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Sunday, 11 November, 2001, 22:34 GMT
Your comments on Coming Clean
Your Comments on Coming Clean
I was deeply disturbed by this programme, not that I already had any faith in the government to protect our health or be truthful with us. Given the risks from surgical instruments I would like to see a similar investigation into the risks from vCJD from dentistry. I have long been concerned about the standards of hygiene in dental surgeries. I believe it is common practice for dentists to use the same gloves on successive patients, after subjecting them to a quick dip in disinfectant and I am not convinced that all dentists are meticulous in using the autoclave for sterilisation.
Rock Ferry Wirral
Everyone knows the best policy is openness and honesty. But these politicians have spent their whole lives avoiding truth and responsibility so they do what comes naturally, cover it up and/or blame someone else.
The sooner independant commissions are free of parliamentary influence the better.
Also, a new criminal law needs to be made specifically for politicians. And politician who knowingly tries to cover up, or make a statement which is not completely true and frank, should be charged with "Deliberate deception of the people", with a maximum term of imprisonment of life.
This sentence should be exempt from any form of pardon at all except from the European Court of Human Rights.
All forms of communications in government should be made public, so should any and all reports and data.
But this won't happen as the people who propose laws are politicians. These are obviously not the right people to do this as they are too flawed.
As a retired Chief rnvironmental Officer, I know from hardwon experience that the public have the right to know - the truth will always out and any attempt at cover up ALWAYS ends in tears. Good luck to all concerned in this most disturbing issue -, they surely have the Nations support and keep up the good work Panorama!!
It just goes to show that no government can be trusted. I had an operation this summer and now feel that I could have put myself at more risk than my illness caused.
It is about time we were given answers. This cover up has lasted long enough.
If they were to have been honest from the start the kull could have happened sooner and less people would have been infected. The government seem to be guilty of manslaughter.
Excellent programme ... it demonstrates the total mishandling of the BSE crisis over many years. An outbreak of Foot and Mouth, a decease which poses no risk to human health, results in half the herd being slaughtered without question. Why has this never been done for BSE?
The entire herd should have been slaughtered when the first cases were found. Now we have to worry about contamination between humans at the dentist! No wonder America refused British blood when it was offered in the aftermath of the 11th of September.
We are "contaminated" in the eyes of the world. It makes you proud to be British, it's like we have our own "exclusive" version of AIDS! If we can't be sure that Blood is safe, perhaps we should import blood from abroad for the next 3 generations until we are "clean" again. It's a bloody scandal and heads should roll.
That this sort of information be supressed is an absolute scandal and the complete antithesis of the supposed openess of this government. He should go quick.
Also, the whole question of surgical sterilisation and guaranteeing CJD free blood has been known for 14 years or more since the BSE crisis first broke. Why has it taken so long for anyone to realise the potential risks?
After all the fuss about the shortcomings of the Tory Government tonights' Panorama was an indication that the present government has proved to be ten times worse in many different aspects. With any integrity at all we should have seen several more ministerial resignations over the past five years.It is no wonder that people do not turn out to vote.
How about putting Tony & Cherie Blair's toothbrushes into the same cleansing system as the instruments to see if they would use them afterwards? It does sterilise - doesn't it?
Ok, no great surprise that the government is concealing more information about vCJD but sadly your programme almost totally missed the real point. The risk of contracting vCJD is rather small as many correspondents have pointed out. However the risk of contractiong vCJD from surgical instruments or electrodes used on a patient suffering from vCJD is quite possibly 100%, particularly where neurosurgical procedures are involved.
The programme did talk to John Collinge about the risk of surgical steel but failed to impress that it is currently impossible to remove all infectivity however efficient the cleaning and sterilisation process. Patients have already contracted sCJD from EEG electrodes used on a confirmed sCJD case in spite of cleaning and sterilisation procedures. In other words you severely understated your case.
I thought that the programme was excellent. It gave us the facts which we NEED to know. David Hurrell should be praised for his clear description of a real problem. It is only through programmes like this one that government will be forced to take this problem seriously.
I should be very interested in knowing if a similar investigative Report is being prepared on other Hospital Acquired Infections (HIAs) such as MRSA - the 'super-bug'. This is another case in point - it is essential that patients from one hospital are not transferred to another (where there are people recovering from major surgery) simply because there are not enough beds!
