IEU - Alliance

Striving for patient safety NOW

ACTIVITIES

2010

January 11th 2010 a major Dutch newspaper SPITS published two big stories on the Dutch black list of physicians and healthcare managers, as approved by the Dutch court 25th of september 2009.
The Dutch black list is an initiative of Sophie Hankes LL.M. chair of the IEU-Alliance and chair of SIN-NL Dutch organisation for victims of medical errors. It is an emergency measure to awaken the medical field, to make them aware of their responsibilities towards victims of medical errors.

January 12th 2010 another Dutch newspaper De Telegraaf published also an article on the Dutch black list of physicians, emphasizing the "powerlessness of physicians" to defend themselves and ignoring the negligence of physicians towards victims of medical errors. In the same week the Dutch medical weekly published a similar article, showing the actual collaboration between the newspaper and the weekly. Both media choose not to interview any organisation of victims of medical errors nor to interview SIN-NL/IEU-Alliance on the arguments to publish the black list.
Both media choose not to publish about the verdict of the Dutch court , see above, which granted permission to publish the black list online.
Both media choose not to publish about the scientific report by criminologist Prof. Jan van Dijk, University of Tilburg on the position of victims of medical errors, published December 2009.

April 23th 2010 a complaint by Chair Sophie Hankes LL.M. against the newspaper De Telegraaf was discussed at the Council for Journalism in Amsterdam.
The verdict will be issued within 8 weeks.

2009

Results of our main activities in 2009:
1. participation in meeting with Ministry of Health of the Netherlands in preparation of new law for patients, based on standing legislation.

2. initiation and development of research on position of victims of medical errors.
Publication of report by Prof. Jan van Dijk, criminologist University of Tilburg.

3. Victory in court for SIN-NL Dutch organisation for victims of medical errors: court gave permission to publish black list of physicians and healthcare managers including Minister of Health of the Netherlands online.

4. Articles in newspapers, broadcasts on radio and television.

Survey of the situation of victims of medical errors and focus 2009.

IEU-Alliance Survey of situation of victims of medical errors and focus 2009.

Due to strenuous efforts major progress has been made in the acknowledgment of the situation of medical errors in quantity and in consequences for victims of medical errors. Acknowledgment has been achieved on structural, national and international levels:

1. On December the 15th the European Commission (EC) acknowledged that about 10% of all hospitalisations result in a medical error. This means that the EC also acknowledges the figures of our epidemiological survey 2006 The European commission strives to reduce the number of medical errors. This means:
international acknowledgement of the numbers of medical errors in hospitals.

2. In May 2008 A. Klink, Minister of Public Health the Netherlands, presented a proposal for new law Client and Quality of Care. He recommended that the new law should include the right for victims of medical errors for honest information. This is an enormous acknowledgment for our legal proposal Tell and Repair. Klink failed to include the rights on remedial medical care for victims of medical errors in this new law. Thus:
national acknowledgement of rights on information about medical errors.

3. In March and July 2006 Karl-Heinz Florenz, then President of the Commission Health Care, Food Protection and Environment of the European Parliament, officially acknowledged that physicians in general refuse to give honest information and adequate remedial medical care to victims of medical errors. Thus:
Structural International acknowledgement of the fact that physicians refuse to give the victims of medical errors honest information and treatment.

4. The structural denial of honest information and adequate remedial medical care after a medical error has been acknowledged on November the 7th 2007 by the Association of Medical Consultants, the Dutch Association of Hospitals and the Association of Nurses and Care-takers the Netherlands. Thus:
National acknowledgment by the medical field in the Netherlands.

5. Two months before the above mentioned, September the 6th 2007, the deputy Inspector-General of the Inspectorate of Health Care the Netherlands, admitted that the inspectorate knows that physicians refuse to give victims of medical errors honest information and adequate remedial medical care. Thus:
National acknowledgment by the Inspectorate Health Care.

