Francis Report fails to deliver

The Francis Report of the public enquiry into the years-long atrocities that caused horrendous unnecessary suffering to vulnerable patients, and up to 1200 avoidable deaths, and the worst scandal in the history of the NHS, is available to download in PDF format here: http://www.midstaffspublicinquiry.com/report - After a 31 month public enquiry costing millions of ££, the report has failed to recommend criminal prosecutions for those many, many staff who delivered death instead of care. None of the ghastly staff so gravely at fault has been 'named and shamed'. They have not even lost their jobs. Surely they should be subject to criminal charges? If there is no accountability for even 'the worst scandal in the history of the NHS' then there is no hope at all of ending the cruelty and inhumanity so widely evident in so many NHS hospitals.

We all know that NHS cruel negligence would end if the perpetrators were sacked and subject to criminal prosecution.

We have read in the last two days the most recent reports of extreme cruelty to which elderly patients have been subjected in an NHS hospital, the Alexandra Hospital in Redditch. See these reports in the Telegraph: Here, Here and Here. Yet we all know that NHS cruel negligence would end if the perpetrators were sacked and subject to criminal prosecution.

 

We all know that NHS cruel negligence would end if the perpetrators were sacked and subject to criminal prosecution. We may wonder why no UK government in all the years since the NHS was founded in 1948 has done anything useful to stop the cruelty and negligence, the damaged health, the pain and suffering, the shattered lives of innocent patients. - Why? When we all know that NHS cruel negligence would end if the perpetrators were sacked and subject to criminal prosecution. 

 

Why the official pretence that there are only a few bad (guilty) apples among a shiningly dedicated workforce? We all know that bad apples spread their rottenness to the other apples unless they are promptly removed. We all know that NHS cruel negligence would end if the perpetrators were sacked and subject to criminal prosecution.

 

Why are the most guilty (and usually the best paid) personnel moved sideways to jobs in other localities? - jobs exactly similar to those at which they have signally failed? And why are they paid golden severance settlements? We all know that NHS cruel negligence would end if the perpetrators were sacked and subject to criminal prosecution.

The Ombudsman's damning report of cruel neglect of vulnerable elderly patients in NHS hospitals and staff's callous indifference to their suffering

The Ombudsman's damning report of cruel neglect of vulnerable elderly patients in NHS hospitals and callous indifference to their suffering by staff employed to look after them has filled our newspapers and our broadcast media. See Telegraph report here, BBC report here, Guardian report here. We have many times over many years read of such horrors. Nothing appropriate is ever done about this atrocious cruelty by healthcare staff on their innocent fellow citizens - their patients, their victims. Read the Comments left beneath the newspaper articles and see other sickening examples of arrant cruelty by our highly-paid healthcare staff.

Since its inception the NHS has been protected from censure and sanction alike in matters of professional negligence. For decades its damaged victims were prohibited from even making a complaint! Then when complaints at last were permitted, the standard response to serious complaints was that the complainant was mistaken, lying, half-witted, mentally ill, trying to obtain compensation without cause, and similar nonsense directed toward attacking the complainant rather than investigating the complaint. Nothing was done about actually dealing with the complaints. And this is still the case.

In the intervening years it has become easier to make a complaint, but still nothing is done about the complaint, and the cases of negligence are increasing - inevitably, since the staff learn more and more surely, that they are unaccountable. The NHS Complaints Procedures are, and are designed to be, exercises in futility, and the Government is hoping to put an end to any scrap of justice for victims of medical negligence who go to Law by removing the possibility of legal aid in these cases.

As usual people who are ever-ready to defend the indefensible assure us that these flaws must be looked at in perspective, likewise assuring us that the vast majority of NHS patients are happy with their treatment. - Not remotely true, dear Reader. - That there are a lot of people ready to defend the NHS is not unconnected with the fact that the NHS is the largest employer in Europe, and so its employees and their dependants defend it. By contrast, read this Guardian article: "Half the patients treated in NHS hospitals are dissatisfied with the standard of care, a survey by the consumer organisation Which? reveals today. But it found few patients complain to NHS staff about inedible food, lack of cleanliness or poor organisation on the wards.

