UHS/ Cygnet Behavioural Health Industry grows despite its inadequacy.

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In 2011 the CQC made a routine announced visit to an Alpha psychiatric hospital in Sheffield and spoke to staff and patients on all three wards.

And found the hospital failed to comply with seven of the government’s standards of quality and safety.

By law providers must meet all standards, but there is no sanction, as at best, and very rarely will they be put into special measures.

Alpha Hospitals (NW) Limited were given 14 days to produce plans to show how it intended to achieve compliance.

http://www.cqc.org.uk/news/releases/cqc-calls-improvements-alpha-hospital-sheffield

Three years later Cygnet was bought by USA’s Universal Health Services for £205 million.

http://www.healthinvestor.co.uk/ShowArticle.aspx?ID=4285

Simons Stevens 10 years chief executive of UHS’s global division ,on leaving  his job as Blair adviser on NHS public investment is now chief executive of NHS England .

https://www.theguardian.com/society/2014/oct/23/simon-stevens-nhs-chief-private-past-uk?CMP=share_btn_tw

Then Cygnet bought all its three of Alpha’s Hospitals in Woking, Bury and Sheffield for 95 million.

http://www.healthinvestor.co.uk/ShowArticle.aspx?ID=4274&search=Alpha

But 6 years on and billions of public NHS money later, ‘treatment’ appears worse in the former Alpha Sheffield hospital.

So bad in fact, a Labour MP Louise Haigh wrote two months ago to the Health Secretary demanding an urgent meeting about care in Cygnet Sheffield.

The CQC had rated the hospital “inadequate” on safety.

Cygnet’s response being health and wellbeing of patients was its “absolute priority”.

The CQC inspected Sheffield three times in just 13 months, twice due to serious incidents.

The most recent inspection in July focused on the Haven ward, and identified a number of issues which caused the CQC to have “significant concern for the health and wellbeing of patients”.

Haigh mentioned to the House of Commons that a young woman was found by the inspectors to have MRSA with open wounds on a ward.

The CQC also found shortfalls in patient risk assessments, reporting of incidents and safeguarding procedures..

Haigh has since written to NHS England, Jeremy Hunt and Cygnet Healthcare over a “lack of learning” from incidents at the hospital

http://www.bbc.co.uk/news/uk-england-south-yorkshire-41163094

The Sheffield’s hospital’s latest CQC report of 17 th November is here
https://www.cqc.org.uk/sites/default/files/new_reports/AAAG9219.pdf

Comments of patients in Sheffield on the net are damning .

Maddie Colbrook -2 months ago

my brother got triggered because of all the blood stains on the walls you really need to sort that out of something bad will happen to him and I hate you for not listening to his period issues SORT IT OUT NOW OR I WILL BE SUEING YOU LOT

SL -a year ago
A lot of gossip with staff everyone knows everything about everyone. Not as professional as I would’ve hoped when it came to legal matters. No support given when it was needed.
Bullying from some staff members.
Doesn’t get cleaned as thoroughly as I would’ve thought with it being a hospital. Blood can remain on walls for months.
Over all pretty disappointed with the experience.

In June Cygnet  announced NHS England had confirmed Cygnet Health Care, as a partner in 3 out of the 11 new programmes commissioned for mental health services.

This was the second commission following a wave including Cygnet announced last year.

The 11 new care model programmes will be given a £300m commissioning budget.
Worth  £75 million to Cygnet.

To create new models of care for low and medium secure adult mental health services, Tier 4 child and adolescent mental health services and eating disorder services.

‘By creating new partnerships ( presumably with Health and Social Care Trusts) to explore new opportunities to improve care pathways for our service users.’

https://www.cygnethealth.co.uk/news/new-care-model-projects/

Cygnet continues to increase its empire, building new hospitals the latest in Coventry, a 56 bed specialist mental health service is to be opened by Debra K. Osteen, President of the Behavioural Health Division of UHS admissions in March 2017

https://www.cygnethealth.co.uk/events/cygnet-hospital-coventry-grand-opening/

Cygnet has its own events company and hosts work shops, conferences, award ceremonies, and training on all aspects of behavoural health, the new mental.

It has created its own world from awareness , detection, diagnoses and treatment.

700 attended its latest UK Conference .

It has its own annual National Service User Awards.
https://www.cygnethealth.co.uk/events-archive/

It intends to control all aspects of behaviour ‘disorders’.

How they are diagnosed , treated, even socially perceived.

Personality disorders, anorexia, anxiety, bipolar, psychosis, depression, PTSD, autism, learning disability, neurological injuries, even domestic violence.

But treatments appear similar- the most profitable, detainment and medication.
And all ages are harvested children via CAMHS and adults via AMHS

It’s PR and professional presentation is honed-

‘Cygnet Health Care has been providing a national network of high quality specialist mental health services for almost 30 years.
With a true focus on outcomes those who use or commission our services can be assured we are an experienced, service-user focused, provider of quality treatment, care and rehabilitation’.
https://www.cygnethealth.co.uk/

But what are the comments and experiences of its service users ?

