It couldn't happen in Britain : Staffordshire General Hospital
Finally, at last, the truth has emerged about the scandals of health care in Mid-Staffordshire NHS Trust.
A hospital's "appalling" emergency care resulted in patients dying needlessly, the NHS watchdog has said. About 400 more people died at Staffordshire General Hospital between 2005 and 2008 than would be expected, the Healthcare Commission said.There is a much fuller report in today’s Guardian. Please read it all.
It said there were deficiencies at "virtually every stage" of emergency care and said managers pursued targets at the detriment of patient care.
BBC
• Assessing the priority of care for patients in accident and emergency (A&E) was routinely conducted by unqualified receptionists.Every single one of the problems listed above has been covered time, after time, after time, after time by NHS BLOG DOCTOR. I have today received a comment from a regular reader who, perfectly reasonably, says this:
• No all-day, on-call cover by consultants because of shortages meant junior doctors were not adequately supervised.
• The trust had two clinical decision units (CDUs) which staff said were used as dumping grounds to avoid breaching the four-hour target for being treated in A&E
• There were not enough nurses to care properly for emergency patients
• Nurses lacked training
• The shortage of nurses on wards meant call buttons went unanswered…patients were sometimes left for hours in wet or soiled sheets...
• Delays in operations were commonplace
• There was often no experienced surgeon in the hospital after 9pm
• Few patients were given the drug warfarin to help prevent blood clots
• Essential equipment was not always available or working
• The trust board was more concerned with finance, targets and achieving foundation status, with little evidence that poor standards of nursing care were identified or discussed
• The trust was poor at identifying when things went wrong and managing risk
Full report in the Guardian
Interesting to see what further developments come out of Staffordshire. One can’t but help wondering if things where so bad why there are no reports of Doctors Complaining. If they did not surely there are grounds for disciplinary procedures, and if they did and were ignored it is even more shocking and the investigation should move further up the food chain.I agree with Joseph K. Allowing this appalling lack of care to continue should be grounds for disciplinary proceedings against any doctor who was involved. So why did the Staffordshire doctors not complain? Once upon a time, one of them did. A courageous doctor then working in a hospital a few miles away in North Staffordshire NHS Trust complained about the appalling medical care she had witnessed in her hospital. Look what happened to her. She was treated by the GMC in the way that Stalin used to treat political dissidents, including being accused of being mentally ill.
Joseph K.
I said elderly people were being helped to die - so they tried to say I was mad HOW GMC TURNED ON BRAVE NHS WHISTLEBLOWERPerhaps you now understand why doctors in Staffordshire are too frightened to speak out. Or anywhere else for that matter. But do not lose heart, comrades, for already there is good news from Mid-Staffordshire NHS Trust. "Forward together" the front end of their website proudly proclaims.
By TOM WELLS, Sunday Mercury, 06/02/2005
A BRAVE NHS whistleblower could land a record damages pay-out from the General Medical Council - after it branded her 'mentally ill' in a secret smear campaign. Dr Rita Pal went to the watchdog five years ago, claiming seriously ill elderly patients were being helped to die in Midland hospitals. But instead of taking her shocking complaints seriously, the GMC turned on her. Top-ranking staff openly questioned her sanity and even talked of launching a probe into whether she was fit to practise. Now DrPal could sue for huge damages after a judge blasted the controversial doctors' watchdog for acting like a 'totalitarian regime' similar to Stalin's Russia…
Dr Pal, from Sutton Coldfield, recently won a landmark court case which now paves the way for her to sue the GMC. The preliminary hearing - held last summer - had been brought by the [GMC] who wanted to 'strike out' any lawsuit…before it reached full trial. Instead their case - which cost them £84,000 in legal fees - was thrown out…
Full story here.
That must be the understatement of the year for people living in Staffordshire. But the new commissar, Comrade Eric Morton, is full of reassurance:
"We know that coming into hospital can be a stressful time for many people. We aim to make your stay with us as pleasant as possible."
Following the release of the Healthcare Commission (HCC) report today, Wednesday 18th March, Mid Staffordshire NHS Foundation Trust has formally received the report, its conclusions and recommendationsBe under no illusion. What went in Staffordshire is probably going on in a hospital near you. It may not be as bad. Yet. Or, it may be just as bad, but even now is being hushed up. Maybe you do not believe it. But one day soon, you (or more likely your elderly mother or father) will be admitted to hospital. Then you will know.
