NHS & Francis Report: Who gets promoted?

Did things just happen or was there a master plan?

The NHS has been subjected to reform, re-reform and re-re-reform over a number of years with little actual improvement in clinical care to patients. Yet the bonus culture has led to side effects that were normally the domain of bankers and financiers.

We have to remember that those high up were carrying out the Government’s Master Plan. That was why they were not sacked but promoted.

The Telegraph: Mid Staffs NHS trust: Why is nobody being punished for this disaster?

Between January 2005 and March 2009, the Mid Staffordshire hospital was a terrible place, where patients were left lying for hours in their urine and faeces. Those who tried to get out of bed and help themselves often fell, and their injuries went unrecorded. You see, old people drinking out of flower vases because nurse won’t bring water are of no concern. Not if you want to hit your targets and achieve the holy grail of Foundation Trust, which Mid Staffordshire most definitely did.

The Telegraph:

This is the central question that the Francis inquiry addressed. Why did a hospital – and, to a dismaying extent, other parts of the NHS – stop being sensitive to patients’ distress? What about consultants doing their ward rounds at Stafford every day? Did none of them hear the cries and smell the smells? What about Dr Helen Moss, the hospital’s director of nursing from 2006 to 2009, the worst period of neglect? Did she listen to Helene Donnelly, the shocked junior nurse who outlined her fears about lack of care? Or did Dr Moss believe, as most NHS managers seem to, that airing the hospital’s dirty linen in public was far worse than not bothering to change the dirty linen your patients were lying on?

Warning! You may want a gulp of gas and air before you read on. Yesterday, Dr Moss was cleared by her professional regulator. The Nursing and Midwifery Council (NMC) said that Dr Moss had “no case to answer”. The NMC refused to say how it had reached this remarkable conclusion, since all details of the case are “private”.

So a public servant who was in charge of nursing at a hospital that was complicit in the deaths of 1,200 people is not accountable to the people who paid her wages. If the buck doesn’t stop with Dr Moss, who the hell does it stop with? Certainly not Stafford’s former chief executive, Martin Yeates, who cut 150 jobs to save £10 million at a time when there were already serious safety concerns. An external report recommended that there was a case for disciplinary action against Mr Yeates, but the hospital board decided on “pragmatic and commercial grounds” to negotiate terms for an agreed departure. Therefore, unlike many of his former patients, Mr Yeates left Stafford hospital not in a wooden box, but with a £400,000 payoff.

>>>The Telegraph:

Mr Yeates, who resigned with a pay-off of more than £400,000 and a £1 million pension pot from Mid Staffordshire Foundation Trust, which runs the hospital, told the inquiry he was too ill to appear in person.

But

Bereaved families said they were appalled to learn that Mr Yeates has now taken a job as chief executive of a health charity, Impact Alcohol and Addiction Services, which hold contracts with the NHS.<<<<

Do you need more proof that those involved were part of a master plan? Here they are in the Telegraph:

Cynthia Bower, who was head of the West Midlands strategic health authority at the height of Stafford’s inhumanity, dismissed the hospital’s alarmingly high death rates as “a statistical blip”. Satire lay down and died the day Ms Bower was appointed chief executive of the Care Quality Commission. If you wanted to stop a tragedy like Mid Staffordshire happening ever again, would you really choose a woman who failed to notice the abuse at Mid Staffordshire?

Just for good measure, Sir David Nicholson, who also ran the West Midlands strategic health authority, is now chief executive of the entire National Health Service. Small world, isn’t it? A former Communist, Sir David is said by critics to be the perfect man to ensure that Stalinist central targets are met, whatever the cost may be.

……What about the midwife who told the Today programme on Tuesday that “you are penalised for taking time to care”.

First Class Clinical Care:

I think that the wonderfully clear language of the NHS’s founders, expressing a profound moral good, has been replaced by management jargon of providers and drivers. That change is not cosmetic. Ugly language has created ugly thinking, with behaviour to match. Too many people going into a British hospital will encounter first-class clinical care in third-world conditions.

