Hello all,
The reply to the latest exuses from the UK Department of Health is appended for your perusal... It saddens me to think it is so difficult for anyone to be taken seriously. Well, it is my belief that they cannot say that they did not know and the next step is to seek some alternative publicity.
Kind regards,
xrn
Dear Ms F,
Thank you for your letter dated 19th April.
["Thank you for your email of 16 April about your formal complaint of 20 March regarding the Department of Health's handling of your correspondence. I understand that you also requested and internal review of your Freedom of Information request and you will receive a separate reply for this. I have been asked to investigate how the department treated your concerns about statins and reply."]
["Firstly, I would like to apologise again for the inapproriate tone and language in Mr A's email. All staff in the Customer Service Centre have been reminded about our standards and the need to treat all correspondents with respect. You ask why your concerns were never addressed to Caroline Flint, Minister of State for Public Health and whether the information you provided about possible adverse effects of statins was handled by a member of staff with no knowledge of the subject."]
It is disappointing to find that you should be apologising to me in the first instance. I do thank you for the apology but it is shameful that you should have to provide me with an apology on behalf of one of your staff, who had failed to carry out the work to the standards that you would have expected and I would have liked to see. A little more 'civil' and a lot more 'service' would not have gone amiss. It is the very least which I would expect, in terms of the prevailing standards of decency, when members of the public are dealing with members of the Civil Service.
I was attempting to alert the Department of Health (the most appropriate agency for the government) to some potentially very serious hazards to public health. It was clear to me that Mr A had thought me some kind of madman and had pre-judged the issue to the point where he had decided to tell me to 'go away' albeit in a nice manner. By dint of whose authority (and which legislation) can a minor civil servant make a decision about matters that have implications for millions of people?
["I hope it is helpful if I explain why the Department responded as it did. As you will appreciate, Ms Flint and the other Health Ministers receive a large amount of correspondence, and it is simply not possible for them to reply personally to every letter. The Department has established a Customer Service Centre to answer enquiries and submissions from the public and organisations, including the NHS, on their behalf, as Mr A explained in his reply to your second email of 2 February."]
I had not asked for a personal reply. I was attempting to make the appropriate Minister aware of some significant issues relating to statin therapeutic solutions. I had only requested that the matter be placed before the Minister for Public Health. It was neither requested, nor was it necessary that I should have a dialogue with Caroline Flint. Making an appropriate person aware of facts and issues, that may be unknown to them, is a reasonable act in any democracy. Having my e-mail turned into some sort of private funny joke for the benefit of Messrs, A and T was not my intention, as would have been clear to any half-sensate adult, even to those who occupy positions of little responsibility.
The so-called Customer Service Centre is a misnomer. There was no service rendered to me and it is entirely wrong to label ill people as 'customers'. In a business environment it is doubtful that Mr A would have retained his position. As far as I can tell, there was no intention to pass my e-mail to the Minister and there was also no intention to discuss the matter with the Minister. I believe that no attempt was made to make Caroline Flint aware of the dialogue I was having with her inept proxy, Mr A.
["Customer Service Centre staff work closely with the Department's policy teams to ensure that the information they use is up to date and, in return, provide regular feedback to Ministers and policy teams on the issues and concerns that are being raised in correspondence. The Department's role is to set broad health and social care strategy for England and it devolves a considerable amount of responsibility for implementation to local NHS organisations. In making decisions and setting policy guidelines, Ministers take advice from policy specialists within the Department and draw on the expertise and knowledge of specialist organisations such as the National Institute for Health and Clinical Effectiveness (NICE)."]
The regular feedback to Ministers would be very useful. I would like to know what is the frequency of this regular feedback. If Mr A's contact with Mr T was typical of the Customer Service Section working closely with one of the Department's Policy Teams, then words fail me. Permit me to remind you of the written evidence (as supplied to me under the Freedom of Information Act 2000, and this was apparently the only evidence in existence) of the close working relationship between the Customer Services Department, Mr A and the Policy Team Member, Mr T...
