Patient
Protect is an organisation dedicated to the prevention of neglect and
incompetence in our National Health Service, and to the elimination of the
secrecy which allows these problems to flourish. "Sunlight is the best
disinfectant"¹
Last
updated 04 February 2008.
Please
contact info@patientprotect.org or
call 01227 713661 or fax 01227 711426 for more information or to report neglect
in the
If
your relative is being neglected, then complain effectively
NOW!
You are visitor number
Why do we need Patient Protect?
· How rationing actually works
· How to protect yourselves from
rationing
Brief descriptions of other
organisations, and Links.
Personal accounts of abuse in our hospitals.
If you know of cases of abuse,
tell us now.
Why do we need Patient Protect?
Most
patients enter hospital with the belief that they will be treated by competent
staff, and that they will receive whatever treatment they need in order to
achieve a successful outcome. The
Patients’ Charter, recently abolished by this Government, actually stated
that these beliefs amounted to a right, presumably protected by the Government.
The
reality, however, is there is not enough money in the pot to allow everyone to
get the treatment they need, and rationing is here to stay. Although most hospital staff are caring
decent people, many can and do work beyond their level of competence, free from
accountability, with their mistakes and identities hidden from the public.
Most
rationing in our hospitals also goes on in secret. The elderly are
usually the targets, although anyone who can be labelled as an unproductive
member of society is at risk. As well as working to stop this
discrimination, Patient Protect aims to make patients aware of what is happening.
After all, secret rationing can only survive if it is kept secret.
Although
the initial focus of this site was on NHS Hospitals, it is now clear that the
problems we see are common to all areas of the health care system, both NHS and
Private. For more details of the state of the private sector, check the
article "Private Hospitals can damage your health".
At present it seems that hospitalisation is safest as a private patient in an
NHS hospital.
1)Why the young, the
elderly and the disabled are targeted for rationing.
The
first thing to understand is that the new "NHS Trust Hospital" is
really nothing more than a commercial business, run by business managers whose
chief responsibility is to work within the budget set by the government.
The
managers know that there is not enough money to allow all the patients to get
the treatment they need (and which they were promised under the Patients'
Charter) but they also know that to fail in their duty to provide proper
treatment can lead to huge awards of damages in the courts.
The
solution to this problem is to exploit the method the courts use to decide what
the level of damages should be. If the hospital negligently kills a 30
year old family breadwinner, they can end up compensating the family for the
loss of future earnings - this can be millions of pounds. Similarly,
killing a mum with three young kids can lead to big payments for hiring cook,
nanny, housekeeper plus compensation for any income she may have had.
Negligently
killing a young child, an elderly person or someone disabled, however, is
virtually free of these risks, for the simple reason that there is hardly ever
any dependency requiring compensation. Of course, families can and do
complain bitterly, but 'toughing out' a complaint is cheap, as is the eventual
issuing of an apology.
Government,
of course, knows what is going on, but chooses to do nothing. Please read Watch out, you old chickens! for why.
2) How
rationing works at the level of the ward.
Compared
with wards for younger adult patients, wards for the elderly are affected in
three ways by rationing:
i)
reduction in quality and quantity of staff
ii)
reduction in quality and quantity of equipment
iii)
tighter controls on what treatments can actually be carried out, regardless of
how necessary they are.
A
phenomenon known as "supply driven demand"
then operates as staff learn not to ask for things they know they will not
get. Why do staff, whose primary duty is to put the interests of the
patient first, accept these restrictions?
First,
many of the staff who find these restrictions intolerable either avoid working
on the wards for the elderly or quit altogether.
Second,
of the staff who remain, some do care , but feel powerless to do
anything. All nurses know that if they complain, or stand up for the
patients, they are going to face hardship and sooner or later get fired; all
nurses know the story of nurse Pink.
Doctors also know that 'troublemakers' and 'whistleblowers' do not get good
references or promotions and may, like Dr Bolsin have
to leave the country to find work. A recent
survey in The British Medical Journal found that a quarter of staff in an
(unnamed) NHS Trust reported that they had been subjected to bullying in the
previous year.
Third,
some staff simply do not appear to care. Staff guilty of awful cruelty and
neglect can avoid a guilty conscience by using 'techniques of neutralisation'. Examples
of these techniques in use include:
"The
funding cuts aren't my fault" (denial of responsibility)
"She
was going to die anyway" (denial of victim)
"The
resources are better used on someone else" (appeal to higher loyalty)
Fourth,
some staff have ended up callous and heartless. Although they would not
be tolerated on other wards, management allow them to remain on the elderly
wards, presumably because they can be relied on never to stand up for the
elderly patients.
3) How rationing works at the level of the
patient.
It
can be summed up as 'Lambs to the Slaughter'. Most patients and relatives
will not realise (and will certainly not be told) that they are not getting a
pressure relief mattress, even after they have developed bed sores; they
naturally believe that the 'Nil by Mouth' sign over the bed is there for the
patient's benefit (in some cases, no staff will admit to putting the sign there
in the first place); 'Do not resuscitate' orders written in the notes
frequently come to light only after the patient has died. Even if the
relatives or patients do realise what is happening, it is often too late to
reverse the damage. Patients, their relatives and their friends usually lack
the experience and assertiveness to get past a skilful gatekeeper.
Secret
rationing of treatment is bad enough, but there is worse. Although some
patients may die promptly following withdrawal of treatment, others are
stronger and threaten to linger on. These 'bed-blockers' often receive a
helping hand with, for example, overdoses of diamorphine or diuretics.