Cygnet Hospital Ealing
https://www.nhs.uk/Services/hospitals/ReviewsAndRatings/DefaultView.aspx?id=89330&SortType=1#cmnt1167140

Bury
https://www.google.co.uk/search?q=cygnet+hospital+bury&sa=X&ved=0ahUKEwi_45T9r7nXAhUR6KQKHUpdAJ4Q1QIIbCgE&biw=1366&bih=618#lrd=0x487ba4fdafc234a9:0xccecd98cfed76b7a,1,,,

Coventry
16461120519217253361/place/ChIJIQcsM35xekgR5X_KezCUFPc/@52.6095642,-1.8003492,10z/data=!4m6!1m5!8m4!1e1!2s116461120519217253361!3m1!1e1?hl=en-GB

Christina Jacob 3 months ago

My relative went in as a voluntary patient in March.

By the end of the week they had them on a section 3 was giving them olanzapine injections. I told them the drug had been used in the past and didn’t suit.
Relative became really unwell was not taken care of sent to a god awful place came back months later.
I went to visit and they had had a meeting and put a safeguarding thing in place on me.
I am a woman in a wheelchair who has complained constantly about how my relative had been treated. This place could not organize a piss up in a brewery oh hang on the place is one big boozefest

Beckton
Extremely poor level of patient care. Very unprofessional and incompetent staff including the managers. Vulnerable people with learning disabilities and those who self harm require a safe, therapeutic and positive setting to recover and receive treatment, and this is not the place!

Heather Maclatcy
A month ago
Cygnet I wouldn’t send anyone to this place is not compliant in my view with the mental health act or the code of practice ie restrictive practices form the hospital management down to day to day staffing and some of the practices as seen on hansa ward leaves a lot to be desired Like how some of the staff deal with patients when they are in distress ie restraint isn’t practices are like how you would treat prisoners in prison bending joints in the wrong way which is not at all acceptable, because it could lead people lifelong injury plenty of other ways in my opinion how to get someone to comply with instructions non-pain compliant techniques, lucky was not a issue with me I felt bad for other patients
And as well to get medical care at Cygnet leaves a lot to be desired I had to go Private for dental treatment because The RC would not grant leave to see specialist dentist is medical leave and these guys stretch the truth to the max like in mental health tribunals they lie through their teeth
You are CCG do not send your patients to this hospital under any circumstances
If you got a loved one in this hospital exercise your rights as nearest relative to get them discharge under the mental health act

And what  do Cygnet workers think ?

https://finolamoss.wordpress.com/2016/12/29/comments-on-cygnets-services/

And here are stories of those trapped in hospitals.

https://finolamoss.wordpress.com/2017/10/26/the-bipolar-cashcows-release-this-8-year-cygnet-bipolar-inpatient/

https://finolamoss.wordpress.com/2016/12/25/a-christmas-tale-of-autistic-lives-and-cygnets-12500-a-week-nhs-bonanza/

And two of the many who have died in Cygnet ‘care’.

Jody -Bury Cygnet

https://finolamoss.wordpress.com/2016/12/09/jodies-cygnet-help-no-psychologist-communicationassessment-plan-protection-death-for-21000/

Jonathan Chamberlian Ward Cygnet Stevenage
https://finolamoss.wordpress.com/2016/12/01/24-year-old-dies-in-cygnet-after-11-forced-olanzapine-injections-in-10-days/

And here are their CQC ratings.

CQC CygnetDO2Bl6qWAAELizv

 

 

 

 

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Occupational Stealth – Be wary of revealing mental health issues at work .

Mental-Health-PIC

A review commissioned by our Prime Minister revealed 300,000 workers lose their jobs annually due to mental health.

https://www.theguardian.com/society/2017/oct/26/thriving-work-report-uk-mental-health-problems-forcing-thousands-out

But why are so many losing their jobs and what would be the effect of ridding the workplace of the mental health taboo?

Could it be an employer’s increased use of Occupational Health Services ?

70 years ago Clement Atlee set up a committee which concluded the Ministry of Health as a public independent body should be the provider for British Occupational Health Services.

But this was ignored, and today Occupation Health is a multi million pound private industry.

With the Department of Work and Pensions alone spending over £3,147 m on it annually.

The Committee’s wish was for the services to be completely independent of employers.

But they are still today paid for and commissioned by an employer, and such services owe their paramount duty to that employer, and this is confirmed in the Occupational Health Professionals’ Codes of Conduct.

Yet, there is clearly a conflict of interests between an employer’s interest to make profit and the health of his employees.

And such an employer’s control over Occupational Health destroys a patient employee’s right to medical confidentiality with the service.