But really:

Dr Chris Turner told the Francis inquiry that when he started work at Stafford A&E in 2007, the place was “an absolute disaster”. It was so bad that no one could remember what good looked like. The overworked staff were constantly threatened with losing their jobs if they didn’t get patients through the department within the four-hour target. So when John Moore-Robinson was admitted after a cycling accident, he was swiftly diagnosed with bruised ribs and sent away with some painkillers. John died a few hours later from a ruptured spleen, which doctors could have spotted if they’d given the 20-year-old the tests he needed.

So there you have it, master plan or not, patients died unnecessary and those that comply with the Governments plan cuts and targets get promoted.

Medicine as I know no longer exists in many complying hospitals.

Please don’t cry!

© Am Ang Zhang 2012

Francis Report

Lancet:

Mid Staffordshire scandal highlights NHS cultural crisis

The answers are complex and they are many, says Francis, but at their heart is a profound crisis of culture at every level of the NHS. The inquiry found a deep rooted, pernicious cult of management, obsessed with achieving ill-conceived targets yet isolated and wilfully oblivious to day-to-day operational reality, and fixated on image management and cultivating positive publicity while demonstrating little or no interest in acknowledging or addressing problems. Throughout the period considered by the inquiry, from 2005 to 2008, the executive management of the Mid Staffordshire Trust was blinded to the appalling care given to patients at their hospitals by their excessive focus on securing Foundation Trust status. An oppressive atmosphere in which intimidation and bullying were rife prevented staff from raising concerns, and, when they did, swept them under the carpet.

In parallel, the multiplicity of bodies with regulatory and oversight responsibilities in the NHS seemed to be asleep at the wheel. From health-care systems regulators and performance managers like Monitor, the Care Quality Commission, and the HCC, to professional bodies and regulators like the General Medical Council, the Royal College of Nursing, and the Nursing and Midwifery Council, “all such organisations have the responsibility to detect and redress deficiencies in local management and performance where these occur”, says Francis. “It does not need a public inquiry to recognise that this elaborate system failed dramatically in the case of Stafford. As a result, it is clear that not just the Trust's Board but the system as a whole failed in its most essential duty—to protect patients from unacceptable risks of harm and from unacceptable, and in some cases inhumane, treatment that should never be tolerated in any hospital.” Not a single person has yet been held accountable for what happened at the Mid Staffordshire Trust. Yet the systemic failures that the case has brought to light suggest that although atypical, Mid Staffordshire is unlikely to be unique.

Mid Staffordshire Trust inquiry: how the care scandal unfolded 

Mid Staffs report: the key figures in the scandal 

NHS flaws that led to Mid Staffs scandal

NHS managers are incentivised to ignore problems 

Mid Staffs NHS Trust pays out over £1.1m in compensation over patient deaths 

Mid-Staffordshire: Unbelievable! Unbelievable! Unbelievable!

Mid-Staffordshire: Where Are The Doctors? 

Mid-Staffordshire? Not Just Mid-Staffordshire!

Mid Staffordshire: The Modern Witch Hunt

Mid-Staffordshire: Media Media Media.

Mid-Staffordshire: Where Are The Doctors? 

Family & Healing: Who Is The Real Patient?

In an age when it has become more or less impossible to gear your intervention or non-intervention in the practice of Child Psychiatry because of rigid guidelines, I remember this family fondly.

From The Cockroach Catcher: Chapter 19   Who Is The Real Patient? Part 1

T

he early seventies was a very exciting time in London as the first ever course in Family Therapy in the U.K.was just launched.  Gregory Bateson just published Steps to an Ecology of Mind, which to this day still manages to be exciting for anyone interested in family systems – a term coined to describe the interaction within a family or extended family.   Of course years before that, Ibsen neatly observed family interactions in Ghosts and Wild Duck. 

©2006 Am Ang Zhang

Catherine

         Catherine, aged fourteen, had not attended school for some time and all attempts by the school authority and educational psychologist failed to get her back to school. This was a pity as Catherine was really university material.

