Moll61, I don't have any experience with the Tramadol withdrawal, but I'm glad your back is better. Best wishes.

Did you have any kind of contract with the private medical provider? At the very least you normally would have to sign a document agreeing to the treatment. What did it say? I don't know if you have already, but did you write (always write) to the doctor, copying the hospital's management, stating that you are not satisfied with the outcome and would like to take up his promise of the free follow-up treatment? Ask for a copy of their complaints process. Is the hospital a member of the independent healthcare advisory services? You could also try calling the Patients Association for advice. I guess this is a warning to anyone who embarks on private treatment. Perhaps, like Nolegion's thread discusses, we should ALWAYS audio record our consultations whether NHS or private. But then it's always easy to be smart with hindsight.

I have come to the end of the line in believing that formal complaints to PALS, hospital management, the GMC, Ombudsman etc, are going to have a positive outcome for the damaged patient or bereaved relatives, past or future. It's the same old, same old. You'll be told that 'lessons have been learned' and 'issues have been addressed.' You'll be thanked for 'bringing the matter to their attention,' but how they were unable to see the blindingly obvious is never explained. How is it then that standards are deteriorating so rapidly, especially in elderly care? In the absence of a completely independent complaints process, one that can quickly identify and address failures, (not sweep them under the carpet), one that can publish its data to give us real patient choice, the only course (long, painful and perhaps expensive) is litigation. It's almost never about compensation, but about justice and a desperate belief that our actions may improve the service for the next person. It's hopefully a path to coming to terms with the trauma suffered and finding some kind of peace. Without accountability (and I mean prosecuting managers and medics that have deemed to have consistently failed and barring them from the profession) things will never improve.

Perhaps those who subscribe to GPOnline should also pick up the back issues of Health Service Journal. http://www.hsj.co.uk/resource-centre/best-practice/secret-audio-recordings-know-the-law/1332221.article

Your indignance and anger are palpable even over the ether. I share your outrage. What troubles me is that people may be bullied into accepting this policy as 'law' and bow to the demands of the medics/managers who refuse them permission to record (and it would seem that this is something you would need to ask in advance of an appointment/treatment) or have their device confiscated if caught covertly recording. Do you remember a few years ago (and it may well still be going on for all I know) the police telling tourists that they were not allowed to photograph certain London sites under anti-terrorism laws? They even made them delete the images. It was complete rubbish, but I don't think one person challenged the request. I'm not clear whether the police were ill-informed, power-crazed or just plain stupid. It just goes to show though that we are easily swayed by people we see as authority figures. Since my encounters with the NHS I've adopted the practice of never taking the word of anyone in a uniform or a suit and if anyone tells me they are an expert, I just turn and run. As Cicero said 'By doubting we all come at truth.'

My condolences Lindamannion. I'm tempted to ask which hospital this was. I totally empathise with your distress. My relative suffered very similar treatment. I understand too how frustrating it can be to try reasoning with medics. I loathed the arrogance I encountered. They may well have studied/trained for years, (although I was left wondering about the standard of this), but that does not give them the right to think that they have all the answers, (we are all fallible whatever our profession and we should never forget this), and to feel free to ignore the people who know the patient best. What I think is so tragic and why cases such as these are repeated, is that our legal system is a complete failure. Why hasn't the outcome of the inquest triggered an automatic prosecution in your mother's case? Justice seems to be only accessible to the rich. Leeching lawyers cherry-pick no-win, no-fee cases that feed their avarice or engage in the lucrative practice of defending career criminals where the taxpayers picks up the tab. I want to see the CPS bring charges of corporate manslaughter for such failures. I'm absolutely disgusted that the bereaved families of the mid-staffs debacle are having to take their own case to court. Can you think of any other profession where those guilty of such a serious crime, which is murder/manslaughter in my view, just walk free? Worse, they are allowed to stay in their jobs and perhaps subject other vulnerable people to the same treatment. I loathe this country, or more precisely I loathe the Establishment that allows such horrors to go unpunished, because I believe that only accountability, and the fear of it, will raise standards and rid our hospitals of the cruel and inept. I was born in this country, I live here and will probably die here...but not in an NHS hospital if I can help it.