But despite this, Dame Carol’s Black’s 2008 Review of the Health of Britain’s working population, put Occupational Health provision at the centre of the then Brown government announcing a

”new vision for the health of the working age population”,

” in which the relationship between health and work becomes universally recognised as integral to the prosperity and well-being of individuals, their families, workplaces and wider communities”.
https://www.gov.uk/government/publications/working-for-a-healthier-tomorrow-work-and-health-in-britain

But this review appeared to radically change the very nature of the occupational health service, from that of ensuring an employee’s duties did not adversely affect his health, to ensuring that his health did not adversely affect his duties.

And health concern, particularly mental due to its vagueness can be a useful, paternalistic tool of control of an employee.

As it allows management to silence whistle blowers, ensure collaboration, avoid constructive dismissal , and stress, discrimination and harassment( including sexual harassment )claims.

Line managers are encouraged to refer employees to occupational health, as soon as they have any concerns about their physical or mental ill health.

If an employee refuses a referral, he may be suspended in his own and the employer’s interests, and even disciplined for insubordination.

So effectively an employee can’t refuse an assessment.

Yet that assessment is paid for and remitted by his employer and therefore for his purposes, primarily at best to ensure health concerns are not and/ or will not interfere with an employee’s work duties.

But it can be used as a tool to control employment and to discover an employee’s health history and present issues, despite doctor patient confidentiality.

And worse still, an employer can refuse to allow an employee to see the whole ,or any part of an Occupational Health Assessment.

As whilst s. 2 (1) of the Access to Medical Reports Act 1988, gives an individual a right of access to any report relating to his physical or mental health, prepared by a medical practitioner, who is, or has been, responsible for his clinical care.

‘Clinical care’ is being, interpreted narrowly, so as not to include occupational health care, resulting in an employee having no right to access their occupational health assessment.

Further, section 7 (1) of part 3 of the Education (Teachers’ Qualifications and Health Standards) (England) Regulations 1999 provides that,
‘ A person in relevant employment shall not continue in that employment if, he does not have the health and mental and physical capacity for that employment.

Section (2) (b) providing that when deciding this capacity, employers can consider information,

‘such has been furnished in confidence on the ground that it would not be in the best interests of the person concerned to see it’.

So any information, occupational health, line manager ,another employee or indeed any information on an employee’s health ‘furnished in confidence’ can be withheld from an employee in his best interests.

This is a beyond terrifying extension of employer paternalism which managers but few employees will be aware of.

This Regulation refers specifically to teachers including academics but similar regulations and/or contractual terms probably apply to most occupations.

Rights of access to assessments can be similarly refused under

The Data Protection Act 1998 Sch 8 part 3 para 3 (a),

‘where permitting access to the data subject would be likely to cause serious harm to the physical or mental health or condition of the data subject’ .

So employees can be assessed ,as unfit for their present duties, without ever knowing why, or being allowed sight of assessments, despite the devastating consequences on their present and future employability.

In addition, the excuse of confidentiality can be used by management in respect to other employees, making it impossible to ascertain targeting, and the fairness of the process.

And ‘fit notes’ give occupation health and line managers control over an employee’s ability to return to his former duties.

As rather than just certifying an employee is fit to return to work GPs are now required to certify, that he may be fit for work if certain stated concerns are addressed by his employer.

This change forces an employee’s GP to be part of the Occupational Health system, as this is the body responsible for recommending work related changes .

Thus imperceptibility eroding doctor patient confidentiality, and a GP’s ethical need to act in his patient’s best interests.

‘Fit notes’ replaced the old written GP sick notes in 2009 and are computerised statements so easily subsumed into an employee’s National Summary Care database, which embrace an individual’s complete health profile.

Despite opposition, the Coalition government rolled out this Data Base nationally, but surveys show most public do not even know of its existence, let alone its purpose .

And it has been rolled out to more agencies and professional services with pharmacies now gaining access .

https://en.wikipedia.org/wiki/Summary_Care_Record

Technically an employee’s express consent is required to access his medical records, including his summary care database record.

But consent may be expressly and/or impliedly provided for in a contract of employment, and a dismissal for unreasonably refusing consent can be fair Caplin v Howard Kennedy Solicitors AT 20/1/09.

It is likely, occupational health providers are able to access to the summary care record database.

As an independent academic study of the summary care system back in 2009, revealed that there was widespread confusion about the method of obtaining consent, and to whom such consent is extended, at present it extends vaguely to all specialists, who are providing care or treatment, which could extend to Occupational Health Care.

Documents obtained under the Freedom of Information Act, provide evidence that NHS Connecting for Health , ( now NHS Digital managers of the system), changed a written assurance to patients that non clinical staff,” will not” have access to ”may not”, allowing non- clinical staff to gain access to the summary care record database.