         She had eleven older brothers and sisters. Two older sisters were married.  One of them had a little baby of ten months. The other had two children at school. The youngest of the brothers attended a public school (i.e. an English private school) on a scholarship, and with financial assistance from the older siblings.

         After an initial visit by the social worker, the team decided to approach the case in a family therapy sort of way – big family therapy in every sense of the word.

         At that time, family therapy was a relatively new development and had probably grown out of some group therapy principles. One of the first courses was established at the Group Therapy Institute in London when I was still at the Tavistock. Little did I know then that it was history in the making. Of the people I was with then, either teachers or co-trainees, many have become prominent practitioners in the field.

         Even the rather adventurous social worker was feeling a bit dubious.  “Do you belong to the school that insists on everybody in the family attending?”  She asked, hoping I would be a bit eclectic about it.

         “Let’s try and get everybody at least for the first session.”

         “I will do my best,” she promised.

         Good old Miss Kimble. She always got things done.

         As some of the family were working, the session had to be organised for the evening.   There is so much mystique attached to our kind of work that families often oblige without asking too many questions, at least at the early stage.

         One of the older unmarried sisters took it upon herself to organise the meeting. The main one that caused some problem was the oldest brother who was a long distance lorry driver going all over Europe.  The meeting needed to be on one of those nights when he was back from his delivery tour. The brother at the public school had a cricket match and he was apparently one of their best bowlers. One of the other brothers agreed to go to the match and bring him to the meeting as soon as the match was over.  The sister with the baby would have to bring the little one but the older children would look after her at the meeting.

         I told them that they could all join in.

         Luckily with so many children the family had a reasonable sized council house and the family room was fairly long.  They moved the dining chairs through to provide seating for everybody.

         The scene was set. We just had to deliver the goods.

         “We have come this far.  We just have to do it,” I told Miss Kimble.  She probably had more faith in me than I had in myself.

         Father looked after the parks and gardens for the council and had been with them since leaving school. Mother had not worked outside of home since the first child was born. She used to work in the Council Offices and that was where she met her husband.

         All the unmarried children who had left school had jobs except for the one who organised the meeting. She was in fact the eldest sister. All hope was on the boy and Catherine, except now Catherine was not going to school and had not been for nearly a year.  Two of the sisters worked in an insurance company, which was a very important local employer. Three boys worked for the Parks and Gardens department. One girl was a life guard at the local public Sports Complex that just opened and one boy looked after the gymnasium. The parents had done well and you could see that it was a very close knit and caring family.

         Only the truck driver was absent. We chatted and waited. The baby in the meantime was crawling in the middle with the two older children fussing over her. Catherine sat close to mother and now and again would hold her hand. I was not too sure who was comforting whom but then family therapy was about observing the family interactions.

         Cricket boy was busy devouring a plate of food mum left for him as he missed his school dinner.

         Others were exchanging various gossips about boyfriends and girlfriends.

         I thought that this was fun but there was also a lot to take in. The traditional approach would have allowed one to be more focused but it would probably have taken a long time to get to where we wanted to get to quickly.

         When I heard air brakes, I knew that big brother had arrived. Everybody else knew as well. Swiftly Catherine let go of mum’s hand and went to the door.  One of the other sisters had the plate that had been kept warm in the oven set in a tray complete with a big can of beer.  I declined the offer of beer as I was working.

         Big brother was quite a big fellow but was friendly enough as he shook hands with me. After a few bites and some gulps of beer he turned to me and said:

 “We are all here now. What is this about?”

         To this challenge, I explained in a very simple fashion why I wanted to see the whole family. I went on to use what I had since described to my juniors as a journalistic approach to history taking, as distinct from the traditional topic-by-topic approach. With the journalistic mantra – Who?  What?  When? Where?  Why? How? – the patient or the family would just enter the conversation barely aware that you were taking a history. To keep focused, you do need to have clearly in your own mind the information you are seeking.

         If you are not experienced, you can follow a printed questionnaire and take three hours of history but you will just end up with loads of seemingly unrelated information.

         With my favoured journalistic approach you follow leads.  The whole session becomes more integrated and it is easier for patients and families as you are not likely to appear to be jumping from one thing to another. It also comes across as more professional.