There may have been some cases where the NHS has caved in and paid damages prior to a court case, but have we established that covert recording (by a patient) has been permitted by a judge and used in evidence in a UK court case against the NHS? Here's an excerpt from the East London NHS Trust's policy document. Apologies if you have already seen it. Patients are termed 'service users' which, I think, is a little less human and adds distance. Requests to record meetings or clinical sessions When a request is agreed to, the individual should be discouraged from making their own recording. The Trust should offer to make the recording and give a copy to the individual to ensure the copy is accurate and unadulterated. The individual must give explicit consent in Section 5 above, be advised the recording is for personal use only and advised the Trust accepts no responsibility for the safekeeping of the copy once it has been handed to the individual. The individual must also be advised that the recording must not be used for litigation purposes. This is not permitted under Section 36 of the Data Protection Act 1998. If anyone is found to be making a recording without the permission of the Trust, the individual should be advised this contravenes the right to confidentiality of any individuals being recorded, their human rights and is against Trust policy. The recording device should be taken from the individual and the recording destroyed. In certain circumstances it may be appropriate to withhold the recording device. If the making of a covert recording is discovered after the recording has been made, the individual should be instructed to return the recording to the Trust for destruction. If it has already been published (for example on Facebook, YouTube), the individual should immediately remove the recording and notify the Trust when it has been done. Where this is not done the Trust will advise the individual that legal action will be taken against them. Covert Recording Covert recording is not allowed under any circumstances. This includes service users who record themselves/their treatments, those who make recordings in wards or in community settings where other service users, visitors and staff could potentially be recorded without their consent. This is not permitted even when consent is given by these third parties.

I'm not saying that we should not treat coeliacs (or IVF) on the NHS, but that the NHS financiers/procurers have to be more canny with our money. Historically, like most public organisations, where they do not have to generate their own funds, there is an easy-come, easy-go attitude. The cost (to the taxpayer) of a prescription to those that pay is so much more than 7.65 when you take into account the generating and processing costs. So issuing a prescription for say paracetamol which can be bought cheap as chips own-branded in Lloyds or Tesco is not intelligent. I do want the NHS to be discerning in what they buy, whether it be drugs or lightbulbs or surgical gloves for in-house use, to make sure they are getting the very best deal. It is thought that the NHS could save 500 million pound a year by being savvy in this area.

Well, my advice would be definitely to revisit your GP as soon as you can and don't hold back on explaining how much pain you are in and how this is blighting your life. It must be horrendous to suffer continuous pain. I can only think the pain patches referred to are Fentanyl transdermal plasters. Does your hospital have a pain clinic that you can be referred to whilst your condition is investigated further? Perhaps try to do some internet research on your condition. There maybe other people out there who have found treatments that your own GP/consultant has not presented to you due to cost or just plain lack of awareness. It's easy for me to say, but try to stay positive and believe that this is only temporary.

Isn't this what we should expect from our health service and every public body? We hear stories of the NHS issuing prescriptions for gluten free food amounting to over 40 pound cost to the taxpayer, when an individual could buy it in a store for just a few quid. Millions of pounds are wasted in this way. If we all ran our family budgets the way the dunderheads in the NHS do, we'd be living in cardboard boxes under Waterloo Bridge. The crux of this is whether the cheaper, replacement drug is as effective and has no increased side effect risks. I would be doing my own research on this, not just believing what I'm told by a doctor. GPs work for themselves. Cynically I would be wondering whether they were pushing this replacement for their own self-gain. Are the PCTs (or whatever has replaced them) offering bonus payments or penalising GPs if they do not convert a percentage of patients over to the cheaper alternative? This has happened in the past (and maybe still does) where GPs received payments NOT to refer a patient to hospital. Hospitals were postively encouraged to discharge patients when they were not fully well and received extra payments when (surprise, surprise) the patient was re-admitted. The NHS is, I believe, currently being sued by the makers of a drug licensed for macular degeneration because the NHS was using a far cheaper alternative which is not licensed to treat this disease, but has shown to be just as effective. NHS drug budgets are limited. This switch could mean that far more people could benefit from treatment. The only thing I would ask of the scientists, health-care professionals, organisations such as NICE etc, is that they are open and transparent about about any issues. Cost-cutting is fine, but it should never trump patient welfare.