Among those who were dissatisfied, over a third thought raising an issue would not make any difference. Almost a quarter said nothing because they "expected their hospital stay to be like that" and 12% feared that a complaint would provoke reprisals and compromise their care.

Which? said doctors, managers and politicians interpreted the low level of complaints as evidence of patient satisfaction. But the survey suggested they were fooling themselves."

The appallingly poor treatment, including being left to starve, of thousands of elderly dementia patients in UK hospitals

See this report in the Telegraph. - Doesn't it shock you and make you feel ashamed of the NHS? Why isn't something done about it? We will all be old one day unless we die before our time. Is this the way you would be happy to be treated if you ever suffer the misfortune of developing dementia and going into one of these uncaring hospitals? Why don't staff who are maltreating patients in these ways get identified and punished? - Why are they allowed to get away with it, since this clearly encourages them to continue in the same cruel way?

NICE issues draft guidance that broken hips should be operated on on the day of admission or the day after

NICE has issued draft guidance that broken hips should be operated on on the day of admission or the day after, as reported by the Telegraph, in order to reduce complications. The report states that "in some hospitals around half of patients wait longer than 48-hours for surgery even though evidence shows it doubles the risk of major complications and death."

Surely this is a no-brainer! If delay "doubles the risk of major complications and death," what on earth are surgeons thinking of? - How can they routinely be doubling the risk of their hip fracture patients (who are mainly elderly, and many of whom are frail and ill) suffering major complications and death? This is disgraceful. Is it an example of covert age discrimination?

The longer the delay, the more pain the patients will suffer, the more physiotherapy and other rehabilitation they will need, the longer stay in hospital, the more support/care at home. - All avoidable extra suffering, all avoidable extra expense.

I've never had a hip fracture, thankfully, but I've had a very complicated fracture of the humerus, which needed an operation. If I had had the operation within a few days, as I was promised on admission to the Northern General Hospital, I would have been back at home again within a week, I am sure, little the worse from the fracture. But because my agonising pain from the splint was discounted and it was almost a fortnight before the arm was operated on, there was massive damage to my right hand - mainly radial nerve palsy and ulna nerve injury - and my stay in hospital lasted a month instead of the few days it would have been with prompt treatment. My (dominant) right hand was completely unusable and intensely painful for months. No one in the system ever apologised or even expressed regret.

I needed many months of physiotherapy and occupational therapy before I could move the hand at all. - It takes you a few seconds to read that sentence. - Just think of having to cope with that yourself: months with a swollen hand, totally unusable and exquisitely tender to the slightest touch. And I have had to have carers to help me since then, though I previously had managed without. Are these inexcusable delays attributable to callousness, ignorance, incompetence or what? - They are certainly unnecessary and they benefit no-one.

Age UK survey finds hospitals are still failing on nutrition for elderly patients

See BBC News report. Michelle Mitchell, from Age UK, says, "Not enough is being done to ensure that words are transferring into action on the wards."

BBC Panorama's programme tonight about very poor quality care in some NHS hospitals and the misleading claims they had made about the quality of care

I watched BBC Panorama's programme tonight about very poor quality care in some NHS hospitals and the misleading claims they had made about the quality of that care. For many years I have myself experienced deplorable NHS care both as an in-patient and as an out-patient and indeed had my health wantonly and callously destroyed by the 'caring professions'. And I've had a lot of personal experience of their lies.

If you hold the view that the NHS is admirable and that we are fortunate to have it I very profoundly disagree with you. - You must be one of the lucky ones who has not yet been harmed by the NHS. You can view tonight's programme on the iPlayer here: Panorama: Trust Us We're an NHS Hospital.

