Shattered Lives
Shattered Lives
Shattered Lives
LIVES:
100 Victims of Government Health Care
By
Ridenour, Amy.
Shattered lives : 100 victims of government health care / Amy Ridenour and
Ryan Balis.
p. ; cm.
ISBN 978-0-9665961-0-6
1. National health services. 2. Health care reform 3. Health services
accessibility. I. Balis, Ryan. II. National Center for Public Policy Research.
III. Title.
[DNLM: 1. State Medicine. 2. Government Regulation. 3. Health Care
Reform. 4. Health Services Accessibility. 5. Universal Coverage. W 225.1
R544s 2009]
RA412.R53 2009
362.1’0425--dc22
2009027068
Acknowledgments
The authors wish to express their thanks to the following organizations and
individuals who provided valuable information or assistance.
Lauren Bean, Jack Bloom, MPL, Tom Blumer, Congressman Michael C. Burgess,
M.D., Castanet (Kelowna, Canada), David R. Henderson, Cerere Kihoro, Mark R.
Levin, Paul Mirengoff, On The Fence Films, Congressman Ron Paul, M.D., Vicky
Ringer and Val Ringer of Levi’s Star, Salisbury Journal (Salisbury, UK), Richard
Sementa, Biljana Silke, Norman Singleton, Victoria Strokova and Mark Valenti’s
Liberty Page.
A special thanks is due to David A. Ridenour and Stephen Saunders for developing
the resources to make this book possible, and to David Ridenour for contributing the
title of this book and for his assistance during every stage of production. A further
special acknowledgement is due to Deroy Murdock, who first conceived the idea of
collecting the stories of victims of government-run health care into a book.
Great Britain
Engineer Left Blind for Three Years Awaiting 20-Minute Operation . . . . . . . . . . 9
Small Boy Told to Wait Six Months to Get Painful Teeth Removed . . . . . . . . . . 23
Mother Delivers Baby in Hospital Bathroom With Only Her Own Mother
to Help . . . . . . . . . . 25
Elderly Man Spends Life Savings for Private Hip Replacement After NHS Cancels Four
Appointments . . . . . . . . . . 43
War Veteran Waits Two Years for Hearing Aid; Gives Up and Goes Private . . . . . . . . . 59
NHS Tells Disabled Man with Fist-Size Hernia to Wait for Surgery . . . . . . . . . . 64
Government Tells Cancer Patient: We’ll Take Away Your Health Care If You Pay for
Supplemental Care Yourself . . . . . . . . . . 66
Canada
Canadian Told To Wait 4½ Months to Learn If Brain Tumor is Malignant . . . . . . . . . . 81
Woman With Three Clogged Arteries Dies After Waiting Three Years for
Heart Surgery . . . . . . . . . . 84
Canada’s Refusal to Fix Hole-in-Head a Real Life ‘Humpty-Dumpty Gone Wrong,’ Says
Member of Parliament . . . . . . . . . . 85
Child with Cancer Put on Two-and-a-Half-Year Waiting List for MRI Scan . . . . . . . . . 88
You Can’t Eat, You Can’t Talk, You Can’t Move Your Jaw at All – But You Must Wait
Three Months for Treatment . . . . . . . . . . 106
Brain Cancer Patient Denied Last-Chance Drug Despite Specialists’
Recommendations . . . . . . . . . . 107
Canadian Doctors Hold Lotteries - “Winning” Patients Lose Their Doctors . . . . . . . . 109
In Canada, Protesting Waiting Lists Can Get You Bumped from Surgery . . . . . . . . . . 110
Australia
Painter’s Ailing Hands Not Reason Enough for Speedy Surgery . . . . . . . . . . 115
Elderly Woman Waits Nearly Four Years for Cataract Surgery . . . . . . . . . . 120
Child Waits Hours in Pain Inside Hospital, Only to Be Sent Elsewhere . . . . . . . . . . 123
Wait Prompts Cancer Sufferer to Spend $10,000 for Private Treatment . . . . . . . . . . 126
Arthritis Sufferer Forced to Wait Nearly Three Years for Ankle Surgery . . . . . . . . . . 132
Government Guidelines Say Crushed Hand Should Be Treated in Eight Hours; Hospital
With Waiting Line Makes That Four Days . . . . . . . . . . 134
Young Mother on Waiting List Left Unable to Swallow for Two Years . . . . . . . . . . 135
Two Hospitals Fail to Treat Five-Year-Old After Major Car Crash . . . . . . . . . . 140
Government Health Official Says Woman in Labor’s Frantic Search for Emergency
Room “Not an Emergency” . . . . . . . . . . 142
Nurses Leave Mom to Give Birth Alone in Dirty Hospital Bathroom, Then Scold Her for
Not Giving Birth at Home . . . . . . . . . . 144
Japan
Fourteen Hospitals Turn Away Critically-Injured Elderly Man . . . . . . . . . . 146
Pregnant Japanese Woman Dies After Eighteen Hospitals Reject Her . . . . . . . . . . 147
Russia
Fifth Time’s the Charm in the Russian Health Care Bureaucracy . . . . . . . . . . 149
Sweden
Prime Minister’s Long Wait for Surgery Typifies the Health Care
Experience in Sweden . . . . . . . . . . 152
New Zealand
Colon Cancer Symptom? The Line for a Colonoscopy Lasts Two Years . . . . . . . . . . 156
Take, for example, Canadian Lindsay McCreith, who had to travel across the
border to a Buffalo hospital when he was told it would take over four months to
get a scan of his brain tumor and a further eight months to remove it in Canada.
As an editorial in Canada’s National Post put it, had he put his full faith and trust
in the Canadian government health system, “Lindsay McCreith would likely be
dead today.”
Universal systems are promoted as ‘free care!’ Who among us isn’t tempted by more
of something paid for by someone else? But, of course, in these socialist so-called
Meccas, government health programs cannot escape basic economics.
The immense cost of providing taxpayer-funded health care has forced countries
with a nationalized system to place severe limits on the supply of health services.
They do this by putting patients on long waiting lists or by denying them effective
While health care reform is all the rage in Washington these days, many of
our elected leaders in Washington are looking in all the wrong places. A big
government solution as envisioned by politicians such as President Obama and
Nancy Pelosi would forever limit Americans’ access to life-saving treatment and
would massively increase the size and scope of government’s involvement in the
economy — and in our private medical decisions.
Does America’s health care system have its problems? You bet. But
improving health care should involve giving people more power to control
their own health decisions.
My hope is that Shattered Lives will educate you, the American public, to the horror
of government-managed health care where it exists today.
In this book are documented stories from Canada, the United Kingdom, South
Africa, Japan, Australia and elsewhere – countries in which citizens literally
die waiting for health services. Among other horrifying takes, you will cringe
over tales of expectant mothers unable to find an available hospital bed, elderly
patients denied routine cataract surgery and people in agony who resorted to do-
it-yourself dentistry.
These tragic stories warn us that turning more of our health care decisions over to
the government is sure to bring us nothing but pain.
Mark R. Levin
Host, The Mark Levin Show
Author, Liberty and Tyranny: A Conservative Manifesto
And so it is with government-run health care. Sold to the public in the guise
of “free,” it is in fact more costly than any private alternative, for its price tag is more
than financial. Those who chose to rely on government health care frequently pay
not just in taxes, but in a more costly currency: pain, fear, suffering and death.
As we tell these stories, it may be helpful for the reader to know a bit about
the health systems in the various nations we cover. To follow, then, is a quick
snapshot for each:
South Africa: South Africa has a public system financed by tax dollars and
used by approximately 80 percent of the population. Services are free to
pregnant women and children under six; other patients pay a fee for services
based on their ability to pay. A private system with substantially higher
quality of care co-exists with the public one.
Russia: Russia has a public system that officially is free for all, but in
which corruption – in which medical service providers require bribes before
providing services – is a severe problem. A private health market is legal
and a small portion of the citizenry carries private health insurance.
While absorbing these stories, the reader may desire a fuller picture of some
of the health care challenges facing residents of the countries we’ve covered. The
following statistics provide a glimpse of that fuller picture:
In Britain in 2006, 53,181 surgeries were cancelled at the last minute due to
shortages or errors, while approximately 250,000 surgeries, about 962 per
day, were cancelled altogether in England that year.4
Based solely on cost, Britain’s National Health Service has for years denied
the four best available drugs to kidney cancer patients in Britain, leaving as
many with the choice only of Interferon, to which as many as three-quarters
do not meaningfully respond,6 or essentially being left to die. In 2007, the
Times quoted a Birmingham oncologist saying of Nexavar: “Patients with
this cancer tend to die quite quickly but I know from my own patients who
were on the trial how well this drug works. They are still alive two years
later.”7 In February 2009, after years of pleas by physicians and kidney
cancer patients and their advocates, Britain’s National Institute for Health
and Clinical Excellence (NICE) finally relented in the case of one of the
drugs, Sutent, but continued to block NHS use of Nexavar, Avastin and
Torisel to treat this cancer,8 although they are in wide use for this purpose in
the U.S. and much of Europe.
Patients with rare cancers in Britain have been denied potentially lifesaving
drugs because their cancers are too rare to have received attention from
NICE, the NHS’s drug approval board. Because NHS doctors are forbidden
to prescribe drugs outside NICE’s specifications, patients with these cancers
The cancer death rate is 70 percent higher in the United Kingdom than in
the U.S.14
The British National Health Service typically limits what it will pay to
extend a life by six months to $22,000.15
Over 1,500 ear, nose and throat surgery patients in Australia have waited
over eight years for surgery. Experts say some will never get it, because
more urgent surgery cases will always be put above them in waiting lines.18
A February 2007 survey by the Canadian Spine Society found that some
patients with debilitating and painful back problems were on waiting lists for
up to six years for treatment. Some back specialists had over 1,000 patients
waiting for appointments.21
19% of Americans with prostate cancer die from it, while 25% of Canadians,
30% of New Zealanders, 35% of Australians and 57% of Britons who have it
die from it.23
25% of Americans with breast cancer die from it, while 28% of Canadians,
28% of Australians, 46% of New Zealanders and 46% of Britons with breast
cancer die from it.24
Amy Ridenour
President
The National Center for Public Policy Research
The 85-year-old retired engineer and award-winning dancer began losing his vision
in 2004. That year, doctors diagnosed Adams with cataracts, but an operation to
remove them was not scheduled until March 2007.2
His excitement in 2007 at the prospect of getting his sight and livelihood back was
short-lived because doctors cancelled the surgery.
“I was over the moon when I found out I had an appointment in March [2007] but
when it was cancelled I just went downhill,” Adams said at the time.3
Spokesman Mark Purcell of Ealing Hospital, one of several hospitals that refused
Adams treatment for his eyes, offered no sympathy. “If [Adams] has a complaint
about the standard of care he has received he should write to the chief executive of
the Ealing Hospital Trust.”6 (Whether this bureaucratic solution, which asked a blind
man to write, was intentionally or inadvertently cruel is unknown.)
Adams was scheduled to receive treatment in late May, but this was little consolation
for him. “I’ve been waiting for three years but they don’t seem to care. I think
they’re just waiting for me to die or something,” Adams complained.8
“He was really pleased with the result of the operation,” said Roger Woolsey, a
family friend. “When I went to visit him he would raise the eye-patch and say: I
really can see again.”9
Tragically, four days after the procedure that restored his sight, Adams died. He had
a heart attack after developing blood poisoning in the hospital.10
In early December 1999, following a scan showing that the cancer had not spread,13
doctors were due to remove Skeet’s gullet and to surgically determine the extent
of the disease.14 Skeet’s family had hoped the growth
would be treated in time for Christmas.15
Unfortunately, Jane Skeet’s fears were realized. As the cancer progressed, Mavis
Skeet had to be fed through an intravenous drip because the tumor prevented her
from swallowing.22 By the time doctors got around to work on Skeet in January
2000 – five weeks after the initial scheduled operation – it was too late. The
cancer had spread to her windpipe in two places, and doctors determined the
tumor was inoperable.23
“I know that if she’d had the operation five weeks ago the cancer would not
have spread to her windpipe,” said an angry Jane Skeet.24 “Had they operated
five weeks ago the tumor was operable and could have been removed. Now they
can’t operate.”25
For five months, Jane helplessly watched her mother’s condition deteriorate, until
Mavis Skeet passed away in late May 2000.26 Jane puts blame for her mother’s death
squarely on the British National Health Service. “This is due to lack of resources
and bad planning,” she said. “The government is trying to cover it up by saying the
hospitals are coping, but they’re obviously not.”27
In frustration, Jane wrote to then-Prime Minister Tony Blair, detailing her mother’s
astounding experience with the NHS: “How can you justify the loss of a life because
of the lack of a suitable bed? ...We placed our mother’s life in the hands of your Health
Service and it has killed her. My mother is a devout Christian and she had helped her
church raise funds for hospitals. It is a cruel irony that this is how she is repaid.
“I look at my mother and I still can’t believe she is going to die, but we know she
will. She will because the NHS let her down in the most crucial five weeks of her
entire life.”28
Mahon suffers from the ‘wet’ type of age-related macular degeneration (ARMD).
The condition requires early treatment because it progresses rapidly, resulting in
severely impaired vision and possibly blindness.32 Mahon thought she was fortunate
because doctors in November 2006 prescribed to her a newly-available drug in the
United Kingdom, Lucentis, to treat her eyes. Clinical
trials showed the drug to be effective at stabilizing
vision loss and even reversing damage.33
No Member of Parliament was a bigger fan As Mahon explained, “I was given two reasons for the
of the government health system than Alice
Mahon – until the system, to save money,
refusal – firstly, the treatment I need has not been approved
decided to let her go blind. by NICE [National Institute for Health and Clinical
Excellence – the clinical standards body], and secondly, it
has not been proven to be effective. Neither reason stands up to scrutiny.”35
Meanwhile, during the lengthy review process, Mahon lost much of her sight in one
eye. Fearing irreversible vision loss, she began treatment on her own, that is, with
her own money.36 Though Mahon and her husband could afford to pay for treatment
using their retirement savings,37 the thought of buying private health care was
outlandish to her.
“It went against every principle of mine to consider private health care,” said
Mahon.38 “Everyone has a right to free treatment on the NHS for a condition that
results in blindness and devastates lives.”39
Yet, having few viable options to save her vision, Mahon purchased private care.
By the end of January 2007, she had spent £5,325 (~$8,700) on treatment.41
Says a distressed Mahon, “I have been an ardent supporter of the NHS all my
life, and now feel totally let down. The excuses… for not funding treatment are
scandalously lame.”42
Mahon contemplated suing the NHS, but she did not proceed because, finally, health
officials agreed to pay for Lucentis. Yet it appeared other, less politically-connected
sufferers of ARMD were not as fortunate as Mahon. According to policy, to receive
Lucentis through the NHS, patients must already have been blind in one eye and
show deterioration in the other eye.43
NICE reversed this policy in 2008 to permit NHS funding for the first 14 injections
of Lucentis as soon as wet age-related macular degeneration is diagnosed in one eye.
The drug’s manufacturer, Novartis, will pay for any additional doses under the new
guidelines. According to the Daily Mail, it is believed that some 20,000 patients lost
their sight during the two-year review considering new guidelines.44
Pat Booy of Bristol, United Kingdom lost her husband, Brian, 60, to a heart attack.
Brian had been on the government-managed Bristol Royal Infirmary’s waiting list
for triple heart bypass surgery for 72 weeks since doctors diagnosed him with angina
in July 1997.45
Not wanting to risk missing Brian’s surgery, the family took great lengths to stay
by his side. “We were frightened to go out or go on holiday in case the phone rang
and we missed it. He was looking forward to the life he was going to lead after the
operation,” said Pat.46
But Brian’s turn never came. After being taken to Southmead Hospital because of
Says a frustrated Pat, “When they told us we were on the waiting list we just
accepted it, thinking it might be a few months. But it just went on and on and in the
end you just think it will never happen. Angina is not the sort of thing you can wait
for. It just gets worse and it needs to be dealt with straight away.”48
Astonishingly, the hospital had not recorded Brian’s death. A hospital spokesman
explained, “At present the hospital does not have a way of knowing if a patient has
died unless we are informed by a GP [general practitioner – i.e., family doctor].”51
Two years after Brian’s death, a frustrated Pat remarked, “I know what it is like to
live your life on a waiting list and it’s no fun. When you are dealing with someone’s
heart, there is no such thing as a non-urgent case. I don’t want anyone else to go
through what we have.”52
“I can’t help but wonder,” Brian’s widow added, “that if he’d had the operation
sooner, he’d still be here.”53
Do-It-Yourself Dentistry in
Britain
“I was lying awake at night being driven mad by this constant throbbing ache; it
was horrible,” recalls George Daulat of Scarborough, England.54 Over the course
of several weeks, Daulat had developed a nasty toothache.55 When the pain became
[I]s so hard-hit with the lack of NHS dentists that queues stretched hundreds
of yards earlier this year [February 2004] when one finally opened... Around
3,000 people tried to join [register for care] – but they were left stranded
when Dutch dentist Aria Van Drie fled after it was revealed she had criminal
convictions.58
In desperation, Daulat decided to do the work the old fashioned way – by himself,
using old rusty pliers.
“I knew it would hurt but I thought ‘just suffer it’ rather than go through extended
pain,” Daulat said.59 “In the end I simply could take any more.”60 He added: “I had a
pair of pliers in a tool box. They were old and a bit rusty but I knew they would do
the job.”61
Daulat bought a bottle of vodka as anesthetic and to dull the pain, and drank a
pint of it before pulling the first ailing tooth. Daulat
describes the gruesome process in detail:
“He was obviously in agony and we wanted to help him,” said Kasandra Dowling of
Medimatch dental practice in Scarborough. Though relieved, Daulat said: “I’m so
happy I’ve got a dentist and I’m not in pain anymore but did it really have to go this
far before somebody did something?”65
He added, “People will think I am crazy to have pulled my own teeth out but they
weren’t living with the pain.”66 “It was the hardest and most horrible thing I have
ever done, but I was desperate.”67
As Webb explained then, “At the time, the PCT [Dorset Primary Care Trusts] said
it hadn’t got a policy and it would address the situation in April [2007] – but it has
now postponed this until June. I’m extremely worried that time is running out for
me and other patients.”76
I’m a young woman and want to carry on working, and then I’d like to do all
the things I had planned for my retirement. I’m also worried about the health
of my other eye. I know I’m at increased risk of getting wet AMD in that
eye and this could mean I end up losing my sight. The women in my family
live into their 90s; I can’t accept the possibility of being blind unnecessarily
for the next 35 years.77
In May 2007, the Trust agreed to review Webb’s case on an urgent basis. But for
Tom Bremridge, CEO of the Macular Disease Society in Andover, UK, there is
no excuse for Webb being without the available sight-saving drugs she needs. “It
is outrageous that in this day and age Mrs. Webb faces losing her sight owing to
bureaucratic idleness,” he said.78
This is disgraceful... It’s little comfort for Mrs. Webb that she can’t get
treatment simply because her PCT has yet to decide a policy. The PCT
needs to get its act together and ensure these drugs are available to patients
now and without a struggle... There is a moral imperative to save the sight of
people where we can.79
Finally, in 2008 new health guidelines permitted Dorset Trusts to prescribe Lucentis
for Webb. The guidelines published by the National Institute for Clinical Excellence,
the government’s health advisory authority, allow for funding for the first 14 injections
of Lucentis once wet ARMD is diagnosed in one eye. If additional injections are
necessary, the drug’s manufacturer, Novartis, will pay for additional treatment.80
After unsuccessful surgery, O’Donnell had five inoperable tumors.83 Yet, her
oncologist recommended a platinum-based drug, not Taxol,84 an expensive yet
powerful chemotherapy drug that attacks tumors and
is widely used in the U.S., Europe and even other
locations in Britain.85 If taken at the time of diagnosis,
Taxol prolongs the life of cancer sufferers fourteen
months on average, and patients have a 50 percent
Credit: East of England Ambulance Service
chance of survival.86
Bills for Taxol’s treatment piled up, and O’Donnell and her husband, Geoff, decided
they would remortgage their home if need be. “I stuffed them [bills] in the drawer
and tried to forget about them, because I was fighting for my life, and I knew I
didn’t have the money to pay. It is disgusting really and it does upset me to think
that the NHS could come to this,” said O’Donnell.92
Curiously, though the O’Donnells paid for Taxol on their own, thanks to the
“postcode lottery,” in which there are significant differences in access to care and
treatment depending on one’s postcode, or locality, it happened to be publicly
available to residents nearby through the NHS.
“If I had lived just two miles away, I could have had Taxol because the health
authority in North Yorkshire did pay for it,” explained O’Donnell. “I really didn’t
believe the postcode lottery existed until it happened to me.”93
O’Donnell summed it up: “It’s where you live deciding whether you live.”94
Outraged, O’Donnell visited the local health authority’s office to demand a face-to-
face meeting with its chief executive and got her Member of Parliament involved
to seek change.95 “I became quite a firebrand.”96 Because of her vocal and persistent
campaign, South Tees changed its policy in April 1999 to fund Taxol for ovarian
cancer sufferers.97
“Other women in my position backed away. I think they felt they might have been
victimized. I think they thought the hospital must know best,” said O’Donnell.98
“I don’t even want to contemplate what would have happened on cheaper
chemotherapy. I know women who were ill at the same time who, sadly, are not
doing so well.”99
O’Donnell referred to Taxol as “a wonder drug.”100 It would extend her life more
than three years.
Much of 108-year-old’s Olive Beal’s hearing was gone. The one-time suffragette
and former piano teacher from Kent, England was unable to enjoy music or hear
conversations clearly with her five-year-old analog hearing aid.102 A modern, digital
device would improve Beal’s hearing – and life – tremendously, but she was having
difficulty receiving a replacement.
