David Fillingham. Where is the corporate manslaughter prosecution then?

Smug Git in a Purple Tie

David Fillingham is a negligent Chief Executive. I know that because he dealt with Ward 87. He was never held accountable for his misdemeanors. The reason for this is this - as a doctor, if you kill a patient, the GMC normally comes after you. If you are a manager and you kill patients by breaching the NHS Management Code of Conduct, your salary just gets hiked. There is no regulatory body for managers. Lord Darzi, the man with a lot to say decreed that managers should not have a regulatory body. As such, there are limited ways with which to discipline managers. Most NHS Managers tend to have psychopathic tendencies, have special parking spaces while the doctors struggle to park in emergencies and are paid 10 times more than the average hard working junior doctor.

Essentially, patients died on Ward 87. They didn't just die in the two weeks I worked there, they died in the 20 years before me and the 7 years after me. Now that's a lot of patients. David Fillingham knows all about corporate manslaughter because in a fair world, he would have been found guilty.

After Ward 87, the National Health Service gave him a second position of responsibility. That position was at the Royal Bolton Hospital. The Royal Bolton Hospital is one of the deadliest hospitals in the UK. David being the biggest concealer of death rates in the history of medicine was trying to get himself out of a tight spot, he stated

"David Fillingham, chief executive of the Royal Bolton Hospital NHS Trust, said Bolton appeared to have performed poorly because of how the figures are worked out — for example, if other trusts make improvements, Bolton’s standing is affected"

He added: “The quality of care that patients receive is our priority. We’ve had some outstanding achievements in reducing death rates, for instance, for patients who have had a stroke.”

Dr Foster, a consultancy that analyses health information, said 128 more people died at the hospital last year than expected.

You just keep winding the newspapers up David. The evidence though shows that David is as negligent as they come. Having effected the end of numerous lives by neglecting Ward 87, he continued to do the same in Bolton.

There is a solution to this - David Fillingham should be prosecuted for corporate manslaughter, thrown in a high security prison and left there. The NHS should also strip him of his pension.

Disciplinary and Regulatory Proceedings

The above book is set to be the leading Regulatory Law textbook. I have this view of doctors in the UK, they often use their defense unions as a crutch. After doing this, their brains shut down to the actual issues. They then follow their defense union's advice like sheep. The problem with most defense unions is that they don't know the law themselves. They hire barristers sometimes from Crown Office Row who are quite happy about being paid extortionately high fees. In many cases, their barristers' total lack of knowledge has cost the careers of fledgling junior doctors. Dr Satya and Dr Varma are two such junior F1 doctors shut down in their prime and struck off the GMC register.

It is though painful to watch junior doctors be at the mercy of their defense unions. Both the Medical Defense Union and the Medical Protection Society always threaten doctors if they do not do things their way. Their way often involves sticking your neck in a vice and never being able to remove it. A few doctors who have been served badly by their defense unions are Dr Helen Bright and Dr David Southall. Represented by the Medical Protection Society and Medical Defense Union respectively, they are both senior doctors whose complaints should have been thrown out at the first hurdle. Their glittering careers were never preserved by their defense unions. We therefore ask the question - why did they pay their defense union fees for so many years? The Medical Protection Society has pulled out of Dr Helen Bright's case. The defense lawyers for David Southall is busy extracting money from the Medical Defense Union. Afterall, what motivation is there for lawyers to succeed at the first hurdle of defense when they can multiply their funds by getting the doctor struck off then getting paid treble the amount to appeal.

Complaints against doctors are increasing. The only people who actually benefit from these things are barristers. Barristers eat money. Their fees are often £400 plus VAT. They charge for walking, talking, pissing, eating, sleeping and writing out bizarre arguments. Personally, I have only ever met one barrister who is a decent person. They rest have been lazy, inefficient and lax. That said, there are some good barristers out there. I find it is a bit like searching for a needle in a haystack but nevertheless, every good doctor should have good representation because hearings at the GMC are quite dysfunctional. It is a bit like a kangaroo court, filled with large guffawing idiots who often think they know everything but they actually know nothing.

At the end of this piece, I should say that my defense union was the Medical Protection Society in 1998. You have never seen a such a spectacular cringe worthy bunch of inept suit wearing morons. Then that is what the MPS is - all appearance and little in the way of robust representation for junior doctors. The MPS always feels nauseated because of my case as they commence a series of frantic clicking on posts I write about them. I pulled my own case out of the fire while they were all filing their pretty little nails. Priya Singh does a lot of filing as does Stephanie Bown - both work for the MPS but haven't a clue what they are supposed to be doing. I don't own a nail file but I can cut a pretty OK argument.