Commenting on the report Eric Morton, Chief Executive of the Mid Staffordshire NHS Foundation Trust, said; “The challenges the Trust has faced since 2005 have been clearly outlined in the comprehensive report from the Healthcare Commission. This report highlights the work that the Trust and its dedicated staff have contributed to transforming Stafford Hospital from one that was failing to one that is already significantly better in many areas and continuing to improve in the key areas highlighted by the Healthcare Commission.
“The report has highlighted instances where care standards fell below those that our patients had a right to expect of their hospital and we regret this. We would like to take this opportunity to offer our very sincere apology. We would like to reassure the local community that our focus is, and will remain, on providing high quality, efficient and safe health care for the people of Staffordshire.
Comrade Eric Morton : Mid-Staffordshire NHS Foundation Trust
Ben Bradshaw has apologised to the country. Why has he not resigned? Why has Alan Johnson not resigned? What has happened to ministerial responsibility? Can someone please tell me, how big does a health care catastrophe have to be before the politicians in charge resign?
Labels: dumbing down, get our nurses back to nursing, lack of nursing care, Mid-Staffordshire NHS Trust
37 Comments:
Remind me again, Doc: what was your objection to the GMC offering its staff private health insurance?
My wife is due an NHS operation soon: should I pull her out and pay for an operation myself? (We have no insurance.)
It has to be pretty big, doc, because if they resigned over every single major mess-up, we'd end up with noone holding any of these positions.
Remind me again, Doc: what was your objection to the GMC offering its staff private health insurance?
My wife is due an NHS operation soon: should I pull her out and pay for an operation myself? (We have no insurance.)
++++++
The cost of the gold lined cover they all get out of the now huge contributions we are forced to pay them. And just the general feeling of sadness that the GMC of all people has so little confidence in the NHS that its workers do not use it. Why did not Prince Charles, or Tony Blair, or Harriet Harman, or Daine Abbot (particularly her, as a left winger) use the ordinary nearest comprehensive?
Would i pay for a private operation? Depends what it is and where you are having it
John
I once thought that the Private Eye diary column that replaced The Vicar of St Albions was a joke. It is increasingly clear that the real face of NuLabour is pretty accurately portrayed by the Prime Ministerial Decrees that come from the Desk of the Supreme Leader.
The Labour Party couldn't run a piss-up in their local brewery and the devastation of the NHS by managerialism is pretty much all down to a succession of nonenties promoted way beyond their level of competence.
Sadly this is pretty much the routine standard of care offered thanks to bullying management and craven adherence to targets. Most doctors have burned out their whistle-blowing circuits with repeated overload.
My most recent example was an unfortunate patient of mine who was admitted to one of the local DGHs from a nursing home for the elderly demented. Despite my advice to his family that he would be better nursed there than in hospital they insisted that I send him in. I refused, but they waited until the deputising service was on duty and then he was bundled into hospital. He returned two weeks later from an acute medical ward with a huge stinking sacral bedsore, forlorn, depressed and mute. I'm not sure why his neurological condition deteriorated, either a stroke or depression. He died not long afterwards. The nursing home manager wrote a pointed letter of complaint. But we all know it will do no good.
I'm retiring in September. Can't take it much longer.
I've just read the full report on the healthcare commission's website - depressing reading indeed. But sadly not surprising.
Even from my relatively inexperienced position it is clear to me that the things mentioned in the report go on throughout the NHS.
One thing I will say is that it is partly due to the attitude of many senior nurses and doctors that pushing commodes and cleaning bedspaces should be amongst the most important tasks that nurses are not able to spot deterioration, read cardiac monitors, manage care, prevent pressure ulcers etc. If more time is spent in pre-registration training on clinical knowledge and experience rather than being forced into a competition with HCAs as to who can make the neatest beds just to show that you are not above such menial tasks, then maybe, just maybe, we will turn out a better crop of nursing graduates who can prevent many of these poor standards of care from occuring. It is time we had a serious review of what exactly nurses should be responsible for, and what could be sensibly placed firmly within the responsibility of (adequately numerous) HCAs - it seems to me that as HCAs take on greater and greater clinical responsibilities (bloods, dressings, complex bed-baths, obs, ECGs etc.) with less knowledge than many RNs, the RNs themselves are ending up having to take on much of the traditional HCA role in addition to their own.
READ ALL ABOUT IT!
THE NHS IS PAYING THE PRICE FOR POLITICISATION!
For the first time, companies and organisations can be found guilty of corporate manslaughter as a result of serious management failures resulting in a gross breach of a duty of care.
(The Corporate Manslaughter and Corporate Homicide Act 2007).
I wonder if managers at SGH know about this ?