         One thing led to another and my break came when one of the boys let slip that he remembered mother going into hospital after Catherine was born and big sister gave up a good job at the insurance company to stay home to look after the rest of them.

         Mother was in the local mental hospital and had electrical shock treatment.

         Mother started crying and big brother was rather upset and asked me what relevance this had except to upset mum.

         At this point, the little baby who had been crawling around stopped in her track and crawled to Grandma and started touching one of her slippers. She started crying too.

         I have my own theory that even before acquiring language, babies are able to retain emotional memory of early experiences. Later on in life it becomes difficult to grasp the source of the upset as there are no words to describe such emotional experiences. Traumas in early life have diffused effects; those happening later on in life are more focused and perhaps easier to deal with.

         One famous psychiatrist once talked about his own experience of his mother’s depression. He talked about having images of a wooden arm and it was through years of psychoanalysis that he reconstructed the whole image of his very depressed mother who had a rather catatonic posture in the deepest depth of her depression. He could remember himself as a toddler running into the house after play to be met with the wooden arm, sharply quietening down and then backing off. It was a rather moving seminar he gave at one of the conferences and a rare occasion when a British psychiatrist talked about psychoanalysis.

         Back with the big family – all went rather quiet. A couple of the girls were sobbing. Catherine tried to comfort mum who said she knew it was all her fault. The eldest brother thanked me for making things clear for him.

         All were relieved to hear that I would not be forcing Catherine back to school and that mother would not be prosecuted. 

         All agreed that Catherine would be wasting her brains if she did not have some form of education and I explained that I would be looking into alternatives.

         Miss Kimble told me later that I was lucky to have that break and that it was a good job the baby was there.

         It was uncanny that in my thirty plus years of experience, over half of the children who had problems attending school in a big way had mothers who had serious puerperal (post-natal) depression.  Was the school refusal (school phobia) a clinical manifestation of genetically transmitted depression, or was it the psychological effect of living with a depressed mother? I really do not know.

         Catherine never managed to return to “proper” school but with a fair bit of individual therapy we managed to get her to attend a tutorial unit. This we achieved by getting mother to find some part time work. Big sister too started working part time.

         It was daunting for me to think that a single family session brought about so much change, but then I was reminded that the strength was with the family – we just tried to tap it.

         Catherine had good exam results on the limited subjects she could sit but was immediately offered a trainee post at the insurance company.

         Years later I bumped into one of the older sisters at the Sports Centre.  She thanked me again for what I did for the family and told me that everybody was fine.

         I told her I was scared by the lot of them especially her big brother. She told me I did all right. Catherine was his favourite sister.

         I cannot remember seeing another big family since and with the disintegration of families it became increasingly difficult to do that type of family work.

Review on Amazon

Readers' views.

The Cockroach Catcher on Amazon Kindle UK, Amazon Kindle US

NHS: Granddad Why?

You should have listened to Baroness Kennedy of The Shaws  who neatly summarise what many bloggers and doctors were saying for months:

Care, not money:

My Lords, I make a declaration that I am a fellow of three royal colleges, too, like the noble Baroness, Lady Cumberlege. I should also say that I am married to a surgeon who has spent his life in the National Health Service. He is from a dynasty of doctors. His grandfather was a doctor, his mother a doctor, his aunt a doctor and now our daughter is entering medical school. They all entered medicine not because they are interested in making money but because they want to care for people. It is the idea of being at the service of others that draws most health carers into medicine. They do not want to run businesses; they do not see their patients as consumers or themselves as providers. They do not see their relationship as commercial and they do not want to be part of anything other than a publicly funded and provided National Health Service.

Private Providers and Secrecy:

Health professionals also feel proud, as all of my husband's colleagues do, that Britain is the only country in the industrialised world where wealth does not in some measure determine access to healthcare. They are saddened that the National Health Service is now facing the prospect of becoming a competitive market of private providers funded by the taxpayer. When we hear talk of accountability, they point out that nothing in the Bill requires the boards of NHS-funded bodies to meet in public, so there will be a lack of transparency. That will be complicated by the fact that private providers are not subject to the Freedom of Information Act, so they can cite commercial sensitivity to cover their activities.