Diamorphine (heroin) is fast and effective, especially in someone unused to the
drug and already weak. First it induces coma, followed by respiratory
depression, and death. For the hospital, this has the advantage of having
the patient slip away quickly and quietly without any fuss. Diuretics
cause dehydration, and although the result is ultimately the same as with
diamorphine the patient may survive, conscious, for up to a week even with the
imposition of a 'Nil by mouth' regimen. Relatives who do not know the
signs of dehydration may be tricked into believing that the rapid deterioration
is due simply to the underlying illness.
How to protect yourselves from rationing.
1)
Prevention
Staff
are likely to be more diligent and much less willing to participate in
rationing and abuse if they know they can be identified later. Always
keep a notebook and pen handy, and keep them visible.
Ask
at the nurses' desk which nurses are responsible for hydration, nutrition and
pain control. Write these names down as you get them. These names
should be clearly stated in the Nursing Care Plan.
Write
down the name of the person you are talking to.
Ask
for the name of the consultant responsible for the patient, and also ask for
the name of the doctor who will be responsible for the day to day management of
the case.
If
you ask all these reasonable questions in a friendly manner, you can expect
straightforward civil answers. If you feel you are getting fobbed off
with excuses like 'it's confidential' or 'too busy' or 'you don't need to know'
then do not get upset. Simply go to (or phone) the Customer Services
Officer and ask them to find out for you (don't forget to ask for their
name). Explain that it is important that you know who is responsible for
what in order that communication can be improved and problems can be avoided.
If this does not work then send written complaints (see next section).
2) How to
stop existing problems.
The
first step is to recognise that rationing and neglect are taking place.
Dehydration, bed sores and a general lack of attention from qualified staff
(e.g. soiled bedding, call button out of reach, regular observations not being
done) are all reasons to suspect neglect. Are the staff reluctant to show
you the patient's records and discuss the drugs being used? Is
Diamorphine PRN on the prescription chart? Is a DNR order in the notes
without your knowledge? Are you told that the Consultant/Doctor/Surgeon is too
busy to see you?
If
you feel that the patient is deteriorating rapidly and their treatment seems to
be the cause, rather than the cure, then step two is to complain
effectively. Rationing and neglect are top-down processes, so
* Complain by fax/email to
the Chief Executive of the Health Authority responsible for the hospital (phone
the local Community Health Council for his name, fax and phone numbers) and
* Copy this by fax/email to the Chief Executive
of the hospital and Consultant responsible for your relative's care.
* Immediately follow up with a call to their
secretaries and confirm receipt of the fax. Stress to them that you will
take things further if nothing is done. Ask for their name, write it down
together with the time of the conversation. Send faxed copies to the
other organisations (see below). Keep fax receipts.
*
Keep records of all significant events -
keep a diary with names of staff, what they do/do not do, etc, record
conversations (use recording walkman, dictaphone, mp3 recorder, mobile phone
etc), photograph evidence of neglect.
* If the situation does not improve rapidly,
demand to see the Consultant and demand an immediate transfer for your
relative.
* The following is a suggested outline -
contact us if you can suggest any improvements. Please cut and paste to
your word processor:
[Name
and address of CEO of Health Authority]
Dear
[Name of CEO]
I
have reason to believe my relative [Patient's name], [Date of Birth], [Hospital
Record Number] is not being treated at [Name of Hospital] in accordance with
Article 2 of the Human Rights Act .
My
main concerns are: (e.g. lack of treatment, attitude of staff, unhygienic
conditions, patient lying in excrement, bed sores, dehydration, inappropriate
use of diamorphine, etc)
1)
( write main concerns )
2)
3)
I
require an urgent review of [Patient's name] and if this does not improve the
situation , I would like to request a transfer to a different unit. Staff
in this hospital have been negligent in the care of [Patient's name]. Their
names are
1)
Dr [Name]
2)
Nurse [Name]
3)
etc
I
enclose an extract of my diary of the events leading up to my dissatisfaction .
Failure
of your health authority to improve the standard of care immediately will
result in litigation on the grounds of negligence. In addition , if my
relative, [Patient's name], dies , you will be liable for manslaughter in
addition to knowingly being in breach of the Human Rights Act .
I
look forward to an immediate review . My telephone number is xxxxxxxxxx.
The telephone number of the ward where [Patient's name] is located is
xxxxxxxxxx .
Yours
sincerely ,
[Your
Name]
[Date
and Time]
cc
The Chief Executive of the [Name of hospital]
cc
[Name of Consultant responsible for your relative's care]
cc
Department of Health
cc
Mr David Hinchcliffe, Chairman, Parliamentary Committee on Health
cc
[name of local MP], MP
cc
Editor [Name of local newspaper]
cc
[Name and Firm of your solicitor]
cc
Dossier to European Court of Human Rights
You
can find the name of your M.P. and a contact address at http://www.locata.co.uk/commons
In
the meantime, visit your relative and stay constantly, take pictures and tape
any conversations. Note down everything in detail. That is the key .
Dehydration
can cause death in as little as three days, so it is important to spot it
early. The first effect of dehydration is a sensation of thirst, so
complaints about feeling thirsty should be taken seriously. The
depression, confusion and delusions which follow as the dehydration deepens are
also important signs which are often assumed by relatives to be part of some
natural downhill progression. One useful test for serious dehydration is
to gently pinch some loose skin between thumb and forefinger. Dehydrated
skin stays 'pinched' whereas normal skin returns to its original shape (try
this on yourself first!). Other effects of dehydration include dry mouth
and throat and shortness of breath (in turn making speech and swallowing
difficult), deafness, swollen tongue, constipation and pneumonia.