Lastly, I actually don't give a damn what the MPS think. The fact remains - I was right and they were wrong. The evidence speaks for itself. We ask the question -what did the MPS do with Ward 87? The answer is " Sweet FA".

Club Culture

One important aspect to remember is that doctors exist in a "Club". The club involves accepting certain types of doctors within their fold. To be that certain type of doctor - you need to be Registered with the GMC [ Club], a BMA member [ Club], a practicing NHS Doctor, a member of Doctors.net.uk. That is the criteria. If you do not have one of those, you aren't accepted in the esteemed club/fold. You are then considered an outsider and they deal with you at arms length. It is safer that way for them because they don't have to address ideas that are not within their limited worldview.

Indeed, the Shipman Inquiry and Dame Janet Smith told us all that a club culture existed. It certainly exists on the internet.

I noted a post early today on Jobbing Doctor. JD is a General Practitioner or so he says. His mates are listed on his website here. He laments over the loss of a number of bloggers. This is what he says

"It seems to me that the only 2 active bloggers are Nurse Anne and Dr Grumble. We have effectively lost Mousie, the Brown Stuff, A fortunate man, Dr Rant, and Nice Lady Doctor. NHS Blog Doctor seems to have gone into hibernation for now"

Only 2 eh. How JD's memory fades. I ought to thought point out that the first and oldest blogger on the block was http://www.nhsexposed.com developed in 2001. After us, Dr Crippen came into force and became infamous because clearly what a invisible doctor says is more important that one who names herself. We all accept that because Crippen is a talented writer although his Guardianista influence has rendered him next to toothless recently. He appears to have lost the edge to his controversial writings. Following him, a number of bloggers came to the forefront of the medical blogsphere. There aren't just 2 bloggers as Jobbing Doctor may have us believe. There are many many more. Jobbing Doctor knows of all these bloggers himself. He says this because he belongs to the select club who chat together and write together. They include the above.

The other notable medical bloggers are as follows -

1. Scientific Misconduct - Run by Dr Aubrey Blumsohn - Whistleblower.
2. GMC Human Rights - Developed by Dr Helen Bright Consultant Psychiatrist
3. Doctor Bloggs - Developed by the animated and talented Dr Elizabeth Miller
4. Witchdoctor - Developed by The Decrepit Witch
5. Bad Medicine - Developed and Maintained by Dr No.
6. Ferret Fancier - Developed and maintained by Garth, a hospital doctor.
7. The Cockroach Catcher - Developed and maintained by a very talented retired doctor.

They all work harder than the trumped up invisible consultant Dr Grumble who moans so much that we often wonder whether he does any work at all. He is the kind of consultant who probably eats too many grapes while Rome burns - and lets face it, his profession is burning but he doesn't even have the balls to name himself - nevermind challenge the status quo.

I decided to write this because Jobbing Doctor has made a second catastrophic mistake, the first being to tell Pulse that I had a GMC sanction when I never have had one. It took almost 6 months to correct this error. We all had creepy apologies from Pulse and JD but it amazes me how mistakes like this happen from competent doctors and editors. I suppose JD will say he is only human - well, I know JD's real name. If I wrote " Dr JD was suspended from the GMC Register", he would have something to say about it if it remained online for 6 months plus. But as usual, there isn't any remorse here for disastrous mistakes because we have to simply accept they are all human and accept the fact that neither the editor of Pulse or a senior qualified GP like Jobbing Doctor are able to do basic things like read the material on the GMC Register before putting pen to paper.

On this occasion, Jobbing Doctor - whether done on purpose or just on a whim is showing that he believes that only he, Dr Grumble and Dr John Crippen are the only medical bloggers worth listening to. He tells us there are only 2 bloggers on the medical blogsphere. Well, thats a outright fib and I am not really sure what JD was trying to achieve by this. It is quite true a few bloggers have run off because the dragons at the GMC are breathing down everyone's neck but there are still a few brave souls remaining as listed above.

It seems to me that there are a lot more active medical bloggers than Jobbing Doctor would have us believe. I do not for one minute believe that this was a careless mistake. I do though believe that Jobbing Doctor's head has got too big for the Google door and because these boys originate from the spineless brain numbing social networking forum Doctors.net.uk, they all support each other and club together, vote for each other, feature and quote each other and tell themselves that they are the most famous bloggers of them all.

This is therefore a version of the old boys network - but in this case we have the camaraderie of senior doctors who feel that only they exist in the blogging world and only their ideas matter.