Beal’s granddaughter, Maria Scott, explained: “Her analog hearing aid does not
filter out background noise so it makes it very difficult for her to hear clearly. But
the digital one would allow her to hear people talking to her and to CDs. She loves
music hall numbers.”103
Beal was administered a hearing test in late July 2007, and a hearing expert
recommended a digital hearing device.104 However, the local health authority,
Eastern and Coastal Kent Primary Care Trust, has an 18-month waiting list for new
hearing aids provided through the NHS. Despite her age and despite contributing
income taxes that fund the government’s universal health system into her late 60s,
Beal was told she must wait her turn in line. A spokesman for the Eastern and
Coastal Kent Primary Care Trust explained: “[P]riority is given to patients who do
not have an existing hearing aid...”105
Under the government system, Beal would be 110 years old by the time the new
hearing aid was scheduled to arrive.106
Maria Scott added, “I would have thought they would take her age into account as
she probably has not got 18 months to wait… Her eyesight is falling [sic], and if
she cannot hear then she will be isolated from the outside world.”108
Fortunately, widespread press attention and concern about Beal’s situation prompted
Phillip Ball, a private audiologist, to assist Beal voluntarily. Ball said:
I can see no reason why a lady of her age should be fobbed off by her NHS
Trust and told to wait at least 18 months, so I immediately got on the phone
A digital hearing device costs approximately 1,000 British pounds (~$1,600) each,110
and wait times for hearing aids can be over two years in some parts of Britain.111
“The new digital hearing aids can really transform people’s lives,” said Donna
Tipping of the Royal National Institute for the Deaf, a British charity. “It is an issue
of quality of life, with isolation, frustration and withdrawing from society caused by
loss of hearing, and it is sad because this is reversible.”112
As her grandmother is one of Britain’s oldest living citizens,113 Maria Scott added, “I
thought a 108-year-old deserved to be treated better than this.”114
“I didn’t even ask for a brain scan because I didn’t Delays in ordering a brain scan for young
know at that point that it was procedure at all,” recalled Levi Ringer cost him his life.
Levi’s awful headaches continued into April. He also was awakening at night, sick,
losing weight and becoming withdrawn. Vicky took Levi to a pediatrician, Dr.
Steve Jones, as well as to a dietician, who suggested that a psychiatrist examine Levi
for “behavioral problems.”119 Unsatisfied and frustrated that there was not a firm
diagnosis for the cause of Levi’s headaches, Vicky demanded additional tests.
“I pushed every step of the way to try and get a diagnosis, not just to keep giving
him more migraine medication,” she said.120 “At that stage I was desperate to find
out what was wrong with him.”121
Yet, Vicky was still unable to convince doctors to treat Levi’s case seriously and
perform a brain scan. She explained:
As his mum, I knew he wasn’t well. But I was made to feel neurotic. I
asked whether it could have been a brain tumor, but they disregarded it
because Levi wasn’t displaying what doctors call the usual symptoms. I
knew in my heart it was something more serious and I persistently kept
taking him back.122
Meanwhile, Levi’s condition deteriorated. “It got to the point where he was getting
headaches every day,” said Vicky. “He started with dizzy spells and was too scared
to lie down. He was losing weight and being sick but still there was no mention of a
scan until I pushed for it.”123
At last, Vicky’s determination paid off when she convinced doctors to bypass the
three-month waiting list to perform a brain scan. On July 20, seven months after the
Ringers first visited a hospital and during their sixth visit overall, a scan revealed
a “lollipop-size” cancerous brain tumor.124 A supplemental scan at Leeds General
Infirmary showed the cancer had, unfortunately, already spread to the boy’s spine.125
“I said to him, ‘It’s ok, you can go now baby.’ I didn’t want him to suffer any
more,” recalled Vicky.128
Vicky and Levi’s grandmother, Val Ringer, formed Levi’s Star, a charity to support
children with brain tumors and their families. In April 2009, 100 people in
Newmillerdam, England gathered for a charity walk in Levi’s memory and to raise
funds for Levi’s Star. “I find it very respectful that people are still remembering
Levi almost three years on,” said Vicky.133
In late January 2006, Finn was taken to the White Dental Spa surgery for
examination. The consultation revealed both teeth needed to be extracted by a
specialist, with the procedure to take place at the Weston Clinic, in the nearby town
of Macclesfield.135 But three weeks after the referral was made, Karen received a
letter saying there would be a six-month wait for an appointment. Unable to follow
up with the clinic by phone, Karen returned in person to ask for an urgent substitute
referral to a dental center in Manchester.136
Without finding any luck, Karen brought Finn unannounced to the Weston Clinic,
the original referral clinic. Karen hoped to persuade the staff there to take pity on
Finn, but she was told Finn would have to wait for an appointment. Karen and Finn
were also turned away at the Manchester Dental Hospital accident and emergency
department because they did not have a referral letter.137
“What type of system is it that no one seems to care that a child is suffering for
six months?” asks Karen. “This is an emergency but I cannot get anyone to
accept responsibility, there is no accountability whatsoever. There seems to be no
prioritization.”144
Fortunately, local media exposure about Finn’s months of suffering prompted faster
action by the local health authorities, Cheshire Primary Care Trust. In April 2006, at
last, dentists removed Finn’s two aching teeth.145
Though relieved that her son is no longer in pain, Karen remarked, “[I]t is a shame
that I had to go to such extremes to get treatment for Finn, after all he just needed
a tooth out. I feel sorry for the other boys and girls suffering the same way. The
waiting list for people in pain should never have got to that level.”146
On the evening of February 21, 2007, Brown was rushed to Queen’s Hospital
in Essex after she began hemorrhaging. She was stabilized with intravenous
antibiotics and given a bed in the hospital’s general mixed-sex ear, nose and throat
division, instead of in a maternity ward. The newly-built, nearly half a billion dollar
state-of-the-art hospital did not have a dedicated gynecology division.148
Catherine was left to deliver the baby alone with just me for help before
cleaning herself up and going back to bed. It was horrific. I was running
around frantically for over an hour trying to find gas and air for her, and
pleaded with nurses, who seemed very matter of fact, to come and assist.
The staff I did find told me they didn’t have the training to help.155
Brown added, “There were no staff that could help. They were all very good but
they were not the gynecological ward so they didn’t know what to do. They did
their best but it was like a plumber tying to do an electrician’s job.”156
But Brown’s nightmare was not over. In addition to the details of Edward’s birth not
being recorded by the hospital, to her horror, the baby’s body was nearly disposed
of with medical waste. The family instructed hospital staff that they wished to have
the body released for a burial, but an administrative mistake almost led to it being
wrongfully discarded.157
Despite steps to ensure that a situation similar to Brown’s experience is not repeated,
Brown is amazed at the lack of care she received. “I still can’t believe the hospital
had no trained staff who could help me,” she said.159
Frantically, Cook asked a neighbor, Kath Taylor, for a car ride to the Okehampton
Community Hospital, one mile away. At the hospital, Scarlett was treated with
emergency oxygen.165 “Fortunately the hospital was open until 10 pm but what if
this had happened at night?” asked Cook.166
Doctors at Okehampton then sent Scarlett to the Royal Devon and Exeter Hospital
for further evaluation of her breathing difficulties and treatment. Thankfully,
Scarlett recovered fully.167
They told me that Scarlett had been choking on milk and that it had gone
back into her lungs. She was getting air by this time but her breathing was
still up and down. They put a monitor on her finger and said her oxygen
levels were low. The doctors were brilliant and told me I had done the right
thing in bringing her as soon as possible. I don’t know what would have
happened if I’d waited. I was convinced she was dying.168
Cook should have received speedier emergency service, according to Britain’s own
government health targets. They set a target of exactly eight minutes or less for an
ambulance to reach “immediately life threatening” calls.169 Moreover, Kevin Lyons,
branch secretary of the Ambulance Service Union, acknowledged, “In this case, an
eight-week-old baby choking should have been classed as a life-threatening incident
and a vehicle should have been there within eight minutes.”170
But Cook’s sparse town of Okehampton has only one ambulance to serve it, which
Lyons confirms.
“At Okehampton they have one ambulance and when that is out they are sent
one from Crediton or Exeter [about a half hour away],” he says. “Other towns
like Ivybridge and Teignmouth don’t even have an ambulance. With the system
as it is, there is always the possibility that someone will die as a result of
waiting too long.”171
West was due to give birth at Malton Community Hospital, which is three miles
from her home in North Yorkshire, England. When West began to go into labor,
an ambulance and an on-call nurse were called to her home. But instead of being
taken on a short trip to nearby Malton, West was told she could not be booked there
because the local hospital did not have any nurses on hand. Instead, the on-call
nurse examined West and determined there was enough time before delivery to send
her to the larger Scarborough Hospital, 25 miles away.172
Thankfully, Phoebe was born healthy and without further complication, but Clive
Milson, West’s partner, unfortunately missed the birth of his daughter. He was
following behind the ambulance during the ordeal. He described the scene as “just
a debacle – a nightmare situation.”178 Milson continued, “It’s easy to lose a life in a
situation like this. I thank my lucky stars that our little girl was delivered safe and
well, even if it was in a car park in the back of an ambulance.”179
A spokesperson from the regional health authority, Scarborough and North East
Yorkshire Healthcare NHS Trust, offered an explanation: “[U]nfortunately it isn’t
safe to deliver babies if we’re having difficulty with staffing levels, which can be
quite difficult to maintain in a small unit. Some babies do arrive more quickly than
expected, and it can be better to deliver in an ambulance than attempt to move mum
at a late stage,” said Gilly Collinson, the trust’s communication manger.180
The problem was Tyndale’s local health provider, Cambridge City Primary Care
Trust, which refused to pay for Velcade because of its high cost, although it is
available in other British cities under the government’s health service.183 This
geographical health care variance is referred to as the NHS “postcode lottery,” in
which there are significant differences in access to care and treatment depending on
one’s postcode, or locality.184
It outraged Tyndale, as well as doctors,186 that the NHS was denying Tyndale a drug
that could slow his cancer and prolong his life.
Facing imminent death, Tyndale enlisted the assistance of his parliamentarian and
the Tory Shadow Health Secretary, MP Andrew Lansley.188 “I have put it to the PCT
[the NHS health provider] that they should make Velcade available… but they are
still to come back to me,” said Lansley.189
But Tyndale’s persistence paid off. At last, the health provider authorized funding
for Tyndale’s treatment, and in May 2006, Tyndale received Velcade.191
Nuttall, 57, fractured his ankle in three places after falling off a ladder while on
the job in 2005.193 Because Nuttall worried that surgery would result in further
complications, a plaster cast was used to immobilize the fractured bones. After six
months, though, the ankle had not healed naturally, and, Nuttall said, he was left to
“beg” doctors to revisit the surgery option.194
For Nuttall, postponed surgery means continuing life in constant pain. “I’m in
agony. I can feel the bones grating… I’ve begged them to operate but they won’t.
I’ve tried my hardest to give up smoking but I can’t. I got down to ten a week but
they said that wasn’t good enough.”200
Before they would rebuild the ankle, doctors wanted Nuttall to pledge not to smoke
for three months following surgery.201
Meanwhile, for years, Nuttall took daily doses of prescription morphine to dull the
pain, and used a cane to get around on his good foot.202 Because of the morphine, he
would not drive.203
“I have paid my dues as a taxpayer – and now the NHS won’t treat me,” said a
frustrated Nuttall.204 Worse yet, he feared surgery might not improve his ankle at
this late stage. “The bones have all calcified now – it’s probably too late for surgery
but I want other smokers in my age group to know that we are being denied medical
treatment and there’s nothing we can do.”205
In early August 2007, a pregnant Evans arrived at Royal Sussex County Hospital
in deep pain. She was overdue for delivery and believed she was going into labor.
Nevertheless, the hospital would not admit Evans because it did not have any beds
available. A junior doctor who examined Evans insisted she was not going into
labor and sent her home.
A National Health Service spokesperson later explained that Evans was not believed
to be in “established labor” because the doctor did not observe any blood.
Hours later, now at home, Evans’ water broke. A friend called the hospital, but
doctors refused to send a midwife, insisting there was time before she delivered
the baby. In desperation, they called an ambulance, and paramedics helped Evans
deliver. But her troubles were about to get worse.
The paramedics on site were not permitted to cut the umbilical cord. The hospital
was called but again said no midwife was available to come to Evans’ aid. The
ambulance would have to take her in to the hospital to be detached and monitored.
Thus, with umbilical cord still attached, the 37-year-old mother was forced to carry
her newborn down the stairs of her home to the waiting ambulance.
“I’m disgusted at how I was treated,” said Evans. “They should have more
midwives available and on call to come out when there is an emergency.”
Thankfully, the baby was born healthy, but Evans developed complications and
an infection and returned to the hospital for two days of intravenous antibiotics.
Though recovered physically, the hellish home delivery left Evans so traumatized
that only after four weeks of coping was she able to name her son, Harvey.
“I feel like I lost out on the first week of my son’s life because I went through so
much,” said Evans. “If I did not have a friend with me at the time I dread to think
what might have happened.”
Evans is currently pursuing legal action over her nightmarish experience with the
NHS. “I don’t want people to have to go through the same thing as me,” she said.
Smith’s hair and eyebrows were torched and his arms badly burned. An ambulance
Despite the poor quality of hospital service, an NHS employee seemed to place
blame on Smith for not receiving adequate treatment. “The patient in question
was seen within 15 minutes of arrival and given medication within 20 minutes. In
under an hour the patient had decided to leave under his own accord without the
completion of his treatment,” said Lynda Walker, A&E service manager of the East
Lancashire Hospitals NHS Trust.
“It was an ordeal for my wife and very stressful for me. If Joseph had arrived while
they were in the ambulance he might not be here now,” said Wake’s husband, Roy
Wake. “The situation has disgusted us and our whole family. They can’t believe we
had to be transferred while Adele was in labor.”
Following the ordeal, Helen Thomson, director of nursing for the Calderdale and
Huddersfield NHS Trust, explained the bed shortage. “That day there was an
unusually high demand for our intensive care cots and they were all occupied. A
baby born 10 weeks early should always be delivered in a centre with an intensive
care cot.”
But a shortage of beds situation may continue. The Calderdale Royal and
Huddersfield Royal have a combined total of only six intensive care neo-natal beds.
When the NHS failed to treat him, Don Wilson of Kent, England’s method of choice
for relieving a toothache was using fishing pliers to pull it. Wilson attempted to
see a dentist to have his rotting teeth professionally
removed, but was unsuccessful at locating a public
dentist.211
Wilson has attempted to remove five of his teeth (one such tooth broke in half and
remains stuck in his gum) using this homemade method. In fact, tooth extraction is
not the only reason for which Wilson has turned to his toolkit.215
“If I’ve got a hole in my tooth, and it’s hurting, I’ll put a heated needle in the hole
and that just kills the nerve, and stops the pain,” Wilson explained. “I’ve also used
liquid metal adhesive to stick crowns back on.”216
Alarmingly, such makeshift dental work is not unique in the UK. A thorough 2007
survey of over 5,200 dental patients in Britain by the Commission for Patient and
The British paper Daily Express commented that such a gruesome do-it-yourself
practice is “a damning indictment of a [NHS] system harking back to the Victorian
era...”220 In fact, the British government estimates that more than two million people
who wish to have publicly-done treatment cannot access a NHS dentist.221 Moreover,
some patients wait up to one year just to register with a NHS dentist.222
When it comes to home-done dentistry, Don Wilson apparently speaks for many
Britons: “If you’re in agony with toothache, you haven’t got much choice.”223
For Haupt, a 67-year-old cab driver and Army veteran,224 neither choice was
acceptable. Instead, he performed the job himself by pulling out his own teeth.
In December 2006, Haupt visited ADP NHS Dental Practice in Melton. Despite Haupt’s
agony, staff told Haupt to fill out paperwork and to come back in three weeks.225
“When they told me to fill out a form and how long I would have to wait I said ‘I’ve
got gob ache now, not in three weeks time,” said Haupt. “It’s rubbish isn’t it. When
you say you’ve got bad toothache you expect them to say ‘Yeah, we’ll see you today
or tomorrow.’”226
A private dentist Haupt consulted off the National Health Service quoted him a price
of £75 (~$122) per tooth pulled,227 which would total nearly £55 (~$1,200) for the
seven teeth Haupt needed removed. Haupt considered the sum unaffordable.
“If you can’t get anyone else to take your teeth out you take them out yourself don’t
“The pain was so bad it was driving me mad,” Houghton said. “I wanted to bang
my head against the wall – anything to distract me from the pain – I’ve had four
children and I’ve never experienced anything like this.”240
That Saturday, Houghton contacted her local after-hours dental NHS service,
Bury and Rochdale Doctors On Call. Houghton said she pleaded – in fact,
“begged” – for urgent relief.241 But NHS staff decided the situation did not warrant
emergency service because “I had not been in pain for at least 48 hours,” Houghton
explained.242 Instead, she was told to call back on Monday.243
By Saturday evening, Houghton could no longer tolerate the pain and decided to
pull out the broken tooth using her artificial fingernails.245 “I wriggled the tooth
around until I felt it crack,” she described. “My mum told me not to do it in case I
bled to death but I just could not cope any longer. I felt like jumping off a cliff.”246
On Sunday, Houghton went to the emergency room and was given antibiotics. She
would have to wait until Tuesday to have the root of the aching tooth removed.247
“I know I’m not the only person to be driven to this, [but] there is something very
wrong with a system which leaves you in pain and without help,” she said.248
Aiton, a former medical consultant for a NHS children’s hospital in Sheffield, found
his confidence in the government’s health service shaken when he was warned he
would need to wait several months for an urgently-needed heart bypass operation.
“I was diagnosed 18 months ago with heart disease and chronic atrial fibrillation –
an irregular heartbeat – and my condition soon began to [get] worse,” Aiton, then
43, said. “I couldn’t walk up stairs, I couldn’t travel for my work, I couldn’t lift
anything and I was putting on weight. Effectively I was in heart failure.”
Afraid to take the chance the NHS wouldn’t offer care while his heart was still
beating, Aiton and his wife, Joy, searched for another option.
“[W]hen I found out I would have to wait several months for an operation, despite
my consultant at Aberdeen hospital saying I needed an urgent heart bypass, Joy and
I decided we had to go private,” he explained.
After a brief Internet search, Aiton discovered the Taj Medical Group. The
independent company offered to get Aiton the surgery and recuperation he needed
in Bangalore, India within weeks. The surgery would cost the couple thousands
of pounds out-of-pocket and require extensive travel, but as Aiton faced possible
death if he waited for the NHS to get around to providing the care he was entitled
to as a contributor.
Thus, in September 2007, Aiton and his wife flew to India. The operation was
Aiton praised the quality of care he received in India. “Nothing was too much
trouble for the staff. The care, the cleanliness and the attention to detail were all
excellent,” he said. “There was no comparison to my treatment in Britain, where
I felt like a lump of meat on the production line.” Aiton added, “I’m sorry to say
Third World standards are what we now find in British hospitals.”
Apparently, tens of thousands of Britons who are stuck on waiting lists or afraid of
contracting disease in a public hospital agree. As some foreign health centers offer
timely care at a fraction of domestic private rates in Britain, an estimated 100,000
Britons traveled abroad for medical, dental and cosmetic treatments in 2007 alone.254
The number of these so-called “health tourists” in the UK is expected to increase to
200,000 by the end of 2010.255
To meet growing demand, Britain’s first health tourism exhibition was held in London
in October 2008 to promote medical treatments and health facilities abroad.256
For over five years, Luck’s widow, Debra, and nine-year-old son, Ben, fought for
answers as to why hospital staff neglected Luck, frequently leaving him to lay in his own
vomit and waste and failing to realize the severity of his increasingly-desperate state.
Luck checked in to the Princess Alexandra on June 12, 2002 after being too weak to
eat and vomiting heavily. He had suffered for several years from gastric problems
and was treated twice in 2002 for lost fluids because of vomiting and diarrhea. This
time, an endoscope discovered an ulcer. Doctors prescribed antibiotics to Luck,
gave him fluids and sent him home after a six-day stay.
On June 20, Luck returned to the hospital for a second endoscope exam when the
inflammation in his stomach had not cleared up. However, the ulcer ruptured during
Following surgery, Debra Luck was effectively left to look after his health and comfort.
“No one wanted to help us. Every time we asked for pain relief, or to see a doctor, we
were told to wait, or that we didn’t know what we were talking about,” she said.
Luck’s condition continued to decline, but hospital staff showed an utter lack of
sympathy. Debra Luck recalled that the staff failed to or were slow to perform basic
functions, such as cleaning up after her husband.
“He was vomiting ten times an hour, and there were bowls around his bed to catch
it,” she said. However, “Often they weren’t emptied for more than an hour and they
smelled awful. The first time that happened I found a nurse and asked if she could
empty them. When she said she was too busy, I offered to do it myself.”
Debra Luck began resorting to bringing in clean pillowcases, shirts and pants, and
having to change her husband herself. “As fast as I changed him he was sick again.
The nurses were not interested in helping me,” she said. “An animal would have
been treated with more compassion.”
Meanwhile, it was not known if the bleeding from the ulcer had stopped. “I made
two appointments to speak to a consultant during the course of those ten days,” she
said, “and both times he didn’t turn up. When I tried to talk to junior doctors, they
were either too busy or didn’t know enough.”
Frustrated and fearing for her husband’s life, Debra Luck attempted to have Ian
transferred to a local private hospital. Though the private hospital agreed, staff at
the Princess Alexandra rejected the move because Luck was not stable.
On June 28, at the request of a junior doctor, a consultant at last saw Luck. But
the consultant failed to follow up on the suggestion that a laparotomy (surgical
examination), which might have determined the definitive cause of Luck’s bleeding,
be carried out. On June 29, a second junior doctor called for a consultant’s review,
which was never performed.
