HIV Patients made Prisoners

posted: 03/05/2011

NHS consultants say that security measures imposed by the UK Border Agency have turned Hillingdon hospital’s HIV clinic into a prison.
Hillingdon hospital in west London, is the nearest to Heathrow airport, and some of the people with HIV that it treats are detained at nearby immigration removal centres, who are brought to the hospital for treatment.
 

Patient cuffed to guard

The problems began when an immigration guard who had handcuffed a patient to him refused to remove the handcuffs so the man could be treated in privacy. When the guard refused to uncuff the man the doctors refused to treat him and made a formal incident report to the hospital’s medical director. That’s a serious formal complaint, and it concerns inhuman and degrading treatment.
 

Clinic windows barred - a prison for all
Officials from the UK Border Agency then fitted restraints on the windows at the hospital's sexual health clinic to ensure that detainees could not escape.
HIV specialist Ben Holden, a consultant at the hospital, said: "The unit is now a prison for us all. Our windows only open two inches but UKBA have installed chunky locks on them. We were told they would bring removable window restraints but these are permanent.
 

No attempts to escape
"No detainee has ever absconded or attempted to abscond. As doctors we believe that to keep immigration detainees restrained or locked in is discriminatory. I don't want to be part of a process that treats people in a less than human way."
Doctors are angry that immigration detainees who have committed no crime, approximately half of whom are later released, are treated in this way.
 

Deported without needed HIV drugs
An audit conducted at Hillingdon hospital also revealed that none of the detainees removed from the UK were dispatched from the UK with a full three month supply of anti-retroviral drugs (in accordance with British HIV Association / National Aids Trust guidelines). They left without an adequate tide-them-over drug supply because in many cases doctors at the hospital are not told by UKBA before people are removed from the UK. UKBA frequently cancel clinic appointments and some HIV-positive patients were removed before they were even seen at the hospital.
 

British HIV Association 'disappointed'

Professor Jane Anderson, chair of the British HIV Association, said: "BHIVA and the National Aids Trust have developed advice on appropriate HIV treatment and care for people in the immigration removal system, and we are disappointed to hear that this advice is not always being followed. We want to see the highest standards of care for everyone with HIV in the UK. Any factors that make the provision of high quality clinical care difficult give us cause for concern."
 

Emma Ginn, co-ordinator of the charity Medical Justice – which recently published Detained and Denied, a report cataloguing examples of poor medical treatment of HIV-positive detainees in the UK – said: "Along with the potentially lethal medical abuse they suffer in detention centres, detainees are suffering sub-human conditions in hospital."
 

Window bars excused
The UK Border Agency said: "We have agreed the installation of window locks for detainee treatment with Hillingdon hospital and are working with them to address the concerns now raised. Detainees are only handcuffed when absolutely necessary and they are not handcuffed during treatment.”
"The welfare of detainees is important but this must always be balanced with the security of the detainees and the public. Detainees have round-the-clock access to healthcare services to discuss their medication needs."
 

Hospital’s story
A spokesman for the Hillingdon hospitals NHS foundation trust said: "The UK Border Agency has told us that they do not believe our open ward environment is suitable for the treatment of individuals who may be failed asylum seekers and under restraint. However, a large proportion of the patients who are brought to our sexual health department by the agency are later discharged into the community and are not subject to the criminal law.
"We have agreed a temporary measure with the Border Agency to put discreet bars on windows in the unit, but we are continuing to negotiate an agreement with the agency that will offer a solution that allows us to treat all our patients with respect."
 

George House Trust would point out that Hillingdon hospital has allowed the UKBA to fit restriction devices onto its hospital clinic windows. It was under no legal obligation to treat all its sexual health clinic patients and staff in this way. And handcuffing patients is very rarely justifiable and hospitals must always consider alternatives or risk legal action under the Human Rights Act.

The NHS Constitution seems to have been ignored by the hospital - it says 

"You should always be treated with dignity and respect, in accordance with your human rights. This means, for example, that your right to privacy should be respected."

Complaining is far more difficult for people using Foundation Trusts like Hillingdon Hospital – there is no independent body to represent patients and help with complaints, Hillingdon’s website won’t even let you download its complaints leaflet and you will wait many months for the Ombudsman to deal with any complaint.
 

NHS complaints advice 
 

Source

Hospital Complaints and North Manchester

posted: 21/04/2011

Channel 4 TV’s Dispatches programme last week reported long waits and poor care of some people using North Manchester General Hospital’s Accident & Emergency and the associated Medical Assessment wards.