Insurance-based model by stealth:

Others have spoken of the removal of the duty on the Secretary of State to provide healthcare services and pointed out that that duty is now to be with unelected commissioning consortia accountable to a quango, the national Commissioning Board. The Bill does not state that comprehensive services must be provided, so there may well be large gaps in service provision in parts of the country, with no Secretary of State answerable. Providers will be able to close local services without reference of the decision to the Secretary of State. Although the Government say that the treatment will be free at the point of delivery-we hear the calm reassurances-the power to charge is to be given to consortia. That paves the way for top-up charging and could lead eventually to an insurance-based model.

Monitor & family silver:

Monitor, the regulator, is to have the duty to sniff out and eliminate anti-competitive behaviour-and, of course, to promote competition. According to the Explanatory Notes to the original Bill, Monitor is modelled on

"precedents from the utilities, rail and telecoms industries".

How is that for reassurance to the general public? If anything should be a warning that this spells catastrophe, it should be that this is another step in the disastrous selling-off of the family silver to the private sector, with the public eventually being held to ransom and quality becoming second to profitability.

Monitor: Competition or integration.

The regulator, Monitor, will have the power to fine hospital trusts 10 per cent of their income for anti-competitive behaviour. Any decent doctor will tell you that for seamless, efficient care for patients, integration is key to improving quality of life and patient experience. The question is whether competition and integration can co-exist. Evidence from the Netherlands is that they cannot. There, market-style health reforms designed to promote competitive behaviour have meant that healthcare providers have been prevented from entering into agreements that restrict competition, so networks involving GPs, geriatricians, nursing homes and social care providers have been ruled anti-competitive. There is a fear that care pathways, integrated services and equitable access to care in this country will be lost when placed second to market interests.

Delusion of patient choice: Cherry Picking

Under the delusion of greater patient choice, people are to be given a personal health budget. I am interested to hear what happens if it runs out halfway through the year. Private hospitals will enter the fray as treatment providers and, as in other arenas, they will undoubtedly, as others have said, cherry-pick and offer treatment for cases where they can treat a high number of low-risk patients and make a profit-for example, hip and knee replacement, cataracts, ENT and gynae procedures.

NHS Hospitals: Undermined!

It is essential in an acute teaching hospital to retain the case mix, though, so it will be the teaching hospitals that will also provide the loss-making services such as accident and emergency and intensive care and deal with chronic illness and the diseases of the poor, such as obesity-we can name them all. These are essential services but they are also very costly. An ordinary hospital cannot provide them if it does not have the quick throughput cases as well to maintain a financial balance. If relatively easy procedures go to private providers, the loss of revenue to the trusts will eventually lead to them being unable to provide the costly essential services. It will mean that doctors trained in these places are not exposed to all aspects of patient care. Private companies cherry-picking services undermines and destabilises the ability of the NHS to deliver essential services like, as I have mentioned, intensive care units, accident and emergency, teaching, training and research.

Asset Stripping: as Southern Cross

Clause 294 allows for the transferring of NHS assets, including land, to third parties, and the selling off of assets. Clause 160 allows for the raising of loans by trusts, so hospitals taken over by the private sector could be asset-stripped and then sold on, as happened with Southern Cross homes.

Practice Boundaries:

The removal of practice boundaries and primary care trust boundaries will mean that commissioning groups will not be coterminous with social services in local authorities, so vulnerable people are more likely to fall through the gaps between GP practices. GPs will also be able to cherry-pick by excluding patients who cost more money and can lead to overspend.

Lawyer-multimillion-pound executive salaries, dividends and fraud:

Then there is the issue of the cost of market-based healthcare. Advertising, billing, legal disputes-I say this as a lawyer-multimillion-pound executive salaries, dividends and fraud could end up consuming a huge amount of the pot that can be spent on front-line services. We will end up, as in America, with that extra stuff taking up 20 per cent of the health budget. The downward spiral of ethics, the increase in dishonesty and the conflicts of interest become huge, and you see the destruction of the public service ethos.