Two days later, after a particularly agonizing night in which nurses forgot to inject
painkillers, Luck began to lapse in and out of consciousness and struggle to breathe.
That morning, “He was covered in vomit and had wet himself,” remembered Debra.
“I changed him, but when I asked for clean surgical stockings the nurse said there
were none left in his size... I couldn’t change his T-shirt without help… but I was
That evening, a junior doctor suspected that Luck had suffered a collapsed lung and
ordered a chest X-ray. But Luck went into cardiac arrest during the procedure and
had to be resuscitated. By the time family members arrived, Luck already suffered a
second, fatal cardiac arrest.
“I actually feel that Ian was murdered,” Debra said. “He died because people
couldn’t be bothered to do their job properly.”
Debra Luck contends that the hospital did not carry out necessary tests. “What I’ve
learned since is that his urine and vomit should have been monitored continuously.
Both were vital to working out just how ill he was and whether he would need
further investigations. The fact that no one kept a record probably added to his lack
of correct treatment.”
In October 2007, the Princess Alexandra Hospital NHS Trust agreed to compensate
Debra and Ben a combined sum of £225,000 (~$366,000), though the National
Health Service refused to accept liability for Luck’s death.
For her part, Debra Luck remains angry, telling Britain’s Daily Mail, “No one has
been punished or sacked. No one from the hospital has offered to meet me and tell
me how things went so wrong, let alone offered an apology. For all I know, the
same appalling standard of care is still acceptable in that hospital. If that is the case,
then there will be more unnecessary deaths.”
In February 2007, doctors at Crane’s local hospital outside London in Essex told him
he needed hip replacement surgery. An X-ray performed in the emergency center
revealed Crane was without a hip joint, according to Polly Taylor, Crane’s daughter.
Doctors referred Crane to Queen’s Hospital in Romford, but Queen’s cancelled four
To pay for the expensive operation, Crane used two private insurance policies and
withdrew all his savings. Four days after the last cancelled NHS appointment,
a private surgeon carried out the operation. Though the surgery cost £8,750
(~$14,200), Taylor believes her father might have died if he had waited for the NHS
to perform the surgery.
“If he hadn’t had it done privately he would have died of the pain,” she said. “He
has nothing left now. It’s not fair how the NHS treats old people.”
Because Crane had the surgery done privately, it is unlikely that the NHS will
reimburse his expenses – despite the emergency situation. “It is extremely unlikely
that anyone would be able to claim back money from the NHS if they chose to be
treated privately,” said a spokesman for Barking, Havering and Redbridge NHS Trust.
Under Britain’s rationed care health system, the length of Crane’s wait is not
unusual. The average wait time for a hip replacement is six months in the Barking,
Havering and Redbridge NHS Trust jurisdiction.
Nationwide, according to the NHS’s own figures, some 37,600 patients waited 12
months or more just to go to a NHS hospital in 2007.259
Instead of a quick ride, under the National Health Service the elderly man is stuck
inside an ambulance with other patients waiting to be dropped off for up to three
hours per trip. After the demanding treatment at the hospital leaves Howard feeling
sick and disoriented, the delay on the way home is especially taxing.
“The people who run the ambulance service couldn’t care a tinker’s cuss about
people who are sick and elderly,” an outraged Howard
“The [ambulance] transport is very unreliable and The NHS used an ambulance to transport Morris
haphazard,” Howard said. “We are often told we have Howard, 85, to and from his thrice-weekly
dialysis treatments. The mile-and-a-half ride
to wait for an ambulance to be available, and it’s an took nearly three hours each time.
absolute killer. How can they do this to human beings?”
Howard is not the only kidney patient experiencing a long wait. A 2007 report by
the Nottingham University Hospitals Patient and Public Involvement Forum found
that others being transported by the East Midlands Ambulance Service for dialysis
waited up to four hours to be transported home from Nottingham City Hospital. In
some cases, the report claimed, the hospital sent out a vehicle to pick up patients
who had died.261
Pitman said she was shocked over the “uncaring and mismanaged” hospital’s
“We could see he wasn’t getting any better,” Pitman recalled. “Yet, despite
constantly asking staff why he wasn’t recovering, no none seemed to notice or do
anything about that fact that George was so unwell.”270
Family members were left to sit by while Harvey’s condition deteriorated further
and to watch as hospital staff disgracefully neglected his care. “Once, my sister
went in to find George lying half naked on a bedpan, on top of a bare mattress, with
the sheets on the floor,” said Pitman. “He was in agony and had been left like that
for at least half an hour. Although he had desperately called for help, not one person
had come to his aid.”
“Another time,” Pitman continued, “my husband David and I arrived at lunchtime to
find him sat in bed, his cold, untouched shepherd’s pie left on a trolley at the other
end. George couldn’t even reach it, yet no one had thought to check. Much of the
time he was left not properly washed and stinking in a dirty bed. It is a dreadful
Despite the warning signs of a serious infection, hospital staff insisted on three
occasions that Harvey had cancer and did not test even a stool sample for C. diff.
Instead, after six weeks at the Great Western, Harvey was transferred to a hospice to
receive round-the-clock care.272
“I cried the day he left that hospital,” said Pitman. “But it wasn’t only because I
knew my father was making his final journey as he went into the hospice, it was also
because I felt so relieved he was finally leaving such an uncaring and mismanaged
place.”273
At the Prospect Hospice,274 staff suspected Harvey was infected with the superbug
and isolated him in a private room.275 He was diagnosed with the bug infection,276
but tragically, Harvey was severely ill by this point and passed away two weeks later
in early January 2007.277
Starting in 2003, the 75-year-old from Exning, England received pain relief
injections, called a “diagnostic block,” in her back every six months to a year at
West Suffolk Hospital.284 Townsend suffers from osteoporosis of the spine and found
the injections effective at targeting the agonizing bone disorder.285
“I am just in pain all the time,” she said. “It’s getting worse and while the diagnostic
blocks do not completely cure it, it puts the pain at bay.”286
But in July 2007, Townsend was taken aback when, three days before her next
treatment, she received a phone call that the appointment would be delayed for over
one year – until at least August 2008 and perhaps as late as October 2008.287
“I thought they meant this August [2007]. But I was shocked when they said: ‘No,
it’s next year,’” she explained.288 “By then I will have been waiting two years.”289
Townsend, a widow and retiree,290 cannot afford private treatment and is forced to
get by on tablets and patches, which burn her skin. Hoping to get her treatment
resumed, she turned to her Member of Parliament, MP Richard Spring, who
pressured Dr. Simon How, the general manager for medical services at West Suffolk,
and the Department of Health.291
According to Spring, Townsend was overlooked because the hospital sought to meet
National Health Service targets.292 NHS guidelines state that new hospital patients
should begin treatment within 18 weeks of a referral by a general practitioner.293
“It really is a profound bureaucratic misjudgment that the time period for new
patients in practice pushes existing patients, who are suffering and in pain, into even
greater discomfort,” said Spring.294 “This is a terrible case – the worst I have seen.
It’s bureaucracy gone mad.”295
Armstrong described the chaos inside the ward. “The midwives were rushed off
their feet and clearly couldn’t meet the needs of all their patients. I got the feeling I
was just a number, an item on a conveyor belt,” she said.
Though she was in pain, Armstrong recalled that a midwife checked on her only
once over a period of three hours. Husband Daniel tracked down an anesthetist to
inject an epidural. The epidural should have numbed Armstrong’s lower body, but
the anesthetist botched it by injecting in the incorrect spot.
At last a different midwife appeared, but Armstrong was given what can only be
described as a shoddy examination. “After a quick check she told me I wasn’t
progressing that quickly and it could be a while yet,” she said. “Before I could ask
any questions she was gone.”
When the midwife returned, a second examination was equally incomplete. Again,
the midwife insisted Armstrong was not in delivery, but, according to Armstrong, the
midwife did not check how dilated she was. Instead, Armstrong said the midwife
told her a trainee would come get her “if you really need me.”
Soon thereafter, Armstrong was screaming that she was going into labor. “Daniel
shouted at the trainee to get help, but she just stood in the corner looking petrified,”
Armstrong recalled. Armstrong’s mom administered the delivery herself.
“My mum is not a midwife and I couldn’t believe she was about to deliver my
baby,” exclaimed Armstrong. “Twenty minutes after the midwife had left, the baby
was crowning – the top of its head had appeared. My mum said: ‘This is your little
girl and we have to get her out safely. There is no one else here to do this, so you
“I couldn’t believe the NHS staff had put us in that position,” exclaimed Armstrong.
“Were it not for my mum’s advice and calm attitude, my child could have been
starved of oxygen or had a whole host of other complications from not being
delivered in time – she might even have died.”
For Dunil Almeida, this situation was his own real life health care horror story.
Despite being examined 50 times by various doctors, the pain in Almeida’s stomach
that in fact was colon cancer was somehow undiagnosed again and again under the
care of the government-run British National Health Service.
This incredible tale of medical incompetence started in May 2005, when Almeida
was first seen in the emergency room at London’s Hillingdon Hospital. Over the
next 18 months, Almeida would repeatedly return complaining of stomach pain.
But doctors failed to test for the cancer that would eventually kill him. According
to Almeida’s widow, Chiandra, one doctor suggested Almeida “was probably
imagining the pain.”
It would not be until Almeida visited Sri Lanka in January 2007 to see relatives
that he learned of the cancer. He was scheduled for a long overdue abdominal scan
and returned to London to see a specialist. But by the time the appointment was
confirmed, it was too late. Almeida had lost over 50 pounds by this point, and,
As for Almeida’s grieving wife and three children he left behind, they were given
the following assurance: “A formal investigation is under way,” from Susan
LaBrooy, medical director of Hillingdon Hospital.
At that time, the £6,000 pound (~$12,000) a year treatment was available elsewhere
in the UK under the public health care system.306 But, seemingly, treating Howard
was considered a poor value by the bean counters at his local NHS provider. “In
“Has the government lost all sense of compassion as well as economics? Is there no
way I can get help to save my sight?” a frustrated Howard asked.308 “I can’t believe
I’m being left to go blind in one eye. I’ve spent most of my working life devoted to
public service – I was in the Army, police and prison service – and I’ve never failed
to pay my dues.”309
For Howard and his wife, Mary Ann, purchasing thousands of pounds of private
treatment was not a viable option.
“I can’t afford that kind of money,” Howard said. “I’ve paid tens of thousands
of pounds in taxes and to know I’m going to lose my sight because I can’t afford
private treatment is diabolical. The problem is that we have lived too long and are
just pieces of meat now – a nuisance.”310
To Howard’s surprise, media publicity of his dealings with the NHS prompted a
private hospital to volunteer assistance. Beginning in late April 2007, as part of
its 50th anniversary celebration, Nuffield Hospitals provided Howard with the first
course of treatment free of charge that could save his eyesight.311
“When I found out that the Nuffield Hospitals had agreed to give me the treatment
free of charge, there was such a feeling of elation,” Howard said. “I could not quite
believe it, and I cannot even begin to explain my gratitude.”312
Howard said that a course of treatment with the drug Lucentis “stabilized and may
have even improved [my eyesight] ever so slightly...”313
Though immensely grateful, Howard blasted the NHS for failing to help him and
other wet ARMD sufferers. “I still have this feeling of immense annoyance with
the PCT, not just for me, but for all the other patients who are being denied this
treatment on the NHS,” he said.314
In 2008, the National Institute for Health and Clinical Excellence, the NHS clinical
standards authority, changed course to permit treatment of wet ARMD with Lucentis
immediately upon diagnosis in one eye. NHS will fund the first 14 injections, and
the drug’s manufacturer, Novartis, will pay for additional doses.315
Reacting to the policy reversal, Howard said, “I am absolutely over the moon. But it
The rub at the time was even if Mills paid out-of-pocket to supplement her care, the
NHS would begin to bill her for the entire cost of treatment because she would be
considered a private patient.325
“If a patient chooses to go private for certain drugs they elect to become a private
patient for the course of their treatment for that condition. That is trust policy,” said
a statement by South Tees Hospitals NHS Trust, Mills’ local health care provider.326
Mills was willing to pay the estimated £4,000 (~$6,600) a month to get the
expensive drug and have it administered – but she did not want to be stuck with
the tab for her entire treatment. “The costs would increase from £4,000 a month to
about £10,000 to £15,000 for all my care. I would need to pay charges for seeing
the consultant, for the nurses’ time, for blood tests and scans,” Mills explained.329
Thus, by doing what she thought necessary to improve her chances of survival,
Mills would be responsible for paying some £15,000 (~$24,400) to the government.
“The policy of my local NHS trust is that I must be an NHS patient or a private
patient,” said Mills. “If I want to pay for Avastin, I must pay for everything. It’s
immoral that the drugs are out there and freely available to certain people, yet they
say I cannot have it.”330
The rationale for the bizarre policy that restricted how citizens spent their own
money for health care was rooted in the NHS’s belief that care should be equal
and not based on a patient’s ability to pay. “The Government is committed to a
publicly funded NHS, free at the point of use and available to all regardless of
income,” explained a spokesman for Britain’s Department of Health. “Co-payments
would risk creating a two-tier health service and be in direct contravention with the
principles and values of the NHS.”331
The health care provider, therefore, rejected Mills’ request because it considered
her buying an extra drug to be an “add on” to her existing NHS treatment.332
Mills’ pleas to the NHS health trust were rejected,333 and she and husband, Eric,
abandoned their challenge.334
“I can’t go private...” said Mills. “This decision is totally unjust… this drug would
prolong my life.”335
Mills recognized there naturally may be cost prohibitions for some care. But, she
argued, “The whole concept of the NHS is that it’s free at the point of need. Why
should that stop because I want to pay for something?”336 She also pointed out the
NHS’s apparent double standard. “It is already a two-tier NHS,” said Mills.337 “I’d
had a scan privately when there was a two-week wait on the NHS... If I go to the
dentist I can mix my NHS and private treatment.”338
Reacting to the policy change, Mills said, “This move by the Government is exactly
what I’ve been fighting for – but it has been a long time coming.”
Although the government’s change of policy was welcome news for patients like
Mills, it came too late for Mills herself – four months after her unsuccessful effort
to purchase Avastin herself, her cancer spread to such an extent that it will no longer
respond to the treatment.343
At 7:00 that morning in April 2007, Register called the Norfolk and Norwich
University Hospital, a public National Health Service hospital operated by the Norfolk
and Norwich University Hospital NHS Trust. Though she was near to giving birth, the
hospital told Register she would have to wait for a spot to become available.344
“I was told to wait a bit longer,” Register recalled, “despite my first child being born
very quickly and having been advised not to hang about if I ever had a second child.”345
To her horror, when Register later called a second time, she learned the public
hospital’s maternity ward had stopped taking in new patients. It would remain
closed until 1:20 pm that day.346
Midwives suggested Register drive to a different hospital some 30 miles away. Left
with no choice, Register and her husband, David, frantically set out for James Paget
University Hospital in Gorleston. But only seven miles en
route, they were forced to turn back when Register realized
the hospital was too far away to get there in time. David
Credit: FrancisTyers at en.wikipedia
“A transport official came round to look at the two front door steps and said they
could not carry her over them because it was a safety risk,” explained Tranter’s son-
in-law Gordon McDermott.
“It [was] health and safety gone mad,” described a disgusted McDermott. Appalled
that hospital officials continued to strand his mother-in-law for hours and for
dubious reasons, he contacted the press about the situation. This seemed to pay
off. “Hours later, a second official came about the step and when I told him the
local paper was getting involved, he suddenly said he would sort it out,” recalled
McDermott.
But the family does not accept the hospital’s approach. “It is absolutely appalling
that my mother-in-law was taking up a bed for no medical reason and kept from her
wish to go home,” fumed McDermott.
But she had newfound hope when she discovered an alternative treatment, the drug
Avastin. Though this apparent ‘miracle drug’ offered promising results, Moss’ NHS
provider, Worcestershire Primary Care Trust, refused to
fund the expensive treatment.357 Worse news followed: if
Moss opted to pay for the Avastin with her own money,
Credit: UK National Health Service
Facing death, Moss chose to take an early retirement and to use £21,000 (~$34,600)
from her pension along with money from her elderly mother and her husband’s
pension to pay for private care at Cheltenham General Hospital.360 “When I went in
to the hospital I didn’t assume I would be coming out again,” said Moss.361
“It was like a miracle. I had been planning my funeral – now I had life again,” Moss
exclaimed. “I was accepting death but now I no longer feel like I have to accept it.”364
Though thankful to have survived the cancer, Moss is upset the NHS denied her –
and patients like her – the best possible care to extend her life.
“They should be ashamed of themselves – of the way they turned down the case out
of hand,” Moss charged. “People should be entitled to this. I would not have had
my life extended without private medical health care.”366
Moss lost her March 2008 appeal to the Worcestershire Primary Care Trust to have
her Avastin treatment funded publicly as “an exceptional case.”367 But she was
pleased that later that year, responding to substantial adverse publicity, the NHS
reversed its co-payment ban.368 In November 2008, Alan Johnson, then Health
Secretary, announced that patients who supplement their care privately – and who
must do so at a private facility – will not lose their NHS care.369
Curiously, while the NHS effectively abandoned Moss and patients like her, it had
funds available for tattoo removals. The NHS picked up the tab to remove some
187,086 tattoos between April 2004 and March 2005, spending as much as £2,500
per procedure. One such patient, Tanya Bainbridge, formerly a sailor named Brian,
made headlines in 2006 after receiving NHS funding for the removal of large
“unladylike” forearm tattoos –tattoos Bainbridge reportedly wanted removed in
order to enhance her appearance in sleeveless dresses. Bainbridge’s £20,000 sex
change operation, done in 2001, also was funded publicly by the NHS.370
Since losing a great deal of his hearing in military combat, Bloom has relied upon
a hearing aid to lead a normal life. But when Bloom reached age 85, the outdated
analog hearing aid he had used for 20 years no longer got the job done. So when
hearing became more difficult and new digital devices became available through the
NHS, Bloom visited his general practitioner, who referred him to a hearing clinic.
“[E]very three or four months I was getting a letter saying there would be longer
delays, first six months, then nine months,” Bloom recalled. “The last letter
I received said the wait would be even longer – because they are prioritizing
children, which I think is completely the right thing to do as they have their whole
lives ahead of them.”
After more than two years of waiting, a frustrated Bloom ended up shelling
out £2,000 (~$3,200) out-of-pocket for a new device instead of waiting for the
government to get around to assisting him.
“I think it is disgraceful that if I lived a few miles away in Norwich I would have
got my digital hearing aids within four weeks,” fumed Bloom. “It makes me sick to
think that if I lived almost anywhere else in the country I would have got them much
quicker. I feel very badly let down after paying taxes all my life.”
Some 59 hospitals in Britain have wait times longer than one year for analog-
to-digital hearing aid upgrades, according to a survey by the British Society of
Audiologists.373
In October 2003, Paris injured her shoulder while doing home repair. She got by
for months on private physiotherapy, which she paid for out-of-pocket. But her
condition gradually became more serious.374
“I couldn’t drive, I couldn’t sleep, [and] I was getting more and more angry with my
kids, because I was in so much pain,” Paris recalled.375
When she could not move her arm and had to put it in a sling, the former police officer
went to her general practitioner in March 2004.376 That’s when Paris learned it would
be a six-to-eight week wait to see a NHS physiotherapist. Moreover, for surgery, the
combined wait for an assessment and the operation was close to one year.377
“I was told I would have to wait a year for surgery even if they booked me in for it,
which they were very reluctant to do,” Paris explained.378
Instead of waiting in pain for eventual NHS care, Paris contacted Apollo Hospital379
– a private Indian health care corporation that owns and manages some 41 hospitals.
Apollo offered immediate care “for a fraction of the price,” Paris said.380
In one week, the hospital arranged surgery and luxury recuperation facilities to boot
at a cost of £1,500 (~$2,400). Despite a £550 (~$900) flight, Paris considered going
overseas a bargain.381 An equivalent operation at a private facility in Britain would
have cost her over £10,000 (~$16,000).382
Three days after her arrival in Chennai, India, surgeons repaired Paris’
shoulder.383 Afterward, she raved about her care. “The thing that impressed me
most was how caring they were. They gave me a 24-hour nurse, who was really
sweet. If I went anywhere, they’d send a driver, a security guard and a nurse – I
felt a bit like a celebrity!”384
She continued, “Then I stayed in a spa afterwards and had a great time. It was a
five-star hotel with Ayurvedic treatment [an ancient Indian practice], which was
fantastic and a fraction of the price it would be here.”385
In the mixed-sex ward where she was admitted, Balsom recalled being awakened
twice one night by a man opposite her in their shared unit. “He was standing stark
naked at the end of his bed masturbating,” she wrote in disgust.
While at Hillingdon, she was given only one pillow and refused a spare to prop
up her leg, as a nurse instructed, to ease the swelling caused by a blood clot. She
was discharged the day, not in an ambulance, but by taxi along with what Balsom
described as a “trainee nurse” who made sure to take back an oxygen device used
during the transfer.
Two days later, Balsom was back in the hospital because of breathing difficulties and
again placed in the mixed-sex ward. She was given oxygen and morphine and, to her
horror, asked if she wanted to be resuscitated if she collapsed, as she was terminally
ill. The following day, she was discharged in the back of a NHS delivery van without
a nurse and with only enough medication of one prescription to last a day.
“I feel Hillingdon Hospital are making whatever time I have left so much more
stressful than it need be. They are cheating me out of quality time with people I care
about. Apologies aren’t enough, they don’t buy time back,” Balsom wrote.
The final diary entry on the day before she died read: “Up all night with pain.