Having been both an HCA in a busy teaching hospital (who first received any formal training after working the job 5 months) and now a medical student, I can say the points raised in the Guardian are not news to me at all. Although it may not be going on ALL the time, and everywhere, it still happens far more often than it should. I don't need to go into it again, as John has (as already mentioned) highlighted the issues many a time.
The thing is, everyone muddles through as best as they can. I wouldn't have even known where to start complaining at the time of HCAing, there was so much wrong with the entire system, and I know it would've fallen on deaf ears.
Newly qualified nurse - I have to say that if only the attitude of some of the nurses I worked with was to priorities commodes and bedspace cleaning - unfortunately it was my experience that the majority of them neither did this, or were capable of spotting deterioration, reading cardiac monitors, managing care, preventing pressure ulcers etc. Some of them were incredible and could do all of this, and more, but I recall one nurse point blank refusing to come and even look at one of my patients who was having an angina attack (although could've been an MI for all I knew back then) as she wasn't in her bay and was too busy trying to find a cheap car on the internet.
The fact is good nurses don't get supported, and frankly shite ones don't get disciplined, and the whole ward is mis-managed at every level.
I despair sometimes as to where on Earth the solution is going to come from.
Dr. Crippen is 100% correct. It is happening in hospitals across the country. I recently refused to allow my elderly grandparent to be admitted to hospital from a nursing home. She died at the nursing home with her dignity intact. I am also a hospital nurse.
re "Then you will know."
exactly, and that is what many of us do know already
which is why the nhs supporting GP's like yourself should get yourselves out in random nhs wards to see for yourself
i really dont think you would defend the nhs if you saw it the way i regularly see it
etc etc
"
Newly qualified nurse - I have to say that if only the attitude of some of the nurses I worked with was to priorities commodes and bedspace cleaning - unfortunately it was my experience that the majority of them neither did this, or were capable of spotting deterioration, reading cardiac monitors, managing care, preventing pressure ulcers etc. Some of them were incredible and could do all of this, and more, but I recall one nurse point blank refusing to come and even look at one of my patients who was having an angina attack (although could've been an MI for all I knew back then) as she wasn't in her bay and was too busy trying to find a cheap car on the internet.
The fact is good nurses don't get supported, and frankly shite ones don't get disciplined, and the whole ward is mis-managed at every level."
I tend to agree. I think the pre-registration training system is fundamentally flawed, and this, combined with poor staffing and management, all adds up to a situation of poor care.
I have often commented that I would have been able to qualify without being able to do so much as take a pulse or assess a wound, so long as I could keep my head down on placements and writing meaningless essays on whatever was PC at the time (I remember writing one on social inclusion in the travelling population, and sprouted lots of impressive sounding shit, but I still to this day have no idea what effect it has had on my nursing practise).
Contrary to popular opinion, it also seems to be very difficult to get rid of an incompetent nurse. I worked for a while with somebody who mismanaged just about every emergency situation she came into contact with (on one occasion the patient would have died if I hadn't happenned to walk past the room and peer in to see what was happening), she made repeated serious medication errors, was rude to patients and so on. This had gone on for years, but in the end she was only sacked after she was caught out on a (very) minor technicality which had nothing to do with patient care.
It also seems to be the case, particularly in general medical and surgical wards, that staffing is woefully inadequate. When I was a student (even in my first year) I would often find myself working with one nurse (the HCA shifted to another ward because I was there), caring for upto 30 patients. This is the final straw which seems to break even the best nurses' backs - competent and caring as I am, in that kind of situation (which I now face as an RN), I cannot provide anything even approaching decent care to any of my patients.
I really do think that it is important that we increase the number of RNs, but more than that to increase the number of assistants - cleaners, HCAs, food handlers, ward clerks, phlebotomists, porters etc. It seems that as well as doing their own job, RN's end up covering for all of the other duties which would be better placed on other people.
In the name of "holistic care" and "basic nursing care" I could make all the beds, clean all the bedspaces, bathe all the patients, serve the food, transport patients around the hospital, complete the non-clinical paperwork, take everyone to the toilet etc., but we have to ask ourselves - is this really a good use of an RN's time, when they could be using that time assessing and monitoring patients, planning their care, providing skilled bedside care (such as pressure area care, care of wound sites etc.), educating patients and their relatives, directing the work of others, setting up care for discharge and so on? I would suggest not.
I did a post and you were in the quotes. Thanks.
The Cockroach Catcher
Addendum to the previous post, I have done some research on The Corporate Manslaughter and Corporate Homicide Act 2007, and cannot see why a prosecution could not be brought against the management of the trust, in fact it could have been written for this case.
