-pain/
More information about the film "Freedom from Pain" produced by the UBC can be found at http://www.internationalreporting.org/blog/2011/07/07/the-pain-project/

Incidentally, Human Rights Watch produced an article on this issue at almost exactly the same time last year, entitled, "Pain Relief: A Human Right." Lots of useful information along with reports on the state of pallative care in various countries is available from HRW at http://www.hrw.org/en/news/2010/07/26/pain-relief-human-right

Saturday, 16 July 2011

Pets As Therapy

Amidst all of the depressing news stories this week, it is wonderful to hear something positive in this field. Today, in Ysbyty Glan Clwyd in North Wales, another 'Pets As Therapy' initiative has been launched. The Pets As Therapy (PAT) charity does some really tremendous work. Primarily, it organises visits by volunteer pet owners and their animals to people who are residents in hospitals, hospices, residential homes, nursing homes, day car centres, and special needs schools.

The launch today in Ysbyty Glan Clwyd follows the introduction this initiative in the mental health Ablett Unit at Glan Clwyd hospital twelve months ago. A spokesperson has said that the dogs have been a huge success in this unit and the "feedback from the patients has been extremely positive." According to BBC news, the launch at Glan Clwyd means that the service will now be available at other hospitals inj North Wales too. http://www.bbc.co.uk/news/uk-wales-north-east-wales-14173175

Incidentally, a similar story featured in today's Los Angeles Times - 'Therapy Dogs make the rounds in more healthcare settings', showing this is not a pratice confined to the UK. The LAT reports that "across the country, more than 10,000 trained person-plus-pet teams are registered in Pet Partners, a program established in 1990 by the Delta Society, a nonprofit organization that believes positive interactions with animals can improve people's health and well-being." http://www.latimes.com/health/la-he-therapy-dogs-20110718,0,4456307.story

It is widely known that many people experience profound health benefits from spending time with dogs and cats. Animals encourage interaction in patients who wouldn’t usually get involved in social activity thus boosting their confidence and can have a very positive effect upon people with communication difficulties enabling them to particpate in the life of the community.

The question I would like to raise is: does the fact that pets can help people in such a way mean that access to pets could, whilst in a healthcare setting at least, be part of our human rights? Indeed this seems far fetched at first but it is possible to make some links. What about the right to companionship, for instanc? Or the right to particpate in community life (Art 29 (i) of the ICESCR)? Can we go even further?  Dr. Edward Creagan, interviewed as part of the LAT article , believes that pets are embedded in the soul of our humanity. Is he right? It is certainly something to think on...

Stepping Hill Hospital

It is extremely disturbing to hear the news that three people have died possibly as a result of saline medication being tampered with in Stepping Hill Hospital in Stockport. Understandably, the news reports are still a little vague as investigations remain underway. According to the Telegraph:
"Detectives believe the insulin was deliberately injected into the saline containers which were used by at least two wards but they say the deaths remain unexplained as they await post-mortem results." Read the full story at: http://www.telegraph.co.uk/news/uknews/crime/8641983/Hospital-poisoning-police-to-interview-surviving-patients-after-three-die-in-Stockport.html
Channel 4 news reports that a hotline has now been set up for concerned patients and relatives. I wonder, where else people can find support?

Friday, 15 July 2011

Care, Consultation and Human Rights

The outcome of the recent case R (on the application of Tiller) v Secretary of State for the Home Department highlights the importance of correct consultation procedures where there is a possiblity that the human rights of those being care for may be breached. This case concerns a local authority's decision to replace the 24-hour care provided to tenants of a sheltered housing scheme (due to financial constraints) with an on-site service during week-day office hours and an on-call remote service at other times (the most vulnerable tenants were offered accommodation at nearby facilities that offered greater levels of care).