Crying and want to go in a nursing home to die because I cannot put my husband
through all this... I don’t feel as if anyone in the NHS is really in charge of my case.
It’s all up to me, [sister] Janet and [husband] Mick.”
Balsom passed away on November 16, 2006, never having received a bone scan
and, according to the diary, seen only twice by a doctor during her final two weeks.
She wrote in her diary that she believed her care was rationed because she suffered
from more than one form of cancer and was unlikely to recover.
“Pat’s final wish was that what happened to her would never happen to anyone else
who happened to live in the borough of Hillingdon,” said Janet Street-Porter.389
In January 2009 – 12 years after Labour’s pledge – Alan Johnson, then Health
Secretary, announced a £100 million (~$162 million) initiative to convert the
remaining 15 percent of NHS hospitals to single sex accommodation. Beginning in
2010, the government will fine hospitals that treat patients in mixed-sex wards.392
In March 2007, the Ipswich Hospital cancelled Pople’s surgery the day before it was
to take place. As Pople’s hernia advanced, his family became increasingly anxious.
“I’m not a doctor but I was looking at him and just praying to God it was going to get
done,” said Gordon Harris. “It was a terrifying situation, he [Pople] couldn’t stand up
right because of it [the hernia] and at times he had been feeling sick as well.”
Surgery was rescheduled twice more before it finally was carried out at the end of
March. Nevertheless, the difficulty of getting Pople to and from the hospital brought
his family nearly to the point of exhaustion. “You would not believe what we have
to go through to get him to the hospital, a special bus has to be booked and we have
to sort out our two boys who go to Genesis Orwell Mencap five days a week,” said
Gordon Harris.
The hospital apologized, but it is no consolation for the Harris family, which has
made a formal complaint. “One of our difficulties is that we try to treat everyone
as individuals. But sometimes we don’t live up to our own high standards,” said an
Ipswich Hospital spokesman.
Two and a half hours later, Wesley’s wife, Jan White, decided White’s condition was
serious enough to call NHS Direct, a 24-hour taxpayer-funded advice hotline staffed
by nurses. Jan called back twice over the next three and a half hours before an after-
hours doctor arrived at the couple’s home. Because the rural town of Bellingham no
longer has an after-hours doctor or even a dedicated ambulance through the NHS,
the doctor sent had to travel from outside Newcastle, over 30 miles away.
“My wife rang NHS Direct at 5:30 am, but now I just wish I had dialed 999
[emergency services] straight away,” White said. “The service is totally inadequate.
Having an ambulance or an on-call doctor here would have made all the difference.
They have cut rural ambulances and out-of-hours doctors and there is a chance that
it could kill somebody.”
The doctor arrived at the Whites’ home at 9:45 am and determined an ambulance was
needed. But it would take until 12:15 pm for it to arrive from yet another town 35 miles
away. Worse yet, the paramedic crew was not equipped for urgent care and was unable
to provide morphine. A second ambulance had to be called, arriving 15 minutes later.
By this point, White’s condition was so severe that he needed to be airlifted to Royal
Victoria Infirmary in Newcastle. At 2 pm, finally, White received hospital treatment,
and three days later had his appendix removed. He was thereafter released to
recover at home.
“The time it took is just unbelievable and I am very angry,” White continued. “I am
not a vindictive person, but I would like to see something like this happen to one of
the people who make the stupid health service policies to make them see sense.”
White’s neighbor, Jim Brownbridge, was appalled that it took so long to get White
treatment. “It is absolutely ridiculous. The local NHS is supposed to be hard up
yet the cost of the services on that day must have been massive. It could have been
avoided... If Bellingham still had an ambulance and doctors in surgeries out of
hours, he would have been taken far earlier in the day.”
One possible explanation for the long ambulance wait is that White may have
been the victim of an alleged NHS practice called “patient stacking.”396 According
to government records, tens of thousands of sick patients have been left to wait
for hours inside an ambulance before being admitted to hospital accident and
emergency departments. The alleged practice allows hospitals to better meet
government health targets for admitting, transferring or discharging emergency
patients within a four-hour time limit.397
The 57-year-old was diagnosed with cancer in 1999. She received treatment on the
NHS at Christie Hospital in Manchester, but the cancer became so advanced that
Hirst’s doctor suggested she would “benefit massively” from taking Avastin,403 an
expensive anti-cancer drug widely used in Europe as well as the U.S.404 Though
Avastin was licensed in England, the NHS did not provide it.405 Thus, for Hirst to
get it privately, it would cost her a staggering £60,000 (~$98,000).406
Nevertheless, believing time was running out, Hirst began to save, having been told
by her oncologist that she would be allowed to fund her own Avastin treatment.407
She raised some £10,000 (~$16,200) by December 2007 with help from family and
The rationale for the NHS’s policy that banned so-called ‘private co-payments’ was
to prevent richer patients from receiving preference over poorer ones.413 Patients
“cannot, in one episode of treatment, be treated on the NHS and then allowed, as
part of the same episode and the same treatment, to pay money for more drugs,”
explained Alan Johnson, then-British Health Secretary. “That way lies the end of
the founding principles of the NHS.”414
But Hirst’s lawyer thought the government’s attempt to forbid Hirst from buying
her own drugs in the name of equality was ridiculous. “The argument supporting
the desire to avoid a two-tier system within the NHS is spectacularly flawed,” said
Moreover, what further appalled Hirst was three other patients at her hospital, the
Royal Cornwall Hospital, were paying for Avastin privately and able to continue
their usual NHS treatment.416 According to the New York Times’ investigation,
these three patients had supplemented their care before the government issued
rules forbidding the practice. “Because their treatment began before the Health
Department explicitly condemned the [private co-pay] practice, they have been
allowed to continue,” wrote the Times.417
Fed up that she had “been cheated out of care,”418 as Hirst put it, she approached the
news media to publicize her NHS horror story. “[I]t makes me so angry that even
though I’m prepared to contribute thousands for my care they [NHS] won’t even
meet me halfway,” she said.419
Hirst planned to sue the Cornwall & Isles of Scilly Primary Care Trust, her local
NHS provider, over the co-payment ban.420 But in February 2008 a review panel
ruled that Hirst’s condition had deteriorated sufficiently for the government to pay
for her Avastin treatment, beginning on February 8.421
The news was “better than winning the lottery,” Hirst exclaimed.422 “It’s like
Christmas… My solicitor [lawyer] threatened that if we hadn’t heard from the
health trust responsible by 4 pm on Friday, she would begin a judicial review – and
we had a call at 4 pm saying I could have the treatment on the NHS.”423
Hirst said the legal pressure applied and media interest had something to do with the
NHS changing its mind to pay for her treatment. “I would say to anyone who finds
themselves in this terrible situation ‘Make a fuss and keep fighting – it could save
your life.’”424
The NHS reversed its policy banning co-payments in November 2008. Patients
who pay for private treatment administered in a private facility will not lose their
NHS care.425
When Maddi was discovered submerged and unconscious, doctors had to deliver the
unborn baby by emergency caesarean section.426 The baby survived, but the lack of
oxygen to Maddi’s brain killed her.427
But when Guthrie returned 45 minutes later, Maddi was still in the bathtub and the
door was locked. When she did not respond to knocks, midwives opened the door to
find her submerged and not breathing.431 She had turned blue from lack of oxygen.432
Doctors performed emergency surgery to rescue the baby, Jayden. Though Maddi
was resuscitated, she would not recover. Tragically, she died eight days later in
intensive care.433
“My son will never know his mother,” said shocked father, Phaninder Maddi.434 “My
son might not even have been alive if Paul hadn’t come back when he did. I just
hope that something good will come out of losing my wife.”435
“A number of midwives said it was assumed she would not have been left alone
during her bath, but hospital officials admitted there were no official guidelines on
whether women should be left on their own,” the British Telegraph reported.437
Since the unexpected death of his wife, Phaninder Maddi said he would take legal
action to claim compensation from the Doncaster and Bassetlaw Hospitals NHS
Trust,444 which runs Bassetlaw Hospital. Meanwhile, the British government granted
him residency rights, making it possible for him to raise his son in England.439
“She would have been a wonderful mum. I don’t know what I am going to tell
Jayden when he is older,” said Maddi’s husband. “I have this dream everyday that
Lorraine’s playing with Jayden and her mum is there playing with him too, saying
how gorgeous he is. Then I wake up every morning and there is nothing there.”440
Anthony Jones and his girlfriend, Elizabeth Jones, rushed to Princess of Wales
Hospital early in the morning, thinking Elizabeth was going into labor. Elizabeth
had been monitored at this hospital twice per week during her pregnancy because
her baby was growing slowly.441 She fully expected to deliver at the same
government hospital, which is close to her home.
However, upon arrival at the hospital’s maternity department, Anthony and Elizabeth
were told that all the doctors were occupied with other patients and there were no beds
available. Though Elizabeth was experiencing strong contractions, a midwife she
spoke with did not examine her and told the couple to come back later.442
“They told us they were shut because they were full and to go have a cup of coffee
and come back,” said Anthony. “We only live five minutes up the road, so we
went home.”443
Paramedics arrived to the home as the baby’s head was showing. The paramedics
did not take over and allowed Anthony to continue. “[T]hey said I was doing a
good job and I should just carry on,” he explained, as the paramedics closely looked
on. “I delivered her into the world with the paramedic standing by to help me if
anything had gone wrong.”452
Thankfully, nothing did go wrong, and Anthony delivered a healthy six pound,
eight ounce baby girl, Emily.453 After the birth, two midwives came to the home to
check on Elizabeth and the newborn.454 “It was a great experience – but at the time
I wished we were in hospital in a controlled environment,” said Anthony. “What if
something had gone wrong?”455
Anthony is equally upset that his girlfriend was denied care. “You hear so much
about the NHS being under pressure but you would think that maternity would be
a priority. Many things can wait for a later appointment – but never a baby… It’s
very worrying that they haven’t got the facilities to do the job properly when you
want it.”458
In January 2008, Valerie Tarr of Llanrumney, Wales, who also suffers from arthritis,
came down with pneumonia. Her general practitioner believed her condition to be
serious enough to warrant admission at Llandough Hospital in Penarth for treatment.
Unfortunately, the hospital did not have an available bed for her. Tarr was forced to
spend the whole night in a waiting area wearing nothing
more than a nightgown and robe.
According to government service targets, 95 percent of new patients should spend less
than four hours in an emergency department from the time of arrival to be admitted,
transferred or discharged; no patient should wait longer than eight hours.462
According to the report produced by the Welsh Assembly Government, the four-
hour target was met just 84.7 percent of the time at the Trust’s major hospitals
between December 2007 and December 2008.463
“There’s no doubt the NHS is in crisis and this shows just what’s happening to sick
people,” charged Newman.
“I, along with at least four other patients, spent the whole night in A&E [Accident
and Emergency] on trollies (gurneys). I was told there were no beds available and
the bed manager was aware of the situation,” he said.465
Instead of getting needed rest, Richards was left to observe the ruckus in the hospital
that night. “I was there all night and witnessed some horrific sights, mostly from
blood-soaked drunken individuals who had fallen or been assaulted,” he said.
“From the nurse’s tone it appears that this was becoming a regular occurrence.”466
“My delight was to be short-lived,” Lewis recalled. “The porters pushed me into the
much-awaited ward, where they were greeted by nurses... They said there was no
bed available for me.”473
“I asked a doctor when I would have my kidney stone removed,” she said.
“Incredibly, he told me there was no record of me having a stone and it was more
likely I had a gall stone... This baffled me because I had my gall bladder removed
four years ago.”477
On Saturday, though still ill and not haven had surgery, Lewis was discharged. She
returned to the hospital two days later for morphine but received no word about
whether there would be a follow up examination.478
“I was surprised they sent me home. I hadn’t eaten since Wednesday because I was
so ill all day – they said they would keep an eye on me but they just discharged me,”
Lewis said.479
81-year-old Mary MacBean of Hilton, Scotland broke her pelvis when she fell at
home. The fall left McBean, who had who survived a stroke 18 months before, limp
and unable to stand. Nevertheless, she managed to crawl across the floor to receive
a phone call from her son, Michael, who learned of her injury.
“As soon as I realized she was hurt I raced into my car – I didn’t even put my shoes
on and I just drove up to her house,” Michael McBean recalled.
Upon arriving, Michael found his mother “screaming in agony.” While coming
to her aid, Martin MacPherson, a friend called on to assist, dialed emergency
services. “I was trying to hold her while Martin dialed 999 [emergency services],”
Michael said.
“I said [to the operator] she had broken something. They said it wasn’t life-
threatening and would pass on the details to NHS 24. An 81-year-old who is lying
on the floor with a broken pelvis is an emergency in my book,” said MacPherson.
Michael McBean added, “She was being sick and
sweating. Her skin was all clammy and she was
beginning to drift in and out of consciousness.”
Twenty minutes after the third call, paramedics arrived and gave McBean morphine
and oxygen. An ambulance then transported her to Raigmore Hospital, where she
was successfully treated.
Following the ordeal, a Scottish Ambulance Service official justified its response
policy. “We have to prioritize our resources to ensure patients with the most
need are seen first. The response time of 30 minutes was appropriate in this case.
Although we do appreciate Mrs. MacBean was in a lot of pain and discomfort, it
was not a life-threatening situation.”
Cabel of Ellon, Scotland had been admitted six weeks prior to Woodend Hospital
in Aberdeen for treatment of a urinary tract infection.481 But a fall from a chair
immobilized Cabel on the hospital floor.482 Instead of helping Cabel up, the nurses
and doctors present left him on the floor. Nurses claimed they did not have the
proper training to move the heavyset and elderly man, and said paramedics would
have to be called in to lift Cabel.483
Roughly an hour and half after the fall, Cabel’s family arrived at the hospital,
shocked to find him on the floor and in pain. Cabel’s wife, Elsie, and their son,
Mitch, confirmed that paramedics had been called earlier to lift Cabel.484
“He was moaning and complaining about being sore,” recalled Mitch Cabel.485 “The
doctor had made repeated calls to the ambulance service, stressing the importance
of my father’s situation, but nothing seemed to work… I was amazed. There was a
doctor there and nurses you would assume would be trained in lifting.”486
While waiting for the paramedics to arrive, nurses wrapped Cabel in blankets, gave
him morphine to dull the pain and eventually, three hours on, moved him from the
cold hospital floor onto a mattress.487 “It’s incredible that in a hospital a patient is left
lying on a floor and we’ve got to wait for paramedics to come in,” Mitch exclaimed.488
Because Cabel’s condition was not considered life threatening, he was not given
priority by the ambulance workers. “Had this gentleman not been in a hospital he
would have received a very much faster response,” said a Scottish Ambulance Service
spokesman. “The patient was suffering from a non-life-threatening injury in a hospital
environment with medical staff in attendance. We have to prioritize our resources to
those that need us most, which is patients in life-threatening situations.”489
But Mitch challenges the health authorities’ explanations and questions why the
hospital did not have trained staff on hand to aid his father. Mitch said:
I later went to see a nursing manager and told her I couldn’t believe that in
a hospital dealing with the elderly there hadn’t been a fall before… She
told me my father had had a different type of fall, which I found totally
unbelievable… The whole situation was unforgivable and they made it
worse by trying to get me to believe their ridiculous explanations... Why
was no one there with the training to lift him right away?495
Cabel passed away two weeks after the fall. Though it is not clear his death from
kidney and heart failure related to the ordeal, what is certain is that Cabel never
recovered. “I can’t say that what happened to him contributed to his death, but
having kidney problems and lying on a cold floor for as long as he did hadn’t
helped,” Mitch Cabel said.496
Kerry and her mother, Lynne, were taken by ambulance to Ninewells Hospital
for treatment to clear up sores under the body cast. Treatment was complete
within an hour, and Kerry, confined to her wheelchair, was cleared to be
transferred back home.
But four hours later, Kerry and her mother were still waiting for the ambulance.
The waiting area where Kerry was placed closed. Staff then transferred Kerry to
another waiting room in the hospital’s child-care wing. Yet another two hours of
waiting passed. Finally, an ambulance arrived, only to refuse to take both Kerry
and the wheelchair.
“I was furious,” said Lynne. “They said they could take us home but not the
wheelchair, but I told them absolutely not. It would be like leaving Kerry’s own
legs behind.”
The ambulance crew claimed the ambulance could not accommodate the girl’s
specially-equipped wheelchair. But, curiously, the wheelchair was not an issue
on the initial transfer to the hospital: “I can’t understand why an ambulance was
able to take us to Ninewells [hospital], including the wheelchair, and not take us
home again,” said Lynne.
Following the ordeal, a spokesman for the Scottish Ambulance Service offered
this explanation: “While this child’s injuries were clearly uncomfortable and
upsetting for the family, they were not life threatening… It would not be wise
A spokesman for the NHS admitted, “To wait six hours for an ambulance,
only to be told when it turns up that it can’t accommodate a wheelchair, is
really unacceptable.”
This is the very real situation Canadian Lindsay McCreith faced in Canada’s public
system of “universal” – yet rationed – medical care.
“The system stinks,” exclaims McCreith. “I don’t understand why there isn’t a rush
on government, why people say, ‘I’ll wait a year for a hip replacement, a year and a
half to find out what’s wrong with my brain.’”5
Fortunately, McCreith did not have to wait idly while his life hung in the balance. McCreith
elected for the Buffalo hospital to remove his tumor in March 2006. Though the cost of
treatment, accommodation and travel was $40,000 CAD (~$36,900), McCreith’s wife,
Sandra, is thankful. “We were lucky,” she says. “We had that money from an inheritance
just six months before from my father, so we didn’t have to mortgage anything.”6
Lehotsky received wide praise for his work. “You’d have to look pretty hard to find
anyone in Winnipeg who has made as much of a difference to their neighborhood as
Harry did to his,” said John Gleeson, editorial page director of the Winnipeg Sun.11
Winnipeg Mayor Sam Katz echoed the sentiment, “He showed me and everybody
else that one person can make a big difference.”12
However, since late 2006, New Life Ministries has been without Lehotsky’s
leadership. Tragically, in November 2006, Lehotsky died of pancreatic cancer in his
liver and spleen – cancer doctors determined was inoperable.13
In April 2006, Lehotsky began experiencing constant abdominal pain. Because the
pain had progressed over several months, he sought an examination, but he was told
it would be “months” before his family physician would be available. The second
option, at the Manitoba Urgent Care Centre, was not more promising: a possible
12-hour wait in an emergency room with only one physician on duty and twenty
patients ahead of him in line. Lehotsky said at the time, “I thought I’ll wait until I
Yet, the pain was so intense that Lehotsky returned to Urgent Care on Easter
Sunday. “[T]hat evening the pain increased to the point I couldn’t stay at home any
longer. My family got me to the hospital,” said Lehotsky.15
After Lehotsky spent a total of six hours in the emergency center, doctors
were unable to diagnose a definitive ailment. Lehotsky would need to see a
gastroenterologist and to make an appointment for a barium X-ray. The earliest
appointment time for the X-ray was September – five months away – and November
to see a gastroenterologist.16
“Whatever it [the ailment] was would certainly have gotten much worse – perhaps
even inoperable by that point,” said Lehotsky soon after. “The prospect of waiting
in pain didn’t excite me.”17
Not being able to stand long or have steady meals because of the pain, Lehotsky
saw yet another doctor, who prescribed a proton pump inhibitor not covered under
Lehotsky’s insurance.18
“Friends and family started finding out about my situation,” Lehotsky recalled.
“Responses mirrored my own feelings – everything from shock to disgust that I was
paying for medical care not available to me.”19
“Surgeons have told me that there is no chance they can operate to remove
something that’s already spread so far inside me,” Lehotsky reported to friends after
this diagnosis. “Even a simple pain reduction operation to kill some of the nerves in
my abdomen would likely be obstructed by the tumor.”22
Though Lehotsky’s fight against cancer ended in November 2006, his legacy is
remembered in the community he worked tirelessly to improve. Colleague Trudy
Turner said, “He’s had a huge impact, and got the ball rolling on a lot of things and
we can’t afford to drop the ball now. It would be a real disservice to Harry.”23
In February 2007, Lehotsky was appointed as a member of the Order of Canada for
his life’s service. This honor is considered Canada’s highest achievement award.24
Yet, Dave Chomiak, at the time the provisional Health Minister, failed to see
a systematic problem in the province’s cardiac care. “In Manitoba, we do
1,200 cardiac surgeries a year. In some cases people die on the operating table.
Unfortunately in some cases, people, as we found out, don’t quite make it even
though we have a pretty good ratio.”33
In November 2004, Malleau, then 44, was in a car accident that paralyzed one side
of his body.34 Doctors at Hamilton General Hospital removed a part of his skull the
size of a fist to allow Malleau’s brain enough room to swell. Malleau would need
surgery to replace the missing part of his skull once the swelling decreased.35
an operation],”39 recalled wife Pat, who quit her job to care for her husband.40 In
Canada, “[p]ets…get better care than human beings,” she added.41
But the Malleaus were unable to secure a new date for surgery and did not get a
suitable explanation for the delay. Frustrated, they enlisted the help of Andrea
Horwath, the local representative in the provincial parliament.42
“It was the most disgusting display of lack of responsiveness of a hospital that
I’ve seen in a long time,” said Horwath.43 “Currently, he cannot work and has no
prospect of employment or income until after this vital surgery happens. Only then
can he and his family begin to rebuild.”44
On August 10, 2007, after a little over 31 weeks carrying the four identical sisters,
Jepp began to experience contractions while staying at Calgary’s Foothills Medical
Centre.50 Though the infants were still two months
premature, Jepp had prearranged for doctors there to
monitor and to deliver her babies.51 Yet, because of
three premature births the night before, the hospital’s
neonatal unit was over its 16-bed capacity and therefore
Credit: Thivierr at en.wikipedia
But a search revealed there was not a Level 3 neonatal unit in all of Canada
available for four premature babies together.54 “There wasn’t space anywhere in
Canada, so we had to turn to our friends in Montana,” Phelan said.55 J.P., the father
of the quadruplets, added, “The CHR [Calgary Health Region] had phoned clear
across the country looking for beds. There were only three [neonatal intensive
care] beds available anywhere in the country and they would have been in different
centers across the country. That was a worse case scenario.”56
“[I]t was the right decision to, to send us where... the resources were at that moment
in time,” said J.P. “The... staff at the Benefits Healthcare Hospital in Great Falls,
Montana, were... absolutely amazing. Took care of us medically and then took care
of us as people and it turns out to be a blessing in disguise that we made the trip
down there and we thank them for... all their help.”58
“It was a little disappointing they couldn’t stay in Calgary where their friends and
families are, but they got excellent care in Montana,” said Katie, Karen Jepp’s
younger sister.59 “It’s frustrating. Imagine you’re having quadruplets and all of a
sudden you get sent away from all your friends and family.”60
On May 27, 2004, Debrah Cornthwaite, then 27, began to experience contractions.