Joseph K.
I'm sure we all remember "24 hours to save the NHS". And here we are, ten years later, with an NHS that's only marginally better than it was before, and in some instances - like this - so much worse.
John asked if Bradshaw or Johnson would resign. No chance. They're busy building an argument that this is all Thatcher's fault.
It seems that my provisos post was not published due to some computer glitch. It was speculating on the possibility of prosecutions for gross negligence manslaughter and misconduct in public office, against individuals. If any prosecutions are brought (I doubt they will be) it would be hard to see how doctors and other healthcare staff could escape individual prosecution. Doctor in particular, as if reports can be believed the abandoned seriously ill patients to care for those with minor injuries in A and E, in an attempt to meet targets. If it could be proved that any patient died as a result there is a case for a charge of manslaughter.
Joseph K.
It is an awful thing to say but I for one am glad to see the lid blown off and you and all the other MediBloggers finally being proved right. It's taken a bloody long time. My comment is awful because there have been too many deaths along the way. Too many ignored warnings, sacked whistle blowers and cover ups (nods at Rita Pal).Illness doesn't fit on a clip board, treatment cannot be obtained by ticking a box.
Maybe it is finally time, in the NHS, to take the reins from Sally in accounts and Bob in Human Resources and hand them back to Professionals on the wards that actually know what they are doing.
Mummy x
http://libertarianalliance.wordpress.com/2009/03/17/death-by-paper-cut/
JC
Just to thankyou for featuring my efforts in raising the material on Ward 87. A proper summary is listed here. Ward 87 Evidence
Joseph K is utterly unrealistic when he states "One can’t but help wondering if things where so bad why there are no reports of Doctors Complaining. If they did not surely there are grounds for disciplinary procedures"
I think members of the public like the spectacle of watching a doctor's neck on the chopping block so they can gossip about them and say " Ah they whistleblew and now their lives are ruined". Not one person will actually take their time to assist a whistleblower. Many do though watch much like a good spectator sport. I know the media does anyway.
The above was raised with Liz Bloor on Panorama but as usual, she opted to feature Robert Phipps. The Sunday Times was feature the 2 reports in the hope a wider study could be done but the two journalists Jon Thomas and Mark Macaskill refused. The Daily Mail removed all messages citing the reports. The Sentinel Stoke on Trent refused an advert asking patients to come forward. The Telegraph Editor was sent the evidence and he told Amit Chaudhari that " the material was too technical and he didn't understand it and that the doctor had an axe to grind anyway". The BBC have repeatedly ignored it. Sky News was repeatedly told about the reports and again overlooked it. And I could name legions of the media. If you place this in perspective of the fact that both Labour MPs Mark Fisher et al lied about a referral to the Health Commission, you then start to wonder about the true extent of the cover up. And of course, the death rate at North Staffordshire NHS Trust was far higher than that of Mid Staffordshire. Just that it was never recorded.
Ward 87 was shut probably due to a lot of the work I did to expose what happened there. The truth remains that for over a decade patients died, nothing was done and actually there are a few important points
he summary of the 2001 Creamer Report concealed by the GMC stated as follows
(a) “Patient care was clearly affected by the failures identified”;
(b) “The Directorate failed to take appropriate action when the allegations were made in a statement by Dr Pal”;
(c) “Although medical and nursing staff were concerned about the range of issues...no one voiced their concerns except Dr Pal which either demonstrated a general acceptance of the issues or staff felt unable to raise concerns”.
The above was found on data I left the hospital with - that was a hand full of patients over one/two weeks. I often wonder what the data would have been like on wider data. The NHS Ombudsman refused to find out. The Health Commission has only just offered to look into the matter having told me for many years that whistleblowers could not report concerns to them. They now have the whistleblower reporting protocol.
The Department of Health have spent a great deal of time shutting down this issue. The General Medical Council was asked to investigate these issues following disclosure of the 2005 reports. They have refused.
The GMC is a useless, vindictive organisation. I cannot express in words how they have trailed me for the last decade on one issue or another desperately trying to get me struck off to essentially discredit me. They have driven me to endless litigation because it was the last alternative left and made my working life a virtual hell.
So when Joseph asks why doctors did not raise concerns, if I had my way again, I wouldn't raise concerns either because in the end the public are essentially selfish creatures as are many newspaper reporters. There is nothing at the end of the tunnel of whistleblowing apart from a great file of papers. You whistleblow in one minute and you spend the next of the decade trying to clear your name. I would not expect any doctor to go through that. As for Joseph - he knows that he would never protect or speak out for a whistleblower - that is the essence of the public - they want everything but are able to give nothing - they can though sit in their comfortable sofas and judge the rest of us.