6. Lawyer Johan Legemaate, Head Legal Service of the Dutch physicians organisation KNMG, published his Inaugural speech: Patient safety and patient rights, May 2006.
He wrote that physicians do not give their patients honest information about medical errors for fear of litigation. He specifically confirmed that the right on information according to the Dutch Law on Treatment (WGBO) includes the right on information about medical errors. This means:
Structural acknowledgment by the medical sector in the Netherlands.

7. Until now the medical field did not consider it necessary to correct their medical errors. The medical field refuses to give their individual victims honest information and remedial medical care. This results in unnecessary suffering for thousands of victims, who need medical assistance. Also relatives do not get honest information about their loved ones which makes the processing of a sudden loss much more difficult. It concerns:
Structural refusal of the medical field to provide honest information and remedial medical care to the victims of medical errors and their relatives.

8. Despite -theoretical- possibilities of the medical disciplinary law, the civil right and the criminal law, a relatively small amount of disfunctioning of doctors receives punishment. Patients can hardly realize their rights, thus the Inspection of Health Care in 2006.
It is of fundamental importance is that the physicians have the monopoly on the medical records, which are the basis in disciplinary, civil and criminal courts.
In the NIVEL report Unintentional Damage in Hospitals, 2007 Netherlands, it becomes clear that medical records are incomplete and incorrect in 76%. Physicians frequently do not describe their medical errors in the files. This way the patient hardly has evidence for the medical errors that have been made, this has been confirmed by the report Surviving in the Practice of medical liability (2008), Stichting de Ombudsman. Thus we see:
Structural lack of accountability of physicians.

9. Moreover generally individual members of the Executive Board, the Council of the Governing Board and the Supervisory Board of hospitals seldom resign or take responsibility for serious errors.
They often even seem to be unaware of the lack of quality in their institutions.
This has also been observed by Dr. Gerrit van der Wal, Inspector-General of the Inspectorate of Health Care see speech 14.11.2008. Finally the Minister of Health Care is responsible. He refuses to take action against physicians who structurally refuse to give victims honest information and adequate remedial medical care. It concerns:
Structural lack of accountability of members of the Governing and Supervisory Boards of Hospitals.

Conclusion:
Several law oblige physicians to give honest information en remedial medical care to victims of medical errors. Unfortunately most physicians do not act according to their legal obligations in case of a medical error. In a modern constitutional state, like the Netherlands, individual responsibility and accountability are fundamental values .
The IEU-Alliance is aware of the enormous quantity of medical errors and the dreadful consequences for the victims and the relatives who so far are left without adequate medical assistance.
Therefore the IEU-Alliance will focus in 2009 to arrange measures to provide individual victims of medical errors with adequate medical assistance and to focus on the accountability of individual physicians.

Letter to Minister Dr. A.Klink conc. implementation of Tell and Repair Legal Provision, Jan.16, 2008

On the 16th of January 2008 we had a short personal meeting with the Dutch Minister of Healthcare Ab Klink. Afterwards we handed this letter to him.

Ministry of Healthcare
Attention of Minister Dr. A. Klink
Postbus 20350
2500 EJ Den Haag 16th January 2008