We need a blood test now!! The same technology could also be applied to BSE in live cattle.
I know it is complicated but there are companies in the private sector working on this. The Government grants have been trivial compared to the risks. I do not trust the Government science research people any more. The Government should pour a LOT more money into private sector research now. Not 4 year sheep trials that go nowhere!!
Once more, it is your team that uncover truth. I saw the original piece on this prion, and how it can not be destroyed. The disgrace you uncovered is a scandal but you must ask yourselves one further question. If it is known that this prion is indestructible, why is this stupid government incinerating carcusses and scattering the dust on a nearby field, effectively spreading the problem even further?
The entire saga of BSE has been handled very poorly, simply changing the goalposts and killing cattle at a younger age before they manifest the desease, does not make it go away.
Since November last year, many staff in the NHS have been working at auditing and improving the whole decontamination process both in the Acute and Primary Care sectors. NHS Estates have run a number of 'roadshows' in an effort to make sure the £200m is spent to best effect.
While it is to be applauded that this issue has been brought to the public's attention, unfortunately Panorama didn't mention the efforts that are being made to improve things.
Why do these people treat the general public like children. I thought that after the BSE crisis they would have learnt a lesson about being open and honest. Information gives us the right to make choices. I say sack 'em!!
I am rather baffled that prions in variant CJD are not destroyed by modern routine sterilization techniques. I wonder what happens to "bloody" water used for washing the instruments before sterilization - assuming it goes into general sewage system where the prions are liberated into our water system hence for our consumption.
The courage of Professor Collinge and Mr Hurrell is of the highest order. They have placed the whole nation in their debt. This terrifying debate would I am sure been left unexplored without their concern.
Then to assert a possible 30 year incubation period - again what about some proof? The latest test injected active prions directly into mouse brains - this leaves much doubt about the likelihood of transient contact infecting humans. Did anyone mention this? No, they did not.
Again, prions are apparently present in diseased and stroke damaged patients and there is still only a probability that prions are the cause of nv CJD - it may yet prove that prions are a consequence of the brain being damaged rather than a cause. Did you mention this? No you did not
Finally, just to keep this brief - how can you seriously interview a man about his fears of being infected with nv CJD when he is seen to be smoking! What are the statistical chances of his dying from nv CJD as a result of Factor 8 transfusions, compared with his chances of dying from lung cancer! This utterly ludicrous situation should have evoked some comment.
As a nation we are ill-educated in risk statistics and your programme played into people's worst fears. It was utterly dreadful and the BBC should be much more careful of the information and mis-information that it gives out in such so-called 'serious programmes'.
This is yet more evidence of how arrogant this government has become, and how it has betrayed those of us who hoped for more openness and have been sadly disappointed. If it was the civil servants who chose to suppress the report without Ministers knowledge then they should be dismissed. If Ministers decided that the information should be suppressed, then Milburn should resign. There needs to be accountability - there seems to be none.
I have worked in the infection control sector for the last 30 years. It has been known for at least 20 years that prions existed and that they were difficult to eradicate even by current sterilisation procedures . This is why thorough cleansing of any surgical or dental instrument is so important. If there is a large amount of blood soiling left on instruments this will be baked on during the autoclaving process which could leave prions and proteins still active within the contaimated areas.
We are developing an instrument cleanser which will help to eradicate this problem. We have won a SMART award for the feasibility of this project and are currently hoping that the Government will fund the development of this unit.
Why is it that Alan Milburn's team cannot make the vCJD Report public, but the Scottish Executive can make virtually the same report public? Thank goodness for Scottish Devolution.
This programme was one of the best in a long time!
One big step forward in identifying who is at risk would be to identify who is carrying the prion before they present with symptoms. This would also be a major milestone in assisting in finding a cure (before brain damage occurs). A UK company, Proteome Sciences, is in advanced stages of developing a test that can analyse body fluids for nanoscale amounts of protein markers for vCJD yet we hear little mention of it in the media (or in the Panorama programme).
It would have been irresponsible to alarm the gen. public. The necessary response of the govt. should be to tackle infection as it has done. No point in knowing if you have to have hospital treatment. The Govt. is quite right.