The claimant, however, argued that throughout the process the local authority had failed to give any conscious thought to its duty under the Disability Discrimination Act 1995 (DDA), now the Equality Act, and stressed the failure of the local authority to mention the duty or the Act in any documents relating to its decision. Nevertheless, this argument was too weak to stand up in court. It was ruled that the local authority's consultation process and assessment of tenants needs were adequate and, whilst the court recognised that the DDA had not been mentioned, it made it clear that the local authority had discharged its legal obligations.

This was in fact quite a straightforward case. What it does show, however, is that it is becoming increasingly difficult to change care arrangements as legal challenges to such changes are becoming increasingly common. This is surely a good thing. While the landlords had acted properly in this instance, it is essential that proper consultation takes place before changes are made and the human rights of those being care for are protected.

To read more: http://www.bllaw.co.uk/sectors/social_housing/news_and_updates/human_rights.aspx?lang=en

Indonesia's Human Rights Violations

I have just read an interesting news article in the Telegraph entitled, 'Indonesia's Human Rights Violations Deeply Entrenched'. Indonesia is the world's largest democratic Muslim country but conditions there seem to be appalling . The article reports that "[e]veryday acts – such as complaining about treatment received at a hospital or asking a local official about a land assessment – can result in a defamation prosecution and a prison sentence."

Thursday, 14 July 2011

Gastric Surgery: A Human Right?

It will be interesting to hear the decision of the Appeal Judges in the sad case of Tom Condliff. In April the High Court refused to quash its decision not to provide the surgey he requires. Will this be overruled by the Appeal Court? Will the argument that the Staffordshire PCT, by not providing the necessary surgery, has breached Mr Condliff's right to respect for private and family life, hold up?

Care at Home

Much has been written this week about the adequacy (or rather the inadequacy) of care at home. Findings in a recent report by the Equality and Human Rights Commission are indeed shocking:

"Researchers...found that visits by carers are often so short and infrequent that there is not enough time to carry out even the most basic tasks. That means overstretched home helps often have to make a choice between which essential needs to address, frequently foregoing mealtimes, for example, for washing and dressing." (R. Alleyne, http://www.telegraph.co.uk/health/healthnews/8585086/Home-help-so-poor-for-elderly-it-threatens-most-basic-human-rights-claims-report.html)

Just yesterday the mail reported that an 85yo bedridden widow was left lying in her home without food or water for three days because of a care visit blunder. http://www.dailymail.co.uk/news/article-2014232/Bed-ridden-widow-85-left-lying-home-food-water-THREE-DAYS-care-visit-blunder.html?ito=feeds-newsxml

Of course, this exceeding limited level of care is putting basic human rights, such as the right to life and the right to live free of inhuman and degrading treatment, in danger. What is particularly concerning is the fact that "one in five older people who responded to the call for evidence said that they would not complain because they didn't know how to, or for fear of repercussions." (Alleyne).

Rose Villa Care Home Abuse

It is disturbing to hear that allegations of abuse have surfaced at another of Castlebeck's care homes, Rose Villa, which cares for those with learning difficulties in Bristol. So far four staff have been suspended and an inquiry is underway. Winterborne View, also operated by Castlebeck, closed earlier this month as a direct result of the BBC Panorama's exposure of the terrible abuses perpetrated there.
http://www.telegraph.co.uk/health/healthnews/8633763/Castlebeck-workers-suspended-over-new-abuse-claims-at-care-home.html

Abuse and Neglect in Care Homes

There is an interesting and very moving article in the Daily Mail about the work Eileen Chubb has been doing to expose the neglect and abuse in various care homes around the country.  The full article can be read at: http://www.dailymail.co.uk/femail/article-2014129/A-humble-crusader-One-womans-journey-dark-heart-Britains-care-system.html It is interesting to note that this story has not (as far as I can see) been covered by any other newspapers.

Eileen Chubb runs the charity Compassion in Care.http://www.compassionincare.com/

Tuesday, 12 July 2011

The Right To Health

For information on rights to health please look at 'The Right to Health - Human Rights Instruments' page which can be located at the top of this blog.