Dehydration weakens skin, and once the patient is too weak to move, bed sores
can quickly develop.
Bed Sores (also known as pressure
sores, decubitus ulcers) develop as a result of lying in the same position for
too long. Constant pressure on the same spot reduces the flow of blood to the
extent that the skin dies. If the pressure continues the area and depth
of the tissue necrosis increases. Necrotic (dead) tissue quickly becomes
infected and this infection can spread to the blood. Poor nutrition and
hydration increase the risk of bed sores. The risk of bed sore
development should always be assessed and reassessed frequently, and staff who
fail to do this or who fail to act appropriately to an assessment are clearly
negligent. Make sure you get to see if the patient's back and heels look
healthy. Staff should routinely conduct an objective pressure sore risk
assessment, such as the Waterlow pressure sore 'Risk Score'. The
assessment is very simple to do yourself; just get a
copy of the form, print it and then fill it in. If the patient
appears to be at risk, ask a senior nurse if she agrees with your score.
The Waterlow website has
useful information on both prevention (you can buy a download ‘Pressure Sore
Prevention Manual’) and treatment.
Diamorphine, otherwise known as
Heroin, is usually used in palliative care and heart attack patients. It is
injected subcutaneously (under the skin) or intravenously (through a vein).
Placing it through a vein makes the drug act faster. Its effects are multiple.
Used usually for pain relief, it can also depress respiration thus decreasing
your drive to breathe. It also relieves anxiety e.g. in heart attack patients.
It is a drug that is useful in heart failure enabling the load of the heart to
be less thus relieving the problems of the failing heart coping with a large
amount of blood.
It
can be prescribed as a PRN (dose) which means as "as much as
necessary"(necessary for what?). Being a controlled drug, it has to be
signed for two people when giving it. Usual doses are 2.5-5mg. It may be placed
in a syringe pump, usually in palliative care, (e.g. for terminal cancer
patients) to relieve pain and distress. Diamorphine is contraindicated in
people with respiratory conditions because it may cause respiratory arrest.
How
incompetence is concealed.
This
section is in preparation. If you need information on this section, please
email me at info@patientprotect.org or phone me at 01227 713661 (or +44 1227
713661 from outside the
How
to protect yourselves from incompetence.
This
section is in preparation. If you need information on this section, please
email me at info@patientprotect.org or phone me at 01227 713661 (or +44 1227
713661 from outside the
Complaints
and the NHS
The
original purpose of this website was to help to prevent the elderly and other
vulnerable groups from becoming victims of secret rationing. Sadly most
feedback to this site is to report first hand experience of cruelty and neglect
in our hospitals. Most people report being stonewalled by hospital staff
handling their complaint, and remain dissatisfied with the explanations they
have received. What follows in this section is a very brief survey of your
options.
Hospital
(or GP) Records - Patients, and relatives of deceased patients, are entitled to
see and receive an explanation of the original records and/or have photocopies
of the originals supplied at cost. The Access to Health Records Act 1990 gives
you a right of access to health records of a deceased relative from 1 November
1991. The Data Protection Act 1998 , which repealed most of the 1990 Act,
allows living patients to access their own records, paper and computerised,
with no limit to how far back you can go.
The
fees involved are modest and are limited by statute, but if you have difficulty
finding the money, please give me a quick call. Please note, that
radiographs (x-rays) are very expensive to copy, and it may be better to leave
a request for copies of these out of the initial enquiry unless they are central
to your complaint. Instead, ask for a list of any X-rays and scans held
by the hospital, and ask them to include dates, views and name of doctor
requesting them.
Hospitals
can usually supply explanatory notes and an application form on request, but
you can cut and paste the sample letter below. The holder of the health
record has a period of 40 days from the date of your application within which
to provide the copies requested. Make sure that you enclose evidence as
to your identity with your application - the 40 days only starts when they are
satisfied as to your identity. There are a limited number of reasons for
withholding access to records, but these will rarely apply. Please
contact me if you need help organising or understanding your copies of the
health records.
[Your Address]
[Date]
Dear
Sir/Madam
Re:
[Patient's name], deceased, dob [date of birth]
I
wish to apply for copies of any records you hold for the above patient. I am
the next-of-kin of [Patient's Name], and this application is made under
S3(1)(f) of the Access to Health Records Act (1990). [Patient's Name] was a
patient of yours in [year(s)]
I
understand that a fee will be payable to cover the cost of making the copies
and postage. In view of the high cost of copying radiographs and other images,
please do not copy these, but instead provide me with a complete list
(including dates, views, name of Doctor requesting them) of what, if any, you
are holding.
Please
contact me at the above address if you require payment in advance.
Yours
sincerely
[Your
Name]
NHS
Complaints Procedure - Most complainants find
these procedures a complete waste of time. The Local Investigation of the
complaint usually exceeds all time limits, results in nothing new being
revealed, and merely provides the staff with an opportunity to discover what
evidence you have against them. According to a recent study by the Public
Law Project: "The overwhelming feelings that that complainants were left
with, following attempts at local resolution in these cases, were that issues
had been covered up, staff had been protected, and that no one was prepared to
take responsibility" ( Section 2.53, Cause for Complaint? An evaluation of
the effectiveness of the NHS complaints procedure). Independent review is
far from independent (mine was denied by the Acting Chairman of the Trust) and
when a review is granted the evidence is often presented in a biased way or
even tampered with. The Ombudsman's staff seem to spend most of their
time presenting excuses for not holding an investigation. It is important
to note that attempting to reason with administrators at each of these levels
is very time consuming, and care must be taken not to exceed the three year
limitation period for Civil Litigation, after which civil actions are normally
barred. NHS procedures are not available if you have stated, in a letter
or orally, that you intend to take legal action. A critique of the NHS
Complaints Procedure prepared by SIN also suggests that the whole procedure is
a complete waste of time.