Yes, automatic renewals are something that has annoyed me for some time because it is almost always more expensive than shopping around and taking out a new policy with another insurer. Insurance companies must make a mint from people who allow this to happen. To this end on my last policy I insisted that there was no automatic renewal, but I was fobbed off and had to repeat myself three times before the call-handler accepted my request. In my opinion the law should be to opt in to automatic renewals and not opt out. The insurance system in this country is horrible - convoluted and confusing.

Thank you for that. My relative seems to recall contacting them some years back and reaching a dead end. I might try again. I'm hoping that there are other people out there who also worked for the motor industry back in the late eighties and were in the same scheme. Keeping my fingers crossed for them that the fund has been taken over by another company and that the money paid in is not 'lost.'

I am trying to track down a pension for a relative. They worked in the motor industry. I know the pension was run by MAA Pensions Ltd based in Leighton Buzzard. They seem to have become Motor Industry Pensions Ltd based at the same address, but a letter was returned addressee unknown and the telephone number is never answered. I can find Motor Industry Pensions Plan Trustees Ltd, but this seems to be a private limited company. Any information gratefully received.

Lesley My heartfelt condolences on the loss of your father. Many of us contributing to this forum will have had similar experiences to yours. We too thought that those who were caring for our loved ones were highly trained professionals who knew what they were doing. Probably some are, but it's hard to go on believing when experience dictates otherwise. My advice is to put your complaint in writing to the hospital CEO. I learned to skip PALS as I felt they added no value whatsoever to the process. I would also do an Access to Health Records request http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_112916 for the period concerned. You want all data - X-ray results, ward notes, everything. There will probably be a charge. If you do it now the hospital will have less time to lose things. Like Nolegion, I too feel that you should have had a PM, but that cannot be altered now. It's tough making decisions in the middle of shock and grief. The response from the hospital - which I believe should be within 30 days - together with the notes (if you can bear to read them), will give you a better idea of where you stand. Most of us who have gone through this process find the hospital will do anything not to accept blame, which just adds to the pain. We have 'learned lessons' seems to be a standard response template. If this happens you must decide what outcome you are seeking. Justice, accountability and prevention of recurrence would be top of my list. If you are unhappy with the response from the hospital, there is always the Ombudsman. I wish I could offer you some hope and consolation is this organisation, but I have none. Like the GMC, I'm not sure they exist to protect the patient, past or future. The alternative is a solicitor. Maybe a 'no win, no fee' could be an option. Whichever you chose, it is a long, weary, heart-breaking road and you will need all your reserves of strength. You will feel anger and bitterness and I hope you can channel it to a positive result. One thing is certain, events like these change your whole view of the world, not just the NHS. I wish you well.

Well, I would do two things. Firstly I would contact my GP - make an appointment - and express my concerns to him/her. A letter from them to the consultant on your behalf expressing your distress would lessen the chance of your appointment being bumped again. Also, you could find an alternative hospital for treatment, if you are prepared to travel. I believe NHS Choices is supposed to list hospital waiting times in particular areas. I was looking for an alternative consultation for somebody a while back, researched the possibilities and then they contacted their GP with the information. You are well within your rights to choose where you are treated.

