Friday 21 August 2009

Megrahi and the NHS

This is not a post about the decision to release Mr Megrahi on compassionate grounds. Other bloggers have already analysed and opined on the outcome such as here and here.

The following has been taken from Kenny MacAskill's speech at lunchtime yesterday.

Mr Al-Megrahi was examined by Scottish Prison Service doctors on 3 August. A report dated 10 August from the Director of Health and Care for the Scottish Prison Service indicates that a 3 month prognosis is now a reasonable estimate. The advice they have provided is based not only on their own physical examination but draws on the opinion of other specialists and consultants (my emphasis) who have been involved in his care and treatment. (courtesy of The Lockerbie Case)

Some of my readers may be aware my father died from prostate cancer, so too did the husband of a dear friend and a brother of another. Not one of these men had more than one specialist throughout their treatment. All died within 6 months of the cancer spreading to other parts of their bodies and all were confined to wheelchairs for the last few months.

It was reported in October 2008 that Mr Megrahi's cancer had spread to other parts of his body yet to my surprise, 10 months later, he was able to walk unaided up the steps to the aircraft today. A small observation perhaps but an important one.

An important one because Mr Megrahi appears to have had several specialists looking after his health, whereas the men I know had one. Has that made a difference to his life expectancy? I have no idea as I have no medical knowledge.

Has Mr Megrahi received better care and treatment from the NHS than others? He certainly has received more specialist attention. I am not suggesting because he is a convicted criminal that he should not have received the best the NHS can offer, but I consider every person in the country deserves that too.

Some will think Mr Megrahi had better treatment because of his international status as a convicted criminal. That should not be so. The NHS is for all and 'equality' is often quoted.

Is it not time we recognised that equality within the NHS can be unequal as this case shows? Is it not time we discussed how to reform the NHS and ensure each and every one of us is given the best treatment medicine can provide?


Oldrightie said...

The utter cowardice of Governments to do right by their people, in case of causing international offense, is offensive in its own right.

Witterings from Witney said...

Nice point - unfortunately there is more inequality to come with the govt's latest plans with the NCS!

subrosa said...

It is indeed OR, especially when Brown continues to expound the fact that 'he's protecting the British people'.

subrosa said...

Oh WfW, do tell...

John Brownlie said...


Are you suggesting that because he was able to walk up the steps that he may not have advanced prostrate cancer? That would mean that the consultants/specialists colluded to get him released and they would be made to look extremely foolish if their prognosis was proved to be completely wrong.

The ability to walk, or the inability to walk, is dictated by the parts of the body to which the cancer has spread.

I would also be surprised and extremely concerned if the unfortunate individuals you mention only had access to one specialist or consultant. For example, in my local hospital there are four cancer specialists/consultants who would surely discuss particularly difficult cases with each other.

subrosa said...

Morning Brownlie, good to see you.

Indeed I'm not suggesting that in the least. I'm comparing what we've been told in the press with what I've seen in reality.

The press reported the cancer had moved into his bones. I've seen the result of 3 sufferers with the same disease and all had a similar final few months once the diagnosis was the cancer had spread into the bone. I'm no medic but it was explained to me that it spreads to the pelvis and/or spine and moves quickly. That's the reason they are unable to walk or stand. But hey I'm no medical person and I'm surprised you think I'm stating any doubt with his diagnosis.

What I am suggesting is that he received superior treatment to most.

Brownlie, I myself have had experience of specialists in the past couple of years and I assure you I've only ever seen one (or one of his juniors) on every occasion.

If they discuss my cases amongst themselves then I have no knowledge.

Have you ever asked for a second opinion? Has it ever been suggested to you that another specialist/consultant to examine you would be a good idea? In the same area of expertise I mean.

Even when I was admitted as an emergency I was called Mr X's patient and Mr X wasn't around. It was my good fortune that the house doctor had an interest in my condition so he took control, otherwise I would have had to wait until Mr X was available.

In my father's case there were 2 urologists in the hospital, both worked very separately. At one point when my father was extremely confused I made a request to see the specialist only to be told he was not on duty. When I asked to see the other one I was told that wouldn't be professional.

Fortunately I realised my father's consultant may be at the private hospital so I managed to contact him there and he immediately attended to my father's extreme distress, but if I hadn't had the courage to contact him, then I think my father would have suffered another day of hellish pain.

I'd like to know if any other readers have been fortunate like yourself to be treated by more than one specialist/consultant from the same 'ology.'

John Brownlie said...


You, of course, have my complete sympathy over these distressing matters as my mum suffered terribly as a result of this illness.

It would seem rather unfortunate and completely unacceptable that the area a person lives in dictates how life-threatening illnesses are treated. My understanding from my two brothers' experience is that the specialists hold case conferences in illnesses of this nature.

As far as this individual is concerned time will tell if the decision to release him on the grounds of his medical condition is the correct one.

I'm half-way through a blog on the issues surrounding this but, unfortunately, work keeps interfering.

Anonymous said...

My sympathy to you Subrosa over the situation with your dad. It is an outrage that someone else couldn't examine and prescribe in the situation that you describe.

I suspect, however, having listened to the First minister this morning on the Today Programme, that in the case of this patient, the extra specialists were brought in inaccordance with Scottish law, so that there could be as little doubt as possible in the prognosis (ie 3 months of life), before the Justice Secretary made his decision. I imagine that, if the patient had not been requesting release that that wouldn't have happened.