Overdiagnoses, overtreats and overtests.

I want to scream to the public, "Don't let them do it"-and in fact the public are responding by saying in turn, "Don't let them do it". Market competition in healthcare does not improve outcomes. The US has the highest spending in the world and the outcomes are mediocre. The US overdiagnoses, overtreats and overtests. Why? Because that increases revenue. You change the nature of the relationship between doctors and their patients. You get more lawsuits and doctors therefore practise defensive medicine. You ruin your system.

I say this particularly to colleagues on the Liberal Democrat Benches. They may be being encouraged to think that voting against the Bill may bring down the coalition, but all I can say is that the electorate is watching. If people feel failed by the party on this, I am afraid that it will pay a terrible price.

McKinsey et al: 25 year plot:

This has been a 25-year project, done by stealth. It started with the internal market and is now moving to the external market. It was not thought up by mere politicians but by the money men, the private healthcare companies and the consultancies like McKinsey-the people, in fact, who in many ways brought us the banking crisis. They have funded pro-market think tanks and achieved deep penetration into the Department of Health, into many of our health organisations and right into some of the senior levels of my party as well as those on the other Benches.

The NHS is totemic. It is about a pool of altruism and it speaks to who we are as a nation. It is the mortar that binds us in the way that the American constitution does the American people. For us, it is about this system. It really is the place where we are "all in it together"-one of the few places, it would seem at the moment. Doctors get 88 per cent trust ratings with the public, while politicians get 14 per cent. The vast majority of doctors are saying to us, "Withdraw this Bill". We should be listening.

Granddad, I have read most of these behind your back via Twitter and many Blogs. You should have listened. Now we are paying dearly.

Hansard source (Citation: HL Deb, 11 October 2011, c1551

NHS: Changes Or A Conspiracy Against The Public Interest

Germany: Bayreuth, The Ruling Class & Wagner

Review on Amazon

Readers' views.

The Cockroach Catcher on Lulu.com;Amazon Kindle UK, Amazon Kindle US

Photoshop Fun: Metamorphosis!

Sometimes ii is best not to DELETE!

 ©Am Ang Zhang 2012

 ©Am Ang Zhang 2012

 ©Am Ang Zhang 2012

 ©Am Ang Zhang 2012

 ©Am Ang Zhang 2012

Modern Cameras have a tendency to overexpose by my standards. I shoot most of my shots at -0.7 to -1.0 most of the time and check image. This includes snow scenes. 

THE ORIGINAL!

©Am Ang Zhang 2012

Photography: Best lens for portrait & landscape!

Photography: Point & Shoot!

Vacation: Bird Photography

Fun with Photoshop

High End Photography & Wine

Photography: Pictures at an Exhibition

Kodachrome: 1935-2010

Hello Summer

Finland: Hello Autumn!

Photography: Tasmania & Bokeh!

Adult A.D.H.D. & Faking: Real Psychosis & Suicide.

Adult A.D.H.D. is open to faking and more so by medical students. In children, it was my experience that often parents would report symptoms in order to secure disability benefits. In the case of young adults, it was more an attempt to secure medication that they believe will help them with their studies.

New York Times

Drowned in a Stream of Prescriptions

Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. His mother insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. It was inside the building that her husband, Rick, implored Richard’s doctor to stop prescribing him Adderall, warning:

“You’re going to kill him.”

After becoming violently delusional and spending a week in a psychiatric hospital in 2011, Richard met with his doctor and received prescriptions for 90 more days of Adderall.

He hanged himself in his bedroom closet two weeks after they expired.

The story of Richard Fee, an athletic, personable college class president and aspiring medical student, highlights widespread failings in the system through which five million Americans take medication for A.D.H.D., doctors and other experts said.

Medications like Adderall can markedly improve the lives of children and others with the disorder. But the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers. These efforts are facilitated by a segment of doctors who skip established diagnostic procedures, renew prescriptions reflexively and spend too little time with patients to accurately monitor side effects.