Rubeckia/Night Owl It is hard to ignore the fact that the NHS is deteriorating. You state that you found it impossible to provide good care because of understaffing. I agree that this is a major factor. I've stated before in this forum that I believe that there should be a mandatory nurse (not HCA) to patient ratio, which would vary depending on the ward/patient needs. For areas where it is difficult to recruit - eg. elderly care - I would offer a higher rate of pay. What appeared to me to be endemic, and what I really fear, is the lack of curiosity and nous. The inertia. The absence of objectivity. Effecting both doctors and nurses alike. I think that this phenomenon is not just isolated to the NHS. It seems to be everywhere. Perhaps it was always so and I just didn't notice! Where does this stem from? Poor training? A degree doesn't necessarily mean you are more intelligent and definitely doesn't make you more capable, especially in a job which is still very practical and hands-on like nursing. My relatives trained on the ward. Those candidates not suitable were weeded out early on or left of their own accord. It cannot be ignored either that a high proportion of staff are from overseas where training standards vary. There will also be cultural differences that maybe misinterpreted as 'uncaring' by certain patients. I do know that the NHS would collapse completely without these nurses/doctors. Poor management is also a major issue. I spoke to the modern matron a couple of times , but only after writing to her. In all the time I spent at the hospital, I only briefly saw her once as she flitted through the ward. Maybe she was engrossed in paperwork all day, ticking boxes to keep the politicians happy. I wanted her to be on the ward, overseeing, breathing down necks, ensuring exacting standards that are ingrained into every layer forever. The nursing Sisters, from my viewpoint, liked to direct but not participate in the dirty practises. I guess they felt that they'd done their 'time' in this area and obviously had learned to screen out the screams of pain from the patients left on the commodes too long. But it's more than this. It's like a never-ending fire fight, where nobody is prepared to look for the source of the flames. Demoralised staff rarely do a good job. They become self-absorbed. You could argue that relentless negative media attention is partly responsible. All service-based industries are heavily criticised. That is the nature of the beast. You admit to having tried and failed to change things from within. So, we have to try other ways, and if that is public exposure and criticism, then so be it. Although, I grant you, it's not made much difference so far, just a barrage of reports and no action. Andrew Lansley's proposals will not improve matters. It will be interesting to see how Hinchingbrooke hospital fares. It's disappointing that that the previous government (although I doubt this one would have done much better) have allowed the company running it to take profit before paying off the debt. However, if they end up running it more efficiently and, more importantly, provide high standards of patient care, then the end of the NHS looms ever closer. I may rue the day, but it is not something that I'm overly worried about.

Getting through on the 'phone is no issue but my GP practice has adopted a policy that means you can only see the GP you are registered with. Thus, if he is on holiday or sick you have to wait for his return. The only alternative is to speak to the on-call doctor over the phone at a time that suits them, regardless of where you are, in the office or the supermarket, having to discuss potentially personal details. Prior to this you could see any doctor or if you wanted to see your own GP then you could have to wait. This, they tell me, is an improvement because it has cut down the number of complaints. Well, I complained about the new system and they didn't even bother to reply. I didn't pursue it because I'm afraid of being struck off. GPs make a fortune. Stupid politicians have allowed them to rake in the money and reduce their hours. Fortunately I only have to see a doctor once in a blue moon and long may this continue. Your only choice may be switching surgery, perhaps quizzing them on their appointment times etc beforehand. It's beginning to seem that we have to work around them, rather than they (as you would think a service would do) adopt practices that are convenient to their 'clients.' Hey, we are only paying their wages, what do they care! The inconvenience is all ours.

