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| Fatal overdose doctor 'seemed dithery' Hearing told David Gray was injected with 100mg of diamorphine by out of hours doctor Daniel UbaniA patient who was injected with a dose of a painkiller that proved fatal took the hand of the out of hours GP who accidentally administered it and told him "Thank you very much," an inquest was told today.David Gray, 70, then told his partner, Lynda Bubb, that he was "feeling better already" as Daniel Ubani, a German doctor on his first ever shift in the UK, wrote up his notes downstairs.The revelations came on the first day of a planned 10-day hearing at Wisbech, Cambridgeshire, into the deaths of Gray, who had suffered from renal colic, and another patient seen by Ubani in February 2008.Bubb said Ubani had "seemed a bit dithery" and uncertain when he arrived on the callout, the consequences of which have provoked calls for changes to the way in which out of hours services are organised.Ubani has been convicted in Germany of negligently causing Gray's death. That dismayed British prosecutors and Gray's family because it prevented him from being extradited under a European arrest warrant and possibly facing a manslaughter charge.Iris Edwards, who died on the same shift, was not part of the criminal inquiry, although police and medical experts believed she was inappropriately treated and should have been sent to hospital.The Ubani case has brought calls for stricter rules on the registering and hiring of doctors from within the EU, who do not face the same tests – including of their command of English – as other overseas doctors.The government has promised a shake-up of safety checks, including the way in which local primary care trusts determine whether doctors are fit for individual posts. It has told local health chiefs to review all out of hours procedures.Gray, who had a history of renal problems and other medical conditions, was given a 100mg dose of diamorphine by Ubani.Although the doctor has been asked to appear before the coroner tomorrow, he has yet to give any indication of whether he will attend.Ubani, whose main living comes from cosmetic surgery, is still practising in Germany but has been suspended by the General Medical Council in the UK. He is outside the jurisdiction of the coroner, William Morris.Bubb, 58, who lived with Gray in Manea, Cambridgsehire, told the court she had called the out of hours service run by the Take Care Now company because he was suffering severe pain.She had explained to Ubani – who she said "muttered a lot" when he arrived at the house – that Gray usually had pethidine but she knew the out of hours service did not carry it.She had, however, mentioned the dose of pethidine – 100mg – that Gray had been receiving from his usual GP.When the coroner asked Bubb whether Ubani had heard her, she said: "I don't know." She added that Gray had said "Yes, that's right" when she discussed the pethidine dose.The court was later to hear that on previous occasions, Gray had received no more than 10mg of diamorphine on visits to his house by other doctors working for the out of hours service.Bubb said she had not mentioned 100mg doses in connection with other drugs.The coroner asked: "Did you get the impression the doctor had hearing difficulties?" Bubb replied: "I don't know whether it was hearing difficulties or listening difficulties."Asked whether she had understood Ubani, she said: "He did not say very much. What he said I understood." She added that the doctor had seemed tired and was perhaps not alert.She said she later went to check on Gray, found he was not moving and called an ambulance.Gray's GP, Richard Hirson, said he had regularly given him 100mg of pethidine, with all bar one of the 34 doses he or a colleague had administered to him between 2003 and 2008 of that strength.It was a "safe drug" and given in that dose to women having babies, he said.He told the hearing he was "appalled" and "very upset" by what had happened to Gray.Under questioning from Take Care Now's lawyer, Fenella Morris, he said renal colic was a "relatively standard problem" that one would expect out of hours providers to attend to.He also resisted suggestions that he should have informed the company about the medication normally received by Gray.The coroner read out witness statements from the family of Edwards, who said that, although the doctor had appeared competent, he seemed to "brush over" a list of her previous medication "far too quickly".DoctorsNHSJames Meikleguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
Our homemade fertility crisis | Grant Shapps Britain's acute housing shortage is forcing couples to delay starting a family – leading to lower fertility and rising use of IVF"Twins!" repeated my wife and I as we stumbled out of the IVF clinic and found the nearest bench to sit down and take in this life-changing news. Our twins are nearly six years old now. Looking back perhaps we shouldn't have been quite so shocked. Whereas in natural conception twins are expected in only one out of 90 births, if you happen to see a mother walking down the road with a pushchair containing twins then nowadays it's more than likely (around a 60% chance) that the pregnancy was as a result of fertility treatment.And strange as this might sound, the fact that there are more IVF twins in Britain today actually turns out to have something to do with housing. The charity Shelter