Or you can read about it on this BBC News webpage. If you think that making a complaint remedies anything you are mistaken. Complaints are routinely ignored, and certainly not acted upon. They routinely add to the problems and suffering of the complainants. See Fighting the System.

I firmly believe the NHS does far more harm than good and that it should be scrapped.

Most NHS trusts are endangering patients' lives by not implementing patient safety alerts

BBC News reports that the charity, AvMA, Action Against Medical Accidents, made Freedom of Information requests to NHS hospital trusts and found that 300 (75%) of them had not complied with at least one patient safety alert despite the deadline passing.

Radio 4's File on 4 programme this evening was an investigation into this matter and I listened to it. As a victim of many years of NHS blunders and knowing only too well the futility of expecting any lessons to be learned or remedial action taken, the horrors related in the programme held no surprise or shock for me. But if you are unfamiliar with the routine lack of importance accorded patient safety in NHS hospitals (compounded as they are by the uselessness of the Complaints Procedures) then I suggest you listen to the programme when it is repeated on Sunday, 21 February, at 1700 GMT. Or you can listen via the BBC iPlayer or download the podcast.

Redesigned hospital gowns that preserve modesty are to be introduced into NHS hospitals in England by early 2011.

See BBC News item. Redesigned hospital gowns that preserve modesty and decency are to be introduced into NHS hospitals in England by early 2011. That will certainly remove a huge unnecessary stress from patients. Why on earth has it taken so long to take this measure?

I hope the new designs will be wider/looser in the sleeves to make it easier and less painful for trauma patients with splints/plaster casts on broken arms. I endured excruciating pain in the summer of 2007 in Northern General Hospital because the armholes were so needlessly and thoughtlessly tight.

Hundreds of deaths a year in British hospitals associated with poor health care

The Telegraph reports that the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) say that poor care contributed to at least some of the more than 3,000 deaths they analysed. "One in three patients who died within days of being admitted did not receive acceptable standards."

I urge you to read the report, which is described as "shocking".

Around 300,000 people die every year in British hospitals.

Prison food is better than food in NHS hospitals

Prison food is better than the food in NHS hospitals, as the BBC reports here. I don't think many hospital patients will be surprised at this research finding by Bournemouth University academics. Many patients get their families to take in food for them as they are not keen on the hospital meals.

I was particularly interested to read that prison food is lower in salt than hospital food. When I spent an appalling month in the Northern General Hospital in 2007 I was shocked at how high in salt the meals were, when you consider that the health service is continually exhorting the public to eat less salt. In addition to the meals being so high in salt (e.g. a ham sandwich: both ham and bread are high in salt and the butter was also salted), tiny individual packets of salt were given out routinely with every meal. You would never guess from those hospital meals that the government and their agencies have a policy aimed at lowering the average consumption of salt. - Policy and practice are not going hand in hand.

As a steroid victim I am extremely sensitive to salt and need to avoid it much more assiduously than most people. Incredibly, only one of the many doctors I encountered in the hospital knew that steroid victims needed to eat food with no added salt, and it proved impossible in practice for me to have meals with no added salt, very largely because of the unhelpfulness of the chief dietician, who persisted in claiming, falsely, that the meals provided were low in salt. Since it is harmful and dangerous for me to eat salty food, and as I had no family to visit and bring me suitable food, I was unable to eat much apart from breakfast, when I was able to choose porridge, a food that does not contain added salt.

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Vulnerable groups

Sodium in foods

Details of the appalling nursing care endured by many elderly patients in NHS hospitals

BBC News reports on some of the individual personal accounts of suffering and neglect brought to public attention earlier this week by the Patients Association.

Details of these individual case studies are indicative of the appalling standards of healthcare offered to too many unfortunate sick people in NHS hospitals.

I find the tone of the comments by the spokespeople for the hospitals chilling. There seems to be no real appreciation of the horror these patients/victims have endured at the hands of the 'caring' professions. The indefensible is defended with shocking complacency.