I cannot understand why, after spending a considerable time castigating the officials who have not published this report your programme ended up saying it was on the internet in Scotland - yet you failed to publish the address of the Scottish site so that viewers could visit the site read the report and if necessary pass the information on!
If you want openess then practise it yourselves.
Two years ago I studied nvCJD at night class in college. In July of this year, I worked for a few days in Theatre Services in a major hospital. My job was to inspect the equipment after it had been washed, and lay it in order ready for autoclave disinfecting. There was talk within the T.S.C department, of a nvCJD unit being built within the washroom. The persons allocated to work within this unit were to enter after being disinfected, and were to be re-disinfected on departure. Obviously implements that had been used on nvCJD victims were going to be sterilised as well. But, if the George Elliot hospital mentioned on tonight's programme had a tray of equipment hidden in the loft, due to it being unable to be sterilised, then what exactly are they going to use to disinfect the equipment within the new nvCJD department? I also noticed that no-one mentioned whether autoclave disinfecting had any effect on the prion proteins. I was lead to believe during my studies, that a burning furnace at 1000 degrees had no effect on the prion... so "coming clean" may not be as easy as it sounds.
In a way the programme was well done, because it rightly gives the Government some difficult questions to answer.
But in another way it was unkind to the public, because the very small risk of vCJD was not put in perspective - as a GP I see many people who do not understand risk, and worry a good deal, and many will now worry more than they need. A more responsible way to present this issue should have been found, one which put the risks into clearer perspective. The question should have been put to Banner, for example, would you yourself have brain surgery using existing instruments; he would say yes!
1. Panorama's revelations about the suppression of Mr Hurrell's report say nothing new about large bureaucracies and really don't warrant exclamations of surprise in a sophisticated society.
2. Viewers, however owe Panorama, Mr Hurrell and Professor Banner thanks for highlighting the general risks associated with any hospital procedure entailing surgery (i.e. not just in relation to vCJD). Since it will remain utterly impossible for individual patients to assess the infection-risk to themselves from any surgical procedure, the programme may have the salutary effect of prompting us all to think more carefully before accepting a suggested surgical solution in cases where the problem is minor or at least not life-threatening.
The negligence of the medical profession in this issue, as others, was revealed in the brain surgeon's response to questions. I should like to say to him that it is self-evidently not for the Panorama journalist to know the principles of neurosurgery, but for his profession to know enough microbiology not to infect the population.
It is concerning about the current inability to be able to tell if blood is carrying problems for the future. On the issue of medical instrumentation. The cost implications of having disposable instrumentation is most likely the stumbling block, but the cost cannot be compared to one single life that would otherwise be sacrificed. A greater debate needs to be had, followed by swift government action on this matter.
The issue of successive governments coming clean regarding public safety through blood products has been a closed door for the 4000 UK Haemophilia population infected with Hepatitis C and the 1200 infected with HIV. Over 1000 people with Haemophilia have already died in the UK as a result of their infections via contaminated blood products. Many people with haemophilia received letters earlier this year informing them of the fact that they had received factor VIII originating from donors who had died of CJD. The haemophilia population was told that this risk was theoretical but as tonight's Panorama programme points out the risks are very real. Until a public inquiry is held into the contamination of blood products and why so many NHS Haemophilia patients, through the course of their treatment have been subjected to multiple viruses and now the risk of CJD, the general public can have no confidence in NHS safety procedures.
The people have a right to know the truth.
Dynamite report. To suppress the information from the public is nothing less than I would expect, as this is what the government do consistently. However to deny the information from specialists advising on the issue, who need to know in order to produce meaningful advice, is nothing less than a fraud which deserves a public enquiry.
I wish to thank David Hurrell for speaking out on such a blatant abuse of power. The public have a right to know that they are being failed by the present surgical instrument cleaning procedures and should demand the use of disposable instruments if techniques cannot guarantee safety - regardless of cost! The programme should be shown at peak time viewing to force an open debate of the issues raised. The neuro-surgeon featured was complacent to the point of arrogance!!
Labour was elected with high hopes but has proved to be worse than previous governments in embracing a regime of secrecy and ignoring the electorate. As with Foot and Mouth the excuse is always a fear of panic. The time has come for an openess and trust.
