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maria kane complaints exec. barnet NHS

 Ian Glenn

51 Aeroville


23rd April 2013


Dear Ms Kane,

Your response of 08/04/2013 to my complaint about my unjust and illegal exclusion from your service contains a number of disturbing inaccuracies and omissions.

Firstly, the actual “incident” that led to my suspension is barely mentioned. It is hard for me to understand your rationale in taking such a drastic step as a punitive exclusion without understanding how you perceived the incident. The reasons why you took this decision, in the form of a coherent explanation, are important to me.

Who did I threaten and with what? The only time violence was mentioned was by Ms Mansour, who I presume was the duty worker. Having never been introduced to her, nor were either her or Marc Duncan wearing identification, I can only assume that this is who you mean by Ms Mansour. She is the only one who mentioned violence when being asked by Marc if she was OK on her own with me, she mentioned that she could (would) ‘knock me on my back’.

I have no history of violence, but it is well known in BDAS about my autistic tendencies, for which I have been trying to get help for years. This, however, is typical of certain peoples’ prejudice against me. To find someone in a position of power over me with these prejudices is frightening. This would not have happened had Mary Bell McLeod still held this position.

You say that newly-appointed Marc says it is ‘sometimes a necessary but regrettable step’. What exactly was necessary about the action you/he chose to take? In fact, he is wrong, as is outlined in all the relevant guidelines; ’NICE’, Dunn et al (NTA, 2009) actually titled “preventing unplanned discharges” and the ‘Orange guidelines’ (2007). So as you can see I have no reason to accept ‘regrettable but necessary’ and will go as far as questioning his motivation for making such a determination.

Over three years of treatment and progress was undone in one day by a manager, who I felt lost his impartial professional perspective and became involved in what I described in my original conversation as ‘unnecessary macho head-banging bullshit’ of which I owned my part, but it was never violent and its impossible for me to see how this was the only course of action open to him. I cannot imagine how this incident was presented to the team for them to agree to exclude me. The trauma caused by this will never be forgotten.

I am finding it difficult to believe that I am having to convince you that I didn’t do anything wrong, beyond the misinterpretation of an exchange of views and the above mentioned verbal disagreement; as a victim of a crime who reported the theft to the police and BDAS, finding that I was treated in such a manner by someone who is employed by the NHS, when I am a patient with a condition (s) that I believe entitle me to fair, evidenced and ethical treatment, is hard to come to terms with.

I identified the thief to BDAS and the police, putting myself at greater risk, and have had no support from the support workers; on the contrary, I have had my support removed. Claiming that the time period had elapsed for the recommencement of treatment is entirely down to BDAS, as I made myself immediately available, it was BDAS in fact who instigated a lengthy decision making process which you must have realised would penalise me.

The support I was complaining about not receiving was not after the ban but in the week between the 15th and 22nd February when they had told me their plans but wouldn’t give me any advice as to what I should do. I asked on a daily basis what I should do was I to be banned: I was told to wait and see. No plans for alternatives were put in place or suggested by BDAS. In fact, there are no alternatives in Barnet under the NHS and, until I was helped by a charity, I had been thrown to the wolves by BDAS. I am 50 years old, have heart disease, hepatitis c and mental health problems and was dependent on 70 ml methadone a day. Do you seriously believe your response was proportionate and safe, when I was left to deal with withdrawal or otherwise in the community? I don’t think you need to be a drug worker to know that that is wrong.

You say they wrote to my GP. Do you think this was adequate? When I rang my GP they were very unhelpful and put the telephone down on me. I believe this was due to, or not helped by, whatever had been written in the letter about me being “threatening” or what other misrepresentations they had written. If my GP was able to prescribe methadone I wouldn’t need to go to BDAS in the first place. I am told that this response is not sufficient by my legal advisor.

I underline to you again: I didn’t threaten anyone and was merely waiting for the police to attend. If my behaviour had in fact been as described by Marc I am sure the police would have been interested. They were not, because no such threats happened.

This brings me to my request to see a doctor. After initially being told by drug worker Raymond that there was no reason for my meds not to be replaced and then the farce with this lady and Marc, I immediately asked to see the doctor, as I could not believe what was happening. This was denied and is still being denied up to now. My GP has been unhelpful, and as Su Goulding’s title was my ‘Single Point of Contact for Mental Health’ I am left with no support and the financial burden of paying a private doctor out of my disability benefit. This is not tenable, but as I have been able to get a script, slightly increased due to the stress, anxiety and depression this incident has caused, on weekly collection, and my exclusion period is over, I should have been re-commenced by now. I have not been able to get a response, that is to say my calls have not been returned, so my ‘exclusion’ now is one week longer than the original punishment.