So lets smell the roses shall we and make a statement that other doctors do exist, they have a lot to say in the blogging world - and quite frankly it is important for the public to develop a perspective from all sides - not just the side of three old whinge bag senior doctors - one consultant and two GPs - who to this day haven't got the balls to name themselves. For all we know, they may be pretending to be GMC Registered doctors. After all, we know next to nothing about them even to this day.

It has been like this in the medical blogging world for a while. It is called the Club Culture and I get irritated with it because it serves to encourage narrow minded thinking and non acceptability of others who are perceived as a little different. Jobbing Doctor's club is admirable but there is always a 360 degree side to medicine - and there are more than 2 bloggers to tell the public about it. Well, I hope we aren't going to see the Michele Tempest style of self voting - this Psychiatrist infamously voted herself as one of the top bloggers some years ago. Jobbing Doctor and his club of old men are heading towards the same skull extension. I suppose soon he will tell us that there is only 1 medical blogger left - thats him.

Whistleblowers in Australia

Steve Bolsin Should Come Home

Steve Bolsin left the United Kingdom for Australia. No one campaigned for his return. Steve is a successful doctor in Australia but England is his country. He was forced to leave because England did not fight to keep him. Yet, he was the bravest man of them all and the only whistleblower to have achieved an inquiry into his concerns. As Steve himself points out, the subject matter was children and people have a soft spot for kids. Other whistleblowers aren't so fortunate and neither do they have subjects that tug at the heart strings of the public. The Bristol Inquiry still remains the leading light in whistleblowing. It made a number of recommendations that the National Health Service subsequently ignored. Now we see the cost of this in the high death rate in various NHS hospitals.

Many ask me why I never left for Australia. The answer is this - I am British. I was born in the United Kingdom and this is my home. I have everything I love in the UK and nothing - not even the medical establishment is going to chase me away. I also believe that I should never set the precedent that every whistleblower's fate should be in Australia. This is why it is important for me to develop an existence and acceptability within the UK - as a NHS Whistleblower. As I see it, it is also my job to assist those who require help in many ways to improve the healthcare in the National Health Service. It is impossible to effect improvement singlehandedly therefore my own principles of healthcare improvement is to create a information well that many can find useful in their own challenges of the NHS and other authorities.

I am no diva hence I often shun the media because these issues of patient safety are not about me but about patients. It is therefore the patients and their relatives that require the spotlight of publicity. I am also not Margaret Haywood or anyone else - in that I actually dislike talking about myself as a "case". I do though find my discoveries of the failing system to be worthy of exposure. This is because the NHS currently fails the vulnerable in many ways. We live in a first world country with a third world service. As I see it, it should be the job of every doctor to take part in improving the system they work in. I though understand that the General Medical Council has used its silencer on them. And that is a very sad fact of life - that the doctors in the UK are not free to challenge the status quo to effect improvement in this system. Then I know those that care about the system do whatever they can above and beyond the call of duty. Just that their patients don't understand the number of hoops they have to jump to ensure their patients have basic healthcare.

Good doctors and even whistleblowers are all taken for granted. Few fight for them or ensure they are protected. The public is a great demander for justice for themselves but few will protect those doctors who seek to protect them. This is why Steve isn't back in the United Kingdom - because no one took the time to fight for him. Now everyone talks about him as the whistleblower who had to leave for Australia - but few engage in a campaign to bring him back home. Few forget that Steve's talents and influence could have radically changed the way medicine works in the United Kingdom. He could certainly do a much better job than Liam Donaldson. Liam though is getting fat. He is fat man because he is fed too much crap from the government. Liam's brain runs on one brain cell and that is being quite generous. As Chief Medical Officer, he should be responsible for the high death rates in this country and immediately referred to the General Medical Council. He has clearly been unable to improve matters and given his negligence in the mess created by the MMC [ Modernising Medical Careers], I am surprised he hasn't been ousted from his job. Then the UK must be the only place in the world where you can be negligent as a doctor but never held accountable because the system protects you. As I said, Steve Bolsin needs to return back to a position in the Department of Health - where he can effect and overhaul the entire National Health Service so that it saves more patients than it kills.

GMC Pounces on Whistleblowers

GMC Case Examiners.
"Yes, we cut and pasted Rita Pal's pre-action protocol in our decision in 2007"

Since Count Rubin opened his rather large mouth full of fangs, I find it interesting that Dr Korashi is being slaughtered slowly. The media are no doubt taking the story fed to them by the GMC. I wrote about Korashi last night on our neighbouring blog. Korashi reported negligent patient care to the police. For that, he is now being admonished and whiped with a large GMC Stick.While I observe Korashi from a distance, I am aware that the GMC wanted the same fate for me. At least, I know they were edging there. The General Medical Council wanted to frisk me at a hearing so that my credibility [ one that they have already single handedly ruined] would be tarnished. I like Korashi reported my concerns to several places - the General Medical Council being one. Each place attempted a mammoth shut down and character assasination.