has released a fascinating piece of research this week that reveals that higher housing costs are forcing couples to delay starting a family. Britain's acute housing shortage means that the average age of a first-time buyer without financial help from family or friends is now 37 years old, up from 33 in 2005 and just 29 in 1997. And this postponement of settling down is having a knock-on effect in delaying the point at which women, on average, are trying to start a family.Now, fertility experts know that the chances of natural conception drop with each passing year. Fertility peaks in most women in their 20s and then gradually begins to decline. And, at around age 35, fertility starts to decline at a much more rapid pace. In any given month your chances of getting pregnant at age 30 are about 20% but by age 40, your chance of getting pregnant in any given month is just 5%. So lack of housing affordability means later attempts to start a family, and then more couples forced to turn to IVF treatment in order to have children. And because with IVF more than one embryo is typically used, twins are now more prevalent.My personal interest in IVF led me to author two reports into the availability of treatment on the NHS. Ministers claim that three cycles of IVF should be available to all infertile couples, but in two reports – The Messy Business of Conception in March 2007 and All Your Eggs in One Basket in August 2009 – I found that IVF availability on the NHS is in fact a postcode lottery in Britain. Of course publicly funded fertility treatment does put an additional strain on the NHS and, as this new Shelter report demonstrates, it is a cost which is made all the greater because housing is out of reach for many younger first-time buyers.It has taken many years for the housing shortage to become so extreme and there is no doubt that the protracted recession has pushed first-time buyers away. However, there are practical steps which can be taken immediately and – if we win the election – one of the first things we will do is to exclude nearly all first-time buyers from paying any stamp duty at all. Next we'll scrap the pointless, but expensive, Home Information Packs and then we'll encourage more homes to be built with our pledge to match-fund the council tax received when an area builds more homes.All of this will be designed to help people get a foot on the housing ladder earlier – which may lead to couples starting families sooner, meaning less demand for IVF and, perhaps, fewer stunned parents sitting on benches outside fertility clinics having just been told "expect twins".Fertility problemsWomenHouse pricesFamily financesFamilyChildrenHousingGrant Shappsguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
Teens injured in laneway shooting Two teenagers are shot - one in the lower back and the other in both legs - by a masked man in west Belfast. news.bbc.co.uk |
World Cup ban for 3,000 English football hooligans • Home Secretary to impose 'control period' on known hooligans• Statutory instrument required for month-long sanctionsMore than 3,000 football hooligans will be banned from travelling to South Africa for the World Cup, the government confirmed today. Measures to stop troublemakers who are currently barred from watching matches from going to the tournament this summer will be passed in the Commons in the coming weeks, according to the Home Office.The step will allow the Home Secretary, Alan Johnson, to impose a "control period" on approximately 3,200 hooligans who are currently subject to banning orders.Banning orders prevent hooligans from attending football matches in England and mean they have to surrender their passports to police before international football matches. But in order to apply the sanction for the month-long duration of the World Cup, Johnson has to lay a statutory instrument before Parliament, a Home Office spokesman said.The powers are part of the process whereby officials try to prevent England fans from being able to cause trouble during international events."Football banning orders have proved highly effective in preventing known risk fans from travelling overseas to football matches," the spokesman said. "There has been no significant violence at any England match or tournament played overseas since 2000 when the current football disorder strategy was introduced along with very tough banning order legislation."The behaviour of English fans has improved dramatically in recent years and there is nothing to suggest that people will travel with the intention of causing problems. However, there is no complacency."Police will monitor all England fans on departure and intercept any known to pose a risk of violence or disorder, and we are working closely with South African authorities to help minimise any safety and security risks associated with hosting a major football tournament."Figures released by the Home Office last month revealed the number of football hooligans arrested by the police fell last season. There were 3,752 arrests at matches in England and Wales – a fall of 2% on the 2007-08 season. Half were for disorder and around a third for alcohol offences. Other arrests were for ticket touting and violence.World Cup 2010Football violenceEnglandguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
Doherty fined for drugs in court Musician Pete Doherty is fined after he went to court with 13 wraps of heroin in his coat pocket. news.bbc.co.uk |