I haven't been on here for a while but I felt I had to respond. I stand by what I said before, poor treatment of the elderly and vulnerable seems to be typical. I judge by my own experiences. I saw how my own relatives, (and others on the wards where I sat for hours and hours over many, many months), were treated. I have relatives who trained as nurses (although no longer ward-bound) and who were equally horrified by the poor standards of care that they witnessed. You would have to be living in a cupboard not to hear almost daily reports from the Patient Association, individuals or their bereaved relatives of their own horrendous experiences. I believe these are just the tip of the iceberg. I understand how it must be demoralising for the nursing profession, (although it is not just the nursing staff I found wanting), to be seemingly ceaselessly persecuted by the media, but it is, in my opinion, more than deserved. Whatever the reasons for these low standards - poor training, understaffing, poor management - there can be no excuses for treating another human being cruelly or without dignity. In an ideal world it would be nice to think that you can complain, those in charge would listen, investigate and then act to ensure that the same mistakes never recur. But that's La-La land. The hospitals (and I mostly hold management to blame here) will go to any lengths to hide their errors and faults which may sully the hospital's reputation and possibly impact their job, career or reputation. So, as I have said before in this forum, issues are never openly and transparently investigated and the same horrible fate awaits another poor person. I struggle to understand how situations like Mid-Staffs (and this is not a lone failure)could have gone on for so long without any action being taken despite the desperate attempts of so many relatives. What kind of inhumane nursing staff, doctors, managers were employed here, who so willingly turned a blind eye or perhaps participated in such degrading treatment? Perhaps they thought they would doing a great job! Not one member of staff was disciplined. The CEO walks off with a huge pension and straight into another job. What message can this send to other people employed here and elsewhere? That you can mistreat and fast-track the most vulnerable to the grave with impunity? Andrew Lansley's reforms will not go any way towards resolving the issues within the health service. His only goal seems to be to save money. I'm glad your mother's experience was positive. Perhaps she was under your care. However, for every patient who has a good experience, there is probably another who has not. A good start would be we an independent, objective, transparent and robust complaints system which identifies mistakes and patterns of failure early to prevent catastrophe and recurrence. A good hospital would champion this idea. Published data could also mean 'real' patient choice on where they received treatment. We also need accountability. I totally disagree with a 'no blame' culture in any profession. Knowing there are consequences to failure can only focus the mind and improve performance. Personally, what I saw will haunt me to the grave. I had never felt (and I still do) such helplessnes, hopelessness and despair in the health service. I can only pray to whatever Gods may be that I have the courage and strength to end my life before being admitted to hospital and potentially suffering as my relatives did. Yes, it really was that bad.

Reading turboandy's comments make my veins run with ice. There is very much a circle the wagons mentality amongst our medical profession. Agonising for the victim. Has there ever been a legal case brought against the NHS where audio recording - covert or otherwise - was permitted as evidence? If the audio were covert could it be suggested that the patient was driving the conversation in their favour? If the audio was open, could it negatively impact the consultation for the patient? I was also thinking of tampering. Photoshop (other photo editing tools are available) no longer means that 'a picture never lies.' Audio editing is also easily accessible. A troller posted an audio recording of a footballer - John Terry I think - making racist comments, which I understand was made up of various soundbites linked together to make him sound like a bigot. I never heard this, but I wonder if there were people taken in. If someone denies that it is them on the audio tape, how much effort would a prosecutor make to prove it? How reliable is voice analysis? As reliable as DNA? Even video recording seems to be controvertible. I was thinking of the policeman who won an appeal against his conviction which showed him throwing a woman into a police cell. The appeal judge (and I often think our judges are from the moon) said that the woman's injuries were caused by her letting go of the door frame. In my opinion that policeman, whatever this lady's alleged crime and however bad a day he was having, had a duty of care towards her. He may well get his job back. What a disgrace. Also Ian Tomlinson who died during the G20 demo in London. The video footage of the policeman pushing Mr Tomlinson to the ground was initially dismissed by the police and then there was the suggestion that they had run out of time to prosecute the officer. Who knew that justice had a sell by date? Much pain is added to the victim and/or their family when they have to fight for justice despite mountains of proof. So easily do individuals, companies, organisations, politicians, public bodies and the like put aside their humanity, honour and integrity to serve and protect themselves.

I do not work in healthcare but I would be amazed if this were standard practice- a sign of things to come perhaps. I'm assuming that your partner buys the dressings and then she goes to the nurse to get applied. I think in the first instance you should ring your PCT and seek advice. If it is how they say (as in your wife pays and it could be a post code lottery decision) then ask them to put this in writing and ask for details of when this rule came in and how to challenge their decision. Also - although it may not do any good - write to your MP. This is something that will effect so many women. The last thing you need when you're poorly is to worry about finances.