Some further individual accounts, reported in the Telegraph:
Ann McNeill
Colin Purkiss
Thomas Dalziel.

And here is a young doctor's concerned account of a personal recollection of lack of care and compassion on NHS wards: Dr Max Pemberton writing in the Telegraph.

The government has responded with Statistics not Care.

The Patients Association highlights appalling standards of NHS hospital care for the elderly, giving examples of patients left dehydrated or lying in faeces, blood and urine.

BBC News reports that many elderly patients are receiving appalling care in NHS Hospitals.

The Patients Association highlights appalling standards of NHS hospital care for the elderly, giving examples of patients left dehydrated or lying in faeces, blood and urine.

Claire Rayner, formerly a nurse, now President of the Patients Association said: "I am sickened by what has happened to some part of my profession of which I was so proud. These bad, cruel nurses may be - probably are - a tiny proportion of the nursing workforce, but even if they are only one or two per cent of the whole they should be identified and struck off the Register."

Government chief nursing officer Chris Beasley said: "All patients deserve the highest quality of care from the NHS and the poor care received in these cases is simply unacceptable." Apologists for poor standards of NHS 'care' customarily add, as Chris Beasley adds here in this report, that the 'vast majority of patients experience good quality, safe and effective care."

I am willing to concede that possibly a slight majority of patients are reasonably satisfied, but to claim this to be a 'vast' majority is way off the mark. Most people put up with a lot of substandard care, knowing that complaints are unwelcome and tend to provoke reprisals, this being particularly the case with the more vulnerable and elderly, frail patients.

The organs of nearly 700 British donors have been given to foreign patients, new figures reveal.

Hundreds of British transplant organs given to foreign patients
article in the Sunday Telegraph

Extract:

"The controversial practice has seen patients from as far afield as China fly in for operations at NHS hospitals around the country.

The procedures have taken place despite a severe shortage of organs for transplant in the UK, putting British patients' lives at risk.

Nearly 8,000 people are currently on NHS waiting lists for a transplant, with 305 waiting for a liver and 226 for a lung.

Patient groups and politicians condemned the practice of making organs available to foreigners while so many British patients remain on waiting lists.

The Conservative shadow minister for health, Stephen O'Brien MP, said: "This is not about being xenophobic, but when there is such a shortage of available organs we first need to ensure that we can provide for British patients.

"Ministers must answer the serious questions at stake here. Why, when their organ donation policies are failing, have they presided over so many organs going to people living outside the UK?"

The figures, obtained by Mr O'Brien through a Parliamentary question, show that between 1998 and 2008, around 70 British organs have been transplanted into foreign nationals every year.

A total of that 603 livers have been given to foreigners over the ten year period, as well as 57 corneas, five kidneys and four hearts.

At the same time, only 140 foreign organs were imported into the UK to be transplanted into British patients.

Britain is obliged by European Union rules to make British organs available to all EU nationals. Non-EU nationals are only entitled to an organ if there are no suitable British or EU patients."

A vulnerable patient died of starvation in an NHS hospital after 26 days without food, according to Mencap, the disability charity.

Patient 'died of starvation in NHS hospital'
article in the Telegraph

Extract:

"Martin Ryan, 43, was left unable to swallow after suffering a stroke but a "total breakdown in communication" meant he was never fitted with a feeding tube.

Doctors thought that nurses were feeding him through a tube in his nose, an internal inquiry by the hospital found.

But by the time they discovered this was not happening, he was too weak for an operation to insert a tube into his stomach. Mr Ryan, who had Down's syndrome, died in agony five days later.

Disability charity Mencap said the case was one of several where the NHS "completely and unacceptably failed" patients with learning difficulties through a "catalogue of disasters".

The Parliamentary and Health Service Ombudsman is expected to issue a similarly damning verdict on the NHS later this month.

Other cases highlighted by Mencap include Emma Kemp, 26, who was denied cancer treatment that could have saved her life.