An individual has a right to be ill, and a right to private consultation with his own chosen independent medical practitioner.

And a Human Right to Privacy.

Whilst an employer has a duty to ensure that an individual’s work does not adversely affect his health, which was why the Occupational Health Service was created, this should not  be subverted and then used against an employee.

Many people’s livelihood can be destroyed by the present use of Occupational Health as it can be made a tool of management to control workers present and future employability.

NHS Inpatient Mental Deaths up 50%. No investigations. Numbers unknown.

crying out

If our government really were concerned about our mental health, it would, at the very least, record the number of deaths of inpatients and investigate them.

Particularly as the number of detentions under the MHA has risen by 10% year-on-year since 2010/11.

But the number of deaths in NHS hospitals is unknown, not recorded, and rarely investigated.

No single body is responsible for recording children or adults inpatient deaths.

This crucial information is neither collated, analysed or made public .

And as most hospitals are owned by private corporations, Freedom of Information Notices are being refused on the grounds of commercial confidentiality.

47% of child and adolescent mental health service providers refused to answer FOI requests because of their private status.

http://www.inquest.org.uk/media/pr/number-of-hild-in-patient-mental-health-deaths-not-known

So we pay up to £13,000 a week, an average £900 a day per inpatient for public NHS ‘treatment’, provided by private corporations, but aren’t allowed to know how many healthy people die and why ?

New laws were introduced last year which remove those dying under Deprivation of Liberty Safeguards of their  right to a jury in a Coroners Inquest under Art 5 Right to Life..

Latest statistics from Norfolk and Suffolk NHS Foundation Trust show 140 patients suffered “unexpected deaths” in just 9 months last year .

There are no national figures to compare trusts, like for like, but the consultant used said ,
’’it did not appear that NSFT was an outlier ( out of line)in terms of high numbers of deaths or incidents.”

http://www.edp24.co.uk/news/health/unexpected-deaths-could-reach-new-heights-in-mental-health-care-1-4877737

Panorama last year served FOI requests on 57 English mental health foundation trusts, increasing private companies like Sheffield Health and Social Care .

Only 33 responded

In 2012-13, they reported 2,067 ‘unexpected’ deaths.

By 2015-16 this had risen to 3,160.

Nottinghamshire Healthcare NHS Foundation Trust reported 113 ‘unexpected deaths’ within its mental health services in 2016/17 an increase of 76 from 2015/16,  over 100% increase in  just a  year.

http://www.lincolnshirelive.co.uk/news/health/big-rise-unexpected-deaths-among-83896

The number of ‘unexpected’ deaths in St Andrews Healthcare is still unknown

https://finolamoss.wordpress.com/2015/08/25/how-many-deaths-in-st-andrews-northampton-who-is-accountable/

3 years ago the government reported 1,200 people, 3 a day with a learning disability died every year within our NHS due to inadequate care.

http://enablemagazine.co.uk/mencap-dismayed-by-lack-of-progress-to-stop-avoidable-deaths-of-people-with-a-learning-disability/

A Liverpool MP asked Jeremy Hunt last year how many children and young people had died in NHS care from 2010 and he couldn’t answer.

http://www.mirror.co.uk/news/uk-news/tragedy-nine-young-people-died-7729668

Why are so many young and physically fit patients dying from mental health ‘treatment’?.

We have no answer.

As there is no system requiring any investigation, let alone an independent one,at best, deaths are being investigated by the owners of the institution where they die .

With no transparency of process and in breach of the basic rule of natural justice, that no man should be a judge in his own court.

http://www.inquest.org.uk/media/pr/number-of-hild-in-patient-mental-health-deaths-not-known

The CQC and NHS England refused to investigate the 7 unexpected deaths in St Andrews Northampton in 2013/14 flagged up by the local Healthwatch

https://finolamoss.wordpress.com/2015/08/25/how-many-deaths-in-st-andrews-northampton-who-is-accountable/

A 2016 study revealed that Southern Health NHS one of the largest NHS Trusts, has investigated only 13% of 1,454 of its ‘unexpected’ patient deaths since 2010.

Investigation rates being  particularly low for elderly patients with mental health problems (0.3 per cent) and for patients in general with a learning disability (1 per cent).

This was stated not to be an outlier.
http://www.independent.co.uk/news/uk/politics/a6766961.html

So, we can therefore assume nationally, only 1 % of ‘unexpected’ deaths of learning disabled including the autistic, and 0.3 of the older patients are investigated.

All ‘unexpected’ deaths are supposed to be reported to a coroner so they can be investigated.

But official figures show that that of 1,115 cases recorded by the NHS, only a third, were reported to coroners over the last three years.

http://www.telegraph.co.uk/news/2016/08/09/hundreds-of-deaths-of-mental-health-patients-not-investigated-re/

Norman Lamb blamed
’ Under funding of sometimes threadbare mental health services which are struggling to cope with rising demand for care’.