The TV undercover investigation did not  look into HIV treatment and care at the hospital, which is a regional centre of HIV care excellence.

The Care Quality Commission has now been asked to investigate the problems in Accident and Emergency and Medical Assessment Unit care. The local NHS watchdog, Manchester LINks say “We would encourage the public to contact their local LINks at any time if they have a concern or to report such instances as seen on the Channel 4 programme last night without delay. Your local LINks will be able to investigate with the help of the Care Quality Commission and local Joint Health Overview and Scrutiny Committees. Your identity will always be protected and all information you provide treated confidentially when going through LINks.”

If you have any experiences you would like to tell Manchester LINks about regarding North Manchester General Hospital or any other Manchester Hospital, please contact Danny on 0161 874 2189 or email him.

Making complaints about the NHS, other hospitals and local social care
Each district has its own NHS LINk watchdog – Find your local LINk here

Manchester LINk
BHA, Democracy House
609/609A Stretford Road
Old Trafford, Manchester
M16 0QA
 

Contact the Manchester LINk team 
Anthony Doggett - LINk Administrator 0161 874 2187
Naheed Akhtar - LINk Manager 0161 874 2188; Mobile:07855 233 462
Danny Gough - Community Engagement Officer 0161 874 2189
Valeska Matziol - Community Engagement Officer 0161 874 2190
Lydia Hurford Cato - Community Engagement Officer 0161 874 2191
email: manchesterlink@theBHA.org.uk
 

HIV Tests at Casualty

posted: 27/07/2010

Every person who goes to London A&E departments could soon be tested for HIV under plans being considered by NHS London. In the first move of its kind, the HIV checks could become routine at emergency units and will be offered to any adult attending casualty. The move is being rolled out at Chelsea & Westminster NHS foundation trust following a hugely successful Department of Health funded study at the south-west London hospital.
 

2 people diagnosed every month at one A&E

It comes because of the numbers of people with HIV and the rise in HIV across London. The pilot HIV testing at Chelsea and Westminster’s A&E department found nearly half a dozen new people with HIV in only three months.
 

The Health Protection Agency recently recommended that the NHS should as a matter of routine do a HIV healthcare check everyone when they go to an A&E department in any areas with higher rates of HIV. Now a number of other health trusts are already seriously considering this.
 

North West Too?

In NW England, Manchester, Salford and Blackpool have rates of HIV high enough to justify routine HIV screening in A&E.
 

Better Health and prevention

HIV testing at A&E is one way to improve the health of people with undiagnosed HIV. New figures show that at least one in every four people with HIV do not know they have HIV. Late diagnosis worsens people’s health and shortens people’s lives. Undiagnosed HIV means people don't get the treatment they need for good health and people may be passing on HIV unwittingly to their sexual partners.
 

Under 18s

Dr Rachael Jones, from Chelsea and Westminster hospital, said she has treated nearly a dozen patients under 18 in the last three years in West London but this was just “the tip of the iceberg”.
The consultant blamed ministers for focusing on underage pregnancy instead of on safer sex and said HIV tests should be routine for everyone, regardless of their sexual orientation. She said: “For a long time it was men having sex with men presenting with the virus. Now we're seeing teenagers coming through for the first time with HIV. It only takes one episode of unprotected sex for them to become infected.”
Dr Jones said that the “Don't die of ignorance” shock campaign of the Eighties failed to have a lasting impact and that many teenagers do not even know what HIV is.
 

Source 
 

Hospital Blamed for HIV Stigma

posted: 30/06/2010

The recent publicity and invitation to over 500 patients cared for by a healthcare worker with HIV to have a HIV test at York Hospital has been described as “disgraceful” by one of the city’s leading academics.
 

Professor David Maughan Brown, deputy vice-chancellor of York St John University, accused NHS bosses of not caring “who they terrify” or “how severely they stigmatise people living with HIV”.
 

In a letter to The Press, York’s local paper, Prof Maughan Brown questioned the thinking behind the hospital asking 519 patients to undergo HIV tests “because they have come into contact with a hospital worker who is HIV positive”.
 

Gross over-reaction and HIV stigma
He suggested there had been “a staggeringly inappropriate over-reaction by people so fearful of the risk of litigation, however incredibly remote, that they don’t care who they terrify or how severely they stigmatise people living with HIV”. He claimed the alternative was that senior medical personnel in the UK were so ignorant about the transmission of the HIV virus that they believed it could be passed on by casual contact. “Of the two disgraceful alternatives, one can but hope it is the former,” he said.
 