Complaints
to the UKCC about poor nursing standards are also likely to be a waste of time
- please see the review of the state of the UKCC, copied from the NHS-Exposed
site.
The
following three subsections are in preparation. If you need information on
these sections, please email me at info@patientprotect.org or phone me at 01227
713661 (or +44 1227 713661 from outside the
Civil Litigation - The new website
http://www.medicalclaims.co.uk/ is free and provides information on clinical
negligence claims. The site asks for no personal information and carries
no advertising.
Criminal Prosecution -
Inquest - One of the most
common ploys used by coroners trying to avoid an inquest is to say that they
are satisfied that death was due to natural causes. The cause of death is
usually written by the hospital's own pathologist, who is hardly likely to want
to draw attention to dehydration, diamorphine or negligence as being
significant factors in causing death. A recent court case has made the
'natural causes' excuse for not holding an inquest much less tenable. The
judges in this case made it very clear that if the patient suffered from a
condition which, if not monitored and treated in a routine way will result in
death, and, for whatever reason, the monitoring and treatment is omitted, then
the coroner must hold an inquest unless he can say that there are no grounds
for suspecting that the omission was an effective cause of death.
News.
*
Newspaper and other Reports
*
House of Commons Health Select Committee and Legislation
*
Meetings
*
Newspapers on the Web
Newspaper
and other Reports:
BBC
Website, 25 May 2004
Abused
pensioner's body to be exhumed - An order has been obtained by police to remove
the body of William Pettener, 95, who was a resident at a private nursing home
in Porthmadog in Gwynedd. A member of staff at the Bodawen nursing home has
been suspended following allegations made by several members of staff
concerning abuse by a fellow worker at the home. Members of staff alleged
that a colleague used verbal abuse against them and both verbal and physical
abuse against residents. The retired engineer, from Ormskirk, died at the home
on 12 April, with the cause of death given as bronchopneumonia. It is thought
the exhumation will take place next week.
Shamed
social services say ?sorry? for neglect - Social Services chiefs have
apologised to the son of a pensioner who died through neglect. Frail Mary
Sharpe, 86, died after developing a pressure sore on her back. She was
discharged from
Now
Social Services chiefs have been forced to make a full apology to her angry
son who has been fighting for justice since his mum’s death. He alleges
he only discovered the bedsore when it became infected and began to smell.
Geoffrey claimed: ?I walked through the door and was appalled to find the flesh
around the wound had begun to rot and was exposing the spine. I was furious.
She was unable to walk, talk, or swallow and had little movement. She was
literally on her deathbed but was even robbed of dignity there.?
Ananova,
19 May 2004
Nurses
found guilty of killing patient by neglect - Two nurses have been found guilty
of killing an elderly patient at a nursing home. Dennis Latham, 33, from
Blackburn, Lancashire and Barbara Campbell, 62, from
Latham
was the nursing services manager at the home at the time of the death.
Mrs
Dennis died in July 1999 from septicaemia resulting from pressure sores the
"size of a fist" that developed while she was a resident at
The
Daily Telegraph, 13 May 2004
Care
is being jeopardised and hospital resources squandered in a Government drive to
bring down waiting lists before the next election, NHS doctors warned
yesterday.
Orthopaedic
surgeons are concerned that an initiative to employ overseas doctors in special
private centres could lead to inferior and sometimes "botched"
operations.
They
say the move will end up costing the taxpayer more because the NHS will have to
correct poor surgery and replace hip and knee implants sooner than normal.
Their
concerns follow an NHS inquiry into an unnamed South African doctor employed by
a private company. The surgeon, who worked at the
John
Timperley, consultant orthopaedic surgeon at the Princess Elizabeth Orthopaedic
Centre,
Independent,
13 May 2004
Incompetent
student nurses are being allowed to qualify because hospital examiners are too
reluctant to fail them, an industry report warned yesterday.
The
Nursing And Midwifery Council, which regulates the profession, strongly
criticised senior nurse mentors who assess trainees on the wards for passing
sub-standard students as fit to practice. Patients may be put at risk
because mentors are "failing to fail" students who, in some cases,
have repeatedly had concerns raised about their ability to perform clinical
tasks, the report said.
Andy
McGovern, a mentor at
The
Guardian, 13 May 2004.
Hospital
Meal Times to be Sacrosanct- the government has told NHS hospitals to return to
the values of Florence Nightingale by introducing strict mealtime discipline on
the wards to ensure that patients eat their food.
Health
ministers want nurses to adopt procedures trialled at King's College hospital
in
"We
saw patients were not being prepared for meals, not in a comfortable position and
with food left out of reach. Food was placed on the table next to bottles of
urine and vomit bowls. It was awful. Patients would be eating when someone was
taking blood at the next bed or putting a patient on a commode."
She
said the contracting out of catering over the last 10 years may have
contributed to the downgrading of meal times. Recent NHS research found that
40% of people coming into hospital were malnourished and of those 70% became
further malnourished during their stay in hospital.
Her
response was to introduce a "protected mealtime", setting aside two
hours from noon for eating and rest. Doctors were told to keep away unless
there was an emergency and visitors were discouraged unless they came to help
the patient eat. The diagnostic department which used to do all inpatient tests
during lunchtime has rescheduled to take only outpatients then.