The content of the text file: DE179454... videlicet
"Hi Alan,
Here the case that prompted my clarication request on the statin line
Steve"
The content of the text file: 182440... videlicet
"Hello Alan,
I'm set to tell him to go away (in the nicest possible terms) but would be grateful if you could give it a quick glance.
Cheers
Steve"
I would have to say that this informal exchange does not pass muster as the evidence of one section working closely with another, within the same organisation. Rather... it appears to be an informal chat (with very little of the actual work being allowed to intrude on the obviously friendly relationship) between these two employees. On the basis of this exchange, it is stretching the boundaries of reality to cite this particular evidence; as an example of the close working relationship between two sections of the Department. It is merely an unproductive exchange between two employees, who appear to be intent on taking the opportunity to idle away some time.
["Clinical decisions and care plans are made by clinical practitioners on the basis of clinical need using their knowledge, experience and the best possible evidence and in discussion with their patients. The Department expects clinicians to keep up-to-date with developing medical knowledge as part of their continuing professional development and assists with this by commissioning and publicising clinical evidence, for example via the National Library for Health (NLH). This library can be viewed at *www.library.nhs.uk/. The Department also provides evidence based patient information at *www.nhsdirect.nhs.uk/. If you are unhappy with a decision or treatment made by a clinical practitioner treating you, you may wish to use the NHS complaints procedure. Details of this procedure can be found at *www.nhsdirect.uk/england/aboutTheNHS/complainCompliment.csmx."]
I beg to differ. Clinical decisions and care plans are made by clinical practitioners on the basis of clinical need (and in the case of General Practitioners) their contract of employment (now including QOF criteria) and the needs of the government as expressed through National Guidelines in written policies and soon too be those expressed by NICE, who appear to have changed their name from the National Institute for Clinical Excellence (suggesting a search for excellence in clinical practice) to the more pedestrian sounding National Institute for Health and Clinical Effectiveness. (suggesting that their much vaunted independence has been lost and they are now a formally incorporated arm of the executive). Indeed, the National Policy on Statins mentions on page 23, that in 2007, after NICE have reported on statins, that their guidelines will be the ones that will be followed nationally.
As for complaining about my GP, what use will that serve? He was only following government's imprecations and because he is human, I presume that the additional QOF points are sufficient inducement to prescribe me a medication that I must take for life, irrespective of any risks that may bring to me. I understood from Mr A that the UK's national guidelines on statin therapy, are based on the often cited Framingham study. More than 22 years of data was gathered from that particular community. The conclusion was that high cholesterol was a significant factor in causing heart disease.
Last night, I had discovered a newspaper clipping from Framingham. It is taken from 'The News, Framingham-Natick' and dated October 30th 1970. It is headed "Findings of the Framingham Diet Study Clarified".
"Although there is no discernible relationship between reported diet intake and serum cholesterol levels in the Framingham Diet study group, it is incorrect to interpret this finding to mean that diet has no connection with blood cholesterol", Dr William B Kannel, director of the Framingham heart study has stated.
That was from the director of the Framingham study! I put it to you, Ms F, that if there was no discernible relationship been reported diet intake and serum cholesterol, after testing the citizens of Framingham for 22 years, then regardless of what Dr Kannel wanted to think, that relationship could not have existed. The clipping goes on to reveal more of this psuedo-scientific claptrap, that even my 7 year old son would have no difficulty in seeing the flaws of reason.
Should you be inclined to take this matter more seriously than Mr A, at your request, I will be happy to forward you a copy of the clipping, with my own typed transcription of the faded text. I am seriously trying to alert the Department of Health (generally) and the Minister for Public Health (specifically) that the whole Cholesterol Hyposthesis is wrongheaded and to keep lowering cholesterol levels and raising statin prescriptions is an ill-considered policy that will bring harm and havoc to the lives of millions.