Concerning: situation and implementation of Tell and Repair Legal Provision

Your Excellence,

Our last letter to you was written on the 31th of July 2007. Unfortunately we have had no personal meeting with you nor your top civil servants who are responsible for the quality of care and patient safety.
It is known and acknowledged that the situation of medical errors is very serious, in quantity and in consequences.
The last months several important developments occurred.
On the 7th of November 2007 the Dutch Association of Hospitals, the Association of Medical Consultants and the Dutch Association of Nurses and Caregivers acknowledged again that physicians give almost no aftercare, honest information and adequate remedial medical care, to victims of medical errors.
On the 6th of September 2007 the Inspectorate of Healthcare acknowledged that they were aware of the lack of aftercare to victims of medical errors.
On the 7th of November 2007 the three professional organisations took it upon themselves to formulate a proposal to improve the aftercare to the present and future victims of medical errors, based on the SIN-NL/IEU-Alliance legal proposal Tell and Repair, based on the van Harvard Consensus Rapport (2006) When Things go wrong: Responding to Adverse Events.
On the 19th of December 2007 the Inspectorate of Healthcare signed the legal proposal Tell and Repair and thus supports this important initiative. The Inspectorate also indicated that it was urgent to organise a meeting between the Ministry for Healthcare and the undersigned.
We therefore request to you to arrange a meeting about the implementation of the Tell and Repair legal proposal. Subject of this meeting will be whether the legal proposal should be incorporated in the present Law on Medical Treatment, or should be incorporated in the new Law Client and Quality of Care.
Certainly we will appreciate a personal meeting with you. When this is not possible, we will appreciate to receive your personal answer.
We repeat:our motive is to prevent or to diminish preventable sorrow to innocent fellow-human beings. We trust that you will support this goal.
Awaiting your reply at your earliest convenience, yours

Sophie Hankes LL.M.
Chair IEU-Alliiance www.ieu-alliance.eu
Enclosed: legal proposal Tell and Repair (Text to be found under News)

The IEU-Alliance, the Declaration and the Manifesto 2007.

The IEU-Alliance first met on the 21th of November 2004 in Dormagen, Germany.The meeting was hosted by the Northern-German association DPSB and initiated by SIN-NL, which functions as co-ordinator of this European organisation.
The aim is to improve the patient safety and the quality of the healthcare, especially the position of the iatrogenic patients, on a national, European and international level.

July 2005 the second convention of the IEU-Alliance took place in Utrecht, the Netherlands.
The Declaration of the IEU-Alliance describing the position of iatrogenic patients and necessary improvements a.o. statutory obligations of honest and open disclosure and registration of medical errors as well as the obligation to provide genuine follow-up diagnostics and remedial medical care was signed.

In November 2005, during the third convention of the IEU-Alliance in London, the declaration was presented to Martin Fletcher and Susan Sheridan of the World Alliance Patients for Patient Safety of the WHO.
On the 28th of November 2005 the Declaration was presented to a representative of Tony Blair at Downing Street 10, as well as a representative of Sir Liam Donaldson Chief Medical Officer of the Department of Health in the UK and Chair of the World Alliance for Patient Safety WHO.

In January 2006 the co-ordinator had a meeting with Mr G. Schmetz of the regional office of the WHO in Copenhagen. Mr Schmetz also received the Declaration of the IEU-Alliance.

Alexander Vladychenko, Director General Social Cohesion, Council of Europe

On the 12th of March 2006 the IEU-Alliance held its fourth convention in Strasbourg, France.
On the 13th of March 2006 the IEU-Alliance was received in Strasbourg by Alexander Vladychenko, Director General of the department Social Cohesion of the Council of Europe and presented its Declaration.
Mr John Bowis, former Minister of Healthcare in the UK and a member of the European Parliament met the IEU-Alliance and received the Declaration prior to the plenary session of the European Parliament, March 13th. In his speech to the European Parliament he made clear mentioning of the plight of iatrogenic patients.

John Bowis, member of the European Parliament (MEP) and the
Conservative spokesman on Health and Food Safety in the European Parliament.

On the 22th of March 2006 in Brussels Karl-Heinz Florenz, Chair of the Commission of Public Health, Environment and Foodprotection of the European Parliament discussed the position of iatrogenic patients as described in the IEU-Declaration and clearly stated his support to the delegation of the IEU-Alliance.

July 2006, Karl-Heinz Florenz sent a letter to Robert Madelin, director general Health Care of the European Commision, in which he expressed the nessecity to improve the position of Iatrogenic Patients in Europe and called for a common meeting with the IEU Alliance. July 2006, Robert Madelin announced in a letter to the IEU Alliance that a meeting would be arranged in the near future.The IEU-Alliance will make every effort to improve Patient Safety and the position of the iatrogenic patients.