Daily
Telegraph, 29 April 2004
Nurse
'tried to kill elderly to free beds' - A ward sister tried to murder four of
her elderly patients in a ruthless drive to free hospital beds, a court was
told yesterday. Barbara Salisbury, 47, crossed the line between
"humane nursing and callous dispatch", it was claimed. She gave
a 76-year-old man an excess of diamorphine, telling him as she did so:
"Give in. It's time to go." On another occasion she instructed
a nurse treating a 92-year-old: "Lay him flat. With any luck his lungs
will fill with water and he'll die." She justified her administering
of diamorphine to an 88-year-old woman at
Robin
Spencer, QC, prosecuting at Chester Crown Court, said: "Barbara Salisbury
arrogated to herself the right to decide when patients should die, and
attempted by her actions to shorten what remained of their lives.
"If she thought a patient had no hope of recovery she didn't want to have
to wait too long. If a patient could be made well enough she would aim for
that. If not, she would hasten death. "One way or another, she
wanted these patients off her ward."
Mr
Spencer alleged that
The
Sunday Times, 25 April 2004
How
extra spending failed to improve the public services - confidential research
prepared for senior ministers and aides showed that, although the government
had pumped billions of extra taxpayers? money into the public sector, large
amounts had apparently been wasted.
Since
Labour was elected in 1997, total public spending has risen almost 50% to £459
billion. But the research found the taxpayer, hit by a series of stealth taxes,
had not received value for money. Much of the cash had been swallowed up by an
inefficient bureaucracy and inflation-busting pay rises for civil servants.
The
revelations, contained in cabinet committee minutes leaked to The Sunday Times,
may have lasting consequences for Blair and Labour come the general election,
which is expected next year. The reports showed public sector productivity ?
the key measure of efficiency ? has ?fallen steadily? since 1997. According to
official data never previously released, efficiency has dropped 10% over the
past seven years. In health and education, the key election battlegrounds, it
has slumped by between 15% and 20%. In the past, the government has only ever
admitted to a 3% fall in productivity since the 1997 election.
In
basic terms, this means the extra money being spent on the public sector is not
being adequately reflected in better services. Economists found that the
massive ?inputs? into the public sector were not being matched by enhanced
?outputs? in the form of better schools, hospitals and police forces. Experts
calculate the slump in productivity means Labour is wasting £20 billion a year
? equivalent to almost 6p on the basic rate of income tax.
The
government is also expected to be forced to admit that it will not meet its
pledge to employ 7,500 more NHS consultants by the end of this year. It claims
to have met the target for GPs but professional bodies say many new GPs are
part-timers. The Audit Commission reported last week that, despite the billions
ploughed into the NHS, hospital trusts now had a cumulative debt of £500m.
Times,
April 24 2004
GMC
ignored surgeon warning - the future of the General Medical Council (GMC) was
back under the spotlight yesterday after the disclosure that it could have
acted against a disgraced gynaecologist ten years before he was struck off.
Police
warned the GMC in 1988 that Richard Neale was already banned from working in
Correspondence
has now emerged, however, that shows that the GMC was consulted about Mr Neale
by North Yorkshire Police in 1988, when a decision to take no action against
him was made by Lord Walton, who was the council’s president.
All
GMC papers relating to the episode have been destroyed, but a file found by the
police was handed to a government inquiry into the NHS's handling of the Neale
case. Its findings are expected to be announced this year. The GMC
admitted it was warned about Mr Neale by Canadian medical authorities in 1985.
It blamed administrative blunders for its failure to act when he arrived in
It
issued an unreserved apology yesterday. Its chief executive, Finlay Scott,
described the council’s conduct in 1988 as ?extraordinary and
inexplicable?. An official added: ?A situation like this could not arise
again.?
Guardian,
10 March 2004
Doctors
violated disabled boy's rights - The human rights of a severely disabled boy
and his mother were violated when doctors who thought he was dying overrode his
mother's objections and gave him diamorphine to ease his death, the European court
of human rights ruled yesterday.
The
unanimous ruling by seven judges in
The
court awarded David Glass, who survived and is now 18, and his mother, Carol,
pounds 7,000 in damages and pounds 10,500 in costs for a breach of article 8 of
the European convention on human rights, the right to respect for private life.
The
judges said: "The court considered that the decision to impose treatment
on David in defiance of his mother's objections gave rise to an interference
with his right to respect for his private life, and in particular his right to
physical integrity."
A
"do not resuscitate" (DNR) order was put in his notes without telling
his mother.
David's
condition deteriorated and doctors recommended diamorphine, which depresses
breathing, to relieve his distress. Ms Glass did not agree that he was dying.
She asked to take David home if he was dying, but a police officer summoned by
the doctors advised her that if she attempted to remove him, she would be
arrested. David was given diamorphine and his condition deteriorated. His
family demanded it be stopped, but a doctor said this was possible only if they
agreed not to resuscitate him.
Relatives
tried to revive him and a fight broke out in which doctors and police officers
were injured. While the fight was going on, Ms Glass successfully resuscitated
David. His condition improved and he returned home. Three family members were
later jailed for violent disorder and causing actual bodily harm.
Ms
Glass took her case to
Guardian,
11 February , 2004
Relatives
demand prosecutions for hospital abuse - Relatives have today rejected a
trust's 'unreserved apology' and demanded prosecutions following an internal
inquiry that found vulnerable older people were assaulted by its mental health
staff.