["I am aware that your intention was to clarify whether statin treatment would have an adverse impact on your health and to draw the Department's attention to your concerns about this. I would like to explain a little more about how your correspondence was treated. Staff working in the Customer Service Centre are expected to respond promptly and accurately to all correspondence and to provide as much information as possible about the context of decisions made. I hope this explains why Mr A provided information about NICE work on statins and lipid control."]
If this was just about me and my health, I would say, "fair enough", that is life and I would just get on with making decisions for myself. As a citizen of the UK, I have a duty to act responsibly and... I should also have a care to my fellow citizens and my country. It misses the point to see these concerns as exclusively mine and concerning just my health. I am more than able to care for my own health and I do not need the guidance of medical practitioners, who appear to be lining their own pockets with QOF money, to tell me how to live. Mr A responded, as I had expected when I first opened the dialogue with the Department. His second response was not the response of a responsible person. You may well judge that he followed the Departmental diktat to the letter, but he did not act responsibly.
["To answer enquiries and respond to submissions such as yours, Customer Service Centre staff have access to records of policy decisions, including the Government's current position on statins. When necessary, they also contact the Department's relevant policy specialist to check on any recent developments, for example the reports you quoted on adverse effects related to the use of statins, that might affect the accuracy of the Department's response."]
What you say, Ms F, sounds and reads as utterly reasonable. In the face of being told to 'go away' by Mr A, I submit that a substantial procedural irregularity must have ensued.
["This is normally done via email or telephone call and confirmed again on our correspondence system. In this case Mr Acontacted Mr T, who works in the Department's Vascular Programme Directorate, which is headed by Professor Roger Boyle CBE, National Director for Heart Disease and Stroke, in order to clarify that the information he had was up-to-date. Unfortunately, his email request for information was couched in highly informal tones and I am sorry that this has provided the impression that the Customer Service Centre does not treat correspondence with the respect it deserves."]
It would be tedious for you, Ms F, if I were to repeat what I have already said above. Suffice it to say that I am no nearer to having my concerns heard by the Minister of State for Public Health. I had written to Caroline Flint, initially, on January 21st and if I was writing to advise the Department of some terrible new fatal condition that was contagious, it would appear that it would have been useless. I am no further forward now than I was when I had first written to the Minister. I find that to be a lamentable and rather tardy state of affairs.
["To summarise, Mr A was responding as requested on the Minister's behalf and correctly gave the most up-to-date account of the Government's current position on the use of statins, checking his response with the relevant policy specialists. He also explained that, in determining the Government's position, Health Ministers and the Department rely on expert assessments by specialist individuals and organisations, and the Department is currently awaiting the outcome of NICE's work on lipid control. NICE operates independently of the Department, and therefore I cannot say whether their experts are reviewing the articles you have quoted."]
In other words, Mr A made the decision to tell me to 'go away' because he was aware that the Department were awaiting the outcome of the NICE report on lipid control and because that was due to be published in December 2007, he saw no reason for any material to be passed to the Minister for Public Health and accordingly, Mr A thought that he could tell me to 'go away' with impunity. I am astonished that the Department of Health would tolerate such a lacklustre and egregious performance from a member of its own permanent staff.
["I have checked with Mr T and understand that there is no further recorded information relevant to your correspondence and FOI request. I understand that Mr T confirmed changes to Mr A''s draft reply by telephone. I hope I have explained how your correspondence was handled and would like to repeat the apology offered above."]
Thank you for your apology. I understand that nothing further has been recorded. It is to be expected and it confirms that my communication was not taken seriously by Mr A, Mr T or the Department of Health. I have tried my level best to inform the most appropriate people that statins are a disaster that is happening now. The prescription of statins has reached epidemic proportions and, speaking in general terms, they are not helping the people who are receiving them. The population of the UK are in a unique situation in that health care is provided for free, at the point of delivery. With that service comes the issue of accepting and trusting what the assigned medical personnel have to to say and do. We have no option but to trust the medics and the government and in this particular case the authorities have got it wildly wrong.
yours sincerely,
Jeff Cable