To deliver the twins, the hospital decided Debrah would need to move to a different
hospital two hours away by plane in Edmonton, Alberta. Having little choice,
Debrah, Brandon and two medics boarded a chartered medical flight to Edmonton,66
roughly 700 miles away.
During the flight, Debrah’s contractions steadily increased. “We were an hour away
from Edmonton and my wife’s contractions got to a minute apart and thirty seconds
long,” Brandon said. “There was major, major concern about that… We were just
praying. The medics were… just trying to hold those babies in.”67
“I just hope that something good can come from this and they’ll do something with
this health system, manage the money properly and get the qualified people, because
I’m sure I’m not the first person this has happened to and I doubt I’ll be the last,”
said Brandon.69
In June 2003, Ryan lost a kidney to Wilms’ tumor,72 which is “a rare kidney
cancer that primarily affects children,” according to the Mayo Clinic in Rochester,
Minnesota.73 By January 2005, Ryan was considered cancer-free.74 However, the
boy’s geneticist requested further screening because Ryan was at increased risk of
developing leukemia as well as liver and kidney cancers.75
After several months of waiting,76 the Oldfords were told the startling news: there
“I don’t think anyone at all would tell you it’s reasonable for anyone to wait for an
MRI for two to two and a half years – much less a cancer patient who is four years
old,” said Brenda Oldford, Ryan’s mother.79
“Two years and a half is access denied,” charged Normand Laberge, CEO of the
Canadian Association of Radiologists. “That’s just not acceptable. There’s no
guidelines in the world that would say that this is proper in terms of health care.”80
What also explains the astonishing delay is Canadian children face longer
wait times than adults for an MRI. “You would think kids get a priority,”
said Geoffrey Higgins, clinical chief of diagnostic imaging at the Health Care
Corporation of St. John’s. “[But] kids have to wait longer than adults. They
have to wait longer [for MRI scans] than anybody else because of the sedation
that’s needed,” he explained.81
Since 2005, the Canadian province of Newfoundland and Labrador has added three
In July 2007, the elderly woman (whose name has not been disclosed) checked
into Rosthern Hospital in Saskatchewan, suffering from a minor stroke. While
recuperating, she fell, broke her right hip and was transferred to nearby Royal
University Hospital for emergency surgery.
Because of her age, it appeared that Perras’ mother would be given immediate
attention. The day she arrived at Royal University, in
expectation of surgery later in the day, hospital staff
provided little food.
Credit: Drm310 at en.wikipedia
“I think she should have been higher on their priority list because of her age and her
condition,” Perras said. “Every time they tried to move her she just about screamed.”
The fourth day after Perras’ mother’s arrival at Royal University, surgeons replaced
the ball in the broken hip joint. Surgery was successful, but Perras remained
concerned that her 116-pound mother lost 12 pounds while in the hospital. She has
since moved into an long-term assisted living center.
Dr. Jeff McKerrell, an orthopedic surgeon who heads the Saskatoon Health Region’s
Perras is not pleased with the care her vulnerable mother received. “I don’t think
that’s any way to treat our elderly people,” she said. “They should have some means
of opening more ORs so they can speed the process up.”
Long wait times for surgery are common in Saskatchewan. A 2007 study by the
Canadian-based Fraser Institute found that these residents wait an average of 27.2
weeks for surgical treatments from the time of referral by a family doctor – at the
time, the longest wait in any Canadian province.90
In the fall of 2005, Healey began to experience nausea, vomiting and diarrhea.
She consulted her family physician, who instructed her to discontinue rheumatoid
arthritis medication. But the symptoms continued, and Healey was so dehydrated
that twice she went to the emergency room in the summer of 2006.92
“Anyone with blocked arteries is not meant to wait six months to a year,” said
Healey’s doctor in Canada, Dr. Robert Ellett. “I suggested that with the way things
are in Canada, I would go to the States as well.”96
The lifesaving surgery cost Healey some $41,000 out-of-pocket because she did not
receive prior approval for it to be covered under Canada’s government managed
health system. But for Healey the alternative was waiting in Canada for health
authorities to process paperwork while her condition deteriorated. She had lost
nearly 50 pounds in one year because of vomiting and diarrhea,98 and at the time of
surgery her mesenteric artery was 99 percent shut.99
“If you figure you are not going to make it, then you’ve got to find the money,”
Healey said. “It’s not the fault of the doctors here [in Canada], it’s the health care
system. It’s sad that people have to pay to get their operations; but if I didn’t, I
wouldn’t be here talking to you right now.”100
As a result, Healey had been preparing a lawsuit against the British Columbia
Ministry of Health seeking reimbursement.104 With
the aid of Richard Baker, founder of Timely Medical
Alternatives,104 the lawsuit was to challenge the core of
the Canada Health Act, which bans private insurance.105
Credit: Camille Jensen/Castanet
“The money she spent going to the States gave her two
Bumped twice for urgent surgery on four
more years of life, which she obviously lived to the
clogged arteries, Shirley Healy fled to the fullest,” added Baker. “The day she died she had just
United States for next-day treatment.
come back from playing golf.”107
In December 2007, Meeks and her husband, Wilf, of British Columbia were
finishing an extended stay in Indio, California when she became ill. Though
suspecting only a flu bug, Meeks learned the situation was far more serious after two
local hospital visits. She needed immediate surgery to repair a ruptured appendix
and to remove her gallbladder, which had become infected and gangrenous.108
“She’s frustrated as hell; she’d like to get home,” said daughter Kim Meeks at the
time. “She’s been ready to be transported for two weeks but supposedly there are no
beds for her.”110
The health authority in British Columbia, the South Fraser Health Region, told the
family there was not enough staff or available beds to accommodate Meeks at home.
Moreover, if a bed did become available, there was no guarantee Meeks would not
be bumped in favor of another critical patient.111
“They’ve been saying every day ‘maybe tomorrow,’” complained Kim Meeks.
“Basically they’re just keeping her comfortable at this point; there’s nothing more
they can do for her. She just looks so depressed.”112
At last, almost immediately after her experience of being stranded in California was
publicized, Meeks was flown to the intensive care department at Royal Columbian
Hospital in British Columbia on January 2.
Fortunately for Meeks, she and her husband took out private health insurance
before leaving Canada, so it covered the costs of extended care in the U.S. and the
flight home.113
At first Bureau figured his stomachache was merely indigestion. However, when the
ache continued the following afternoon, Bureau and his mother decided to get his
stomach examined.
“I kept getting calls saying, ‘We tried Hull [Hospital], not working. Gatineau,
not working. Buckingham, not working. Ottawa, not working. Maniwaki, no
response.’ I thought, oh my God, where are we going to end up, the States?”
recalled Bureau’s father, Robert Bureau.115
At last, an available surgeon was found – in Montreal, over 120 miles away.
Not having another option and in pain, Bureau was put into an ambulance at
approximately 8:37 pm to embark on the several-hour journey. Unfortunately, his
ordeal was just beginning.
First, the driver could not find the correct way to the hospital. “I could hear them
[the paramedics] asking directions to people outside because they didn’t know
where they were,” Bureau said. Next, the paramedics mistakenly unloaded Bureau
at the wrong hospital. At last the right hospital was found, and at 12:15 am Bureau
arrived at Montreal General Hospital. His father, who had left at nearly the same
time as the ambulance, had arrived 90 minutes earlier.
By this point, the surgeon, who had to wait longer than expected for Bureau to arrive,
was occupied with another trauma patient. Bureau was left to wait, and would not be
operated on until the next night – over 21 hours later.
“When they opened him up, it was busted. There was pus all over the place. There was
dead tissue. So they cleaned it all up and they removed the appendix,” Robert Bureau said.
“As a parent, I cannot believe that there is no emergency services or surgery for our area or
the Ottawa area to deal with something as simple as an appendix,” said Robert Bureau.
Dany asked, “If someone had something a lot more serious than me, what would
they do? Or if the Montreal hospital had no personnel, what would I have done?
Where would I have gone?”
The delays could have cost Dany Bureau his life. According to a British Medical
Journal Group publication, “About 17 in 1,000 people die if their appendix bursts
before they have surgery.”116
“Every child that is in our critical care unit requires a ventilator to breathe and
specialty care. Sometimes when that happens… it means we have to reschedule
other surgeries,” explained Lisa Lipkin, hospital spokesperson at Sick Children.120
But for the de Zeeuws, the hospital’s explanation was no comfort. Julia’s surgery
was rescheduled for April 24, but Sick Children cancelled it again. According to
Colleen de Zeeuw, the hospital told the family that further tests showed she did
not need immediate surgery. “This is not fair to my family. You can’t mess with
people’s lives like that,” said Colleen de Zeeuw.121
Meanwhile, the family was left hoping the hospital will eventually operate on Julia.
“She will still need an operation, but we don’t know when. It could be this year,
next year or in five years,” continued Colleen de Zeeuw. “We just have to live day
to day and we will have to go through this all again.”122
The test results should have alerted Canadian doctors that de Vries was in need of
urgent treatment. Instead, de Vries would be shuffled around from doctor to doctor
in Canada’s publicly-provided health care system.
First, after she saw her family doctor – himself frustrated he could not speed along
de Vries’ treatment – de Vries learned she would need to have a CT scan done, but
in Canada. This required her to see yet another doctor, a specialist, who referred
her to a general surgeon, who, in turn, sent de Vries to a gynecologist. Then the
gynecologist refused to see de Vries due to a perceived conflict of interest involving
a colleague who previously had treated her.
“Less than an hour before my appointment I got a call from his office staff saying
they would not see me,” said de Vries. “[T]hat doctor sent a note… saying that I
needed to see somebody in London [Ontario].”
The runaround was perplexing, but de Vries sensed she needed to be treated
right away. Yet, there would be another immediate roadblock to overcome. The
gynecologist – now the fourth Canadian doctor she had seen – told her he believed
she did not have cancer.
“I was referred to a gynecologist out in the county and I saw him on the 16th of
October [2006],” said de Vries. “He did an internal examination and sat down
with my husband and I and said to the two of us, ‘I do not believe that you have
ovarian cancer.’”
Worried that she might soon die if she stayed in Canada, de Vries went back to
Michigan. There Dr. Michael Hicks at St. Joseph Mercy Oakland hospital examined
her on October 19. One week after the Canadian gynecologist assured de Vries
she did not have cancer, Dr. Hicks removed a massive 18 kilograms of cancerous
tissue and 13 liters of fluid. The operation claimed de Vries’ ovaries, uterus, cervix,
fallopian tubes and appendix.
According to Dr. Hicks, de Vries would have been in great danger if she waited even
two more weeks for surgery. She faced “impending respiratory compromise with
potential multi system failure requiring intensive medical support, thus rendering
her unstable for surgery.”
De Vries stayed in the U.S. for six courses of chemotherapy because there was
“How did we pay for it? We drained all of our savings. We maxed out all of our
credit cards,” de Vries said.
The de Vrieses also had to open a line of credit to pay for the care. A spaghetti
dinner fundraiser a friend hosted also raised $11,125 CAD (~$10,300 USD).124
With the cancer battle behind them, the de Vrieses turned to putting their financial
house back in order. Unfortunately, this meant appealing to the government-run
Ontario Health Insurance Plan, which refused to reimburse the $60,000 worth of
out-of-country care because de Vries did not receive prior approval for financing.
“There’s no question that Ms. De Vries required the medical service or she was
going to die,” argued Kate Sellar, de Vries’ lawyer.125 “She’s being denied [a claim
for reimbursement] basically because she didn’t hand in the forms before she went
for this urgent surgery,” she also said.
In February 2008, McDonough shattered her right humerus bone while skiing on
vacation with her husband, Bill,126 at Holiday Valley in Ellicottville, NY. The doctor
at a local clinic, who X-rayed McDonough, recommended she have the fractured
shoulder completely reconstructed.127 Although immediate treatment there in the
U.S. would relieve her pain, the McDonoughs decided against paying out-of-pocket
for what would be major surgery. Instead, they drove back to Ontario to rely on
their own government’s universal health care system.
Morphine dulled McDonough’s pain, but she had to endure not being able to eat or
drink each day between 8 am and 4 pm in preparation for possible surgery. Coupled
with an uncertain wait, the added discomfort of being without food or water “makes
it doubly tough,” said Bill McDonough.130
Finally, four days after the accident, McDonough’s status was upgraded to “Priority
B,” which meant surgery should take place within two to eight hours.131 That night,
surgeons at last repaired – but did not reconstruct – McDonough’s badly broken
shoulder,132 which was broken in three or four pieces.133
The McDonoughs received little compassion for enduring such a lengthy wait. “It
really is tough to wait, but there certainly are a number of procedures that can wait
between two and seven days,” said Patty Welychka, who directs the Niagara Health
System’s surgical program.135
Shetty had developed severe osteoarthritis in his left hip joint.137 He was in so much
pain that, even with the aid of painkillers, each step was tormenting.138
“He can barely walk. He drags his legs everywhere he goes,” added daughter,
Shilpa Shetty.140
Shetty, a 20-year resident of Calgary, discovered the wait for partial hip replacement
surgery would be up to two years. At the time, in 2004, some 25,000 patients were
on waiting lists for surgery or diagnostic scans in Calgary’s hospitals.141
Facing a bedridden wait on Medicare, Shetty and his wife, Prema, looked elsewhere
for quicker treatment.142 They discovered a private facility in Chennai, India offering
immediate care.143 The entire out-of-pocket cost for the operation and for both to fly
to India would be $15,000 (CAD), but the couple believed waiting up to two years
for care locally was not a realistic option.144
“I had no choice but to try elsewhere for my surgery due to the long waiting period
and severe pain in my hip joint,” Shetty said. “I could not walk more than a few
meters. Under these conditions, waiting for one to two years was simply not
possible for me.”145
“Of course, my first choice would have been always Canada,” he said.147 “However,
in recent years, the waiting period for major surgeries is too long for patients
suffering from severe pain and serious medical conditions.”148
Daughter Shilpa objected to the tedious wait her father would have endured if he
stayed in Canada. “We’ve given up on our health care system. Why don’t they
understand that some people are in so much pain that they just can’t wait?” she
asked. “We don’t have any options and can’t wait anymore.”149
Though the long wait forced Shetty to look outside Canada, the health department
in the province of Alberta rejected his claim for reimbursement for his care in
India. Generally, the government reimburses only such patients who go abroad
when treatment is unavailable locally or if the patient’s life would be in jeopardy
while waiting.150
Aucoin had to go to the U.S. for treatment initially denied to her. While ill, she then
engaged in a prolonged and complicated fight to get access to a life-extending anti-
cancer drug and to recover the exorbitant amount she was forced to spend out of her
own pocket on treatment.
In 1999, Aucoin was diagnosed with colorectal cancer. Surgeons removed large
portions of her intestine and colon. But about four and a half years later, Aucoin
became easily fatigued and felt pain in her side. A follow-up visit with her doctors
revealed that the cancer had reappeared and spread to her lungs and liver.153
Worse yet, Ministry of Health officials denied Aucoin’s application for out-of-
country funding to permit Aucoin to get the potentially life-extending drug in
the U.S.156 However, Aucoin claimed, the government was paying for three other
patients with a similar form of cancer to receive treatment abroad. Reviews are on a
case-by-case basis,157 but the health ministry did confirm it paid for some patients to
receive Erbitux in the U.S.158
Despite the government’s refusal to fund her treatment, Aucoin began receiving
weekly treatments of Erbitux at a cost of $14,000 (USD) a month at a clinic in
West Seneca, NY.160 The U.S. Food and Drug Administration approved Erbitux in
February 2004.161 Thankfully, friends and supporters raised more than $180,000
(CAD) over several years to help pay for her treatment.162
“You can’t wait with this cancer,” she said. “You can’t wait for people to make
decisions about your health. You can’t wait for forms to be filled out. You have to
go where the drug is.”163
In fall 2005, Health Canada – the Canadian agency responsible for evaluating drugs
– approved Erbitux.164 But health officials refused to cover Erbitux and limited the
number of patients who could have access.165
Fortunately, a loophole existed. In December 2005, Aucoin was the first patient
allowed Erbitux under a Special Access Program set up for seriously ill patients.
She would have to pay over $6,000 (CAD) a month for treatment, which
she received at a Hamilton, Ontario clinic,166 while the government paid the
administrative costs.167
“I just want to take care of myself,” Aucoin said. “My job is to get well and I feel
like my government’s letting me down because they’re not doing their job.”168
Following another appeal for out-of-country funding several months later, the
government changed its mind and, without explanation, agreed to cover Aucoin’s
treatment.169 The decision meant Aucoin would no longer pay out-of-pocket, but she
would again need to travel across the border. Oddly, the government directed her
to a Buffalo, NY cancer hospital that charged thousands of dollars more for Erbitux
than the West Seneca clinic Aucoin used for out-of-pocket treatment.170 She began
treatment at the Roswell Park Cancer Institute in April 2006.171
After losing on appeal and running out of options,175 Aucoin appealed to Ontario’s
ombudsman, Andre Martin. Following his investigation, in January 2007
Ontario’s health officials finally agreed to pay over $76,000 (CAD) for Aucoin’s
out-of-country care and for legal expenses.176 The ombudsman blasted health
officials for their “cruel” treatment and “slavish adherence to rules at the expense
of common sense.”177
“I should never have had to deal with this, it takes all my energy to fight cancer,”
Aucoin said. “It rights a wrong on some levels but you cannot put a price tag on my
mental strain and stress.”178
Tragically, Aucoin lost her fight against cancer. She passed away in November 2007.179
The London, Ontario man first went to the emergency room in November
2003, complaining of back pain. Though an ultrasound showed no sign of an
abnormality, he returned to the hospital an additional two times over the next two
months in pain. Djukic’s doctors suspected he was suffering from back spasms
and a urinary tract infection.
In April 2004, Djukic discovered blood in his urine. He was referred to a urology
clinic in London where, in June, an ultrasound revealed a lesion thought to be
cancerous. A follow-up CT scan in late September showed he had renal cell cancer.
Though doctors established the cause of the ailment, Djukic faced waiting until
January 2005 – 14 weeks and three days away – for an operation.
“I felt very bad,” Djukic said. “I couldn’t believe that in a rich country, you had to
wait so long.”
Maja Djukic initiated an appeal for her father to receive compensation for his
medical costs abroad. In January 2007, it was reported that the Ontario Health
Services Appeal and Review Board sided with Djukic, ruling, “a delay in obtaining
treatment… would result in medically significant, irreversible tissue damage.” The
Board ordered the Ontario government to reimburse Djukic for the cost of surgery –
but not for his other expenses.
Hooked on Prescription
Medication While Waiting
for Surgery
Canadian Susan Warner became addicted to doctor-prescribed painkillers while
enduring 16 months waiting for knee replacement surgery.
“At that point, I just couldn’t believe it because it was excruciatingly painful,”
Warner said.182 “It’s inhuman. The quality of my life is horrible and there’s
absolutely nothing I can do about it.”183
To cope with the pain, Warner began taking medication while waiting for her number
to be called at Rockyview General Hospital.184 She started on Tylenol 3s – Codeine –
then moved to Percocet. Despite the risk of dependency, Warner had little choice but
to take the doctor-prescribed medication to continue making a living.185
“I couldn’t take the luxury of not working,” Warner, who is single, explained. “If I
would have stopped working, I would have lost everything I own.”186
After a few weeks taking Percocet, Warner strongly suspected she was developing
a dependency.187 “When I wake up in the morning, I’m shaking and have
headaches,” she said.188
Warner described living with the addiction as “absolute hell.” Her bones would
ache and legs spasm. She found it difficult to get sleep and keep warm. “The drug
ha[d] just completely taken over the body,” she said.191
Finally, she received knee surgery in January 2005.192 But her ordeal was not over.
After receiving a new knee, she was told she would have to wait another six months
for detoxification treatment.193
However, the wait in Canada took a tremendous toll on all aspects of her life. “I
paid dearly… my health, my finances, everything was put on hold for two, almost
three years,” she said.195
“It’s left my life shallow, and I’m angry, and it’s going to take a bit of time for me
to rebuild,” she added. “I just hope I’m never injured again or need to use their
[Canadian Medicare’s] resources in this way.”196
“I looked like a Pac-Man with his mouth open ready to gobble things up... except I
couldn’t move my mouth,” Nesenbrink said in 2007, looking back on the experience
27 years ago.
Despite the continuous problem restricting her jaw movement, Nesenbrink’s doctor
was unhelpful.
“My doctor told me it was all in my head,” Nesenbrink recalled. “But I couldn’t
chew, I couldn’t smile and I was in pain.”