Norma
Chatt, whose 81-year-old mother spent more than a year on Rowan ward at
Withington hospital in Greater Manchester, said today: “I want the people
responsible brought to justice, that is what all the relatives want. What use
is an apology nearly two years later?" She claimed her mother, who
has Alzheimer's disease, suffered six black eyes while on the ward. She said:
"When all the relatives got together and compared what had been going on
it was awful. There were reports of patients being scalded, not being fed and
having soap put in their mouths."
The
call for prosecutions comes a day after a report into the inquiry by the mental
health trust, which was responding to a damning inspection last year of care
standards on the ward by the Commission for Health Improvement (Chi). Chi inspectors
found poor management and supervision and low staffing levels.
The
inquiry report revealed patients with dementia, schizophrenia and depression on
Rowan ward were kicked, slapped and beaten by staff. It concluded standards of
nursing care were outdated, doctors failed to report patients injuries, systems
to detect abuse were poor and there was a culture of "intimidation and
even fear" among staff on the ward.
However
the report failed to single out who was to blame for the injuries and concluded
they were "unattributable".
Greater
Sunday
Times, 08 February 2004
Coroner
seeks inquiry into ?mass euthanasia? at hospital - A Coroner is demanding a
public inquiry into claims that 11 hospital patients were deliberately starved
to death. He believes that it could be
There
is now increasing concern across
The
allegations first surfaced after Jayne Drew, a healthcare assistant, alerted
the hospital managers after the deaths of Simon Smith, 74, and Arthur Boddice,
81, in the summer of 1997. Families of fellow patients at the hospital
claimed that some staff had become so upset at seeing elderly people being
starved that they had taken it upon themselves to feed them secretly. One
relative has described how it was distressing to see his father go without food.
Andrew Hughson said his 75- year-old father, also called Andrew, would vainly
stretch his hand towards meals being delivered to other patients. ?We
kept being told that feeding him would be bad for his general health, and he
was too frail to tell us otherwise,? he said. Simon Smith’s son Michael
said ?At the time we thought my father’s treatment was consistent with what you
would expect. Now it appears he was not being fed. We all want to know the
precise causes of these deaths and we still haven’t had an answer.?
Ann
Alexander, the solicitor acting for the bereaved families, said it was unfair
that top QCs and junior counsel were being provided out of public funds to
represent the health authority, medical and nursing staff at the inquest while
no legal representation was being provided for the families.
Police
are also investigating the unexpected deaths of 62 patients ? all pensioners ?
who had been admitted for postoperative rehabilitation at the Gosport War
Memorial hospital in Hampshire. In
CHI
Press Release, 22 January 2004
CHI
gives evidence to Health Select Committee on the abuse of older people - The
plight of older people who are abused while receiving NHS services was
highlighted before a Government inquiry today.
"Some
older people are among our most vulnerable citizens and that makes it possible
for them to become victims of abuse. It must be a matter of extreme concern
that even when we would expect them to be safe in the care of the NHS, some
older people are still at risk," said Commission for Health Improvement
(CHI) chairman Dame Deirdre Hine.
"We
know that most NHS staff are caring and committed and give sensitive care to
older people. However, caring for older people is a demanding and complex job,
especially if the patients are showing challenging behaviour. If staff don’t
get the full support, training and supervision that they need, then this can
result in some older patients being abused. That abuse can take the form of
physical abuse, but also emotional abuse, neglect or inappropriate restraint
and sedation".
"Our
findings so far show that older people’s services are generally given low
priority in comparison with other services. We believe that the standard of
care of older people nationally is worrying and what is more, the NHS doesn’t
seem to be learning because the same issues keep coming up again and
again," said Dame Deirdre.
"Despite
the best efforts of many staff, we are seeing too many cases where older people
are not getting the care they need and this is unacceptable. We are delighted
the Health Select Committee is holding this inquiry and we hope the resulting
report will lead to action to help ensure a greater focus on older people’s
services," said Dame Deirdre.
Friday, 16
January 2004
Cancer
ward nurse arrested after patient's suspicious death - Murder squad
detectives have arrested a nurse in connection with the death of a
pensioner and are investigating the cases of other patients who were treated on
the same cancer ward. The 25-year-old was arrested on suspicion of
administering a noxious substance at Hull Royal Infirmary.
Wednesday, 24
December 2003
Patient
challenges doctors for right to live - Aman with a degenerative brain condition
has launched an unprecedented human rights challenge to guidance for doctors
which he believes could allow them to end his life by legally sanctioned
euthanasia.
Leslie
Burke, who has cerebellar ataxia, is mounting a right-to-life challenge to
General Medical Council guidelines on withholding and withdrawing
life-prolonging treatment which spell out when doctors can stop artificial
feeding and let a patient die.
'Our
gran died after long wait on trolley' - an 86-year-old woman died of a brain
haemorrhage after being left for eight hours on a hospital trolley.
Her
family claim they were told she was suffering from a simple chest infection.
Dorothy Atkinson's relatives say they were told by Leeds Infirmary that she was
"fine" and were urged "not to worry." But hours later tests
showed the great great grandmother was suffering from a brain tumour and was
bleeding heavily. Two days later she was dead.
The
retired hospital worker was taken to LGI after collapsing at her nursing home
in Pudsey on Thursday, December 11. She was admitted to hospital just after
5am. Soon afterwards her family telephoned the hospital to check on her. They
say they were told she was "fine" but was suffering from a chest
infection.
But
when they arrived at the hospital at around 1pm that day, they say they found
her lying on a trolley in the corridor, unable to move and covered in her own
vomit.
Her
son, Peter, said she was eventually moved to a bed but only after the family
"caused a scene." On the Friday she was taken for tests and a CT
brain scan revealed she had a tumour and was suffering a major haemorrhage.