Thank you BBC! I'm disgusted that such a report has been buried. All ministers responsible must be forced to resign immediately. The British people must not accept this treatment!
I thought the programme was very interesting and I find it absolutely incredible that the government would keep such important
information from the public, it is very disturbing and the government should rectify immediately. Thank you Panorama for your honesty.
It is amazing that the government should have spent millions of pounds on the Phillips (BSE) Inquiry only to ignore the key recommendations regarding openness. It is disgraceful that the government should have buried such a report. We have a right to expect better.
If surgical instruments can be so dangerous, what about the more frequent visits to the dentist? I have had sessions 'in the chair' where the dentist has drawn blood. So I could have or have been infected with this dreadful disease.
The programme itself was a demonstration of the black art of government cover up and I'm sick of those faceless men in grey suits.
Congratulations on a well put together programme.
We have now developed a system that tracks individual instruments to individual patients, so we do not have to worry about migration and in fact our system warns the operator packing an instrument set if migration has been detected. Our system is already in use in the US, but we are having great difficulty in getting acceptance in the UK because there appears to be no Government funding available for tracking systems. An NHS hospital with say 100,000 instruments would need to spend about £180K to implement a full tracking system and this amount seems to be beyond the budget of most UK hospitals. Perhaps you could ask DOH about the provision of central funding for tracking systems.
I had a neuro-surgical procedure three and half years ago. I am absolutely shocked by tonight's programme and feel deceived by the Dept of Health. I would not wish to know if I was at risk, what you do not know you cannot worry about.
An incisive interesting programme.
One can only hope that there will be a follow up to keep us informed with regards to the actions taken by the Government after this exposť.
Having had three operations in the past few years I can only say this has created a certain amount of anxiety.
Being a fairly regular Blood Donor of course has extra implications. I felt that having not been transfused during surgery I was safe, and nobody else was at risk. Now who knows.
I thoroughly enjoyed the programme about possible BSE infection during surgery - but I am more than convinced that it is essential that one is able to discuss the reasons why the Government has decided to suppress this report. I have always been more than interested that "the government" can apply a veto on any report that it considers to be detrimental to its general policy.
It would have been much better if you had put the risks into context. From this programme a lot of people will be scared for no reason.
Geoffrey H. Lloyd
Thank you for a most informative programme. Yet again you have done us all an enormous service.
I was not surprised at your findings, secrecy is endemic throughout Whitehall as the Scott Report/Enquiry showed. It is only by the actions of courageous whitleblowers and the highest quality of investigative journalism as exemplified by Panorama, that these issues emerge into the public domain. We really do have to name names. Senior civil servants responsible have some way or other to be publically brought to account.
The situation as it currently stands is outrageous and untenable. What price a really effective freedom of information act I wonder?
Warmest congratulations to all concerned.
The attitude of the surgeon you interviewed made me very angry. Whilst I'm sure many of his operations are life saving, brain surgery is carried out to hopefully correct illnesses eg:epilepsy.
I feel therefore he shouldn't act so arrogantly and God like in his attitude.
Disturbing enough, but more disturbing may be what happens to the water used in the sterilising process. Does it re-enter the domestic system? and, if so, how is it sterilised?
Tonight's programme was in the best tradition of Panorama. More of the same please. It is a welcome change to be treated as adults at last. As a pensioner I welcome any move towards freedom of information.
I will be writing to my M.P. for comments on this programme.
I wish to see the the report published in full so the public have the true facts.
As a doctor, I am fed up with the press scaremongering the public with so-called 'public awareness' documentaries. Tonight it was vCJD and surgical instruments.
All these documentaries serve to achieve is to frighten the public, so that when they do need medical attention it makes them all the more frightened.
I believe that people should be informed of risks that are pertinent to their problem and/or surgery, but I do feel that scaremongering programmes like this, only increase anxiety when patients present to us. We then have to put all this rubbish into perspective and try to reassure these people.
Please, in future, try to make the programmes less anti-NHS and anti-doctors, and try to find a balanced view.
The NHS and, incredibly most doctors are actually doing a bloody good job!
When there is little helpful to be said or done we can always rely on Panorama to do its alarmist worst.