No if you will all excuse me - I have a battle against the GMC to fight in court - because my biggest mistake was to ask for a drip set - which is basic equipment that should be made available in a hospital in the UK.
No doubt many will judge the above as bitter and twisted. No doubt it is but I am in the process of getting my life back post whistleblowing as I don't wish to be a pariah or a spectator sport any more. The fact remains patients died, no one noticed or cared and now I have done my job in raising the issue.
Dr Rita Pal
Ward 87 Whistleblower
I apologise for the typographical errors above, possibly due to exhaustion on my part. Perhaps JC would like to edit the post and correct my spelling :)
Thanks
Rita Pal
good luck rita pal
As a qualified clinician I would be extremely reluctant to whistle blow. Despite all the policies I've seen and public interest "protection" I am absolutely certain that any NHS Trust will, like all organisations, go into self-protective mode and initially seek to kill the messenger. It makes me very sad.
Dr Pal, if you are going to quote me please do so in full. The part you left out, is the important bit about if medical staff did in fact highlight problems then the investigation should move higher up. Please do not accuse me of not supporting whistleblowers, unless I am very mistaken you know nothing of me, my background or career, so any accusation is a mere assumption. As I am sure you realise there are a number of ways of speaking out and highlighting problems without going to the media, any of which could be capable of switching all culpability from medical professionals to management. I have just listened to an interview with a nurse who stated that she did not bother to fill out incident forms. By not doing this she has given a defence (in the media, hopefully not in court) to the trust management, who can now claim that all they saw when the looked down where smiling monkeys. I am truly sorry that the GMC treated you so unfairly and that you have had to go to court multiple times to clear your reputation and this is not meant as a personal attack on you. But if media reports are to be believed, senior doctors allowed themselves to be shifted from seriously ill patients to less ill ones, in an attempt to meet targets in A and E. Please tell me how that is justified if you are an independent professional, and how that sits with a doctor’s individual duty of care not to mention the Hippocratic Oath. This is not to distract form the obvious problems with and liability of the trust management, which I mentioned in a previous post, but it appears that no one has covered themselves with glory.
Joseph K.
Dr JC, thank you so much for bringing these issues to the attention of the public. I'm not that concerned that the government and NHS try to do intricate cover ups of their failiures- rather I'm more concerned by the fact that the mainstream media are often so disinterested in publicising these failiures or helping whistleblowers such as Dr Pal (cos' without an impartial media getting involved, there's no accountability whatsoever no matter where you look).
It's only today through this particular story that I've found out what happened to Dr Pal and wish her every success in fighting the GMC. I am aware that the GMC are on a very busy witchunt against quite a few Drs who work for the best interests of their patients such as Dr Myhill
Neelu
Will these managers be facing manslaughter or even murder charges? As for the government ... well everything the political class touch seems to be rotten to the core.
Joseph K's question (how did clinicians respond to abysmal clinical standards) is an important one but it is certainly not new.
Here is an extract from Hansard, 1999
A patient died, waiting in pain, on a trolley at St. George's hospital in London. His consultant described the conditions as the worst that he had seen in 20 years, with the standard of care being worse than in India. An elderly man died of heart failure in Whipps Cross hospital after waiting over 18 hours on a trolley. A child died from meningitis after being left on a trolley for hours in Rotherham general hospital because there was no bed.
Bodies were stacked up in refrigerated lorries at two hospitals in Norwich and at the Derbyshire Royal infirmary because there was nowhere else to keep them. A patient's body was lost for five days in the grounds of Chase Farm hospital, Enfield, after he had walked out of the ward and fallen into a ditch. At two Portsmouth hospitals, relatives were forced to provide basic nursing care for their loved ones for the first time in the history of our health service.
18th Jan 1999: Column 581
http://www.publications.parliament.uk/pa/cm199899/cmhansrd/vo990118/debtext/90118-10.htm
Targets were introduced because of perennial problems but then precipitated a new set of problems - burgeoning management interference was one of them in my opinion.
I think the simple answer to Joseph K's question is self preservation - few doctors for example are likely to throw away years of training, and self scarifice on a lost cause (whistle blowing in the NHS).
Incentivising targets (such as QOFs) seems to work a treat as well - money is a language everybody understands.
The depressing thing, charge nurse, is that here we are ten years down the line, billions poured into the NHS, endless diktats and policy initiatives from the centre and yet still any one of those stories from the Hansard in 1999 could have happened yesterday at Localtown NHS Foundation Trust.