Finally, Nesenbrink went to her dentist, who diagnosed her with temporomandibular
joint syndrome (TMJ). According to Canada’s Globe and Mail, the condition affects
one out of every seven people. For most people, it causes temporary, minor issues.
However, in one percent of cases, TMJ requires jaw joint replacement surgery.
“We see patients who are in dire straits: Talking, eating, chewing, smiling are all
Many other patients are forced to wait. In 2007, there were some 50 people in
Ontario waiting for TMJ replacement. There is intense competition for slots
because Ontario has only one hospital, Mount Sinai, that offers full joint jaw
replacement surgery, and it has a budget of only $210,000 (CAD) (~$193,600 USD)
annually to commit to all such operations.
Chad’s long battle against a stage two-to-three brain tumor began when he was
diagnosed in June 2003.200 The bout with cancer forced the 37-year-old autoworker
from Windsor, Ontario to quit his job at the Chrysler Canada assembly plant. It
would paralyze his left side and confine him to a wheelchair.201
The financial burden for the Curleys to buy Avastin themselves would be tremendous.
The drug carries a price tag of $5,000 (CAD) (~$4,600 USD) for each treatment.
Chad faced the need for three courses initially to determine its effectiveness;206
thereafter, he would need to continue the treatment every two weeks.207
“We get shoved away from everywhere we go,” Meira Curley said. “I’ve
already taken out a second mortgage. I’m just not going to let something
The couple and their friends managed to raise enough money to fund the first course
of treatment, which occurred in mid-November 2007211 at the Windsor Regional
Cancer Centre.212 The second round, again at Windsor Regional, in late November
had to be charged to a credit card.213
“It has to be paid by January but I’ll worry about it then,” Meira said at the time.214
According to Meira, the results were promising. “You can see he has more feeling
on the left [paralyzed] side,” she said soon after Chad’s second treatment. “You can
see he’s starting to improve.”215
The government health system still refused to provide Avastin for Chad, despite
Meira’s appeal to Ontario’s then Minister of Health, George Smitherman MPP.216
A fundraiser was held to help with the escalating medical bills,217 but, regrettably,
Chad passed away on February 21, 2008.218
Meira wrote on a website dedicated to her husband’s struggle: “He touched many
people throughout his life and will always be remembered with love... Rest well
my Sweetie.”
In Canada, demand for government-managed health services is high, but the supply
of doctors is dwindling.219 In fact, more than some four million Canadians do
not have a primary doctor, forcing many in need of medical attention to seek out
alternative treatment centers or emergency room care.220
Still, thousands of patients are stuck on waiting lists for necessary treatment.221 As a
result, some Canadian doctors faced with large patient loads have turned to lotteries
in order to select at random patients to drop from their practice.222
Dr. Runciman explained that his rationale for eliminating roughly 100 patients in
two drawings was an objective way to thin an overstretched practice.225
“It was just my way of trying to minimize the bias… rather than going through the
list and saying ‘I don’t like you, and I don’t like you’,” he said. “There is only a
certain number of people I can see in a day. My day is already 11 hours and I don’t
care for it being longer.”226
Runciman is not the only Canadian doctor using a lottery to drop patients. Canada’s
National Post has reported several such instances:
A new family practice in Newfoundland held a lottery last month [July 2008]
to pick its caseload from among thousands of applicants. An Edmonton
doctor selected names randomly earlier this year to pare 500 people from his
heavy caseload. And in Ontario, regulators have heard reports of a number
of other physicians also using draws to choose, or remove, patients.227
Moreover, according to Gauthier, in some cases the lottery system removes elderly
patients. “Everybody was kind of mad about it,” she said.228 “Everybody thinks it’s
a joke.”229
As for Gauthier, she was able to register with a different doctor in Callander, but she
was not pleased about driving 11 miles further during bad winter weather to see her
new doctor.230
Carly suffers not only from severe scoliosis but also epilepsy and cerebral palsy.233
As of February 2009, her spine was curved at 90 degrees.,234 The condition is so
severe that Carly’s organs are in danger of being crushed, and she is 40 degrees over
a typical surgery candidate. To keep her spine in place, Carly has worn a back brace
since age seven.235
“At seven years of age, our daughter had to begin wearing a back brace 22 hours a
day to help her spine from worsening and has worn these and also two stints in back
casts done under General Anesthetic 24 hours a day for six weeks at a time right up
until March of this year [2008],” elaborated Susan Watson, Carly’s mother.236
In February 2008, Carly was added to the 18-month waiting list for surgery.
According to Watson, Dr. Firoz Miyanji, the orthopedic specialist, said that despite
his recommendation that Carly should soon have surgery she “would be at the end
of an 18 month waitlist for surgery as you don’t put Peter in front of Paul.” Carly
“could wait like everyone else,” Watson further wrote.237
The delay was frightening for the family. “We have been told by Carly’s orthopedic
surgeon that her spine will deteriorate during this time,” wrote Watson in the
Vancouver Sun. “She is at 70 degrees now. At 90 degrees organs can begin to be
damaged” by the spine crushing them.238
However, Watson’s public protests, instead of pressuring the hospital into action,
received a hostile reaction.
“One of the doctors had gotten angry at me for doing so at a meeting we had at
the beginning of May 2008,” she wrote in the Internet petition. “I told them all
In the summer of 2008, at a routine follow-up appointment for Carly, the family
learned in writing that the hospital’s orthopedic surgeons would no longer treat Carly
except in a case of emergency. Instead, they would refer the family to a pediatric
specialist in Edmonton or Calgary because of differences with Carly’s parents.241
The letter, which was signed by Dr. Chris Reilly, Head of the Department of
Pediatric Orthopedics at B.C. Children’s Hospital, and Dr. Miyanji, read in part:
There have been many communications regarding Carly’s care both through
our offices, the hospital administration and also public media, including
newspapers and the recent website… We feel that we have not been able to
establish a therapeutic relationship with your family that will allow us to care
for Carly.243
The two doctors are the only specialists in British Columbia that perform spinal
surgery on a child.244 As a result, the family is faced with traveling outside British
Columbia to get Carly surgery – something they wish could be avoided.
“We do not want to travel out of B.C. to have this done,” Watson wrote. “We are
residents of British Columbia and pay our taxes. It is an extremely delicate and
dangerous surgery, especially for kids with Cerebral Palsy…”
Watson also wrote that post-op treatment will require “a year’s worth of recovery”
and many follow-up examinations. “This would mean us traveling back and forth
between wherever we could find a new specialist outside of B.C. to help Carly and
then who knows how long of a waitlist she will be put on then?” wrote Watson.245
Carly is one of 150 children in British Columbia waiting for spinal surgery.246
During a seven-week stretch in the spring of 2008, the B.C. Children’s Hospital
cancelled at least 25 surgeries because of a shortage of intensive care nurses.247
Out of options in Canada and her back getting worse, Misangyi found a way to
bypass government-managed Canadian Medicare by flying to India for top-notch,
affordable care right away.
“It got to the point where it was so bad that my pain medication had increased so
much that it was affecting my work life,” Misangyi said. She recalled that even the
private doctors in Canada she contacted “thought I was drug-dependent and too high
a risk for them.”250
“There are a lot of people in Canada suffering with back pain and it’s very hard
to get surgery there,” Misangyi said. “Waiting lists just to see specialists are 6
months to a couple of years, and another couple of years before or if they will do
the surgery on you.”251
That figure included airfare for her and a companion, as well as hospital and hotel
accommodation and expenses.252 Moreover, the hospital issued a partial refund when
the actual cost of the operation was less than charged.
Misangyi never believed she would be flying around the world as a medical tourist.
But she raved about her experience.
“It was a wonderful experience. I’ve got my life back. The medical team – the
doctors, the nurses and everybody right down to the housekeeping staff, is just
wonderful. They make you feel very warm,” she said. “I would most definitely
recommend it [medical tourism] highly to anybody.”
Moreover, by going abroad, Misangyi added, “I’m saving the Canadian medical
system money.”
Misangyi was back at work as a nurse five weeks after surgery. The decision to get
care in India rejuvenated her life, and Misangyi is able to celebrate that on a new
motorcycle she bought that not long ago would be unthinkable for her to be on.
“I have been off all pain medication for at least 9 months and am back exercising
building muscle,” she said. “I really do have a second chance at life.”
Horne waited painfully for reconstructive surgery to rebuild his hands so he could
get back to his beloved profession, but on two occasions, the Royal Melbourne
Hospital in Parkville, Australia, an inner-city suburb in northern Melbourne,
cancelled scheduled treatment. In April 2007, after Horne had been waiting two
years, the hospital let a tentative appointment pass without notifying Horne.
“You get your hopes up and they [the public health administrators] say: ‘We will put
you on for so and so,’ but we have been shunted off,” says Horne.
The sad reality is that Horne could expect to wait indefinitely. Under Australia’s
rationing of public health services, Horne’s ailment is not judged severe enough to
warrant a speedy operation.
“Our priorities need to be trauma cases and the urgent cases,” explained Dr.
Christine Kilpatrick, executive director of the Royal Melbourne’s clinical
governance department. “There are some patients who do unfortunately wait for
long periods of time: clearly they are not the most urgent cases.”
Today, Horne has difficulty not only handling a paintbrush, but also performing
daily tasks like dressing himself. His deteriorating condition forced him to quit his
job teaching art at the Alamein Community Centre. Horne attempted to practice his
craft by holding a paintbrush using both hands – an inadequate, temporary solution
at best. “I just want to be able to get out there and contribute: I want to work for
another 15 years,” he said.
On the night she fell, Robins’ family took her to Royal Perth Hospital, but instead of
receiving urgent medical attention, the elderly great-grandmother would endure two
cancelled surgeries and spend the next 82 hours waiting in agony, unable to move.
Kyle Inglis was diagnosed in June 2006 with a tumor in his left ear. The boy suffers
from cholesteatoma, a skin growth that can result in bone loss in the ear and lead to
deafness and even brain infection.4
An operation that takes half an hour to complete was scheduled for November 2006,
but was cancelled because a surgical microscope was unavailable.5 Then, a second
surgery, scheduled for April 2007, was cancelled because the special microscope
was in use at a different hospital.6
At last, after a newspaper publicized the boy’s situation, doctors operated in May
2007. However, Kyle’s doctors at Fremantle Hospital discovered that the long wait
had, unfortunately, allowed the cyst in the ear to become inflamed. This required the
removal of destroyed ear bone.7
“[W]e’ve been told by doctors that the reason it got so serious is because it has taken
so long to be done and I’m angry about this,” said the boy’s furious mother, Tracey
Balkham. “How many other kids and adults are waiting?”8
Balkham maintains that the government-managed health system long has failed her
son. Inglis’ hearing has steadily deteriorated since 2002 but doctors erroneously
believed he merely suffered from glue ear,9 a painless condition in which fluid
collects behind the eardrum. She adds that hearing loss stunted her son’s verbal and
educational development.10
“This has definitely held his education back and held back his speech at an
important part of his development,” she said. “He’s got to sit up [at] the front in
class, he’s had ear infections in between, because of leakage from the cyst and we
have to yell at him so he can hear us.”11
“This poor boy is a victim of our health system in crisis,” exclaimed parliamentarian
Dr. Kim Hames, then Shadow Minister for Health.12 “It’s pretty bloody disgraceful
that a poor little kid had to have a section of bone removed in his ear because he
had to wait so long in our health system and now has to go back and get another
operation to repair the defect.”13
Kyle’s dealing with the public health system is not an isolated case. According to
the Australian Sunday Times, in 2007 there were roughly 1,000 children in Western
Australia “waiting up to 642 days for ear, nose and throat operations.”14
Nisha’s appalling care began months before, in November 2006. After her general
practitioner discovered she was pregnant, it took 12 weeks for Nisha to be seen
for a prenatal appointment at Westmead Hospital’s University Clinic. Although
Nisha believed she was a high-risk pregnancy because of a history of reproductive
complications, the health care system was breathtakingly inattentive to the 36-year-
old’s needs.
For instance, doctors administered only one ultrasound evaluation during her
pregnancy - at 20 weeks - despite her age. Moreover, when Nisha became
concerned her baby was at risk of having Down syndrome, no test was performed at
the clinic. Eventually, she paid out of her own pocket for a private test.
Tragically, by the time doctors discovered the baby was in danger, it was too late
to save him. In April 2007, at seven months pregnant, Nisha’s doctor noticed a
problem and sent her to Westmead. Despite the doctor notifying the hospital of
her impending arrival and need for urgent attention, Nisha was told to wait nearly
30 minutes. At last, a test revealed that the umbilical cord had wrapped around the
baby’s neck twice and killed him.
Despite the tragic circumstance, hospital staff said that “there were no beds”
available for Nisha to deliver her stillborn son. She would have to return when
space became available. At 2 am the next day, Nisha went back to the hospital to
give birth to her son, Aahil, around 8 pm.
Following her ordeal, Nisha had strong words to say about Australia’s government-
managed health care service. She compared it to that of her native Fiji, where she
had delivered her first child nine years previously.
“The standard of care is higher in Fiji then it is here,” she said emphatically.
examined her.17
“It was really upsetting. We felt like no one was looking after us. She was bleeding
in the waiting room in front of everyone else,” Simons said. “They could have
given Rachel the dignity of a private room.”24
Before a doctor attended to her, Murray went to the bathroom, where she had a
spontaneous miscarriage. A doctor finally saw her around 8:15 pm25
It is no surprise that Murray and Simmons feel let down by the government-
managed health care system.
“I think it was disgusting the way they treated her,” blasted Simons. “No woman
should have to go through that.”29
“At the moment her life is hell. When she gets to a door
and the light hits her it’s just bang and then she can’t
“It’s a terrible thing for me to say, but I did tell the clinic staff that if she’s dead
when they finally get around to getting the surgery done will they then dig her up for
it,” said Cowell. “My mother is 83 years old and I am disgusted how the aged are
treated in this state.”
Fortunately, after Cowell wrote to the local press about her mother’s wait, less
than a week later a public hospital, North West Regional, sprang into action.31 The
hospital’s chief executive, Jane Holden, intervened to get de Bomford a scheduled
cataract operation in early May 2008.32
“I feel on top of the world about it but I am still worried about the other people still
waiting,” de Bomford said.33
The ordeal began at 7 am in early May 2008, when Patsidis went to the maternity
ward at Royal North Shore Hospital in Sydney. It took two-and-a half hours to
admit Patsidis to a room,35 though her contractions were 10 minutes apart.36 After
finally securing a room, the couple was effectively abandoned thereafter.
The couple complained that midwives offered little assistance; instead, they were
told repeatedly that staff were “too busy” to monitor Patsidis.37 They asked for an
epidural 90 minutes before her water broke, but were told “the anesthetist is too
busy” to administer one. They report that the anesthetist “never showed up.”38
“She was in a state of rage… she told the midwife, not once but twice, it feels
like… there’s a bowling ball coming out of me,” said Nick Patsidis.39 He added,
“The midwife’s not done anything, just held my wife there, not done an internal
examination or anything.”40
Suddenly, his wife went into labor that afternoon in the hospital’s bathroom.
According to Nick Patsidis, a midwife left them as Kathy Patsidis was going
into delivery.41
“She’s gone to the toilet,” recalled Nick Patsidis, “and all of a sudden she screams
and says I can’t hold it and the baby’s coming…”42
Hearing his wife in agony, to his horror, Nick Patsidis dashed into the bathroom to
find her on the floor giving birth. Instinctively, he opened his wife’s legs and caught
the baby as she was being pushed out.43
“I ran into the toilet and there’s my little baby girl coming out of my wife with the
umbilical cord around her neck, turning blue,” said Nick Patsidis.44 “I’ve actually
gone and grabbed [her] head from falling…”45
Hospital administrators offered little compassion. “This was not a staff shortage
issue. This was about a very quick birth,” explained Dr. Michael Nicholl, director
of maternity services at the hospital. “In a labor that from start to finish is an
hour’s duration it is a near impossible task… All women know that the starting of
elective procedures, like inductions of labor, do depend on the activity of the ward
at the time.”49
But Nick Patsidis believed the midwives were purposefully delaying his wife’s
delivery. “The whole day was ‘we do not have enough staff, I’m sorry we are
extremely busy,’” he said. “They were prolonging it as much as they could
[because] they didn’t want it to happen… They [midwives] were coming and going
and when things were happening they weren’t able to deal with it.”50
Maria Patsidis, Nick Patsidis’ mother, went further by accusing the hospital of lying
and covering up “something… out of a horror movie.” She added: “It wasn’t (a
quick labor). The midwife who was standing on top of Kathy should have known
what this was. She didn’t call a doctor, she didn’t call anybody.”51
One morning in late April 2008, Logan accidentally slammed his mouth into the
windowsill when he jumped from his bed. The impact ripped open his gums, broke
off one tooth and twisted another seven teeth. The boy’s mother, Julie Birney, said
she wrapped a towel over his bloody mouth and around his shoulder “like a big bib
with him dribbling.”
“His mouth was so swollen that he couldn’t swallow saliva,” Birney explained.
“One tooth fell out and I had to put it back in his mouth.”
“A nurse came back in and said the doctor would be back in half an hour,” Julie
recalled. “I asked on the progress of the doctor one and a half hours later.”
Meanwhile, the boy could not drink any water in case he needed surgery. In pain, he
passed out during the tedious wait.
“I said to the nurse, I think he went into shock,” Birney said. “He ended up sleeping
over an hour.”
Logan would have to wait until 1:40 pm to 2:15 pm, depending on reports,53 for
a doctor to see him. Logan was given merely a common pain-reliever, Panadol –
similar to Tylenol – and a prescription for antibiotics.
The doctor also provided a referral for an ear, nose and
throat specialist – but in a different town, Lismore,
roughly 100 miles away.
The pregnant woman, identified only as Erica, arrived at Gold Coast Hospital at 8
am in May 2008. Though in labor, she waited in a closed waiting room for one hour
until she was moved to a mattress on the floor of a linen storeroom.55 There, with
husband Mitch and sister Maurita, Erica endured an agonizing three hours waiting
for a room to become available in the maternity ward.56 She nearly gave birth before
reaching a bed.57
“She wanted pain relief but they wouldn’t really give it to her because they couldn’t
examine her properly, so they ended up giving her the gas,” explained Maurita.59
(Dr. Adrian Nowitzke, CEO of Gold Coast Health, denied that Erica received no
pain relief while in the storeroom.)60
The wait was particularly unpleasant because the room did not have air
conditioning. Moreover, for the first 45 minutes Erica had to use spare blankets as a
makeshift pillow until one was found for her.61
“We thought ‘Stuff this, we’ll look after ourselves’ and pulled heaps of blankets out
and tried to make it as comfortable as we could,” said Maurita. “I sat on the floor
next to her. It was disgusting.”62
“We started to get pretty stressed,” said Maurita. “Surely there was somewhere they
could take her to have a baby boy?”64
Eventually, roughly four hours after arriving at the hospital, a room opened
and Erica was given a proper bed. She soon gave birth to a baby boy, Jackson.
Despite being overjoyed and while praising the hospital staff for doing their job,
Erica does not plan to have another child because of this and other distressful
incidents in hospitals.65
“Being in a bed earlier would have saved me a lot of pain,” she said. “In the
storeroom you couldn’t get comfortable.”66
Dr. Nowitzke apologized personally for the mishap, but he acknowledged that the
hospital might again experience such a bed shortage. “He said at the moment it might,
but in the future it won’t, so that’s good to hear,” Mitch, the husband, recalled.67
At the time, Gold Coast Hospital’s facilities included eight delivery rooms and two
alternative birth center rooms. On the day of Erica’s birth, the hospital delivered 17
babies – between an additional 7-9 more than average.68
Peter Nelson, 63, from Cairns, Queensland had terminal cancer in his spine and was
in excruciating pain. Despite his dire condition, Australia’s government-managed
health care system would have Nelson wait seven weeks for life-extending radiation
treatment at the public Townsville Hospital.
In early May 2008, Nelson faced a decision whether to wait until June 20 for
publicly-provided treatment or travel to a remote private facility and pay $10,000
for immediate care.
Not able to suffer any longer, Nelson and wife, Bev, “packed [their] bags” for seven
days of pain relief treatment at the Wesley Private Hospital in Brisbane.
Though his pain was relieved, Nelson regrets that other cancer patients in
Queensland face major delays for urgent treatment.
“Those people believe [the government] when they say they will be treated in 20
days and they don’t know it’s just not true,” he said.
Under health care standards in Queensland, 10 days is the maximum waiting time
within which cancer patients should receive radiation treatment. But at Townsville
Hospital, the average wait time was 27 days – nearly three times the allowable limit
– according to a leaked government memo.