G Laird said...

Dear Subrosa

The unfortunate thing about illness is that is unique to each individual.

Not every broken leg is the same and not every one with cancer is the same.

I was at university for most of my adult life, met a lot of medics, some of whom I would have trusted with my life and some I wouldn't want taking my temperature.

Yours sincerely

George Laird
The Campaign for Human Rights at Glasgow University

subrosa said...

Brownlie, I don't know what you're talking about.

I'm talking about prostrate cancer. Megrahi has been diagnosed with prostate cancer. I don't have a clue if he has diabetes or not.

We seem on very different wave lengths.

subrosa said...

No Tris I missed that today.

There MacAskill's words yesterday were wrong. He said what I put on the post.....'care and treatment'.

Of course extra reports would be required from different specialists regarding his diagnosis, but clearly they were just that.

subrosa said...

Oh quite agree George. I know people who wouldn't let my doctor near them.

My point with this post is really to say it's time we had a debate about the future of the health service.

I'm beginning to regret I used Megrahi's treatment to make the point!

John Brownlie said...

We do appear to be on separate wave-lengths. I'm aware that he's suffering from cancer and I did not mention diabetes at all.

Alan W said...

Interesting angle SR.

MacAskill must have had a fit when he saw the hero's welcome the mass murderer got. If Megrahi's still alive come the elections next year, this will come back to bite him (and the SNP) on the bahookie.

subrosa said...

All things considered Allan I wouldn't expect that but what do I know?

I think Kenny MacAskill might just have had a rethink if he'd realised how Megrahi was going to be feted in Libya yesterday don't you.

Alan W said...

In which case, the man's an idiot. Imagine a Scot imprisoned in an African country for a crime our media tell us repeatedly he didn't commit. A high profile campaign is run for ten years that he's the victim of a political stitch-up. Then it's announced that he is being released and is coming home to die. Do you think there would be a crowd waiting at Glasgow airport?

Anonymous said...

If you get a chance to listen on the iplayer SR, it's worth a listen

AW...There was a crowd waiting for that drug smuggling English girl when she was compassionately sent back to England to have her baby rather than face the death penalty in Laos, so I'm inclned to agree that the Lybian reaction could have and should have been foreseen. I know that Salmond condemned it, but I'm inclined to think that he must have known it would happen.

I think it probably didn't help that Lybia was instructed by the USA not to give him a hero's welcome.

Perhaps Mr Obama will learn from this that not everyone rolls over when the United States tells them to. Really just the muppets in London.

subrosa said...

I'll listen later Tris although my post is really about the inequality in the NHS when so many people think they're getting the very best.

subrosa said...

If there was Allan I'd be utterly ashamed.

It now appears Brown wrote a letter to Gadaffi asking him to ensure there was no 'heroes' homecoming. That was ignored.

It shows the standing Brown and Britain have in the world doesn't it.

Bill said...

You are quite right that the NHS needs 'revamping'. Having lived in a number of other countries which had various medical systems, at least partly financed from taxation, I'd say we have a lot to learn. There's no ideal model, but our own certainly needs a rethink.

As for me, I continue to pay quite a lot each month for private medical insurance just to ensure I get specialist consultations and treatment promptly in case I ever succumb to a major disease. One of the diseases I've always had in mind is prostate cancer as I know how dangerous it can be and that many men leave it too late to go and get themselves checked-out and even when they do may have to wait too long for a specialist consultation, time they may not have.

Luckily I can afford the 'luxury' of PMI, I know very many are not so fortunate.

subrosa said...

Indeed you are lucky Bill. I decided I'd do it the 'pay per private visit' route after the cost of my PHI went up radically some years ago.

Fortunately it's not too bad here compared with some parts of England.

All Seeing Eye said...

It's an odd point that al-Megrahi would probably have died in a US jail cell if he was over there - but probably not from prostate cancer. Only 19% of those who contract prostrate cancer die in the United States. 57% of Britons who contract it die from it. Furthermore, those in North America have a higher incidence of prostrate cancer than in Europe, primarily because the US health care system which Obama wants to mess around with diagnoses it much earlier than in other countries. Probably just some doctors being overzealous in an attempt to make money, eh, Barak?

subrosa said...

Morning ASE. Now that's an interesting statistic - I hadn't done a comparison with the US. We're towards the end of the table for Europe with prostate cancer though.

I've had friends from Michegan here this week ASE and he was telling me exactly that there was a higher percentage. His view was that people took more responsibility for their health there and expected the best for their money. Also men aren't nearly as inhibited as the Brits.

Clarinda said...

It is interesting to note that in the UK there is a continued relectance by men to consider disorders concerning their 'nether' regions in particular and their health in general. It is much more difficult to treat advanced disease due to late presentation. The treatment can only rely for it's success on the timing of the presentation by the patient seeking medical advice and examination.
The male US population, that actually can afford medical care, are much more likely to access regular health checks which will pick up earlier stage disease. This results in more successful outcomes - hence the 'better' statistics.
It's important to consider that US statistics may not reflect the total US population as a significant number do not attend as they have no health insurance. There may be a horrendous number dying of prostate cancer for example who are excluded from these statistics. Be wary of what is and what is not included in these studies!
Men on the continent also appear to have less in the way of embarrassment etc in seeking medical care.

subrosa said...

I'm not sure if I'm right Clarinda, but somehow I think annual medical checks are required in the US and these catch many diseases at the early stages.

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