I left the NHS to return to Australia a few years ago. None of this is news to me. Some of the jobs were OK. However, when it was bad...
I recall: no working computer system for patient administration; ad hoc unit lists, meaning that I occasionally found patients in the ward that I should have been looking after for days - one had had no medical attention for five days.
CT/US booking system melted down. Patient with an acute head injury still not CTd 2 weeks later (which was when I arrived). I went to CT and went apeshit in the middle of the department, and forced the radiologist to issue me a "receipt" for the updated CT request with his name and the date and time...
No-one had been discharged from the "Care" of the Elderly ward I was covering for over two weeks. I suspected the doctors found it too much work to discharge patients and admit new ones. Eventually I found the requests for psychiatric assessments (they were all waiting for these predischarge) neatly placed in a manila folder in a drawer, where they had been sitting for weeks.
One Monday morning I arrived to find every single sheet of paper from the entire ward's collection of patient files had been removed from the notes (?why - I don't know) and strewn randomly around the doctor's office, behind the couch etc...at that point I refused to come back.
I did return once, however. I walked from my room to the wards and noticed many sirens and helicopters etc. at around midnight...turned out a psychotic axe murderer had escaped from the secure unit next door, but no one had informed the doctors who were wandering around the grounds....
Your country is unfortunately (I did like many things about the UK) run by a criminal cabal. I seriously do not understand why much of your legislature and executive is not facing prison time.
"As I am sure you realise there are a number of ways of speaking out and highlighting problems without going to the media, any of which could be capable of switching all culpability from medical professionals to management"
And what is the repercussions of that Joseph?
"But if media reports are to be believed, senior doctors allowed themselves to be shifted from seriously ill patients to less ill ones, in an attempt to meet targets in A and E. Please tell me how that is justified if you are an independent professional, and how that sits with a doctor’s individual duty of care not to mention the Hippocratic Oath"
Doctors are not independent, they are dependant on the GMC for their livelihood and are employees of the Trusts in question. Essentially, managers control them. Given a choice between being unemployed and having your family life ruined and speaking out - which do you think you would opt for.
Of course, you aren't sorry about the GMC's actions regarding myself. You don't even understand the integral system of medical politics. You expect every doctor to be subjected to the same treatment by the GMC. So you can come along and say " Well, I am sorry about the way the GMC treated you" BUT........
There is this bizarre expectation from the public that the doctor has to sacrifice their careers for them? I find that expectation hugely flawed. It is developed through a concept of moral obligation and Hippocrates which has no application to the real world. The real world isn't perfect and in the end everyone gets on with their lives - it is simply the whistleblowing doctors who are left with the baggage.
My whistleblowing was utterly accidental. It was never purposeful. I attempted to save a patient because it was the right thing to do. In retrospect, had I known then what I know now, I would have walked away - as many doctors should.
If anyone is to blame for the lack of whistleblowing doctors, it is the public who continue to demonise doctors, remain unsupportive of whistleblowers. It is also the media who seek to make out that all doctors are liars and all patient kind are innocent. There is no reason known to man that my colleagues should raise concerns no matter how many people die as a result of neglect. The NHS and the media are directly to blame. We have a system as it is because of their inaction and inability to raise important concerns.
To my mind, if the public want to have whistleblowing doctors, they should fight to protect their good doctors. If the media consider the tales of patients to be more valid than that of doctors - then they are welcome to them. Afterall, in the NHS as we have seen with the Health Commission in the Stafford case - patient power is vastly given more credence than any doctor. The patient relatives have not been considered mentally ill or liars or whatever. When a doctor raises identical issues, the Health Commission neglects them, when they work hard to discover all the evidence and re-present it, the Health Commission tells them it is too late. And that is what happened to me.
So, if the word of the public and of patient kind is more important, the NHS should rely on this adhoc reporting to manage their systems. If doctors are undermined in the way I have been, then there is no point in raising concerns in the first place.
Harris HHJ referred to the GMC as a totalitarian regime. That should be front page news. It of course won't be because even after judgments like that the influence of the GMC to silence whistleblowers by holding their registrations as a sword of damocles isn't enough to convince the public that no doctor wants to face what is nearest to hell on earth.
Peter Wilmshurst was reverse investigated. Robert Phipps was reverse investigated and there are legions more doctors who fell into the forgotten pile of whistleblowing doctors.
Joseph as I know nothing about you, you don't even have a concept of what it is like to be a whistleblower in the NHS. Don't pretend you do because no one does.
