Haematology

Letter from consultant Dr A to GP following July 22 appointment:

I was pleased to review Lord Avebury who was feeling much better since undergoing angioplasty three weeks ao. He is suffering less pain and able to move better. He has lateral left ankle
ulcer which is healing gradually and I explained it could take a few weeks to heal completely. He was instructed to leave it open, I am happy for Lord Avebury to continue on Hydroxycarbamide 0.5 g three days a week in addition to Aspirin and Clopidogrel and arranged to see him again in three months.

More on Bahrain's attempts to silence opposition

Sayed Jameel Kadhim, president of Al Wefaq's consultative board, has been released after fully serving a 6 month sentence for expressing political opinions. Sheikh Hussain Aldaihi, Al Wefaq's Deputy Secretary General, says the Bahraini regime must stop targeting dissidents and begin a reconciliation with its people, but this can only happen if there is far stronger pressure by the international community for human and political rights.  Al Wefaq was the only opposition political party that had a very confined space in which to operate, but since late 2014 their leaders have been targeted in a wave of spurious criminal charges.

Meanwhile, Amnesty International has released a statement on the occasion of the opening of the trial of 57 persons, mostly detainees in Jaw prison [http://bit.ly/1JNUtjP] calling on the Bahraini authorities to make public their investigations into allegations of torture and other ill-treatment of inmates in the prison at the ime of the March 10 disorders and in the following weeks.  

UK silent on Bahrain human rights violations

When prominent Bahraini opposition leader Ibrahim Sharif was released from prison last month after serving four years and three months of a five year sentence, supporters of the Bahraini government presented it as evidence of the country’s continued appetite for reform. The Obama administration even justified its decision to restore military aid to Bahrain on the grounds that unnamed political prisoners - presumably including Sharif - had been released from prison and “meaningful progress on human rights reform” was being made (a statement which echoes British Foreign Secretary Philip Hammond’s declaration earlier this year that Bahrain was “making significant reform”).

Six weeks later, however, and Sharif is back in prison, facing charges of inciting hatred against the regime. His arrest is believed to be linked to a speech he made at a memorial service for a 16-year-old boy who was killed by police in 2012, during which he called for reform and reconciliation and described violence as a tactic of the government, rather than the political opposition. Both Amnesty International and Human Rights Watch, as well as Bahraini human rights organisations, have since called for Sharif’s unconditional and immediate release.

Sharif’s re-arrest is significant not just because it contradicts the Bahraini government’s narrative of reform, but also because it demonstrates the fallacy of another argument which the monarchy and its supporters have been keen to make: that Bahrain’s political crisis is driven by a sectarian protest movement comprised exclusively of the country’s marginalised Shia majority. Sharif, however, is a secular Sunni Muslim who espouses sectarian unity and non-violence and enjoys the respect of both Shia and Sunni opposition activists in Bahrain. It is perhaps for this reason that the government considers him such a threat.

As one of thirteen prominent opposition leaders who were imprisoned in 2011 for their role in Bahrain’s pro-democracy movement, Sharif was held in solitary confinement for 56 days and subjected to torture, including sexual abused, beating and deprivation of sleep. With Sharif back in detention, the rest of the Bahrain Thirteen still behind bars and the General-Secretary of the country’s largest opposition bloc al-Wefaq Sheikh Ali Salman recently sentenced to four years in prison for inciting “hatred” and “disobedience” against the regime, the entire leadership of Bahrain’s political opposition is now in jail.

Other prominent figures have also faced reprisals from the government in recent weeks, including Al-Wefaq board member Majeed Milad who was detained in early July in relation to his participation in a political seminar. Another opposition leader, Fadhel Abbas, who heads the Al-Wahdawi political society, was sentenced to five years in prison on June 28 for criticising the Saudi-led bombing of Yemen. The imprisoned Al-Wefaq leader’s deputy Khalil Al-Marzouq was also summoned by the Ministry of Interior on June 30 for questioning about a speech he gave.

The United States responded to the wave of arrests by issuing a statement of concern and calling for the government of Bahrain to “protect the universal rights of free expression and assembly.” The United Kingdom, however, has remained silent. Its recent statements on Bahrain have failed to call for the release of political prisoners and even criticised Al-Wefaq for boycotting parliamentary elections last November which it bizarrely deemed “transparent.” As the crackdown on the political opposition continues to intensify, Britain’s behaviour will provide little incentive for the government of Bahrain to reverse course and engage in meaningful reform and dialogue. On the contrary, it may embolden the regime and encourage more repression. 