Risk ‘very low’
His comments come after the paper revealed last week how 101 former hospital patients in York had received letters asking them to attend HIV testing, after being treated by a member of clinical staff who was found to have HIV. Patients were offered support, counselling and the opportunity to undergo testing, but experts said the risk of cross-infection was very low.
 

A spokesman for NHS North Yorkshire and York said it would be “inappropriate” to comment on Prof Maughan Brown’s letter, due to an injunction preventing the publication of any information which could lead to the identification of the staff member. However, the trust repeated an earlier statement that only those who had received a letter asking them to undergo testing needed to contact their hospital.
 

Not one HIV infection from any HIV+ healthcare worker
Thousands of people have been scared across the NHS over the years, but no-one has ever been found with HIV from a NHS healthcare worker. George House Trust believes this was another pointless scare, stigmatising people and HIV. Much of the advice in the cautious NHS guidelines (now 5 years old) seems to have been ignored.

York Hospital's bad record with HIV

Two years ago York Hospital lost 19 people’s HIV medical notes in the street

NHS Guidance: HIV Infected Health Care Workers: Guidance on Management and Patient Notification [July 2005]
 

Source
 

‘Health Tourism’ Mischief

posted: 08/06/2010

Sunday Times deputy editor Isabel Oakeshott has written an ignorant and mischief-making scare story about people from abroad using NHS money. People with HIV were included among those the NHS ‘counter-fraud unit’ listed as responsible.
 

The story calls it health tourism. The Department of Health has published no evidence that people with HIV come here as tourists deliberately to get HIV treatment. The only evidence there is (a snapshot survey by George House Trust and Terrence Higgins Trust) shows people do not know they have HIV when they travel here (to seek asylum, to start a university course, or to work, or visit family …. ).
 

Legal rights ignored
Most people from abroad who do have HIV treatment have every legal right to this. The few who are chargeable under the legal rules usually only find out they have HIV months or years after arrival, and their HIV diagnosis is always a big shock.

The NHS charging rules worsen public health in the UK by discouraging people from taking (always free) HIV tests. Untested and untreated people with HIV are likely to be much more infectious and lead to more HIV infections in the UK. Testing and HIV treatment can make people with HIV almost uninfectious, and that can save the NHS a lot more money than not treating everyone who needs this. HIV is the only sexually transmitted infection that can be left untreated because of these charging rules.
 

The Times report says that in eight-months last year, hospitals reported £24m in “bad debts”, 'most linked to patients from abroad'. The article suggests hospitals recover some of the cash later, but not much. The report says ‘According to the NHS’s counter-fraud unit, health tourism has a particularly heavy impact on maternity services, HIV care and cancer and heart units’.
 

Wrong about pregnant women, cancer, serious heart disease, HIV rights
The newspaper report is mischievous and malicious. The law and official guidance to NHS hospitals tells hospitals they must provide ‘immediately necessary’ or ‘urgent’ treatment.

Who would or could refuse a pregnant woman emergency care, or someone with life-threatening heart conditions, cancer, HIV?
 

Accident and Emergency – wrong again
It claims, without quoting any evidence, that “thousands of foreigners have been diagnosed in their own countries who cannot afford treatment there simply turn up at accident and emergency units in British hospitals and demand to be seen”.

Again this completely ignores the law and official NHS guidance – anyone needing accident and emergency care is always entitled to it without any charge. We get and would expect this if we are abroad and need emergency care.
“6.7 Some NHS services provided in NHS trusts are free to everyone regardless of the status of the patient. This Regulation says what these services are. The current list includes: a. treatment given in an accident and emergency department or casualty department......”
 

Doctors opposed
It correctly reports that most doctors dislike the charging system because medical ethics and the Hippocratic oath mean it is unethical to turn away patients who need urgent medical help.
 

Blame the Irish and Welsh – wrong
It also falsely blames people from the Irish Republic. Irish Citizens have always had the right to come and go freely and live here and use UK services. Brits can do the same in Ireland.

It seeks to create divisions within the UK by blaming people living in Wales for using NHS services in England, although the Welsh pay UK taxes just like everyone else. The Welsh are not foreign or migrants.
 

The Department of Health is already reviewing its policy on foreign patients.
 

Times article