Dr Rita Pal
I would heartily recommend anyone interested in Rita's case watches the video made about it on YouTube:
http://www.youtube.com/watch?v=fFtNXqDvH8c
The music is particularly stirring, especially when the photos of her fade in & out.
Lovely.
It's sad this is still going on, back in 2005 Milton Pena, a surgeon at Tameside Hospital, compiled a dossier on all the faults and problems that were endangering, and in some cases killing, patients.
The Hospital promptly gagged staff and set about damage limitation rather than fixing the actual problems - why? They wanted Foundation status, and god have mercy on anyone getting in their way of achieving it.
Around a year, it finally fell to a coroner to condemn the place and start an investigation. Even then they did their level best to distract everyone from looking into what was happening.
That four years later this is still happening is a damning indictment of what Labours done to the NHS, and there are fools out there who think they saved it?!
How sad. I am suprised that no one leaked a story to the papers earlier...I have worked in EDs in London where freelance reporters used to "hang out" looking for a story.
The saddest thing being that many of the complaints listed in the Guardian article are commonplace throughut the NHS...use of CDU/assessment units so that ED patients do not breach for example. However, as the government FINES hospitals for every patient that does breach (regardless of the reason) this isn't exactly a suprise. We have had patients who were dying transferred to a medical ward at 4am so that they would not brach in ED. I kid you not.
The saddest thing about this is that we know whats coming. The failings will be deemed to be down to poor management and inability to meet targets...so we (the NHS in general) will be deludged with even more pointless pieces of paper to fill in every month to report back to HQ. Rather than having a sensible, OPEN discussion as to why all the billions poured into the NHS have lead to this sorry state? Why doctor and nurse training is failing to produce competent individuals, why staff retention is so poor, why the IT systems are still 20 years out of date...I could go on but then I would just depress myself. Those of us who have been in the NHS since the Thatcher years ( many of whom write on this site) hang our heads in shame for not speaking up when things started to go wrong with the Trust system in the first place.
Dr Pal, I am sorry that I seem to have offended you, and I apologise if this is essentially a double post, as my previous one seems to have disappeared. In some respects you are right; I am not a Whistle blower in the NHS. Nor am I likely to be as I do not work for the NHS, although there is the (slim) possibility I may do in the future. I also have no idea of the internal workings of the GMC.
Unfortunately you answer the question of why there are no media reports (that I have read) of clinical staff highlighting the problems with the trust. The only time I have heard this addressed was on the Radio late last night, where a nurse stated that she did not fill in incident forms because she did not believe that they would do any good, and then went on to admit that she and her colleagues did not bother as they did not want to stay after their shift.
If you read my original and subsequent posts you will find that I am not attacking you personally, or even doctors as a group, but I am asking questions on a medical blog that the media seem not to be asking. If this makes clinical staff uncomfortable, then it is all the more reason to ask these questions. But if problems were highlighted (as you did) and then they were ignored, or that even worse any attempt to highlight problems internally was stamped on this makes the management of the trust even more culpable. The reason I am not asking questions about the management of the trust is that the facts seem to speak for themselves, and I am wondering why there is no talk of prosecutions. In fact as I realise that this would put a spotlight on ministers and senior civil servants as well as the management, there are to many vested interests for any prosecution to be likely.
If you wish to answer this post, please take what I have written as a whole and in context, rather than selectively quoting from parts and failing got provide a coherent answer, such as what are the consequences of filling out an internal report in an attempt to flag up a problem? Or why doctors allegedly allowed themselves to be stopped from treating the seriously ill (do bean counters stand over your shoulder, or physically direct you to a different ward).
Finally I have done you the courtesy of not attacking you personally, or professionally, neither have I speculated as to your actions in a hypothetical situation or made assumptions about your behaviour or support of a worthy cause, I would appreciate it if you would return that courtesy.
Joseph K.
JK
I didn't think you were attacking me personally. I simply find it appalling that any member of the public would have an expectation that health professionals should stick their neck out.
"I am asking questions on a medical blog that the media seem not to be asking"
They aren't asking it because they don't understand it. They are taught that because of PIDA, it is safe to whistleblow. This is what the Department of Health aligned charity PCAW propagates as well. The media are well primed at simply turning out government run spin.
The UK has the highest death rate in the EU. Yet, no one asks why the Department of Health does not make death rate recordings compulsory. See below
DE00000364718
Dear Dr Pal,
Thank you for your further email of 6 November to the Department of Health about mortality rates. I have been asked to reply on this occasion.
I can confirm that there is no regulation or law requiring individual hospital wards to calculate patient death rates.
I hope this reply clarifies the Department’s position.