Cardiac trans thoracic echo scan

This scan was performed at 15.30 this afternoon at the request of Vascular, I think when they were considering a graft to replace my left femoral artery, and perhaps they forgot to cancel it when the angioplasty was successful. Anyway it is reassuring to know that the heart doesn't appear to have deteriorated since a cardiac trans thoracic scan was carried out on June 19 last year when I was an inpatient. The technician said that she would  confirm this after looking at the two scans side by side.

All Party Parliamentary Group on Dalits

At the AGM of the APPG on Dalits on July 6 I was re-elected as vice-chair, Jeremy Corbyn and Richard Harries remaining as co-Chairs. The Group arranged to pepper the Government with questions to pin down their intentions about the legislation agreed as long ago as April 20013, to add caste to the listed characteristics in the Equality Act. The Government are now arguing that the case of Tirkey v Chandhok is a precedent for cases of caste discrimination, but the judge in that case said the court was addressing the particular circumstances of the case, and the determination wouldn't necessarily apply to other cases. This means that a litigant would have to show that his case was on all fours with Tirkey before proceeding to his substantive argument, making attempts to gain redress for caste discrimination expensive,

Haematology

Blood results last 10 months

	22.07	3.07	17.06	9.06	27.05	25.03	2.03	21.02	24.12	26.11	Normal
Hb	100	104	107	93	96	98	98	101	104	109	130-180
WBC	3.19	2.85	2.25	2.55	2.91	3.15	3.36	3.52	4.00	3.02	4.5-10.0
Neutrophils	1.2	1.16	1.17	1.14	1.3	1.57	1.78	1.6	1.8	1.16	2.0-7.5
Plt	325	249	232	296	342	369	449	494	551	391	150-450

Hydroxycarbamide to be 3 times a week. 

Hb increased in June following a transfusion, but it could be expected to dip below 100 now, even with the low dose of hydroxycarbamide.

No remedy when a Secretary of State breaks the law

In July 2013 the Secretary of State for Communities and Local Government [SSCLG] issued a Written Ministerial Statement [WMS] providing that Traveller Appeals in the Green Belt [GB] would no longer be decided by independent Inspectors but were ‘recovered’ – that is, decided by the SS himself. Rather than being issued around 8 weeks after the hearing, these recovered Appeals took literally years. Two Travellers, Mrs Moore and Mrs Coates, challenged the WMS in Court and on January 21, 2015 Mr Justice Gilbart allowed both of their Judicial Review applications. The judge said:

“I have found that the challenges based on breaches of the Equality Act 2010 and of Article 6 of the European Convention of Human Rights have succeeded. Both are part of the law of England and Wales. These are not to be dismissed as technical breaches.. The Article 6 challenge has succeeded because substantial delays have occurred in dealing with the appeals of Mrs Moore and Ms Coates, and with many other cases. In the context of delay, Article 6 of the ECHR does no more than encapsulate the long standing principle of the common law that justice should not be unreasonably delayed, as it was and has been here. The Claimants were and are entitled to have their appeals determined within a reasonable time…I have no doubt that the Secretary of State and his Ministers will not seek to carry on a practice which this Court has ruled unlawful. …But it must also be said that the issues raised by Mrs Moore and Ms Coates are not limited to their appeals. There are, as the figures set above demonstrate, many others whose appeals have been recovered and who must be experiencing delays, as are those who oppose their appeals. If, as appears to be the case, the appeals were recovered not because of their merits but because they were cases of travellers’ pitches in the Green Belt, then the effect of the judgment will be to call into question the legality of many other recoveries…”

Following this judgment, the SSCLG ‘de-recovered’ all those Appeals that were undecided and claimed he had no power to revoke the many decisions he had taken pursuant to the unlawful WMS (which is the subject of on-going litigation). For Mrs Moore and Mrs Coates, their wait was not yet over, despite the Court having found unlawful delay. When the target date for issuing Mrs Coates’ Appeal passed at the end of June, a further Judicial Review was threatened if the Decision was not issued by 17.00 on July 15, 2015.  Both Mrs Coates and Mrs Moore’s Appeals were issued within 5 minutes of each other just after lunch on that day – and both Appeals were allowed. The planning consultant for both appellants, who was also their expert witness in the High Court, was Dr Angus Murdoch MRTPI (angus@murdochplanning.co.uk). For a commentary on the Green Belt recovery cases by the Community Law Partnership  see http://bit.ly/1CPE8OG.

None of the Travellers whose appeals were delayed by the unlawful actions of the SSCLG has received any compensation for the stress and uncertainty he caused them.