Your letter doesn’t compare at all to the interview I had with Cindy Mukomegumi, and communications with Shivon Genus and Su Goulding make me think that either you don’t understand the ‘incident’ or are deliberately protecting a colleague you know has done wrong; I say this not lightly, but because you have simply ignored the facts or given an acceptable version of events from your perspective. Isn’t the NHS for the public benefit? The role of the drug worker is to try to work with the patients presenting difficulties, not merely removing those who you dislike or feel challenge your authority. If you don’t see the injustice here, put yourself in my position, or one of your family, and you might begin to imagine.

Was I to expect life to stop for two months? Do you know what methadone withdrawal would be like and are you suggesting I could have endured this without medical help? As my support had been withdrawn by Marc Duncan, my choices were limited. Also, to take such a drastic measure on the say-so of one medically unqualified person giving his version of events, presumably not contradicted by Ms Mansour, over my medical treatment has eroded any faith I have in BDAS.

I hope you now have a better understanding of what happened, and what didn’t, on the 15th February.

What is the process for replacing lost medicine? I still don’t know. As a victim of crime this should be looked at again. If someone was stabbed in the street outside the pharmacy would it still be ‘against your policy’, and would you never replace lost medication? Would you assume such an incident was a ploy to prise 490mg out of the system? It’s really too formulaic and loaded with prejudice to be credible for a professional service to make such blanket judgements.

If BDAS were as concerned about diversion of methadone as they say, surely the fact that someone had 500ml that they had stolen should have been a concern to them. I had told them who had stolen it and he was well known to them. They, however, chose to punish the victim of the theft, who was already suffering due to the stress of the theft and attempt to report it, as well as early withdrawal symptoms from methadone. What do you suggest I should have done? All fault that day after that of the thief, even if I accept I left myself vulnerable to abuse, which I do, albeit by an excess of trust, clearly lies with your two staff that caused this, Marc Duncan and Ms Mansour. They treated me with contempt, made me feel like I had stolen my own medicine and then refused to help and started this present situation in which I find myself with no medical support, other than at the private clinic I cannot sustain due to cost and a complaints procedure that is biased against me.

How can the damage that has been done during this time be undone, and what benefit has been achieved by this sanction? It is hard to see any sense other than this being clearly punitive, which is against all guidelines. In what other field of medicine would it be acceptable to not replace stolen medication?

The previous incident you refer to resulted in my previous complaint to which you responded on 21th March 2012. You assured me then that a plan had been out in place to ensure that any changes that need to occur in the future are managed in the least disruptive way. The way that the theft of my methadone has been dealt with is far from not being disruptive. In fact, my life has been disrupted beyond recognition. Privacy over my medical situation has been totally compromised as I scrambled for help in the first few days and weeks of this ordeal. The history of my contact with BDAS has been characterized by lack of stability, inconsistency and failure to appreciate my needs and “complex presentation issues”.

From my perspective and from the history I have outlined I feel that it would be impossible for me to re-engage with BDAS in a trusting and productive fashion, as your reaction to my genuine need for help has been unacceptable and after three years it should be well known that violence and aggression are not part of my psychological make-up.

It was me who had to call the police on the 15th of February, initially to report the theft, but as the situation deteriorated I was telling the officer on the phone how I was being intimidated by the two drug workers who had me in a small office. This is one fact that I am sure can be verified, unlike the accusations against me.

I believe I was provoked to be in this distressed state as one of the first things said to me by Marc was “do not swear”, and when I told him that I had issues with stress he was dismissive. At this stage I was more concerned by the fact that I was the victim of a theft and these strangers were making things difficult for me, not with swearing or spilling instant coffee powder. My first contact with Marc in the waiting room was pleasant and we talked about ‘Clark’ desert boots. It was only when he became belligerent and uncooperative that things deteriorated; obviously this is his responsibility being the professional in the situation. I believe I understand now why Fuad and Raymond didn’t want to get involved, because they knew how unpredictable and unreasonable Marc was to deal with. As it states in the ‘Methadone handbook’ (Andrew Preston), which is supposed to be given to all new patients;

“Stopping methadone suddenly is dangerous and should only be done under medical supervision.”

A letter to my GP hardly qualifies as medical supervision.

Marc’s actions were dangerous and foolhardy and undoubtedly put my health at risk. My angina has increased and my stress levels are obviously higher even than has been normal since my last heart attack.

The fact is well known that not being in methadone treatment increases an addicted person’s risk of many unpleasant things. This makes me sure that the intention here is clearly to cause me harm and the fact that my key worker, I am sure, made all these points to Marc Duncan makes me again ask you to look at his suitability to hold this position.

This brings me to today. A week has now passed since my suspension was finished and I contacted BDAS. I have still not heard from them so the suspension has entered its third month. Please explain the benefit of these actions to me or any staff of BDAS. I write this as the time I was quoted for a call back ticks by, once, then twice, now I am told no-one is available, etc.

How do you suggest I get my prescription reinstated as soon as possible?


Ian Glenn

c.c. Release.

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