The Government owe us a duty of care. We have a right to make choices in the light of the best possible scientific advice. How can we have confidence in Government advice after Panorama's disclosures?
If this programme is scaremongering then why didn't the Minister come on the programme to state his department's case? In certain parts of the country anyone who has visited hospital recently can see that cleanliness of the wards could be improved. If these standards are allowed to affect operating theatres cleaning processes then it really does appear we have a serious cause for concern and the government should correct the situation by ensuring that adequate cleaning processes are carried out on operating theatre equipment.
Why is everyone so surprised at the extent of the government deceit? If you assume you're always being lied to, majority of the time you'll be right but once in a blue moon you'll be pleasantly surprised when you find that you're not.
It's the naivety of the general public which fills me with incredulity. Did they really expect a Labour government to have any more integrity than any other? I guess the electorate really does get the government they deserve.
You mentioned that no test existed for vCJD. A blood test would be the solution to this problem as anyone with CJD could be operated on using disposable instruments. A company called Proteome Sciences (listed on AIM as PRM)is developing a blood test which is at second stage testing with the help from the CJD surveillance unit in Edinburgh.
The other concern not mentioned in the programme tonight is contamination via dental instruments.
Sarah Barclay's report tonight raised very serious concerns for all patients entering hospital. It seems to me that we are putting our lives at risk, and nobody wants to make us aware of any of the information gathered on life threatening diseases. Surely the government has a duty to make any information gathered on whatever the disease available to the public. I feel they have a duty to publish, and we have a right to know. David Hurrell is to be very much thanked for making the public aware of these goings on. Also, thank you Panorama for alerting the general public to these practices. I wonder what else is being hidden from us by the powers that be in our hospitals?
Thank you BBC for providing the platform on which to convey such vital information to the public.
I watched this evening's programme with horror that yet again we are not being told the truth.
I believe that everyone who was at risk should be informed, but not in the callous manner in which they were informed. I also do not see the point of alarming 118 people that they know were at no more risk than anyone else undergoing surgery. I feel that the 7 people on whom the instruments were used should have been told the facts - all of them.
Unless I missed the point somewhere I believe it to be a total misuse of resources to alarm the other 118 people and to have to undertake interviews etc with them and use more resources. The National Health seems to be able to spend money aimlessly - the money spent on this could have been used to fund disposable instruments.
I have just watched the programme "Coming Clean" with interest and concern.
I wonder at the decision to inform people that they are at risk without any proof or facts at hand. Surely this will cause a great deal of worry and stress.
Also, can anyone tell me why, if the lives of so many patients are at risk, the people who are responsible for decontaminating these instruments are amongst the lowest paid in the NHS?
An appalling indictment of the present government. We had hoped (and were promised) so much better than the last lot, yet Blair's is no better, possibly worse. Can anyone be surprised at the low turnout at polls? It is not apathy - mere disgust!
Brilliant programme, demonstrates the government's need to hide rather than heal.
I understand that in France the equivalent of our minister for Health can be held criminally responsible if he does not act upon any information he has which may lead to deaths, which is why they would not let our Beef in because of any slight risk. What a shame that our ministers can cover up information at will and not act to protect the public to whom they are supposed to protect and serve.
I was shocked by the report in this programme, all surgical, and other hospital/dental instruments should be now checked and cleaned properly, or destroyed! how dare the Government try to hide such a
One piece of information missing from the programme 'Coming Clean' was the frequency of cases of CJD. The only figures given were so far 111 people had died from what we all know to be a devasting disease.
To enable people to have a better idea of the risks of contracting CJD from any source it would have been useful to have published the yearly mortality figures attributed to CJD for say the last twenty five years. It may have given the risk some sort of perspective rather than dramatising the situation and causing further concern to almost anyone waiting to undergo surgery or have a blood transfusion.
The concept of risk is not well understood. People buy lottery tickets week in and week out, yet the chance of getting six balls on the lottery is about the same as dying from vCJD, according to a recent article in the journal "Anaesthesia".
I suggest the risks associated with alcohol, tobacco and illicit drugs are orders of magnitude greater than the risks posed by vCJD. The sporadic rate of CJD(human) is of the same order as that of vCJD and the true extent of the problem is unquantifiable at present.... Eat, drink and be merry etc,etc.