His Trust much like North Staffordshire NHS Trust is attempting to silence him. North Staffordshire NHS Trust concealed the data for many years. Half of it still remains concealed. Had I not run off with my patient list taken while oncall and my notes, I would never have achieved vindication. If I had not done that, I am quite positive the powers that be would have white washed the entire episode, said I was wrong and then told the GMC that I was making malicious unfounded allegations. That is of course the way of the General Medical Council. They are a malevolent body with criminal intentions. Having done that [ which is what they were edging towards] they would have strung me up at the General Medical Council hearing and crowed about how I was bringing the profession into disrepute. Of course, I have always known this was happening at GMC Towers.

I think I had a fairly close shave from the General Medical Council. I certainly know that fighting them twice has been bloody hard - not because they are difficult - but because they lie, cheat and do not play a straight game. On the two occasions that they have tried to pounce on me and rubbed their hands with glee, the issues have exploded into court. The General Medical Council on each occasion has spent millions of doctors subscription money on cases related to me. In 2004, yes I wanted them to understand the price of being malicious to a whistleblower. In 2007, I wanted them to understand the price of incompetence within their procedures and the resultant repercussions on junior doctors. Sure, I am quite positive that most people believe that I deserve what I get - but they also fail to understand that the case law created by the GMC in relation to me also affects them. So, yes, my face may not fit but the case law will affect those whose faces do fit. That is of course the danger.

These dangers are currently not understood by doctors - the dangers being

1. A lack of definition of misconduct. This is left to a subjective decision by the GMC Registrar
2. The immediate disclosure to all employers of the complaint against you during a GMC investigation
3. The lack of rights for doctors. The balance appears to have tipped to the complainant. There is no balance.
4. The requirement to declare a GMC investigation whether you have been cleared or not. This has to be done in all application forms.

Those in the know-how will understand the immediate dangers of the above. Dr Korashi is being taken down the steps of the GMC because of the widened definition of misconduct. Misconduct is now anything the GMC wants it to mean. Dame Janet Smith had recommended a definition but the GMC have not done it. Legions of doctors will sit around much like sitting ducks, quacking away at the current circumstances created by their money and in their name.

During revalidation, the GMC will stop licenses and doctors will be trapped within their system of idiotic behaviour. The profession currently cowers at the wrath of the GMC. The GMC have achieved supreme control by their current system. No doctor should whistleblow in this climate because it is plainly dangerous. The promises made by the GMC and their whistleblower's protocol are show pieces designed to placate the media.

It is a fact that the GMC reverses the investigation on whistleblowers. It has not only happened to me, it has happened to Dr Peter Wilmshurst, Dr Shreedar Vaidya, Mr Robert Phipps, Dr Raj Mattu etc. The list is endless. While Margaret Haywood's case was frowned upon, the method used by the GMC to silence whistleblowers continues to remain unrecognised.

The GMC is anything but fair. Sadly, few will understand it until it is far too late. It is fine turning a blind eye until one day the GMC comes after you.

Fish and Chips.

Whistleblowers are often people in trouble. All aspects of their life is affected by the kind of establishment mobbing that seeks break them. I think the establishment always tries to take everything away from you until you stand their absolutely naked and say " OK, what now". For someone like me - you start to say - OK Hit Me Baby One More Time - and this time give it your best shot.

The medical establishment believes that all tell tale tits must be taught a lesson. I believe in quite the opposite, all those who want to teach us a lesson shall have that lesson reversed back onto them and shoved down their pristine reputations. It's just the basics of my survival kit.

It is true that I have had one person in my life who has stood by me like a knight. He was there when I was in tears in 1998. He didn't understand a great deal about medicine but he was on the end of the telephone when no one else was prepared to be. He was my lifeline. He was my best friend.

I think the tough terrain of whistleblowing differentiates those men who will just be there to use you and those who will stand by you always. I am no stranger to men. I like them. That is no secret. There are different types of men - those who will desire you much like a trophy, those who will use you and those who are brave enough to stand by you. It wasn't until I whistleblew that I developed a understanding of the real value of a friend standing by you through thick and thin. He wasn't my boyfriend, he was just a person who was on the end of the phone. He has watched the system try to dig my grave and throw me in without a coffin. He has moaned at me about how rubbish the medical system is. His hatred for all things medicine grew the more he read of the issues surrounding me. Before me, he hadn't heard of the GMC. After me, he felt they really were a pathetic little body who are completely deluded.