Save lives! be a stem cell donor

At the Anthony Nolan reception last week. They are trying to recruit stem cell donors, particularly among young people 

Angiogram of legs, taken before angioplasty

El Salvador speech 1982

Dorset Travellers Planning

Under the Department for Communities and Local Government 'Planning Policy for Traveller Sites' of March 2012, local authorities are obliged to 'use a robust evidence base to establish accommodation needs' and to 'set pitch targets for Gypsies and Travellers and plot targets for travelling showpeople which address the likely permanent and transit site accommodation needs of travellers in their area'.

Many local authorities have been avoiding their statutory obligations under these rules since 2012. At my request Dr Simon Ruston of Ruston Planning has produced a report showing that Dorset local authorities will not have produced a Joint Development Plan Document for Traveller sites until the end of 2016, and in the meanwhile only one pitch has been provided against a need assessed at 138 pitches, As Dr Ruston points out in an email to me,

'What the report sets out clearly is the failure of policy on the part of the Dorset councils over the last 5 years in completing work on a cross border Development Plan Document.'

You can view the report here.

LjbDem budget response

Liberal Democrats Budget Day Response Briefing Amongst the gimmicks and giveaways, the Chancellor has hidden four more years of pain, austerity, and cuts. The Tories used to say we were in it together, but this budget says - you’re on your own. When today’s budget fireworks fizzle out, thousands of public sector workers, families and young people face another four years struggling to get by. If life is comfortable, if you have cash in the bank, if you have savings, or if you’re big business - today was a good day. But if you’re starting out in life, struggling to support your family, struggling to get ahead, unable to work, today things got a lot tougher. The safety net is being torn apart. People who are sick and disabled, people struggling to get into work, young families, students, children from poorer families, and people who find themselves out of work through no fault of their own, are all going to find life more difficult. Living Wage There’s no doubt this is a big move from the Chancellor which will make a positive impact on low paid workers. But his smoke and mirrors performance hides the true face of what’s happening for the poorest and most vulnerable people in Britain. Young people If you’re looking to get ahead, and make a start in life, this Tory budget hits young people hard. Housing benefit has been taken away, you won’t get the living wage, and your student grant has been axed. ESA True to form, Osborne is taking an axe to welfare, and is hitting those who need the most help. Employment Support Allowance is paid to people with disabilities, sickness or mental health problems who are looking for work. Around 2 million people in the UK receive the Employment and Support Allowance in some form. Under Conservative plans future claimants with conditions like depression, schizophrenia and bi polar will face £30 a weeks less - a third of their weekly support. That £30 that is designed to help them get well and get extra support in getting back into the workplace. Public Sector Pay Osborne’s attack on the public sector continues, with four more years of pay restraint. Liberal Democrats were calling for real terms pay increases. Public Sector workers have already endured five years of pay restraint, now Osborne is punishing them for dedication with four more years of pain. A junior police officer on £25,000 faces a real terms cut of £600. Child Tax Credit The Liberal Democrats blocked these proposals in government. The Social Mobility and Child Poverty Commission says any cuts to Tax Credits will cut the incomes of 45% of working families.  Changes would have a disproportionate effect around the country. Barnardo’s Scotland estimates 49.1% of families in Scotland currently use tax credits. Liberal Democrats in Government stopped these cuts from happening. Nick Clegg referred to potential cuts to working age people as "extreme... unrealistic and unfair." The Benefit Cap The Liberal Democrats backed the £26,000 cap in Coalition, but this goes too far. Liberal Democrats do not support the lowering of the cap. This is an ideological step based on politics not on economics. By introducing a new set of benefits, the Tories opening the door to regional pay. Something the Liberal Democrats fiercely oppose. The IFS stated: “Reducing the benefits cap from £26,000 to £23,000 per year would hit some families with several children and/or high rents hard: the biggest losers would be about 24,000 families who are already capped and who would lose another £3,000 (up to 11.5% of their income)”. Inheritance Tax Just 6% of the richest estates in the country currently pay IHT. Helping the richest families in the country should not be a priority at this stage. Lib Dems blocked changes to inheritance tax in Coalition because we believed it would help only the richest families. Now, true to form, the Tories sketch out their first budget plan to offer this prime tax break to the wealthiest. Student Grants This is a direct attack on the poorest families, adding a barrier to young people going to University. The Lib Dems blocked these plans in 2013 and insisted in it to provide extra support to the poorest students. The Tories are imposing unnecessary debt on more students, and removing support that helps poorer students into University. Latest figures show that over 600,000 students are in receipt of a maintenance grant.