Yet a fifth of our total NHS budget is being spent on mental health , the CCGs budget being up by £342m, and an extra £1.4bn is allocated by this Parliament.

How can the present £13,000 a week and minimum £900 a day even be justified, let alone insufficient ?

And would venture capital be investing their cash, as they increasingly are, in ‘threadbare’ services ?

Last year the government ploughed £433 million into safeguarding the vulnerable in their family home or individual’s non state home.

https://finolamoss.wordpress.com/2016/05/19/how-will-433-million-carers-act-implementation-money-be-spent/

With so many dying in state care, the vulnerable need to be safeguarded in state care, not removed to it,  as in such care deaths are not even recorded let alone investigated .

 

The bipolar cashcows. Release this 8 year Cygnet ‘Bipolar’ 4 million pound inpatient.

bipolar798440-1508887256-wide

In the USA  Prior to 1955, bipolar illness was a rare disorder. There were only 12,750 people  hospitalized with that disorder in 1955.

In addition,  there were only about 2,400 “first admissions” for bipolar illness yearly in the country’s mental hospitals.

Outcomes were relatively good too.

 Seventy-five percent or so of the first-admission patients would recover within 12 months.

Over the long-term, only about 15% of all first-admission patients would become chronically ill, and 70% to 85% of the patients would have good outcomes, which meant they worked and had active social lives.”

Today over 5.7 million US citizens have bipolar and are mostly unemployed, hospitalised and medicated for life.

https://www.madinamerica.com/2016/03/do-5-million-americans-really-have-bipolar-disorder/

And according to NHS Digital 2016, 2% of the UK population mainly children and under 25s screened positive for bipolar.

https://www.bipolaruk.org/news/bipolar-uk-welcomes-inclusion-of-bipolar-within-official-statistics

Yet there is no proven pathology and bipolar can be diagnosed on a few hyper episodes by those employed by corporations who gain millions from its diagnosis .

A psychiatrist commented to me fifteen years ago ‘ Bipolar is where all the money  is now’, as it appeared in soap characters  and celebrities like Stephen Fry. 

As  David Healy  noted

‘how a very few people in key positions can determine the course of events and shape the consciousness of a generation’.

Many bipolar victims have been holed up in mental hospitals on secure wards for years as they now earn £13,000 a week on secure wards and £7,000 on others for their private for profit providers paid from NHS funds.

This is not treatment under the MHA, as it is not determinable and  patients are mentally and physically deteriorating on an increasing in breach of NICE guidelines  diet of  polypharmacy, as they suffer in captivity.

They have no voice, no IMCA, no nearest relative appointed, no meaningful reviews, no future, no life, all experts and treaters are  employed by the private corporations that profits from their encagement.

The girl pictured above is just one  of the many victims.

We only know about her because her grandmother Gillian Speke, has  petitioned the government for her release from a Cygnet hospital.

She has been held medicated on a secure bipolar ward for 8 years, earning her Cygnet providers earning  over 4 million pounds of NHS money to date.

Here are comments by workers on Cygnet services.

https://finolamoss.wordpress.com/2016/12/29/comments-on-cygnets-services/

Why is this allowed to happen ?

Can she not be more effectively treated under a treatment order in her community.

When, if ever would she be released ?

Here are the words of her grandmother from her petition, please sign it, this young woman  and  thousands silently suffering need our help.

‘My name is Gillian Speke.

Please help release MY GRANDDAUGHTER from CYGNET HOSPITALS by signing our petition.

She needs to be near to her Nan. 8 YEARS she has been incarcerated. Her physical & mental health have deteriorated, she has had no help from a Nearest Relative because this has not been attended to.

Her weight has doubled due to the long list of meds she is forced to take. She has to stay on a secure BIpolar ward, she gets no fresh air or exercise, there is no structure, no organised activities except for Mindfulness & she has been denied access to education for the past 11 YEARS.

She has not had an assessment for a move to the community as promised in 2016. She is DYING in there. She does not deserve to be punished. She is a vulnerable woman who needs help for Trauma (PTSD) 

https://www.thepetitionsite.com/en-gb/798/440/513/release-my-grandayghter-from-detention-in-cygnet-private-hospital/?taf_id=44510916&cid=twitter

Is this how you want our NHS money spent ?

Here is the list of medications this lady is forced to take and originally her stay  was estimated at 2 to 3 years.

Regular Medication:

Sertraline 200mg mane; Depakote 750mg BD; Mebeverine MR 200MG BD; Metformine 1G bd; Atorvastatin 40mg OD; Omeprazole 20mg mane;  Furosemide 50mg mane; Dapaglifozin 10mg mane; Diazepam 5mg TDS; Colecalciferol T OM; Kwells 300mg TDS; Clozapine 225mg BD .