Karl-Heinz Florenz, Chairman of the Committee on the Environment,
Public Health and Food Safety, European Parlement

September 2006 further contacts with the WHO were established.

From October 2006 till January 2007 representatives of the IEU-alliance participated in several conferences.
Each time the IEU-Alliance gave statements in public.
November 2006 the IEU-alliance gave a powerpoint presentation on the obligation of physicans for full and open disclosure in case of medical errors, at a Dutch conference organised by the Royal Dutch Medical Association.
December 2006 an interview on the goals and activities of the IEU-Alliance was published in a magazine of the Dutch Ministry of Healthcare, Welfare and Sports.

January 2007 the IEU-Alliance declared 2007 as Year of and for Victims of Medical Errors.

On the 26 th of March 2007 the IEU-Alliance published its Manifesto with recommendations to improve transparency and the quality of healthcare, including proposals for truthcommissions and parliamentary inquiries on medical errors and the position of victims of medical errors. Press-releases were sent out.

April 2007 a book was published in the Netherlands:Hoe overleef ik de zorg? How do I survive healthcare?by Alice Fuldauer, which contains several references to information provided by the IEU-Alliance.

April 16 th 2007 Sophie Hankes, chairwoman of the IEU-Alliance presented the Manifesto 2007 in person to Mrs J.
Bussemaker, Deputy Minister of Healthcare of the Netherlands at a plenary debate on solidarity in healthcare, organised by Ministry of Healthcare She would hand it over to Ab Klink Minister of Healthcare. Sophie Hankes stressed the serious situation of victims of medical errors and requested urgent measures for improvement.

June 12 th 2007 Sophie Hankes attended the congress of the Dutch Inspectorate of Healthcare on patient safety in Rotterdam, the Netherlands and handed the Dutch Minister of Healthcare Ab Klink the Tell and Repair proposal, as well as the Manifesto 2007 and the epidemiological survey of medical errors in Europe. She was given the opportunity to publicly stress the need to improve the position of victims of medical errors. we sincererly hope that a meeting with Minister Klink will be arranged as soon as possible.
We also spoke with various top stakeholders of Dutch healthcare, consultants and hospitals as well as the Health Inspectorate and we agreed to discuss the subject of victims of medical errors within the next months.
RTL a national television company broadcasted an item about the congress which focused on the need to reduce the number of medical errors and included a short interview with Sophie Hankes.

September 3rd 2007 Sophie Hankes participated in a public debate organised by the Radboud University Medical Center, Netherlands. At this debate The Dutch organisation of Medical Consultants openly acknowledged that the follow-up care to victims of medical errors is practically nil. This acknowledgment is of major importance.
In a meeting on the 6th of September 2007 with Chair Sophie Hankes LL.M of SIN-NL/IEU-alliance Mr Nico Oudendijk deputee Inspector-General of the Dutch Health Inspectorate confirmed that physicians do not give honest and open information nor adequate follow-up medical care to victims of medical errors.
As the situation was so clear he did not deem it necessary to start investigations.
Oudendijk admitted that complaint-boards of hospitals do not deal adequately with complaints of victims of medical errors. He pointed out that in addition to the physicians and nurses, the leadership of the hospital is also accountable for medical errors.

Sophie Hankes requested institution of the �Tell and Repair� legal proposal in order to achieve that victims of medical errors would receive honest information and remedial medical care.
She also requested that surviving relatives would be informed in an honest and open way.
Deputee Inspector-General Oudendijk agreed to give his written support for the �Tell and Repair� proposal before the 1st of January 2008.

Moreover the Dutch organisation of Medial Consultants, the Dutch Association of Hospitals and the organisation of Nurses and Caregivers VenVN, as well as the Center of Nursing Expertise LEVV, have explicitly agreed to attend a common meeting with the IEU-Alliance to discuss improvement of the position of victims of medical errors.