When I was in pain due to sheer exhaustion, he wrote my letters to the GMC for me. And they still called me intemperate. I recall the response from Peter Lynn moaning that the letter that had been written by my friend was intemperate. We both sat there and thought - " Yep, the GMC are indeed fruitloops". And that is important - it is vital to get this organisation into context. They think they are so important and all powerful. In the end, they are actually filled with inept human beings with very little in the way of proper skills.

Without my friend, my survival time would have been limited. Through him I found the art of separating the issues of whistleblowing to that of real life. I had a life to lead, it was important to lead it and not be consumed by the issues of whistleblowing. The anger against the system can consume you if you allow it. We ate Fish and Chips together on the pier and decided that the sugary doughnuts sold in Blackpool were considerably better than dealing with correspondence from the General Medical Council. It is these fragments of reality and enjoyment that I have always valued. I love Fish and Chips. I have it on special occasions and it is best eaten by the sea. I think these wonderful things makes us all understand that life is indeed worth living. I have learned not to rush my Fish and Chips, I have learned not to rush my life as I used to. I have effectively learned to live and living takes some effort.

One day, we are going to have a great big bonfire and burn all my GMC papers. We shall cook marshmallows on the fire and enjoy ourselves. You come to the conclusion that what the GMC says is really quite pointless in the grand scheme of things.

The one advantage of whistleblowing is that I have stripped and streamlined my life so only people who are worth knowing are around. I have dispensed with those who were essentially pointless hangers on. This has saved me an inordinate amount of time, effort and energy. Post Whistleblowing, you tend to spend your time effectively. At least, I value each good day. I certainly hate wasting my time with time wasters. One of my relatives told me yesterday - " It is amazing after all you have been through, you still get up early in the morning and you continue your day as if none of this has ever happened". Yes, that is of course quite correct.

It is important to understand, one cannot change the past but we all have the power to change the future. The future is always bright. Well at least, the future has Thorntons Chocolates for me :).

Oversensitive

Everyone dies in the NHS

Whistleblowing is a dangerous escapade. Had I known this in 1998, I would never have done it. Indeed, when I did it, I didn't even know it was whistleblowing. I was simply attempting to save some patients. That as I saw it was my job. I raised many concerns at the time in good faith and subsequently discovered the truth faces of the medical profession's professors. The wrath of the senior shall silence the junior. That is the rule they all worked by. Their efforts to control me had failed. And yes, I am still standing 10 years later trying to tell everyone about the state of the NHS that is costing endless lives. Is anyone listening? Probably not.

This week we see my previous haunt Selly Oak Hospital being given the Dr Foster treatment. While the world is shocked, I am not because I have always known that the NHS offerred patients substandard care. The care is universally bad but when people were told that in 1998-2000, no one believed me. Now, we have the results of turning a blind eye as I predicted many years ago. The soaring death rate is currently being featured slowly through the media.

The media appear all excited about it but in April 2000 when we protested on the subject, no media featured it. So we ask ourselves, where is the Telegaph editor who felt Ward 87 was simply about an axe to grind?

So whose fault is the high death rate? Well, there are a combination of factors, one being the attitude of those in the higher echelons of power in the UK. So I was right about everything. What use is it now? Thousands of people have died and I don't feel good about it. I feel angry that I wasn't listened to. Had I been taken seriously, deaths could have been prevented nationally. And that is a sad fact of life ie that despite all the sacrifices made by a whistleblower and I have made a few including paid the price of my medical career, nothing was ever achieved. Many were quick to criticise me but few were prepared to correct the problem.

I am aware that Professor David Brenton once wrote that I was too oversensitive to the failings of the system. Well, it is true, I did not expect to see the kind of NHS that apparently existed.

I have never accepted it and perhaps that is my fault. My colleagues though have managed to accept it, managed to earn their ounce of corn and managed to ignore the failings of the NHS. It is a national medical concept that failings in care should be ignored by doctors. Whistleblowing is culturally outlawed in the NHS. Even if good doctors tried to raise it, they would have met the same fate as me.