PRM Medication:
Ibrufen 200-400mg up to QDs; Epipen 0.3mg up to 0.9mg; Cyclizine tab 50mg up to 150mg;  Procyclidine 5mg PO max in 24 hrs 10 mg; Olanzapine 2.5-5mg max 200mg (PRN + regular); Promethazine 25-50mg max dose 100mg in 24 hrs;  Salbutamol 100mcg; Glucogel/Glucsgon T; Corsodyl ; Lactulose;  Stat dose of Clopizol Acuphase given on 3 occasions since admission – forcibly injected.

https://psychiatricabuseuk.com/

And read here the full story of the horror of this lady’s very expensive minimum £900 a day ‘treatment’

https://m.facebook.com/story.php?story_fbid=1623331831021618&id=1609298589091609

 

And, there appears systemically, no effective accountability for health services, as under the Health and Social Care Act 2012, NHS England and not the Department of Health is liable for services but are also the commissioner and regulator of these services and liable if inadequate.

So there is a huge conflict of interests between these roles of regulator and commissioner, which equals no accountability.

 

 

 

 

 

 

 

Serco, Priory and Mydentist – A tale of monopoly venture capitalism and leadership.

White-Monopoly-Capital-Definition-use-and-denial-by-Chris-Malikane

The Priory Group is the UK’s main provider of mental health, learning disability and specialist education services almost exclusively financed by public funds via NHS clinical commissioning groups and Local Authorities.

Tom Riall joined the Priory from Serco in 2013, where he had been Chief Executive of their Global Services Business.

He continued to build on the strength of the Priory’s care pathway service ensuring the business was well positioned to manage the transition of the healthcare commissioning reforms.

Riall sold the Priory Group to venture capital backed US Acadia for 1.28 bn last year.

And in May this year moved on to Integrated Dental Holdings Group, who own UK’s largest NHS dental chain Mydentist which also provides private treatments.

https://www.mydentist.co.uk/about-us/investors/archive/lists/investors/2017-03-21—announcement-of-new-chairman-and-chief-executive

https://finolamoss.wordpress.com/2016/11/06/us-acadia-group-pay-1-28bn-for-the-priory-group-mental-health-feeds-venture-capital-profit/

Did Riall’s sojorn in the Priory Group improve services ?

Deaths spark fears at Priory Hospitals.
https://www.thetimes.co.uk/article/deaths-spark-care-fears-at-prioryhospitals-jdtf38khp

Coroners have issued five formal notices over the past five years, highlighting care failures after deaths of patients in the care of the Priory Group’s hospitals.

Among the recurring problems highlighted in the coroners’ “prevention of future death notices”, are a failure adequately to monitor patients at risk of self-harm, failures in training and inadequate record keeping

Riall’s meteoric climb began 25 years ago with the advent of monopoly corporatism and outsourcing.

He held senior leadership positions in the Onyx and Reliance Groups working with local authorities and central government across the UK.

And oversaw Reliance’s successful tender in 2003 for the use of private contractors to transport prisoners in Scotland.

When the firm mistakenly released a number of prisoners, including a convicted murderer in 2004, Riall offered an apology but defended his company’s performance, before joining Serco’s Civil Government and Home Affairs divisions

Riall spent eight years at Serco , most recently as chief executive of Serco’s global services division, spanning 12 countries.

Serco provides a variety of services and products relating to defence, home affairs, aviation, and transport.

Since the 16 October 2017, Integrated Dental Holdings Group, who own Mydentist has had Omar Shafi Khan as its Chief Financial Officer and Board member.

Omar joined IDH with a wealth of experience and  strong track record in financial leadership, strategy, business development and treasury.

He was previously Group Chief Financial Officer at Innovia Group, a private equity backed leading advanced polymer solutions company, and prior to this spent 16 years at Royal Dutch Shell.

So can we expect a venture capital purchase of our NHS dentistry soon ?

In just 17 years, Mydentist  developed from just 3 NHS practices in North West England to the largest dental corporate in the world with over 672 Practices across the UK.

Their core business is the provision of primary NHS  dental services, but the majority of dental practices also provide private dentistry services including dental replacements.

Practices can make over £500,000 a year just from the NHS, if they see 60 patients a day.

IDH also own the dental supplies and equipment to their practices.

But will it help our teeth, particularly with our government’s policy for ‘preventative’ dentistry?

See my recent experience of Mydentist
https://finolamoss.wordpress.com/2017/10/10/my-private-corporate-preventative-nhs-dentistry/

http://www.dentistry.co.uk/2017/03/06/another-mydentist-practice-closes/

My Private Corporate ‘Preventative’ NHS Dentistry.

no teeth hqdefault

My sojourn with Sheffield dentists started back in 1994 when I was recommended Mary Taylor NHS .