Yours sincerely,
James Butler
Customer Service Centre
Department of Health
The bottom line is that without the recording of death rates, poor care cannot be caught early. Ben Bradshaw was asked about the above question and when he responded we wrote the piece here
Ben Bradshaw Refuses to Record Death Rate
My MP has the entire response. We then progressed to ask Ben Bradshaw what research he was reliant on in his refusal. He has still not responded. Cat got his tongue I assume. Anyway, you will find this interesting
"Discharging Patients For Life
Source Times Daily
"While those four countries averaged a 106.6 amenable mortality rate, Britain was almost 29 percent deadlier, with its rate of 135.3. The TPA thus calculates that the NHS took the lives of 17,157 Britons who otherwise would have survived were they treated by doctors across the English Channel. This figure is more than two-and-a-half times Britain's yearly alcohol-related deaths, and is quintuple its annual highway fatalities. Comparing 60 million Brits to 300 million Yanks, this is like a federally operated health agency eliminating 85,785 Americans in 2004."Anyone looking to reform the American health-care system should learn lessons from the European experience," says Matthew Sinclair, the TPA policy analyst who authored this study. "Britain's NHS has produced dismally poor results. Thousands die every year, thanks to its poor performance and its failure to make good use of new resources. Other European health-care systems deliver greater competition, decentralization and independence from political meddling."
"I am wondering why there is no talk of prosecutions"
I attempted to report the Ward 87 matter to the Police once. Staffordshire Police rang the hospital and say " Hey if you find any criminal activity, report it to us". The hospital replied " Yes sure". And that was the extent of their investigation. They met me a few years ago [ conversations which they kindly recorded and presented to me]. In it, they refused to inform the patient relatives of the neglect of patient EP. They refused to look at her death certificate or her medical notes. When asked to obtain death rates, they didn't obtain a proper calculated comparison figure nor did they report the matter to the Health Commission. When I asked them to get the full unredacted copy of the 2001 Creamer report into the ward, they refused this as well. And then they stopped responding to me.
Corporate Manslaughter charges are incredibly difficult and the NHS are virtually immune as is NHS management. Darzi refused to create a regulatory body for managers for obvious reasons.
The General Medical Council owns all doctors in the UK. There is no recognition of their complete and utter madness that exists when it comes to whistleblowers. Their aim is to silence them and do whatever it takes to ensure they are kept that way.
Here is a quote from the Department of Health representing their client Prof Rod Griffiths the man who oversaw the years in Mid Staffordshire and North Staffordshire NHS Trusts
" Our client was asked by the General Medical Council as to why the Complainant might have made these allegations and whether our client thought that the General Medical Council should proceed against the complainant for making what appeared to be accusations in an unprofessional manner"
Dr Peter Wilmshurst was reverse investigated for making " accusations in an unprofessional manner".
Prof Rod Griffiths though has a lot to answer for - Midlands Hospitals had high death rates. Just that no one knows what they are because no one records it - as its not compulsory. Without compulsory death recording, there is no prosecution for corporate manslaughter. The government are quite clever really.
I noted the Press Release from the government on Mid Staffordshire today, well, as I have always said, they knew about it all many years ago. They all knew about it but credit to the relatives because they are the only people who managed to achieve something in the way of justice. If a doctor had tried, they would have been silenced. Of course, there are many ways of silencing NHS staff. The Department of Health works in tandem with the General Medical Council. It is very easy to sink a doctor or a nurse. Every whistleblower will tell you the same story.
I have attempted to request that the Health Select Committee in Parliament set up a post Bristol Inqury into Whistleblowing but as yet they have been reluctant.
Dr Rita Pal
Dr Pal, Thank you for your replay, it goes a long way to answering my questions. Especially as to why the media are not asking similar questions to ministers.
Joseph K.
As if this appalling story is not enough, we have the nauseating Ben Bradshaw trotted out on every news programme that will have him, bleating that the chasing of targets (and therefore government policy) had nothing to do with it!
There is nothing bad in this country that this useless government cannot make worse.
"What went in Staffordshire is probably going on in a hospital near you. It may not be as bad. Yet. Or, it may be just as bad, but even now is being hushed up."
Ignore me if I've got this wrong, but I thought the inquiry was triggered by the death rates being markedly worse than other comparable units, so it isn't going on to the same extent at other hospitals?
Quite worrying that this is a "Foundation" Trust. Even as a medical student, I thought that that might carry some prestigue that reflected practice. Instead, it looks like anyone can get alltheir "Michelin Stars" by hiding patients on a myriad of "decision units" and not caring for any of them.
Truly desperately sad.
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