However, health officials disputed the comprehensiveness of the memo, calling the
figures only a “snapshot” and its contents for planning purposes.70
Jeffrey Miners, 58, a retiree from Bega in New South Wales (NSW), desperately
needed 13 teeth extracted to relieve excruciating gum pain.71
“I only got one decent tooth in my head, apart from the four rotten ones at the
front, and the rest are just old teeth that have snapped off at the gum levels,”
Miners explained.72
Miners recalled that since 2001 he waited on various lists for dental work, receiving
only “one filling done in a tooth, back in 2005, and that’s in a seven-year wait.” In
“Nothing was being done for me, and it [the cavity] was getting to a size that it
was interfering with me health,” Miners explained. “Every day for two or three
weeks solid prior to the extraction I was having six to eight aspirins, six to eight
paradine [painkillers] for it... I was sleepless... through the nights and days and it
was just agony.”74
Miners explained that many of his teeth had decayed because of a “chemical
imbalance” in his mouth. The combination of drugs he took for different health
ailments produced a side effect that deteriorated his teeth.75 And because of his bad
heart, doctors needed to operate at a hospital with a cardio backup system available
in case Miners suffered a heart attack.76
“Because... I have other medical issues, that they couldn’t extract me teeth normally in a
dental chair under just a local anesthetic because I have a cardiac problem,” Miners said.77
In March 2008, Miners underwent heart bypass surgery. He recovered from the
operation and was in condition to have the surgery to remove his teeth. Yet, he was
told it would be another 18 months until he would receive an operation at Prince of
Wales Hospital in Sydney.78
Living on disability income, Miners was unable to afford private dental care,79
but the prospect of facing a seemingly unending wait on the public health care
system while living with intense pain and daily painkillers that Miners said caused
him to feel “like a zombie” was intolerable. In late May 2008, Miners took the
extraordinary step of pulling out his own aching molar tooth.80
“Through inaction, I had to start taking action myself,” Miners said.81 “I kept
working on it to loosen it, the cavity was so big I could fit my forefinger into it, and
I just pulled it out.”82
“You don’t need to be a dentist to see that patients like Jeffrey Miners need urgent
dental care, but the [NSW Premier Morris] Iemma Government is so incompetent it
can’t even get that right,” Skinner charged.85
McKenneth Atkinson, then 19, from the town of Pinjarra in the Australian state of
Western Australia, was in training to become a mechanic when the accident occurred
in July 2008. Atkinson was taken by ambulance to the public Royal Perth Hospital
(RPH) around 3 pm on a Thursday.86
“They told me there was no way of saving my fingers,” Atkinson recalled. “One of
the doctors had a look at it and went away and came back and said if they did the
operation to save them there was still a risk they wouldn’t be saved.”91
However, a different surgeon told the family that the fingers could be reattached and
regretted that surgery had not been performed earlier.92 Still, that night, Atkinson
“He had been waiting in emergency for about 28 hours before they shifted him into
the hospital,” said Colin Atkinson. “Then they had another trauma [victim] come in
and he got pushed back into the ward.”94
“The patient was not able to be moved to a ward sooner because the hospital
was experiencing heavy demand for beds,” said a spokesman for RPH,97 one of
Australia’s largest hospitals.98 “The hospital is sorry about Mr. Atkinson’s wait for a
ward bed.”99
Despite the apology, the wait for Atkinson was extremely nerve-racking. “Basically,
it was hard to come to terms with the decision the doctors made in such a short time,
which I have to deal with for the rest of my life,” he said.100 “I remember feeling
so helpless in the emergency department. I was angry at the state of the health
system,”101 Atkinson would later recall.
In April 2009, the Western Australia state government began requiring state
emergency departments to follow a new “Four Hour Rule Program.” The new
regulation states that a target of “98 per cent of patients are to be seen in emergency
departments and admitted, transferred or discharged within a four-hour timeframe,
unless they are required to remain within the emergency department for clinical
reasons.”102
Williams’ daughter, Samara Cupit, suffered from chronic tonsillitis. The outbreaks
and staph infections that result occur several times a week and caused Samara to
miss school frequently.
Removing Samara’s tonsils is a routine operation that could have resolve the
affliction immediately. But for two years, attempts by the girl’s general practitioner
to land an appointment for a specialist’s evaluation – the first hurdle on the way to
an eventual operation – were not been successful.
“We’ve been waiting for the phone call but we’ve heard nothing,” Williams said
then. “We can’t even get on a waiting list to see a doctor but after that we’d have to
go on the waiting list for the operation.”
Samara is perhaps one of the lucky ones, as hundreds of patients remain on the
elective surgery waiting list in Australia. According to government health figures,104
as of June 2008, some 2,786 patients were on the waiting list for elective surgery
at Gold Coast Hospital. Some 440 of these patients were enduring a “long wait,”
which is defined as a wait longer than clinically recommended.105
According to the same report, when including all public hospitals in the state of
Queensland, there were 34,703 patients waiting for elective surgery – 249 additional
patients from July 2007. Of this total, over 7,500 were patients on the “long wait” list.106
Jennifer’s ankle had gradually worsened over a three-year period. By the start of 2007, the
pain was unbearable. Putting any weight on it caused her to “hit the roof,” requiring the
use of crutches.
Jennifer had been waiting a couple of months for an appointment for corrective surgery
when she received an appointment notice in the spring of 2007. Optimism turned to horror
when she learned the appointment date just to see an orthopedic specialist at the pubic
Maroondah Hospital was June 2008.
“I thought it was for this year and I nearly turned up [at the hospital] before I realized it was
June 2008,” Jennifer said.
By that time, her wait for a consultation would have been 14 months. On top of that wait,
she likely faced an even longer 18-month wait for the eventual operation. For Jennifer, the
logic of such an incredible delay when she was in obvious need of help did not make sense.
“It’s very short sighted because the longer people have to wait for an operation, the worse
the problem gets and the more it’s going to cost,” she explained.
The wait has not been easy for Jennifer. Not only does she suffer from the arthritis in
her ankle, but she also has heart ailments and Meniere’s disease, which is an ear disorder
causing dizziness and nausea. Moreover, she cares for her 79-year-old husband, Roy, who
has had back surgery and is in a back brace. She also helps her elderly mother, who lives
in a nursing home.
Julian was scheduled for surgery once in July 2008 and twice more that August, but
each surgery was cancelled because the hospital lacked an intensive care bed for
recovery. Julian’s fourth scheduled operation was cancelled yet again the day before
it was supposed to take place on August 28th.110
“We just have to put him in the pram [stroller] and push
him around so that he will stay still,” Michielin added.
“We just can’t wait for the day where we don’t have to
do this – when Julian can play and sit down on his own Julian Michielin (front left) endured four
cancelled heart operations at the Royal
and we know nothing will happen to him.”113 Children’s Hospital in Victoria, Australia.
Unfortunately, cancelled operations for children and babies such as Julian are
common. Some 60 operations were cancelled in July 2008 alone. On one Friday in
August 2008, the hospital cancelled all cardiac surgery.115
Finally, soon after the Herald Sun publicized these boys’ ordeals, they and several
other children waiting for heart surgery were operated on and are now healthy.117
Bob, 39, was forced to wait in terrible pain and without a meal each day while
doctors attended to other patients with conditions considered more pressing.
The accident happened in late August 2008 near Bob’s home in Goodna, Australia.
He was admitted to Princess Alexandra Hospital, which is one of the area’s major
specialist hospitals with a staff over 5,000,119 that night, a Thursday.
Government health guidelines say Bob should have been treated within eight
hours and absolutely not longer than 24 hours after admittance, but three surgery
cancellations delayed an operation because hospital staff had too many patients with
higher priority needs to treat Bob on schedule.
“I had two morphine shots each day for the pain,” Bob said. “Every time I moved, a
bolt of pain would shoot from my hand and I couldn’t sleep.”
What made the wait even more unbearable was Bob did not receive meals each day,
apparently as a precaution in case his number was called for surgery. He ate only
twice over the four days waiting in the hospital.
“Eventually I got so fed up I got them to disconnect my drip and I was over at the
fast food joint across the road in my hospital gown,” Bob recalled.
Bob is not the only patient enduring a lengthy wait at Princess Alexandra.
According to government records, thousands of other patients are on the waiting list
there for surgery. As of April 1, 2009, some 4,293 patients were waiting for elective
surgeries there.120 Of this number, 1,683 patients were on the “long wait” – meaning
wait times longer than clinically recommended.121
For two years, Silke put up with a diet of soft and mushy foods, such as porridge
and soup. She used water to force down her food, because achalasia affects the
normal functioning of the esophagus, preventing esophageal muscles from relaxing
to allow food and liquids to pass into the stomach.
“I never have a good meal – every single meal is a struggle,” said Silke, who at the
time was enduring a choking sensation whenever she tried to swallow. “I have three
young children, aged 11 months, three years and 11 to look after, and can barely
look after myself at the moment.”
After the birth of her youngest son, Silke’s discomfort increased. In December
2004, she was added to a “semi-urgent” surgery waiting list for the one-hour
Silke was bumped up to an “urgent” waiting list, which meant surgery could be
expected after a six-week wait. Eventually, she was booked for surgery on April 12,
2005 – only to find the operation cancelled because of a patient emergency.
“I hadn’t eaten for 24 hours; I felt weak and I felt sick and distraught,” Silke
recalled. “I had only had a bowl of soup and a few glasses of water in 42 hours. I
almost passed out in the corridor on the way home... My children were extremely
distressed about being separated from me.”
Silke was told her surgery would be rescheduled within weeks. Instead, her
difficulty at Monash Medical Center made headlines in the Australian press.
Two days after her story appeared in the Herald Sun, the newspaper reported that
Silke had undergone successful surgery. Afterward, Silke was ecstatic about finally
being able to enjoy her favorite food, doughnuts, and eat a normal meal out.123
“I’m just looking forward to the simple things in life and leading a happy, healthy
life,” she said.124
17 weeks into her pregnancy, Booker’s contractions were three minutes apart. The
21-year-old Barrack Heights, Australia woman rushed to Wollongong Hospital on
the advice of her doctor, worried that she was suffering a miscarriage, but upon her
arrival at the government-managed facility, she was told to sit in the waiting area.
After more than an hour, Amanda still had not been examined, despite pleading with
the nurse. “I was sort of hushed back to my seat and told just to wait for the doctor
and the doctor was coming,” she said.
Finally, a nurse called her to a triage room, but while moving from the waiting area,
Amanda suddenly gave birth.
“I said [to the nurse], ‘something’s coming out’… out came a bag and I could see
my baby inside it,” Amanda said. “It fell to the floor… I’ve never forgotten the
noise it made.”
What made losing her baby boy more humiliating was the door to the triage room
was left open. Unfortunately, a group of men involved in a bar fight were outside
the room to witness the event.
“The men [in the waiting room] stopped their mucking around and… looked quite
concerned,” Amanda said. “I’ve never seen men look compassionate before.”
“If a woman turns up and she’s going to lose her baby or go into early-term labor
she should be rushed immediately to the birthing unit to give birth or to lose her
Curiously, hospital records indicate that Amanda was moved to the triage room
“immediately upon arrival.”
As for Amanda, she buried her stillborn son with a clear dent on his head because he
hit the hospital floor. She remains “haunted” by the incident.
On March 12, 2005, Pringle, of Kleinskool, South Africa, arrived at Dora Nginza
Hospital around 1 am along with her parents. The pregnant woman’s clothes were
covered in blood and she was in excruciating pain. She asked to see a doctor
immediately, but hospital staff told Pringle to “go and sit in the queue” with some 10
other pregnant women also waiting for treatment.
“The nurse was rude and not very sympathetic,” Pringle recalled. “I was told to
wait in a queue even though I was drenched in blood. I begged her to get a doctor.”
Pringle became drowsy, but the nurse twice more told her to wait for a doctor. As
the hours passed in the waiting hall, Pringle, increasingly agitated, went in search
of a doctor herself. The hospital had only one doctor on duty that night, but Pringle
managed to find an intern who examined her and moved her to the hospital’s
maternity department, where she continued to wait her turn.
“I was so worried,” Pringle said. “I thought my son and I would die. I remember
praying that nothing should happen to us...”
At 7 am, it was determined that Pringle’s baby was in jeopardy. However, it would
take roughly another hour for the doctor at last to attend to Pringle, just before she
gave birth at 8:15 am. Tragically, though the full-term baby, named Vince, was
otherwise healthy, he could not breathe. He later was pronounced dead.
“[M]y worst fear was realized when they told me he had died,” Pringle said. “I
looked at his little dead body in the labor ward. My heart was filled with pain.”
Following the death of her newborn, Pringle sued the Eastern Cape Health Department
and the hospital’s medical superintendent for negligence. In March 2008, Judge Johan
Froneman of the Port Elizabeth High Court awarded Pringle a R200,000 (~$25,600 USD)
judgment. Judge Froneman ruled that if hospital staff had monitored the baby more
closely, a caesarian section could have been performed and Vince would have lived.
The Dora Nginza Hospital made headlines in 2007 when a government health
official warned that severe short-staffing put the hospital in “a crisis.”2 Fred Rank,
head of clinical governance for Port Elizabeth’s hospitals, reported that only one
nurse was available for every 90 patients. He emphasized that the hospital was
so understaffed that doctors and nurses were forced to do extra duty as hospital
cleaners and baggage carriers.3
“In the casualty ward we have two nurses attending to about 30 patients. In the
maternity ward two or three midwives attend to about 10 women [in labor] at any
time,” Rank told the National Council of Provinces, the upper house of South
Africa’s legislature.4
One evening in May 2008, Munashe Princess, 5, was traveling with her stepmother,
Judith Tshipugu, and father, Ezekiël Keswa, originally of Zimbabwe. The family
was moving its belongings to the town of Kwaggafontein to escape violence in
Duduza. Tragically, however, the stepmother and daughter, riding in a separate car,
were injured when they struck another vehicle head-on.
“I was driving in a bakkie [pickup truck] behind the car,” explained Keswa, the
girl’s father. “Tshipugu swerved to the right because a car had suddenly stopped and
they were in a head-on collision right in front of me.”
Seeing his daughter in so much pain was “terrible to see,” said Keswa. “My
Keswa followed them to Witbank Hospital in his car, arriving roughly four hours
after the accident. Upon his arrival, he discovered his family seemingly neglected.
“When I got there at about 22:00, they were still in casualty [emergency
department]. To one side a nurse was sitting and sleeping,” he recalled.
At roughly midnight, doctors told Keswa that the hospital did not have the
necessary equipment working to operate on his daughter. Yet again, Munashe
would need to be transferred.
But it took roughly two hours for an ambulance to arrive. To make the situation
worse, the ambulance first needed to return to Delmas to switch drivers before taking
Munashe, her father and stepmother to what was their third medical destination.
“I sat alone in the back of the ambulance with my wife and my daughter,” said
Keswa. “The nurse was in the front with the driver.”
Now back at Delmas Hospital, the ambulance sat in the parking lot for 30 minutes.
Frustrated, Keswa went inside the hospital to inquire about the delay.
Finally, the ambulance left with the family to Pretoria Academic Hospital. According
to an account in the South African daily newspaper, Beeld, several elite specialists had
assembled there to attempt to save the girl’s life. However, by the time the ambulance
arrived at 4 am, it was too late for Munashe. She died of chest trauma.
“My daughter was the best thing ever. I saw her suffering,” said Keswa. “I’m
trying to handle it, but it is unbelievably difficult.”
As for Keswa’s wife, she remained in the hospital. An official investigation into
Munashe’ death was undertaken by local health authorities. Moreover, the South
African Human Rights Commission, an independent institution, was asked to
determine if human rights violations occurred.6
Sina Minnie, 21, of Middelburg, South Africa went into labor early one morning
in July 2008. Her husband called for an ambulance to take Minnie to Middelburg
Hospital, the town’s local public hospital. However, the ambulance did not arrive
for more than two hours.7
Minnie nonetheless managed to get to Middelburg Hospital that morning, but there
she waited nearly four hours without receiving any medical attention. The family
was told to wait because the hospital had “only cleaners” on duty at the time.
Eventually, the couple decided to find a different hospital.
At 11 am, the couple arrived at Witbank Hospital, another government facility, but,
yet again, there was a delay getting her into a delivery room.
The family waited an hour and a half at Witbank before realizing they needed to
find Minnie another hospital – one with a delivery room available – and quickly.
Delivery was imminent. Minnie’s father-in-law, Frans Nagel, rushed her to yet
another government hospital in Ermelo, over 60 miles away.
Following her ordeal, the mother, Nikie Judith Mashego, provided details of her
experience to hospital officials.
Mashego said she pleaded for the nurses again while in the bathroom with her baby
still attached. Finally, a nurse came, but would not enter the dirty bathroom. She
threw Mashego a bed sheet to wrap up her baby. Astonishingly, Mashego recalled,
the abusive nurse then scolded her for coming to the hospital for the delivery.
“The patient has made a presentation to the hospital management and if her
allegations are true her rights as a patient were violated,” said Mpho Gabashane,
spokesman for the Mpumalanga provincial health department.
The accident, which occurred at 10:15 pm in the Japanese city of Itami, left the
69-year-old bicyclist, who was not identified, in critical condition with back and
head injuries. Paramedics arrived on the scene five minutes after the crash and
administered first aid. Yet, for about an hour, they were unsuccessful at locating a
hospital to treat the man.
Helpless, the elderly man waited in the ambulance at the accident scene as hospital
after hospital rejected treating him, citing unavailable beds, staff shortages and a
lack of equipment and specialists. All told, fourteen hospitals in the neighboring
prefectures – i.e., governing districts – of Hyogo and Osaka refused his entry.
“There were four other emergency calls in the same time frame of that night,”
explained Mitsuhisa Ikemoto, the fire department spokesman. “[A]s a result, we
were unable to find a hospital.”
It took a second round of calls for rescue workers to find a hospital. Finally, at
11:30 that night – 75 minutes after the accident – they took him to a hospital in
Itami, which had initially declined to accept him. Unfortunately, it soon became
apparent that the hospital’s resources that night were unsatisfactory.
At the time of his arrival at the hospital, the elderly man was already in critical
condition from the accident and post-accident delay. When his condition suddenly
deteriorated, hospital staff scrambled “to transfer him for better treatment,”
according to the Associated Press.
Two hospitals rejected that transfer request. By the time a third hospital agreed to
take the man, his condition was too poor to permit him to be moved.
The Associated Press reported that the man “initially showed stable vital signs,” and,
attributing the assessment to Ikemoto, reported the man “might have survived if a
hospital accepted him more quickly.” Ikemoto was quoted saying, “I wish hospitals
are more willing to take patients...”
The frustrating, and in one case, tragic experiences of the two accident
victims initially denied medical care are not unique in Japan’s universal health
insurance system.
Takasaki was 41 weeks pregnant4 when she was taken to Oyodocho Municipal
Hospital at about 6 pm, suffering a headache.5 Her limbs started to stiffen,6 and she
fell unconscious at about 12:15 am.7
The doctor initially believed Takasaki had fainted because of birthing pains, and did
not believe she was suffering from a serious brain ailment.8 However, a brain scan
was not performed, despite one doctor raising the possibility of a serious issue.9
“My wife died without seeing and holding her own baby,” said husband Shinsuke
Takasaki. “I really urge… improvements in transport system for pregnant women so
that this kind of tragedy will never be repeated.”16
Life is similar in St. Petersburg, Russia – but with a dangerous twist. There the sick,
elderly and handicapped can be seen spending all night waiting in extreme cold for
a government-issued medical form – the first of many hurdles to getting taxpayer
provided advanced medical treatment.
One such case that drew considerable media attention in Russia involved the
disabled mother of a Russian blogger identified only by her Internet name, “Lassi.”
For Lassi’s mother, it took five trips waiting outside a local administrative health
center, in frigid conditions, without anything warm to drink or a toilet, just to get the
referral form she needed to schedule a surgery on a bad leg.
Lassi’s mother’s hurt her leg in February 2006. She was taken by ambulance to
the St. Petersburg State City Hospital No. 26, but was not issued a room. She
instead stayed overnight in the hallway, as the cost for a room was 2,500 rubles
(~$80) per day.
She was discharged, but the pain became so overpowering that eventually she could
no longer stand. By March 2008, she decided to go on her own to have her leg
checked further.
As a result, nearly 100 sick people or their line-stander camp out in front of the
“[P]eople in wheelchairs and on crutches, as well as their relatives and friends, start
coming to that courtyard to secure their place in the waiting line from 2:30 am,”
reported Lassi.
But on four occasions her mother did not reach the front of the line. Lassi became
involved on the fifth attempt when she learned of her mother’s efforts.
“She ‘was afraid to disturb me,’” Lassi recalled her mother saying. “She just tried
to do it by herself. And failed.”
The morning of the fifth attempt, Lassi asked friends to hold a spot in line until she
arrived at 4 to 5 am. She described the scene at the health center:
Wearing a winter coat at 5 am I was not able to be even one of the first 30
people. People are standing in a dark yard on crutches, in wheelchairs.
They all recognize each other – the referral is one-time use only – and it’s
not the first time they don’t get it. There are tons of cars. People help each
other like during the blockade [of Leningrad in World War II]. [T]hey allow
others to sit in relatives’ cars to get warmed up. It’s cold, dark, there are no
bathrooms, [and] people are barely standing.
At 8:30 am, Lassi’s mother arrived to take her spot in line. When the doors of the
center opened at 10, she could move inside, but there were seats for only 10 people
in the crowded hallway.
Finally, she obtained the referral form at 11:50 – 10 minutes before the health office
closed. She is one of about 40 to 50 patients who usually receive a quota out of the 100.
However, obtaining the medical referral form was just the first step. Next, Lassi’s
mother was told to register the form at the “other end of the city, [and] wait in
another enormous line from 1 to 5 pm to get a registration number for their form,”
recalled Lassi.
Unfortunately, despite a quota and registration number, the mother will continue to have
to wait for a surgery date. The type she requires on her bad leg has a two-year wait.
“For me to stand here [waiting in the health center] is a real insult,” said Ershova
Tamara Grigoryevna, another patient in line who worked 40 years as a surgeon. “I
was working during the Soviet time and could not imagine that such [a] thing would
be possible. Even during the blockade [of Leningrad] we were standing in line for
bread in warmth... [L]ife seemed a lot happier.”