Human rights in El Salvador

This afternoon there was a wreath-laying ceremony in memory of Archbishop Oscar Romero of El Salvador below Great West Door of Westminster Abbey, who died at the hands of a death squad as he was saying Mass on March 24, 1980. He has been recognised by the Abbey as one of the 10 great Christian martyrs of the 20th century, whose images can be seen above the Door.

We then trooped over to the Palace of Westminster for a reception given by Mr Speaker in his apartments and the presentation by the Ambassador of El Salvador to Sir Peter Bottomley MP, former MP Kevin MacNamara and me of the Dr Jose Gustavo Guerrero Medal for Diplomatic Merit Silver Category, in recognition of the nomination by us and other Members of both Houses from the Parliamentary Human Rights Group of Archbishop Romero for he Nobel Peace Prize in 1980,

As I said in my brief remarks, our nomination was unsuccessful, but his work for peace in El Salvador had now been recognised at an even higher since he had been beatified in May his year.

I recalled that the Parliamentary Human Rights Group (PHG)had sent a delegation to El Salvador at the end of 1978, headed by the late Lord Chitnis and including Peter Bottomley MP and Dennis Canavan MP, after the assassination of priests and nuns had been launched with the killing of Fr Rutilo Grande in March of that year and leading in the end to the murder by the death squads of more than 9 priests and nuns. It was perhaps the largest number of Christian priests to have been martyred in any internal conflict since the second world war,

You can read the PHRG report on the delegation's visit from 1978 here.

Obviously the PHRG had no power to bring the death squads to justice, but in the long run maybe our voice, together with the voices of other international NGOs, had a little role to play in restoring human rights and the rule of law.

With Julian Filochowski, Sir Peter Bottomley MP< Kevin MacNamara & H E the Ambassador of El Salvador

With Sir Peter Bottomley MP, former MP Kevin McNamara & H E the Ambassador of El Salvador

N

Speaking at the awards ceremony

Update on operations

Lindsay steadily improving since her nephrectomy 9 days ago, and she managed to get the district nurse to come in and change the dressings today. The main exit wound via which the kidney was extracted is still a bit sore but the nurse said it was OK. She has gone out for a gentle walk in the park with her friend Mary.

I'm also making satisfactory progress three days post angioplasty. Discharge note reads:

'Elective admission for left leg angioplasty - critical limb ischaemia, ulcers and rest pain, due to SFA occlusion. Angioplasty performed to good effect, patient discharged the following day with marked improvement both symptomatically & functionally'.

The occlusion will probably return, but as I said to Dr Jason Wilkins, who carried out the procedure, as long as it lasts for my expected remaining 12 months of life I'm  perfectly satisfied.

Blood results last 9 months
	3.07		17.06	9.06	27.05	25.03	2.03	21.02	24.12	26.11	Normal
Hb	104		107	93	96	98	98	101	104	109	130-180
WBC	2.85		2.25	2.55	2.91	3.15	3.36	3.52	4.00	3.02	4.5-10.0
Neutrophils	1.16		1.17	1.14	1.3	1.57	1.78	1.6	1.8	1.16	2.0-7.5
Plt	249		232	296	342	369	449	494	551	391	150-450

Haemoglobin shot up after I had he blood transfusion in June, and I'm hoping it will stay above 100 if the Hydroxycarbamide can be maintained at 3/week.  That depends on the platelets remaining within normal levels.

At the back door this afternoon - look, no stick

Procedure

I was discharged from hospital at lunchtime today after a stay of less than 48 hours! The surgeon Dr Jason Wilkins, cleared the obstruction of the artery, which extended all the way from groin to knee, using catheters with balloons on the end to push the walls of the artery open, Several of the balloons burst, because the calcium deposits in the artery which let to its occlusion have jagged edges. I wonder if I should be taking calcium tablets, which are intended to remedy falling bone density, but haven't achieved that purpose.

The procedure took 90 minutes, and I had to lie still flat on my back for 3 hours afterwards, to allow the plug closing the perforation in the groin to access the artery to settle down.

The result is very satisfactory, because I no longer have pain in the leg at night or when walking, and with luck the artery should remain free of occlusions for the remaining estimated 12 months of my life. I'm going to start work again from Monday.

Thursday 2nd July 2015 17.15 hrs

Report from Lindsay:

Eric has been returned to his ward from Theatre.  He just had the angioplasty and did not need the bypass operation, which is good news.  He tells me that Jason Wilkins, who unblocked his renal arteries last summer, carried out the procedure, which took about 1 and a half hours.  Several bubbles/balloons were inserted into the femoral artery - a few exploded because there is a calcified lining to the artery - but stents then followed in.  He now has to lie very still for a few hours and we
hope he may be allowed home tomorrow or at the weekend.  More news to follow.