Professor Brenton felt that all doctors should be all grown up, overlook the failings of the system just like he did and move on. Brenton now is a aged man, I wonder when he will be admitted into a hospital. I wonder whether he will think the same things when he lies in his own feaces and urine like other patients in the NHS. I wonder if he will feel the same when he cannot feed himself and the nurses walk past him. I wonder if he will feel the same when the oxygen is not given to him by the nurses when he is gasping for breath. I wonder whether he will feel the same when the junior doctor checks her lipstick in the mirror before attending to a cardiac arrest. We rely on our seniors to be outspoken, to fight against poor care but in Professor David Brenton [ at University College London], I found a conceited man who was quick to dismiss my concerns as that of a oversensitive young doctor. I am now older and I feel the same way about David Brenton. I feel that he failed many patients and he did this because he was quite happy to ignore poor care. I could name legions of professors who neglected poor care. We can commence with Professor Elizabeth Paice, Professor John Temple etc. Naming them though will never make an ounce of difference because the media won't understand the reasons why there are such disastrous death rates. They will not understand that part of the reason stems from the inadequacy of the profession's seniors who spent more time wallowing in their own self importance than they do holding the system to account.

As for Professor Rod Griffiths, the other rogue of the Midlands Public Health Department, I wonder what he has to say about the catastrophic status of the Midlands hospitals. He will deny all responsibility as he always does. I suspect all these old men of medicine have private healthcare plans but I have worked in private hospitals and the care is not much better. All these old men of medicine are way past 65. They are closer to death than someone like me. I often wonder what those closer to death think about the current system. I often wonder whether they will gasp their last breath in hospital and say "We were wrong, we should have done something because if we had done something, even we could have been saved". Griffiths though has always been a deluded man when it comes to addressing poor care. For years, he probably concealed poor care just like Ward 87. Now that the shit has hit the fan and he has retired, Griffiths will say " What me? Of course, it has nothing to do with me, I am retired". We have to then ask the question - how many years have patients been dying for? Well, in 1998, the Midlands Hospitals were extremely bad. Now, I suspect the situation has worsened due to a series of cover-ups. I don't ever recall Professor Griffiths doing anything useful during his time in office.

There is limited justice in the world of medicine. Karma afterall comes to all those who travel the path of the dark side. The Dark Side though is tempting for these elderly doctors of medicine. They often convince themselves that they have the wisdom that age is supposed to bring. They brush aside the younger generation, dimissing our concerns as "naive". When we are proven to be right, none of them have a thing to say about it. They remain tightlipped publicly, only whispering away within closed doors.

Sadly, the grandees of medicine have often lost their way from the path of the truth or justice. Their judgment has been clouded by the influence of the medical fraternity. Patients die, doctors remain silent. Those who teach them to remain silent are the elderly professors of medicine.

These are the professors who relish the control over life and death. This is because they love the supreme power that comes with control. Medicine is about power not about patient safety. That is how it has been developed by those who are the leading movers and shakers in the medical fraternity.

In Search of Tamiflu

No Tamiflu Outreach Service

So this week I went in search on Tamiflu for a elderly lady who requested it. I was only asked to use the internet for her, she continued the rest. She had developed Swine Flu symptoms and felt she ought to have Tamiflu. Rumours flown to her implied that Tamiflu can be obtained on the internet quite easily. This elderly lady is in her sixties with multiple medical problems. She often calls on others to assist her but this week no one was available in her local area. She lives about 15 miles from any city. So my adventures of trying to obtain Tamiflu commenced one bright morning.

1. The first website to visit is this one. NHS Choices on Swine Flu. Again, it isn't obvious where the online Tamiflu can be booked from.

2. There is a small link on the left that takes you to the National Pandemic Flu Service.

3. Again from point 2, it isn't obvious where you get Tamiflu from until you read through the entire rubbish and come across this. This is the Swine Flu Online Assessment.

4. You then move to this section by clicking on the relevant "I agree"to everything button. You then complete the assessment. It is at the end of this that you get a reference number. The idea is that you print out your reference number and find the nearest collection point. And there lies the difficulty! I would have thought that all pharmacies in the UK could have been collection points but clearly this has not been the case.

5. The next issue was where to obtain the Tamiflu from. You have to take your personal ID, the patient's ID and go down to the specific collection point.

6. So the collection point consisted of 3 chemists in the City 10-15 miles away from the elderly lady. These are some collection points. This elderly lady was housebound, did not have her own transport, was fearful that the freezing cold would aggravate her already deteriorating flu.

7. She rang her local pharmacy who told her that they didn't dispense Tamiflu. They sent her to the main Boots in the small town.

8. She rang Boots who told her that they did not supply Tamiflu without a doctors script. The National Pandemic Flu Service Tamiflu ID would only be used in the specific chemists 15 miles away.

9. She rang the doctor who told her that it probably wasn't swine flu over the phone and refused to give her a script.

10. She then rang her PCT and asked for help with the collection points. The PCT stated that she would need to ring the National Pandemic Flu Service ID. She told them that she had already been there and they suggested contact with the PCT.