Daily
Mail, 17 July 2003
NHS
targets ?cost lives" - Patients are being left to die by hospitals forced
to meet ?meaningless" targets rather than give proper care, it was claimed
yesterday (16/07/03). Liberal Democrat health spokesman Dr Evan Harris claimed
the latest NHS star ratings showed only how well hospitals could hit targets
and fill in spreadsheets. He said, ?Star ratings divert the attention of
doctors and nurses and force hundreds of managers to spend their time
collecting information, not improving patient care."
The
Guardian, 18 December 2003
Mental
health patients 'neglected' - Chronic staff shortages in NHS mental health
trusts in
The
Commission for Health Improvement said mental health remained "the poor
relation of the NHS", four years after ministers pledged to make it a
priority.
Its
inspectors found that "significant national shortages of psychiatrists and
nurses are having a major impact on clinical leadership and quality of patient
care".
Mental
health trusts commonly relied on excessive numbers of agency staff who did not
have the skills needed to cope with a violent incident, the commission said.
This left permanent staff working long hours and feeling unsafe.
Patients
were also concerned about their exposure to violence from other patients. Bed
shortages led to inappropriate mixes of patients with different needs. Staff
struggled to stop illicit drugs and alcohol.
The
Daily Telegraph, 04 December 2003
IVF
mother was killed by negligence of hospital staff - medical negligence by her
own hospital colleagues led to the death of a doctor just hours after the birth
of the twins for which she had yearned.
A
verdict of "medical misadventure to which neglect contributed" was
recorded at an inquest into the death of Dr Sandyha Senanayake, who gave birth
to a boy and a girl at the hospital where she worked, only to die shortly
afterwards of internal bleeding.
30,000
nurses desert the NHS
RECORD
numbers of nurses are quitting amid growing concern about the continuing staff
crisis in the Health Service. The number who left the
The
exodus of 30,200 nurses almost cancelled out 31,700 new recruits, many from
overseas. In the previous year, 18,700 nurses left the profession.
The
Royal College of Nursing said it feared the loss of experienced nurses heralded
a 'demographic timebomb' with increasing numbers of NHS staff becoming eligible
for early retirement.
Daily
Mail. 02 December 2003
Life-saving
treatment 'denied to over-70s' with breast cancer'
THOUSANDS
of older women are being denied surgery for their breast cancer because of
their age, a cancer surgeon will claim today.
Ian
Fentiman, professor of surgical oncology at Guy's and
Instead
of surgery, many women over 70 were only given the standard breast cancer drug,
tamoxifen - but in many cases without the test which would show whether the
drug was likely to work for them or not, he says.
Prof
Fentiman, an eminent cancer surgeon, is speaking at a debate today run by
Cancer Research
"This
practice is very widespread. Across the nation it must run into thousands.
The
Daily Telegraph, 29 October 2003
June
18, 2003
'Ignored'
surgeon's fury at death of patient, 85 - Staff at a hospital with one of the
highest death rates in the country are alleged to have allowed an elderly women
to die against the specific instructions of her surgeon.
David
Shields said that he was overruled behind his back by anaesthetic staff at
The
woman’s family have complained to the hospital and called for an independent
inquiry. In March, the independent Dr Foster guide to hospitals said that
Oldchurch had one of the highest mortality rates for emergency admissions. It
awarded it one star out of a possible ten.
The
hospital denies the allegations and said that an internal inquiry had found
that the patient should not have been operated on because she was suffering
from a number of pre-existing medical conditions.
Mr
Shields, who was working as a locum at the hospital, resigned, saying that he
was appalled at the management of patients there. He added that the woman’s
care had been his responsibility, not that of the anaesthetists who run the
high dependency unit, where the patient was being treated.
?I
am not prepared to accept responsibility for the death of patients under my
care when treatment is either not given or withdrawn by others without my
consent,? he said.
He
has won support from SOS NHS Patients in Need, which represents the families of
patients whom it believes die unnecessarily in hospitals. ?This highlights the
fact that so many doctors are prepared to write off someone just because they
are elderly,? Julia Quenzler, a spokeswoman, said.
The
affair began when the 85-year-old woman was admitted to the hospital on April
19 with an apparent obstruction of the bowel. She was taken to the high
dependency unit and operated on by Mr Shields. His instructions had been that
in the event of cardiac arrest she should be resuscitated. The next day, he
said, he saw her twice and she appeared stable. But on his ward round the
following morning he was told she had died and from the medical notes
discovered that a decision had been made by the anaesthetic staff not to
resuscitate her.
A
report prepared by another surgeon, Shukri Sami, said the death was caused by
heart disease and failure, with no evidence that a medical intervention had
caused the death. Mr Sami blamed a ?lack of communication? between the surgical
and anaesthetic teams for confusion over resuscitation.
Mr
Shields resigned immediately. He was suspended from operating and caring for
his patients. ?Accordingly, the person who drew the trust’s attention to the
problem has been removed, instead of the problem being addressed,? he said. ?So
much for the Government’s charter for whistleblowers.?
The
hospital said that the order not to resuscitate had been entirely appropriate
in this case, and claimed that it had been agreed by Mr Shields, who had
subsequently changed his mind. A spokeswoman said an inquiry had found Mr
Shields should not have operated on the patient because she was not in a suitable
medical position. She said the surgeon had then tried to influence the woman’s
family, who had agreed that she should not be resuscitated, to change their
minds after the event.
Mr
Shields denies all these claims. He also strongly denies the trusts's claim
that he had been in favour of a DNR order. ?The form was actually signed by the
anaesthetic senior house officer, who certainly knew my view,? he said.