She was dedicated and served me and my teeth well until the new NHS contract of 2006 started to pay dentists on the number of ‘units of dental activity’ performed each year.

This, and no doubt the fact that the funding structure made it more profitable to remove rather than save teeth, forced Mary’s early retirement.

So I moved to the NHS practice my husband and daughter used.

But within 3 years it went private, one dentist left to work for a NHS practice and my daughter and husband followed her.

Trusting my own dentist I stayed until last year when his bill for my fillings lead me to consider the savings of NHS dentistry.

My husband and daughters dentist was fully subscribed so I was allotted a new kid on the block .

I arrived at the bright white reception bedecked with large photographs of happy smiling teeth and filed my two forms up.

And was promptly lead into the treatment room by a young dental nurse and greeted by an even younger dentist ,who I regaled with nervous chatter about my front gum being inflamed but treated with corsodyl , my lack of oral hygiene due my horrendous home life, and that my smoking didn’t help my gums.

Had I known the government had just released an agreement on preventative dentistry, l’d have kept my mouth literally and metaphorically shut.

http://www.dentistry.co.uk/2017/02/13/nhs-contract-reform-are-you-ready/

https://www.pcc-cic.org.uk/article/dental-contract-reform

But the dentist made no comment other than ask why I didn’t have an accent and where I was from.

20 minutes passed as every tooth was fastidiously x- rayed and noted by the nurse .

I was impressed by such attention to detail, the first time in over 20 years.

The dentist cleaned around my sensitive gum area, but did not inspect or poke my other teeth which I thought a bit odd.

And ended with the ominous words, ‘I’ll have to see how many I can save’, peering at my x rays .

Having never had a tooth out, I began to wish I’d brushed more often, didn’t smoke and gone to the NHS sooner.

But  wondered how my teeth could have deteriorated so badly in the 8 months since by private dental check up and fillings.

When I found out from the receptionist I would need three more appointments, my concern grew but was partially dismissed by the NHS’s obvious  thoroughness.

The first, on the 13th April but not a Friday arrived, and I was promptly ushered into the surgery room .

And my  chair tipped back as the dentist exclaimed, ‘We’ll be doing an abstraction today, the one at the back’ and threw a mirror on my almost horizontal chest.

I assumed it to be the small top tooth at the end, but had no time to reach the mirror let alone have a look..

So with the shock of my gums being worse than I’d thought, but at least I wouldn’t miss such a tooth, so had got off lightly, I braced my self for the inevitable, already prepared injection, willing the ordeal over.

Within 5 minutes on an aggressive wiggling and tugging, and a request from the dentist,’ to let me see that root’, but no further comment, except for how well I’d done, bunged, with blood poring I was ushered out with a leaflet entitled ‘After your extraction’.

The bung seemed large, but again I put it down to more NHS thoroughness.

Many ibuprofen later on removing it I discovered my upper molar was gone, leaving an inch gap in my mouth.

I pondered how this could result from gum inflammation under my front tooth and why it was needed, as the tooth had never ached.

And read my leaflet telling me I might lose some self esteem, but could avail myself of a replacement bridge or implant  the expense measured in carrot symbols.

Only  then  did I question my experience and the ethics of NHS dentistry.

Resorted to my Google friend, searching ‘unnecessary tooth extractions’ and found this

http://www.dailymail.co.uk/news/article-3726896/Dentists-pull-THOUSANDS-teeth-unnecessarily-year-NHS-rules-pay-simple-extraction-complex-surgery-probe-finds.html

And beat myself up for weeks for being such a trusting idiot, vowing never to go back to the NHS.

I couldn’t face more bureaucratic professional fights which couldn’t be won, so asked my husband to ring and cancel my next two appointments.

When he asked what they were for, the receptionist happily trotted out two more extractions with teeth references to a lower molar and a wisdom tooth.

But no mention of their Complaints Procedure.

Months later, as if to add insult to injury, a letter of concern that I hadn’t been back reminding  me of the importance of dental care  arrived.

And received  this standard survey to complete for Corporate PR and Self Regulation in November 2017.

https://mail.google.com/mail/u/0/?tab=wm#inbox/15f9665dda9854a5

As a lawyer I know this was not informed consent, nor appeared necessary treatment, but the stress of a risk adverse complaints system, fighting corporate lawyers, risking their costs and wasting so much time was not worth facing.

I went back to my trusted non NHS dentist, and over three half hour appointments, with the effective loss of two more healthy teeth, drilled to hang a bridge on, and £ 980, the hole in my mouth was filled, as was a small filling that NHS had not noticed.

My old dentist could not understand why the tooth had been removed nor why two more needed removing.

But did say that he’d had a similar story that week from another patient.

So my trip to the NHS cost me a molar and two healthy teeth, but two other teeth could have gone.

With no toothache, or reason given, and 7 months on still no pain  and gums now healthy.