“Right now I’m in quite a lot of pain, but that’s not the fault of the health system,”
said Persson at the time. “I’m counting that this will be managed through public
health care. I would be very surprised if not.”5
During the months of waiting, Persson walked with an obvious limp and was
rumored to be on strong painkillers. In 2004, he canceled an official trip to the
EU-Latin America meeting held in Mexico because his hip was too bad to handle
a long flight.6
Though his operation was scheduled for December 2004, Persson got his operation
early. After an over eight-month wait,7 he was operated on successfully in June
2004 at the public Söder Hospital in Stockholm.8 Though he waited in pain, a
“The main problem with Swedish health care is not its quality, but its accessibility,”
says Waldemar Ingdahl, director of the Stockholm-based think tank, Eudoxa.11
In 2007, David Hogberg, Ph.D. wrote for the National Center for Public
Policy Research:
A recent study that examined over 5,800 Swedish patients on a wait list for
heart surgery found that the long wait has consequences far worse than pain,
anxiety or monetary cost. In this study, the median wait time was found
to be 55 days. While on the waiting list, 77 patients died. The authors’
statistical analysis led them to conclude that the “risk of death increases
significantly with waiting time.” Another study found a mean wait time
of 55 days for heart surgery in Sweden and a similar rate of mortality for
those on the waiting list. Finally, a study in the Swedish medical journal
Lakartidningen found that reducing waiting times reduced the heart surgery
mortality rate from seven percent to just under three percent.12
In October 2003 Mrs. A., who lives in Malmo, Sweden, gave birth to a baby
boy. She was signed out from the hospital after delivering the baby. There
are not enough beds, so delivering a baby “without complications” is an
outpatient procedure. Budget cuts have eliminated beds and medical staff.
The next day Mr. and Mrs. A. noticed that their baby was weak and did not
want to eat. As is common in Sweden, they did not call a doctor. Instead
they called the tax-paid “TeleMedicine” service. Nobody advised them to go
see a doctor right away.
In May 2006 another couple lost their three-year-old son to the budget-
starved medical system. When Mr. and Mrs. B.’s son suffered from diarrhea
and had been vomiting for almost two days, they took him to the emergency
room at the nearby university hospital. A doctor ordered a supply of
intravenous fluids, and the boy was sent on to the pediatric clinic to have
them administered. When he arrived, the nurses had no time for him. Mr.
and Mrs. B. repeatedly called on the medical staff to ask why nobody was
coming to give their son the intravenous fluids he so desperately needed.
Every time they got the same answer: nobody has time. They have too many
patients and too little staff.
You do not have to be a child to die from denial of care in Sweden. In April
2005 Mr. C., 61 years old, became concerned about an unusual feeling of
fatigue. He went to see a doctor at the local government-run clinic. The
doctor sent him home with some encouraging words.
Mr. C. came back a while later with worsened symptoms. Again he was sent
home after a superficial examination and with more reassurance.
Over the next year and a half Mr. C. visited this tax-paid local clinic a
total of 14 times. He had no choice – all Swedes have to go through a
government-run primary care physician at a tax-paid clinic in order to see a
specialist. He developed blood in his urine. But the doctors refused even to
take a blood test.
They told Mr. C. and his son that they were denying him the blood test
because of budget restrictions imposed by government bureaucrats.
When, finally, Mr. C.’s son convinced the doctors to do one blood test, they
found out that Mr. C. had cancer. He was referred to a regional hospital.
There they established that his cancer, originally curable, had spread
throughout his body.
In October 2007, the Cancerfonden, the Swedish Cancer Society, reported that the
shortage of radiologists and mammography nurses in Sweden “is so serious that, if
nothing is done, within a few years it will not be possible to provide mammography
for women in most counties in Sweden.” The group further reported that throughout
the entire country, only six chest radiologists were being trained, while the average
age of working mammography personnel at the time was over 50.15
In May 2005, White visited his general practitioner after noticing blood in his stools.
Because White’s younger brother had been treated for colon cancer, White had an
urgent need to be tested for the deadly cancer.
“If I had waited any longer, I know I would have died,” White said. Prudently, he
carried private health insurance – beyond that supposedly provided publicly – that
would cover private treatment.
In July 2006, a private surgeon carried out a colonoscopy. The test showed
colon cancer had spread to his lymph nodes, and an operation was scheduled at
Mercy Hospital.
In May 2007 – two years after he initially consulted a doctor in the public system –
Auckland City Hospital at last got around to scheduling White for a colonoscopy.
“The doctor didn’t really care and the nurses were rough on it when they were
putting the butterfly stitches on and wrapping it up,” Beckett said.
Staff told Beckett to bring Jordann back in two days. The mother, angered,
believed hospital staff accepted the possibility that the fingertip would be lost.
“Basically they don’t care if his finger stays on or falls off,” said Beckett, who
accused the staff of treating her son uncaringly. “They said you can’t do much
about it.”
There, Jordann’s hand was X-rayed and a hand surgeon was called in to operate.
The surgeon realigned the bone, removed the fingernail and stitched up the finger
with thread.
Though thankful her son’s sliced finger was repaired, Beckett is upset over the lack
of care at the state facilities.
“I was angry,” she said. “Jordann’s three and a half. Who’s to say he doesn’t need
the tip of his finger when he’s grown up.”
The 28-year-old Christchurch, New Zealand woman had waited a year for
gynecological surgery. She needed a cyst removed from her fallopian tubes and
possibly treatment for endometriosis (an external growth of the tissue lining the
uterus that can result in infertility)6 as well, if detected during the operation.
Before surgery, she was told that both the cyst and, if need be, any endometriosis
adhesions would be removed during the same operation.
“I’m really angry about being misled about what could happen,” Amy said. “If you
started bleeding on the table or something had gone wrong they wouldn’t have just
left you there, would they?”
Mark Leggett, General Manager for Medical and Surgical Services at Christchurch
Women’s Hospital, said the surgery was not halted because the anesthesiologist
needed to leave the hospital. Moreover, according to Leggett and the Canterbury
District Health Board, the regional government health care provider, it is not
uncommon to divide an operation into multiple sessions if it runs over.
But for Amy, the explanation is little comfort. The endometriosis causes lower
abdominal pain and painful menstruation. She doesn’t believe the wait for complete
treatment for her condition should stretch to a year and a half.
Wigmore, 34, called for an ambulance one afternoon in September 2008, after
his right side became numb. Suspecting a stroke, Wigmore was dropped off at
the government-managed Waitakere Hospital at roughly 2 pm that afternoon. He
was taken in for initial tests, but the staff determined he should be transferred to a
different, larger hospital to undergo further scans.
An ambulance took five-and-a-half hours to arrive for the transfer in the early
morning hours. It dropped off Wigmore at North Shore Hospital – also a
government-managed hospital – at 2 am.
But North Shore Hospital had no room. Staff gave Wigmore the option of sleeping
in a bed parked in a corridor or in a La-Z-Boy recliner chair in a TV waiting room,
which he chose.
“I thought it was kinda strange,” Wigmore recalled thinking. “No one should have
to sleep in a La-Z-Boy chair in a hospital. That’s just a joke.”
Wigmore spent about eight hours in the recliner before being put into a proper bed
for further evaluation of his condition.
North Shore Hospital is investigating the matter. “The District Health Board’s chief
medical officer has acknowledged Mr. Wigmore’s concerns and will discuss this
complaint with the staff who were on duty at the time,” read a hospital statement.
Wigmore’s experience, while unfortunate, could have been worse. Waiting lists for
surgery or to see a specialist in New Zealand’s public system are commonplace and
growing. While the precise number of people on waiting lists is subject to debate,
present estimates range between 70,000-110,000.
Great Britain
1 “Cataract Surgery,” Health Encyclopedia online, National Health Service, available at http://www.nhsdirect.nhs.
uk/articles/article.aspx?articleId=89&PrintPage=1 as of July 14, 2009.
2 David Doyle, “Hope in Sight for Richard,” Ealing Times (UK), May 29, 2007, available at http://www.ealingtimes.
co.uk/mostpopular.var.1432502.mostcommented.hope_in_sight_for_richard.php as of July 14, 2009.
3 Ibid.
4 Ibid.
5 Ibid.
6 Ibid.
7 David Doyle, “Nearly Blind after Three Years’ Wait for Eye Op,” This Is Local London (UK), May 11, 2007, avail-
able at http://www.thisislocallondon.co.uk/mostpopular.var.1391015.mostviewed.nearly_blind_after_three_years_wait_for_
eye_op.php as of July 14, 2009.
8 David Doyle, “‘He Was a Real English Gentleman,’” Ealing Times (UK), June 27, 2007, available at http://www.
thisislocallondon.co.uk/search/1503134._He_was_a_real_English_gentleman_/ as of July 7, 2009.
9 Ibid.
10 Ibid.
11 “Cancer Surgery Postponed Four Times,” BBC (UK), January 11, 2000, available at http://newsvote.bbc.co.uk/1/
hi/health/598555.stm as of July 7, 2009; Trudy Harris, “Flu Crisis Leads to Critical Delay in Cancer Case,” Times (UK), Janu-
ary 14, 2000.
12 Dr. Rebecca Fitzgerald, “Oesophageal Cancer: From Bench to Bedside,” University of Cambridge, Cambridge,
UK, class lecture, October 4, 2002, available at http://www.cam.ac.uk/cambforall/scienceseminars/cancer/oesophageal.html
as of July 7, 2009.
13 “Cancer Inoperable after Flu Delay,” BBC (UK), January 13, 2000, available at http://news.bbc.co.uk/1/hi/
health/602393.stm as of July 7, 2009.
14 “Cancer Surgery Postponed Four Times,” BBC (UK), January 11, 2000, available at http://newsvote.bbc.co.uk/1/
hi/health/598555.stm as of July 7, 2009.
15 Stuart Qualtrough, “NHS in Crisis: Destined to Die, a Woman Who Had Faith in the System,” Sunday Mirror (UK),
January 16, 2000, available at http://findarticles.com/p/articles/mi_qn4161/is_20000116/ai_n9705929/?tag=content;col1 as of
July 7, 2009.
16 “Cancer Surgery Postponed Four Times,” BBC (UK), January 11, 2000, available at http://newsvote.bbc.co.uk/1/
hi/health/598555.stm as of July 7, 2009; Sarah Lyall, “In Britain’s Health Service, Sick Itself, Cancer Care Is Dismal,” New
York Times, February 10, 2000, p. A1, available at http://query.nytimes.com/gst/fullpage.html?sec=health&res=9501EFD91
33EF933A25751C0A9669C8B63 as of July 15, 2009.
17 “Cancer Inoperable after Flu Delay,” BBC (UK), January 13, 2000, available at http://news.bbc.co.uk/1/hi/
health/602393.stm as of July 7, 2009; “Cancer Surgery Postponed Four Times,” BBC (UK), January 11, 2000, available at
http://newsvote.bbc.co.uk/1/hi/health/598555.stm as of July 7, 2009.
18 “Cancer Surgery Postponed Four Times,” BBC (UK), January 11, 2000, available at http://newsvote.bbc.co.uk/1/
hi/health/598555.stm as of July 7, 2009.
19 Ibid.
20 Jill Palmer, “Too Busy for Seriously Ill Baby,” Mirror (UK), January 11, 2000, p. 2.
Australia
1 For all source material and references, unless otherwise noted, see Grant McArthur, “Patient’s Patience Runs
Out,” Herald Sun (Australia), April 5, 2007, available at http://www.news.com.au/heraldsun/story/0,21985,21505526-2862,00.
html as of July 22, 2009.
2 “The State of Our Public Hospitals, June 2006 Report: Are Patients Waiting Longer for Elective Surgery?,” De-
partment of Health and Ageing, Canberra, Australia, January 3, 2007.
3 For all source material and references, see “Granny Suffers 82 Hours of Agony,” Sunday Times (Australia), May
19, 2007, available at http://www.news.com.au/perthnow/story/0,21598,21759824-2761,00.html as of July 8, 2009.
4 Paul Lampathakis, “Year’s Wait for 30 Min Surgery,” Sunday Times (Australia), April 1, 2007.
5 Paul Lampathakis, “Deaf Over Delay,” Sunday Times (Australia), May 6, 2007.
6 Ibid; Paul Lampathakis, “Year’s Wait for 30 Min Surgery,” Sunday Times (Australia), April 1, 2007.
7 Paul Lampathakis, “Deaf Over Delay,” Sunday Times (Australia), May 6, 2007.
8 Ibid.
9 Ibid.
10 Ibid; Paul Lampathakis, “Year’s Wait for 30 Min Surgery,” Sunday Times (Australia), April 1, 2007.
11 Paul Lampathakis, “Year’s Wait for 30 Min Surgery,” Sunday Times (Australia), April 1, 2007.
12 Hon. Kim Hames, “Surgery Cancelled Twice for 8-Year-Old,” Media Statement, Office of the Leader of the Op-
position, April 1, 2007.
13 Paul Lampathakis, “Deaf Over Delay,” Sunday Times (Australia), May 6, 2007.
14 Paul Lampathakis, “Year’s Wait for 30 Min Surgery,” Sunday Times (Australia), April 1, 2007.
15 For all source material and references, unless otherwise noted, see Edith Bevin, “Horrendous Hospital
Treatment,” Daily Telegraph (Australia), April 11, 2008, available at http://www.news.com.au/dailytelegraph/sto-
ry/0,22049,23518170-5006009,00.html as of July 22, 2009.
16 Adrienne Agg, “Miscarriage Leaves Couple in Anguish,” Berwick and District Journal (Australia), April 7,
2008.
17 Ibid.
18 Troy Keams, “Rachel’s Baby Agony,” Pakenham Cardinia Leader (Australia), April 2, 2008.
19 According to the website of Casey Hospital, among its services offered are “a full range of imaging services
including computed tomography, ultrasounds, nuclear medicine, cardiac stress testing and fluoroscopy; and has a 4 bed day
ward for pre and post X-ray procedures.” See “Casey Hospital Information for GPs,” Casey Hospital, Berwick, Australia,
available at http://www.southernhealth.org.au/gp/CaseyHospital.htm as of July 22, 2009.
20 Adrienne Agg, “Miscarriage Leaves Couple in Anguish,” Berwick and District Journal (Australia), April 7,
2008.
21 Ibid.
22 Troy Keams, “Rachel’s Baby Agony,” Pakenham Cardinia Leader (Australia), April 2, 2008.
South Africa
1 For all source material and references, unless otherwise noted, see Lynn Williams, “Mother’s Harrowing Tale
of Baby’s Death,” Herald (South Africa), March 26, 2008, available at http://www.theherald.co.za/herald/2008/03/26/news/
n01_26032008.htm as of July 22, 2009, and Lynn Williams, “Money Won’t Take Away Pain, Says Mom Who Sued Hos-
pital,” Weekend Post (South Africa), April 5, 2008, available at http://www.weekendpost.co.za/main/2008/04/05/news/
nl10_05042008.htm as of July 22, 2009, and Lynn Williams, “Woman Who Lost Baby Wins Lawsuit,” Herald (South Africa),
March 31, 2008, available at http://www.theherald.co.za/herald/2008/03/31/news/n03_31032008.htm as of July 22, 2009.
3 Max Matavire, “Dora Nginza: ‘The Situation Is A Crisis,’” Cape Times (South Africa), August 16, 2007, available
at http://www.iol.co.za/index.php?set_id=1&click_id=13&art_id=vn20070816041643505C915130 as of July 22, 2009.
4 Ibid.
5 For all sources and references, unless otherwise noted, see Antoinette Pienaar, “Hospital Blamed for Girl
Dying,” Beeld (South Africa), June 11, 2008, available at http://www.news24.com/News24/South_Africa/News/0,,2-7-
1442_2338324,00.html as of July 22, 2009.
6 Thabisile Khoza, “Dead Baby’s Records ‘Missing,’” AfricanEye.org, July 7, 2008, available at http://www.
news24.com/News24/South_Africa/News/0,,2-7-1442_2353218,00.html as of July 22, 2009.
7 For all source material and references, unless otherwise noted, see Daleen Naude, “Hospitals Unable to Deliver
Baby,” Citizen (South Africa), July 14, 2008, available at http://www.citizen.co.za/index/News/718809.page as of July 9,
2009, and Buks Viljoen, “‘I’m Going to Lose My Child!’,” Beeld (South Africa), July 16, 2008, available at http://www.
news24.com/News24/South_Africa/News/0,,2-7-1442_2358120,00.html as of July 9, 2009.
8 For an audio recording, see “Dis Walglik!,” Beeld (South Africa), October 29, 2008, available at http://jv.news24.
com//Beeld/Video/0,,3-2082_2417923,00.html as of July 9, 2009.
9 For all source material and references, see Riot Hlatshwayo, “Nurses Probed after Mom Gives Birth in Toilet,” Sowetan
(South Africa), October 16, 2008, available at http://www.sowetan.co.za/News/Article.aspx?id=863975 as of July 22, 2009.
Japan
1 For all source materials and references, unless otherwise noted, see: “Man Dies after Being Refused Admission by
14 Hospitals,” Associated Press, February 4, 2009, available at http://www.breitbart.com/article.php?id=D964IBAG0&show_
article=1 as of July 23, 2009; Mari Yamaguchi, “Injured Man Dies after Rejection by 14 Hospitals,” Associated Press, Febru-
ary 4, 2009; “Japanese ERs Turn Down Accident Victim,” United Press International, February 4, 2009, available at http://
www.upi.com/Top_News/2009/02/04/Japanese_ERs_turn_down_accident_victim/UPI-67461233758375/ as of July 23,
2009.
2 Chisaki Watanabe, “Survey Finds Japanese Hospitals Rejected 14,000 Emergency Patients in 2007,” Associated
Press, March 11, 2008, available at http://www.blnz.com/news/2008/03/11/Survey_finds_Japanese_hospitals_rejected_7098.
html as of March 3, 2009.
3 “Pregnant Woman Refused by 18 Hospitals for Treatment, Later Dies,” Japan Economic Newswire, October 17,
2006.
4 Hiroshi Osedo, “Tragedy as Pregnant Woman Turned away by 18 Hospitals,” Courier Mail (Australia), October
21, 2006.
5 “Man Sues Town, Doc over Death of Pregnant Wife,” Daily Yomiuri (Japan), May 24, 2007.
6 Ibid.
7 Hiroshi Osedo, “Tragedy as Pregnant Woman Turned away by 18 Hospitals,” Courier Mail (Australia), October
21, 2006.
8 “Man Sues Town, Doc over Death of Pregnant Wife,” Daily Yomiuri (Japan), May 24, 2007.
9 “Pregnant Woman Refused by 18 Hospitals for Treatment, Later Dies,” Japan Economic Newswire, October 17,
2006.
10 “Man Sues Town, Doc over Death of Pregnant Wife,” Daily Yomiuri (Japan), May 24, 2007.
11 “Comatose Woman in Labor Rejected by 18 Hospitals Dies,” Japan Times (Japan), October 19, 2006, available at
http://search.japantimes.co.jp/cgi-bin/nn20061019a3.html as of April 20, 2009.
12 Hiroshi Osedo, “Tragedy as Pregnant Woman Turned away by 18 Hospitals,” Courier Mail (Australia), October
21, 2006.
13 Ibid.
Russia
1 For all source material and references, unless otherwise noted, see LiveJournal User Lassi, “Need Advice, Guys…
Saint-Petersburg,” LiveJournal, October 10, 2008, available at http://users.livejournal.com/lassi_/7545.html as of January 23,
2009; document translated for authors by Victoria Strokova; and LiveJournal User Nisovsky, “About Self-Respect,” LiveJour-
nal, October 19, 2008, available at http://nisovsky.livejournal.com/143725.html as of January 23, 2009; document translated
for authors by Victoria Strokova.
Sweden
1 Waldemar Ingdahl, “His Hip, Hooray!” TSCDaily, June 4, 2004, available at http://www.tcsdaily.com/article.
aspx?id=060404D as of January 5, 2009.
2 Ibid.
3 “Equal-Opportunity Suffering,” Editorial, Chattanooga Times Free Press, May 31, 2004.
4 Waldemar Ingdahl, “His Hip, Hooray!” TSCDaily, June 4, 2004, available at http://www.tcsdaily.com/article.
aspx?id=060404D as of January 5, 2009.
5 “Swedish PM to Wait in Line for Hip Operation,” Reuters, May 25, 2004, available at http://www.freerepublic.
com/focus/f-news/1142285/posts as of January 5, 2009.
6 Waldemar Ingdahl, “His Hip, Hooray!” TSCDaily, June 4, 2004, available at http://www.tcsdaily.com/article.
aspx?id=060404D as of January 5, 2009.
7 Ibid.
8 “Ministers Humble and Hip,” Local (Sweden), June 4, 2004, available at http://www.thelocal.se/208/20040604/ as
of June 12, 2009.
9 “Swedish PM to Wait in Line for Hip Operation,” Reuters, May 25, 2004, available at http://www.freerepublic.
com/focus/f-news/1142285/posts as of January 5, 2009.
10 Pia Maria Jonsson, et al., “Health Care: Status Report 2003,” The National Board of Health and Welfare, 2003,
p. 13, available at http://www.socialstyrelsen.se/NR/rdonlyres/1DA644DE-5036-43C5-A186-3DC31171F021/2519/summary.
pdf as of January 5, 2009.
11 Waldemar Ingdahl, e-mail to Ryan Balis, December 20, 2008.
12 David Hogberg, Ph.D., “Sweden’s Single-Payer Health System Provides a Warning to Other Nations,” National
Policy Analysis #555, May 2007, available online at http://www.nationalcenter.org/NPA555_Sweden_Health_Care.html.
13 Sven R. Larson, Ph.D., “Lessons from Sweden’s Universal Health System:
Tales from the Health-care Crypt,” Journal of American Physicians and Surgeons, Volume 13, Number 1, Spring 2008, avail-
able online at http://www.jpands.org/vol13no1/larson.pdf as of July 21, 2009.
14 Ibid.
15 “Mammography at Risk in Sweden, Says Cancerfonden,” press release, International Union Against Cancer,
October 3, 2007, available online at http://www.uicc.org/index.php?option=com_content&task=view&id=16003&Itemid=63
as of July 16, 2009.
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“On a good day the practice of medicine is demanding and difficult. A bad day can range from frustrating to
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