Even In The UK – It Happens

Often medical blacklisting is done in more insideous ways and rarely in the literal sense of the word do you find it as a physical list. Blacklisting deniers commonly use this as a reason to doubt that such things really happen to patients, but in England a true physical list does in fact exist. A man living in the UK diagnosed with Adhesive Arachnoiditis found himself embroiled in a major scam going on in which many GPs are in fact placing patients on an official list under a program called

“The Violent Patients Scheme” . 

From the NHS Scheme Handbook; 1.1 Background

The Violent Patient Scheme was introduced as a Directed Enhanced Service in 2004,
with the aim of providing a secure environment in which patients who have been violent or aggressive in their GP practice can receive general medical services. The

Violent Patient Scheme (VPS) is a Directed Enhanced Service to provide general medical services to patients who meet the criteria for inclusion into the scheme and cannot be used for any other circumstance.

This scheme allows NHS England South (South West) to balance the rights of patients to receive services from GPs with the need to ensure that GPs, their staff, patients and bystanders deliver and receive those services without the threat or occurrence of violence or who might otherwise have reasonable fears for their safety. Removing a patient under the terms of this scheme should only be used as a last resort.“

Apparently this was the appointment after which he was placed on the list;

Although slightly emphatic, I don’t see where his body language indicates any impending violence whatsoever. He remains seated until she asks him and his friend to leave and neither of them make any attempt to prevent her from walking out. It is a clear-cut abuse of power, and the doctor appeared to be overdramatizing the incident, as it probably wasn’t any more threatening than an argument with her husband would have been. (The word “aggressive” in the designation is way too subjective, yet the criteria is clear that it should be used “only as a last resort” and yet based on one slightly heated in-person discussion this man’s name was submitted to the list. Anyone can see the great potential for abuse such a system poses.

Probably the whole encounter could have been curtailed if she’d just apologized and taken responsability for her rudeness on the phone earlier. It appears to me that he was trying his best to clear the air and get things worked out so that they could move on and deal with his treatment. Doctors often expect patients not to have a mind of their own and feel it’s alright for them to dress down a patient, (on the phone or in-person) but a patient isn’t allowed to address this and when one does it’s viewed as overly confrontational. In this instance it appears the doctor was more offended than scared, as evidenced when she asked him to turn off the video showing their phone conversation.

Confronted with the evidence that she had obviously lied the only thing she could retaliate with was to deflect from the objective facts and turn the focus back on him, play the damsel in distress and drag her staff into the interaction leading them to think she was genuinely in danger. Even though this was a manipulation on her part to rid him from her practice neither man in the room objected to her bringing another person in nor made any move to stop her. Had there been true aggression there would have been full-on yelling, direct threats of bodily harm and/or the man and/or his friend would have tried to place themselves between her and the door, but neither did any such thing. In fact they audibly said “OK” when she said she wanted to bring another person into the room.

It hardly seems appropriate to lump somebody like that in with convicts and out of control people who are actively psychotic and really are violent. Furthermore, having one’s name added to such a list is not only stigmatizing, but it might actually make this man branded for life with the assumption that he is violent when in fact he is not. Should the program become unfunded and the list still exist he may never be able to obtain healthcare because doctors would be afraid to take him as a patient. In effect he would be regarded as having committed a criminal act without a fair trial. Such a system is a very bad idea, not unlike outpatient committment in this country (the US), although this man has not had a hearing nor was he provided any way to dispute his designation.

Below he has recorded a phone conversation with a GP who is sent many of these patients. Understandably he does not trust this doctor after nobody will treat his 2 bothched shoulder surgeries done by a surgeon who actually got into trouble for malpractice with other patients as well (the press had covered it in a newspaper article).

The GP he was referred to on the other end of the phone actually empathizes with these patients and admits he’s aware that such charges of violence are often false and that he is sent these patients because of silly reasons such as minor disagreements between them and a former GP. He benefits financially from these referrals so it remains to be seen what his true interest is but may actually be trying to help patients he know have been done wrong by others in his field. This may be why the patient hangs up without making an appointment and concludes that he too is a part of the problem. Still, it is understadable why the patient would not trust him to be any different than the others he’s seen, because he is receiving money from the NHS under The Violent Patient’s Act and so many he’d gone to for help were too concerned about disputing another doctor long enough to correct the damage done in the two surgeries.

He has video documented some of his doctor’s visits on Youtube; one in particular, in which scans he was shown are passed off as his by a doctor (which in fact belong to another patient).

In this video the doctor is very nervous when the patient announces that he’s going to film the appointment and acts as though he has something to hide (reason being that the scan he’s showing the man is not really his scan, therefore the doctor has violated some other patient’s confidentiality even by showing it to one person (even if it hadn’t been videotaped). Without this video as evidence the patient would have no wittnesses to this bait and switch.

This is rare footage to be able to capture and this man is courageous for documenting the kinds of malfeasances that many patients encounter in the course of their healthcare yet have neither the equipment nor the fortitude to attempt to video document.

This scenario, termed Iatrogenic Injury, (injury caused in the course of one’s medical care) is something many doctors don’t want to acknowledge, nor treat. Often they blatantly deny the existance of the injury or illness a patient comes in with because the mere admission of the diagnosis is taken in the doctor’s mind as an indictment of another physician and violates their unwritten code of silence.

I have had so much to research this week that I didn’t get this Blogmas post up until the end of the week, but found this case and it was so blatant I figured better late than never.