11. The elderly lady subsequently decided to give up, have a cuppa, commence some ginger tea and hope she didn't develop complications.

12. She then opened her post that day to find a letter telling her that Swine Flu vaccinations were happening and that the district nurses would ring her. She rang the District Nurses whose number was engaged for 7 hours. It has now been nearly a week with no news of the Swine flu vaccine.

The elderly lady developed Swine Flu but is recovering slowly.

And there we have it, Tamiflu accessibility in action in the vulnerable group. In Africa, you have an outreach service to target isolated groups. In the UK, the elderly just have to fend for themselves.

To Rita, From Beau Eckland

Desiderata

-- written by Max Ehrmann in the 1920s --


Go placidly amid the noise and the haste,
and remember what peace there may be in silence.

As far as possible, without surrender,
be on good terms with all persons.
Speak your truth quietly and clearly;
and listen to others,
even to the dull and the ignorant;
they too have their story.
Avoid loud and aggressive persons;
they are vexatious to the spirit.

If you compare yourself with others,
you may become vain or bitter,
for always there will be greater and lesser persons than yourself.
Enjoy your achievements as well as your plans.
Keep interested in your own career, however humble;
it is a real possession in the changing fortunes of time.

Exercise caution in your business affairs,
for the world is full of trickery.
But let this not blind you to what virtue there is;
many persons strive for high ideals,
and everywhere life is full of heroism.
Be yourself. Especially do not feign affection.
Neither be cynical about love,
for in the face of all aridity and disenchantment,
it is as perennial as the grass.

Take kindly the counsel of the years,
gracefully surrendering the things of youth.
Nurture strength of spirit to shield you in sudden misfortune.
But do not distress yourself with dark imaginings.
Many fears are born of fatigue and loneliness.

Beyond a wholesome discipline,
be gentle with yourself.
You are a child of the universe
no less than the trees and the stars;
you have a right to be here.
And whether or not it is clear to you,
no doubt the universe is unfolding as it should.

Therefore be at peace with God,
whatever you conceive Him to be.
And whatever your labors and aspirations,
in the noisy confusion of life,
keep peace in your soul.

With all its sham, drudgery, and broken dreams,
it is still a beautiful world.
Be cheerful. Strive to be happy.

Beau Eckland was larger than life. He was a big man with a big soul and a big heart. Beau and I met many years ago while working in Lancashire. He was my consultant. I had whined about a different consultant's attitude when he had upset one of my patients. Beau essentially told me to shut up, be quiet and do my job and quit the temptation to fight in battles that cannot be won. Beau was right because he always wanted to protect me.

Six months later the Spanish consultant from hell was struck off the General Medical Council's Register following various other complaints. I showed Beau the copy GMC Today that quoted the case. We both sat there and thought that sometimes fate is a strange thing. One doesn't even have to try to direct karma, it just happens.

Beau and I remained very good friends. The most surreal picture of both of us is with Beau and I fighting over the large amounts of freebees in the Lilly Rep's car boot. Lilly is a drug company which manufactures a drug called Olanzapine. Lilly spends its entire life trying to tell us all that patients don't get fat on it - actually they do.

Anyway, on that day, Eckland and I were scavengers. We were in the Blackpool Royal Infirmary car park bagging the gifts from the wise man of the esteemed drug company. It was shared loot. Eckland always got the good pens. It was so frustrating. Eckland always used the trick of tickling me so that I couldn't reach for the best bits of the freebees - I was always after the glassy pens. In trying to reach them that day, I practically fell into the Lilly rep's boot. Eckland was insistent that if I fell in, he would take a picture of my M and S opaque tighted legs and plaster it on the doctor's mess so I would never live it down. Such a wicked wicked man with no shame!

It is a load of rubbish to suggest that we were persuaded into prescribing the drug. We weren't interested in the drug - we were interested in free stuff. It was a bit like the days of the fabulous Viagra pens. Yes, we all had them, all the surgeons had them and even those who didn't have any testosterone had them. Eckland and I intently listened to the bullshit given to us by various drug companies for one aim only - to get the freebees. When it came to clinical management, we did what was best for the patient. Long gone are the days of freebees but it was fun then. It was just fun to eat drug company food, whip their goods and have endless supplies of post-it notes. We both figured, drug companies were rich, we weren't so we called it "equalising profits". My supply of post-it notes have lasted me to this day.

Beau was and always will be one of the best doctors I have ever worked with. His clinical management was extraordinary. He spoke with an Australian twang. He loved food, he loved life and he loved living.