Lead me to ask, in whose interest is ‘preventative’ dentistry and why is our government pushing it ?

 

 

s4 and s5 Mental Capacity Act – No blame, total control ‘care’ only ?

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Despite the unworkability/illegality of capacity assessments and the draconian, no rights nature of the Mental Capacity Act.

And the secrecy and lack of independent representation of the ‘incapacitated’ in the Court of Protection, the executive appears intent with its latest Law Commission Report on Deprivation of Liberty Safeguards, renamed Liberty Protection Safeguards, to merely tinker with and enforce the present MCA practice, to aid ever more efficient private care and speedier pathways.

http://www.communitycare.co.uk/2017/03/13/law-commission-reveals-deprivation-liberty-safeguards-replacement/

It also appears that without ‘incapacity’, care providers are reluctant to provide care, as they wish to avail themselves of the protection from liability the Mental Capacity Act s5 affords them.

And control the service provided by making all decisions in a person’s best interests as allowed in s4.

s 5  states;

Acts in connection with care or treatment
(1)If a person (“D”) does an act in connection with the care or treatment of another person (“P”), the act is one to which this section applies if—

(a)before doing the act, D takes reasonable steps to establish whether P lacks capacity in relation to the matter in question, and

(b)when doing the act, D reasonably believes

(i)that P lacks capacity in relation to the matter, and

(ii)that it will be in P’s best interests for the act to be done.

(2)D does not incur any liability in relation to the act that he would not have incurred if P—
(a)had had capacity to consent in relation to the matter, and
(b)had consented to D’s doing the act.

And s 4 states;

Best interests

(1)In determining for the purposes of this Act what is in a person’s best interests, the person making the determination must not make it merely on the basis of—
(a)the person’s age or appearance, or

(b)a condition of his, or an aspect of his behaviour, which might lead others to make unjustified assumptions about what might be in his best interests.

(4)He must, so far as reasonably practicable, permit and encourage the person to participate, or to improve his ability to participate, as fully as possible in any act done for him and any decision affecting him.

(6)He must consider, so far as is reasonably ascertainable—

(a)the person’s past and present wishes and feelings (and, in particular, any relevant written statement made by him when he had capacity),

(b)the beliefs and values that would be likely to influence his decision if he had capacity, and
(c)the other factors that he would be likely to consider if he were able to do so.

Barrister Alex Ruck Keene author of LAG Court of Protection Handbook, authority and practitioner says,

many professionals behave as though section 5 provides an authority to act.

Worse still, in doing this the professional might be motivated by a desired outcome from the start, followed by the question: ‘does this person have capacity?

In effect, some professionals want the person to not have mental capacity, in order to authorise their decision making, conveniently forgetting about principles 4 and 5 of the MCA, and section 5.

The MCA then is frequently skewed in practice, not to enable the person, but to provide a dubious mechanism for going against the person’s will.’

Exactly the opposite to the Parliamentary justification  for the MCA, which was to safeguard people who had capacity from  others making  their decisions, and to maximise a person’s capacity, and if this proved impossible to give effect to the ‘incapacitated”s wishes and involve them in the decision making.

http://www.communitycare.co.uk/2017/09/27/mental-capacity-act-10-years-still-misapplied-used-people/

So  professionals employed by the care providers will not be liable for any act done to the reasonably suspected incapable, if they reasonably believe it is in  that person’s best interests.

That is a lot of ‘reasonable beliefs’ and protects a lot of people and corporations in fact everyone.

In  no  other service, do we have such whole scale exemption.

And, as these actions are done to  our most voiceless, in secret, with no independent voice, or possible whistle blower for profit, scrutiny and liability should be the highest possible not effectively non existent. .

In addition, it appears service providers are  assuming ‘incapacity’ to enable all care decisions to be made by them,  even in respect to decisions a person is capable of making, despite the s1 overriding provision stating capacity must be presumed and this presumption rebutted by evidence on the balance of probabilities.

‘Incapacity’ can in any event,  be bureaucratically  tick boxed, by a non engaged expert assessment.

But even this is often not happening, as providers are relying on s5 that they reasonably believe a person is incapable and then making all their decisions under s4, purportedly in their best interests.

s4’s requirements that ‘so far as is reasonably ascertainable the person’s past and present wishes and feelings’ and  the need to involve them in the decision making process is being ignored.

As who will argue and check they have  been complied with ?

And what in any event would be the sanction ?

If a Company’s prerequisite for provision of services is the avoidance of any liability and control of  all  the service users’ decisions, what is that saying about the service ?

s4 and s5 are  very dangerous provisions, particularly in the for profit , commercially aware , secret world of the itinerant care of those without a voice.

Particularly as the courts will not in anyway interfere into the provisions of services.

https://finolamoss.wordpress.com/2017/05/06/best-interests-no-choice-no-outcomes-no-accountability-the-story-of-mn/