Mark
Rees, chief executive of
?We
have met with the patient’s daughter and would wish to make it clear that they
are understandably unhappy with the management of their relative’s care.
However the decision made by the clinician after discussion with the family to
implement the ?do not resuscitate? policy was in our opinion clinically
correct.?
June
18, 2003
Nurse
'tried to kill five patients'
By
Russell Jenkins
POLICE
have charged a hospital nursing sister with the attempted murder of five
elderly patients who later died.
Barbara
Salisbury, 47, who worked at
It
is understood that the inquiry, led by Detective Chief Inspector Adrian Wright,
has centred on medication administered to patients while under her care on a
general ward.
Detectives
began their investigation in May 2002 after colleagues raised concerns in
relation to a ?number of issues? over her treatment of four men and one woman
in the NHS hospital who later died. It is understood that detectives looked at
many other cases as part of their inquiry.
Mrs
Salisbury went on holiday in June last year for two weeks and returned to
discover that she was suspended from duty. She has remained off work on full
pay since.
She
lived with her family in
The
brief hearing before magistrates was told that Mrs Salisbury had been charged
with the attempted murder of five patients between May 1999 and April last
year.
She
is alleged to have attempted to murder James Byrne, 76, on or around May 18,
1999, Reuben Thompson, 81, between February 22 and March 14, 2002, Frances Mary
Taylor, 88, on March 21, 2002, Frank Owen, 92, on March 31, 2002, and Bertram
Madeley, 76, on April 28, 2002. All five have since died.
Mrs
Salisbury was released on conditional bail to reappear next week. An order was
made by magistrates banning the publication of her address.
Any
members of the public with queries should contact a hotline, 01270 612 132, he
said.
Michael
Mackey, the nurse’s lawyer, said that she would fight the charges. ?All I can
say is that these charges will be strenuously denied and this will be
contested,? he said. ?She has been conditionally bailed and was due to appear
at Chester Crown Court on Tuesday.?
Shipman
experts aid inquiry into hospital deaths
An
expert in the use of the heroin-based painkiller diamorphine is to be appointed
by police conducting an investigation into the deaths of more than 50 elderly
patients at a community hospital. Relations allege that the drug, used by
Harold Shipman to kill many of his patients, was overprescribed at the
The
Times 07/11/02; p.3
Police
investigate deaths of 30 elderly patients
Police
are investigating the hospital care of up to 30 elderly patients after
relatives complained that they may have died from overdoses of powerful
painkillers. The families have hired the solicitor who represented many of the
relatives in the Shipman case to put the argument for a full public inquiry
into the deaths. All of the patients who died were admitted to
The
Times 05/11/02; p.5
July
2000
Telegraph,
15 July 2000
Jail
for relatives in hospital fight over boy - A judge yesterday jailed three
relatives of a severely disabled boy after violence broke out around the
hospital bed of David Glass, then 12, as an uncle and two aunts fought with two
paediatricians trying to administer diamorphine, which his relatives claimed
would have killed him. After the confrontation at St Mary's Hospital,
Complaints
by the family that both doctors should be accused of attempted murder were
investigated by Hampshire police but the Crown Prosecution Service decided
there was insufficient evidence to charge them.
June
2000
Telegraph,
6 June 2000
Sick
boy's relatives 'attacked doctors' - A hospital ward erupted into violence when
the family of a seriously ill child turned on doctors who were "trying to
kill" the boy, a court was told yesterday. Alastair Malcolm, for the
prosecution, told the court that the doctors had given David diamorphine as a
painkiller and to help him breathe but the family ordered that the dose be
reduced and accused them of trying to hasten the child's death. Raymond
Davis, 43, Julie Hodgson, 37, and Diane Wild, 42, all of
Times,
5 June 2000
Consultant
is suspended over organ disposal - hospital consultant pathologist, Geoffrey
Hulman, has been suspended following allegations about the disposal of dead
babies' organs.
Mortuary
workers at the King's Mill Centre in Sutton in Ashfield, Nottinghamshire
claimed they were ordered to throw babies' brains and hearts into rubbish sacks
for incineration as well as the vital organs of adults. They said that
they had been ordered to clear them out soon after guidelines relating to organ
disposal were published by the Royal College of Pathologists in March. The
guidelines advised hospitals to search records to see if organs had been kept
without relatives' permission. They also alleged that in some cases they
had been told to destroy evidence of identity. John Watkinson, chief
executive of the King's Mill Centre
for
Health Care Services, said that following post-mortem examinations the disposal
of tissues as clinical waste was "normal practice"
May
2000
April
2000
Sunday
Telegraph, 30 April 2000
Doctors
leaving young disabled to die - Seriously disabled children and young people
are being left to die because doctors have deemed there quality of life so poor
that they do not merit being kept alive. Hospitals and care homes are
increasingly placing secret DNR (Do Not Resuscitate) orders in their notes
which effectively means they are "written off". In recent
weeks, concern has grown about the withholding of treatment from the
elderly. Now patients' groups are worried that a similar policy is being
applied to the young disabled.
Mother demands inquiry into delays at son's death - Although 25-year-old Stephen Hill had spina bifida and was paralysed from the waist down, he was a keen football supporter who led an active life and attended college in Bedfordshire near his residential home. In 1995 he complained of neck pains and headaches and, when he became breathless, a nurse was called. She arrived 10 minutes later and felt a faint pulse but agreed, as she later admitted in an inquiry statement, that she did not resuscitate him for three minutes "because of his physical disabilities and the suddenness of his