Beau had developed health problems earlier this year when he ended up in hospital. He came out shocked at the treatment of patients in the NHS. He told me " They are f**** killing em Reets". He had essentially worked so hard that everyone had forgotten to take care of him. Indeed, he had forgotten to take care of himself. The hundreds of patients he cared for were never there for him. And this is the fate of sick doctors. They become a nameless grave. All their good work is never remembered but remain as fragments of memories locked in the patients' minds.

Eckland used to tell me that he felt trapped by many things over the years. He simply wanted to be free on a sandy beach and at peace. He wanted to lie flat and watch the blue skies and think of nothing but the beautiful world we all lived in. I suppose he got his wish. Beau became difficult to deal with, he refused help, he refused everything. He would ring me and tell me he was dying but refused to see me. His dislike of everything wrong in life appeared to take over - because illness makes doctors weak. Eckland wanted kindness but failed to accept it. I was essentially helpless and this worried me day by day. I was terrified that one day he would never ring again.

A few months ago, Beau Eckland was found dead in his hospital room by the police. He had died while oncall. His wife called me a week later. I should have attended the funeral but I just didn't like the thought of remembering Beau as a dead man. Funerals for me are such fake places where some pretend to mourn the loss of their loved one. They say what a lovely person the deceased was but were never there when the person was a living being. I have attended many funerals like that. I often sit and watch the many people pay their respects. As if the dead care about who attends their funeral. I am sure Beau was away somewhere having fun than watching the crocodile tears of those who see funerals as a way to purge their consciences.

For me Beau was never dead, he was alive in his spirit, in his laughter and in all the things in the world that I remember him by. Eckland was also prepared to write me a reference for the General Medical Council court hearing while he was ill in hospital. Beau never liked the GMC and always said that as doctors we were all fighting a losing battle. I told him that that organisation had no meaning in my life. What bothered me was their failure in cases causing untold damage to those who could not cope with them, There were far far more important things than them.

I went into court in 2009 essentially with no backup because out of the world of people I had known or helped, only Beau Eckland was prepared to stand by me - only Beau as a doctor was prepared to say " My name is Dr Beau Eckland and I am a friend and colleague of Dr Rita Pal". And this meant a great deal to me. It meant so much to me that I would never have allowed him to risk himself for me. I stopped him in his tracks and told him that under no circumstances was he going to align himself with me and place himself in jeopardy.

To me, his offer was real friendship - those who have the courage to stand by their medical friends. During my court hearing in 2009, many many people had pulled out then as Beau said, if they don't want to protect their future, stuff em. He was of course right about that and about many things. One cannot force the population of doctors to understand that they are essentially sitting ducks and that the GMC case I was involved in shows us all what a disastrous situation the current regulatory system is in. Essentially, it is much like a time bomb waiting to happen where innocent doctors will be destroyed. As Beau said, doctors have to accept the path they opt for. To some extent, that is true.

Beau always told me that no one would ever miss him and that the entire world always wanted something from him. He had three wives in total and it amazed me how he married so many. He felt like a Money Making Machine.

Beau was a simple man, all he was ever looking for was kindness. As he pointed out to me, there is little kindness in the world. Beau though was a kind and generous man. He was there for everyone but in the end no one was there for him - not even me. Dr Eckland though was a complex man who towards the end of his life just remained a voice on the telephone because for once he refused to meet me - not the other way around.

Anyhow, the above poem was given to me by Beau Eckland a few weeks after we first met. It teaches us many things about the world we live in. Most of all, it teaches us about leading a different kind of life. I am honoured to have known Beau Eckland and even though he always bagged the plush Olanzapine pens, he gave me more than that - he gave me true friendship that is extremely rare in a medical world full of superficial arrogance. I don't believe the medical world knows how to care. They do though know how to be doctors. Because for many, the title is far more important than the concept.

I miss Beau Eckland but in time we all learn to refill that vacuum with all the memories our friends leave us with. Eckland was a very special individual - I wish he had felt that himself while he lived.

Anyhow, if there is a life after death, I am sure he will be in Australia drinking a beer. I am also quite positive that should I meet him one day, he will be buying me that beer. It should of course be a Castlemaine XXXX.

Written in memory of Dr Beau Eckland, a good friend and colleague.

IF

I recently sent the above to a good friend of mine who isn't feeling great. I first read this when I was 10 years old and it stuck in my mind during all the times that have been difficult. Difficulties are really only a state of mind. Once you have got over that, everything is really simple. The key is to do all tasks in life with the utmost integrity. If you work hard enough on a path of honesty, the answers will soon be yours. Even if they do not appear all at once, you will have paved the way for those after you. That is every person's legacy.