Richard Fee’s experience included it all. Conversations with friends and family members and a review of detailed medical records depict an intelligent and articulate young man lying to doctor after doctor, physicians issuing hasty diagnoses, and psychiatrists continuing to prescribe medication — even increasing dosages — despite evidence of his growing addiction and psychiatric breakdown.

Read more >>>>


“There’s a sense that greater powers, profit-driven and amoral, are pulling the strings in our children’s lives. There’s a sense that those who should best protect us — our government and our doctors — are so corrupted that they can no longer do the job. There’s a sense that childhood has, in many ways, been denatured, that youth has been stolen, that the range of human acceptability has been narrowed for our kids to a point that it has become soul-crushingly inhuman.”


                                                Judith Warner      New York Times

In my book The Cockroach Catcher, I told the story about this boy with hydrocephalous who was referred to me. He had just started school and his teacher considered him hyperactive and wondered if he had this new disease called ADD/ADHD and should he be on Ritalin. This is what I wrote about the ADHD phenomenon in that chapter:

“A treatment that had a history of over fifty years, starting life under fairly relaxed FDA rules, was approved for a different purpose in 1980 under fairly dubious circumstances, based on minimal research data on some very small samples. The treatment never caught the imagination of the child psychiatrists of the time and was so rarely used that in 1986 the drug was withdrawn from the British market. Then suddenly it took off and if I say anymore about my personal view on how and why it took off, I might be faced with libel action from the main parties concerned.

The drug concerned is still hardly prescribed in France, a country well endowed with child psychiatric services and the French are rather fond of their medicament. There is no market yet in China which has a fifth of the world’s population and presumably also roughly a fifth of the world’s child population. It probably would not take long for China to adopt it though. Contrary to popular belief, admiration for all things American is endemic in China if not epidemic. You may not think so considering the rhetoric of the leaders. On a recent visit, I noticed one of their bottled water advertisements proudly saying “using the latest US reverse osmosis technology”. For now there are countries both in the first world and in the developing world that have not found it necessary to use the drug.

Most research showed that Ritalin would eventually lead to addiction; but there are some who prefer to insist there is no truth in that. The U.S. is the world’s No.1 prescriber of Ritalin and is also the world’s No.1 consumer of Cocaine. The other listed use of Ritalin is for Cocaine withdrawal.

Why then is there such a renewed demand and interest in diagnosis and drug treatment of ADHD.

It is a sad reflection of our times that we demand fast responses. Being patient is no longer seen as a virtue. Have you not noticed that with faster and faster computers we still consider them slow and therefore manufacturers can continue to sell us “faster” ones? TV and computer games have conditioned kids so that they can rarely hold their concentration for more than three seconds. Even the term “three minute culture” is now out of date – no modern day television or film scene must last longer than ten seconds. How many children nowadays can withstand five hours of waiting at the fishing rod without catching anything? How many mothers have to cope with lines like: I am thirsty, mummy, I want my juice now, please. Are they really going to die of dehydration if mother makes them wait a bit?

Concentration like most other things in our modern society is no longer something that is packaged by our Maker. People need to acquire it and one way is by taking a stimulant such as Ritalin.

Ritalin has also become popular because it takes the blame away from those responsible for the child – the parents and often the teachers as well. Some parents who do not wish for their child to go on Ritalin are often put under tremendous pressure by the teachers. Very few have even bothered to find out if there is any non drug related method at all.”

The Guardian

“According to data obtained exclusively by Education Guardian under Freedom of Information legislation, there has been a 65% increase in spending on drugs to treat ADHD over the last four years. Such treatments now cost the taxpayer over £31m a year.”                          More>>>>

Ritalin: no long term benefits

Related:

Please don't poison our children with stimulants

Bipolar and ADHD: Boys and Breasts

ADHD: Back To Nature?

ADHD: Why?

The File Snatching Sign

ADHD, Heart Risks, Kinko and Jetblue

Review on Amazon

Readers' views.

The Cockroach Catcher on Lulu.com;Amazon Kindle UK, Amazon Kindle US