I think Ann Abraham lost touch with reality long ago. I would say good riddance to her slipshod heels, (whilst gnashing my teeth that she'll get a whopping pension) but she'll only be replaced by another institutionalised zombie who gets repetitive strain injury from regularly patting themselves on the back. What is so appalling is that Trusts are not legally obliged to provide the number of complaints they have received from the public to the NHS. Even then can we trust the Trusts to provide accurate data? http://www.guardian.co.uk/society/2011/aug/25/foundation-trust-hospitals-complainst-data This astonished me as much as when I found out that the Trusts were mostly self-assessing. What a recipe for disaster. How can a patient ever make an informed choice? I have believed for some time now that we need a completely independent complaints system, entirely separate from the hospital/GP which can react in a timely manner. Get rid of that chocolate teapot that calls itself PALS. What I found so difficult was that once I had complained to the hospital (again and again on the exact same issues) whilst my relative was a patient, there was nowhere else to go. I used to go to my car and sob (I didn't want them to see my weakness) because I felt so helpless. I telephoned the CQC at the time but was told they did not take complaints from members of the public. The only other place to go was the Ombudsman...and that takes 6 months plus before they even decide to investigate. If you are seeking justice you'd be better off with a dolly and a bumper pack of pins than go to the Ombudsman. I have a new mission statement for them. I have stolen it from the great author Dickens who used it to refer to chancery, but it fits the bill for PHSO. 'We give to the monied might the means of abundantly wearying out the right which so exhausts finances, patience, courage, hope; so overthrows the brain and breaks the heart. Suffer any wrong that can be done to you, rather than come here!' In all my dealings with the every aspect of the NHS and its supporting services I oftentimes felt as though I'd tripped and fallen down a rabbit hole into an hallucinogenic world where absolutely nothing made any sense. The NHS taught me how to hate.

I question why so many damaged patients or bereaved relatives have to take civil action, especially when there is a wealth of irrefutable evidence supporting their case. Some of these cases are not settled for many years. I cannot imagine how mentally and physically draining this must be. What the hell is the Ombudsman doing? Certainly not fulfilling its mission statement. As I said before, the bodies that should support and defend are wholly inadequate and inept. As for Winterbourne, I almost fell off my chair when I heard people had been arrested. They are still on bail as far as I know. I couldn't watch the documentary, it would have given me nightmares. However, how is it that the head of the CQC escaped discipline when her office had been warned on several occasions of the mistreatment. She probably thinks she's wiped the slate clean now by producing a report on poor elderly care in hospitals. Astoundingly, those CQC staff who witnessed the sub-standard care notified the person in charge at the hospital (eh, if they didn't know already then they are in the wrong job) and then went back to their office to write up their notes leaving those vulnerable people exposed to God knows what. Heaven help us! I remember when my elderly relative was in hospital for a long ten months. There were many occasions when I found unexplained bruising and reports from my relative that the nurse had been rough with them. I thought then - I even suggested it in one of my many letters - that CCTV should be considered. Should the privacy of a vulnerable individual come before their safety? I know I should have more trust and faith but it was all eroded long ago.

That would suppose that the govt are interested in our health and not filling up their coffers with our money so that they can spend it on something completely useless....like a computer system for the NHS!

I haven't read your link but I heard about this in the news. It makes me foam at the mouth. If this tax was imposed in the UK those of us who manage to keep a healthy weight and eat sensibly - and that includes some foods with fats in - would be financially punished because a minority (well, perhaps a majority now) of people cannot stop stuffing their faces. When people tell me that they've 'tried everything' or 'eat like a sparrow', I'm sorry, mostly I don't believe them. There may be a miniscule number of cases which have an underlying medical cause, but these would be easily identified by a doctor. This is not about education. I have a relative that works in the health service. In her office of 8, all medically trained, three have diabetes because of their weight and they continue to eat junk, risking sight and other serious complications. Madness! This is not about income. It is possible to eat well on a small income. This is not even about time. Many healthy dishes can be made in half an hour. If people want to make poor lifestyle choices, they will whatever may come. Perhaps those with a high BMI should pay extra NI contributions - but then that's a slippery slope.

The only way recordings of consultations/treatment will ever improve patient care is if the data was successfully used in a prosecution. I cannot imagine, today, that even if such evidence were produced to the CEO of the Trust, lessons would be learned and future patients protected. Hospitals are all about keeping things quiet, sweeping mistakes under the carpet...and so they are repeated. And even if the prosecution were successful, what of the punishment? The GMC is inept and continues to register dangerously incompetent doctors, the CQC, despite its recent report on elderly care, (how many reports do we need before something is actually done), is weak and the NMC seems to prefer persecuting whistle-blowers and nurses who wear crosses. It seems hopeless.