The facts put forward are highly embarrassing for the government. What we learnt from the programme, is that the risk of attracting vCJD from an operation is next to negligible. What is much more disturbing, is that we have a government that, fearing bad publicity and being asked questions by reporters and public which they cannot answer, put a lid on facts and possibilities that they cannot handle.
The problem disclosed tonight is not the danger of attracting vCJD in the operating theatre. It is much more the disclosure of an incompetent civil service in crucial positions in our community. Which other problems are stowed away in the attic? What other problems, dangers and threats are "effectively" dealt with - and how many of honest and thorough experts have made well contemplated reports, recommendations and scenarios of real importance - only to see their results put in a drawer and they themselves have been silenced and told to be loyal?
Loyal to whom?
Jim Hacker and Sir Humphrey are very, very alive. I know - I have made government reports myself (not in UK!) and seen nothing after them.
Presumably the possibility of vCJD contamination will also apply to knives used in butchery. Does this mean that eating pork/lamb/chicken poses the risk associated beef?
Some years ago I heard that when tonsils or appendix were removed in surgery they were to be tested for vCJD to determine how widespread it was in the general population. I have heard of no findings from this survey.
I thank you for a most informative and well balanced documentary on the risks of Variant CJD transmission. I wonder how long we are going to allow this government to continue with its disgraceful habit of covering up what it doesn't think the public needs to know.
Sorry to plagiarise Arthur Streatfield, but he encapsulates our thoughts precisely.
Someone should walk, or be pushed.
I watched the Panorama programme with increasing incredulity. By presenting the material in the manner you did, you increased public fear and concern without appearing to recognise your responsibility to presenting information in a balanced way. The question that was not answered was whether instruments that were macroscopically "dirty" had a greater likelihood of transmitting CJD than instruments that looked clean. I suspect that there is in fact no difference. The prions attached themselves equally to "clean" instruments as to "dirty" ones.
Very disturbing. I would like to see instruments subjected to thousand degree temperatures and hard gamma radiation between operations. Quick to disassemble instruments and, where possible, disposable ones would seem to be a sensible move. As for the blood bank, I think we should start importing some quick from the USA. Finally, I hope the wash-up prior to sterilisation doesn't really happen in the usual English 'all in dirty water' method shown in the film!
As an Operating Department Practitioner of 10 years experience, including several years Neurosurgical work, I have to say that I questioned the validity of instrument sterilisation some years ago. An autoclave (a device used for the sterilisation of surgical instruments) works using steam at a temperature of 137 degrees C for 3 minutes. This struck me as inadequate when we were being told that cooking beef at temperatures of over 200 degrees C for periods far longer would not destroy prion proteins responsible for the disease. The programme tonight didn't mention this fact and I believe it is this that has led to the introduction of disposable instruments for some high risk procedures. I would add that there are huge inconsistencies in what is regarded as 'risky'. For instance, a tonsillectomy is regarded as high risk due to the possible transmission of prions believed present in the particular lymphatic tissue of the tonsil. However, laryngoscopy is performed far more frequently and even when not, a device known as a laryngeal mask airway is used instead. Both of these procedures frequently result in a minor trauma to the pharynx around the tonsils and yet the devices employed are reused, often with the minimum of disinfection. Consistency is illogical and the measures taken strike me as token gestures.
I have personal knowledge of the course of this dreadful disease and the devastating effects on a human life.
However, there was one thing I think Panorama did not mention tonight - the possible link with 38% of the
British population who carry the MM gene! If you are going to comment on "Blowing the Whistle" on any subject,
check all research and mention all factors which come into play! If this government can allow errors like "sheep's brains"
being used for research, how can we believe that nvCJD is not carried in faeces, urine or any other waste matter, never
mind the blood. Mind you, we were also "reassured" that children born after 1986 were not at risk, and now the youngest
is an 11 year old! So, I suppose, better to blow the whistle on all things the government thinks we, Joe Public, are too
stupid to understand, or that we need never know!
I could hardly believe what I heard. An absolute disgrace. Surely it is now time for electors to be told the truth about this and so many more isssues?
The usual BBC left wing scaremongering rubbish. Wish I hadn't wasted my time watching this one sided trash!
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