Another patient Mark Cannon, 30, died two months after being admitted to hospital with a broken leg.

Three other cases followed similar patterns, with warnings ignored or problems missed until it was too late, often because the patients had difficulty communicating.

The father of one man who died, who was just 20, said: 'People like my son are treated as less than human'.

The six cases were raised by Mencap in a report entitled Death By Indifference."

Horrific avoidable suffering and death like this would not happen if health professionals were accountable for failures in their duty of care. If the police were to do the inquiries, rather than the hospital, and if the negligent doctors and nurses in this or a similar case were named and shamed and sent for trial for an offence called something like 'professional negligence leading to manslaughter', and received an appropriate sentence - surely a prison sentence - this dreadful cruel neglect would stop immediately. - Although they clearly do not care about the welfare of these patients, they assuredly care about their own...

If MPs wonder why voters are cynical, they need only consider the history of Labour's "promise" to get rid of mixed-sex wards in NHS hospitals.

Wards of shame
article in the Telegraph

Extract:

"It is bad enough that patients already concerned about their health have to suffer the additional degradations and embarrassments that come with mixed-sex wards. It is intolerable that they must also put up with the continued pratings of Government ministers, who think that saying something is the same as doing it. Four times since Labour came to power this promise has been trotted out whenever a favourable headline has been sought. Ministers should either admit they cannot fulfil this pledge – or keep quiet until they have."

I suspect that if Ministers and MPs and their families had to use the NHS and get the same treatment as ordinary members of the public receive, that this deplorable situation would quickly be remedied.

More than 100,000 operations have been postponed by the NHS over the past year for non-clinical reasons.

NHS cancels more than 100,000 operations in a year
Article in the Telegraph

Extract:

"The number of cancelled operations is almost twice as high as previously admitted by the Government with thousands of patients suffering from multiple cancellations.

Ministers have previously said that cancelling operations is "unacceptable" yet have failed to act to prevent hospitals from cancelling procedures, often just hours before surgery is due to take place.

The figures have been obtained by the Conservatives who used Freedom of Information laws to request the data from NHS trusts."

The major operation I had last year was twice postponed 'at the last minute' and so instead of having it a few days after going into hospital, it was actually done almost a fortnight afterwards. This caused me agonising pain, immense extra suffering and continuing disability, and the need for carers still even now. It meant extra weeks in hospital and hundreds of hours of traveling to and from the hospital and waiting and time spent with occupational therapists and physiotherapists. It meant intense, needless, agonising pain. - And even now, it appears, I may need to have another operation because my extreme pain went unheeded and uninvestigated for almost a year after returning home after my hospital stay...)o: - Terrible, prolonged, unnecessary pain and suffering and disability; great, unnecessary additional financial cost...)o: - The NHS is a national disgrace.

Hospital acquired infections or medical errors are more likely to cause death than extreme sports like high-altitude mountaineering and bungee-jumping

NHS hospitals more dangerous than bungee-jumping
Article in the Sunday Telegraph

Extract:

"The risks from infection, mistakes over drugs and failings in care mean that nearly one in 100 patients admitted to an NHS hospital will die an avoidable death, compared with one in 1,000 of those taking part in dangerous sports.

The findings define health care as a "hazardous activity" for patients and compare it unfavourably with air travel and the nuclear power industry, both of which carry a one in 100,000 risk.

The research, which was compiled by the NHS National Patient Safety Agency and the health care charity, the Health Foundation, reveals that up to 104,000 patients die each year as a result of poor infection management and basic medical errors."

I'd say this is a gross underestimate of the harm done by hospitals and by doctors.

Claire Rayner has some well-justified criticisms of the NHS and some suggestions to improve it.

NHS at 60: In the end I had to go private
Article in the Sunday Telegraph

Extracts:

"In 1988 she suffered chest pains. Efforts to contact a local doctor at 3am led instead to a locum service, which insisted she find her NHS number before any help could be given. "In the end we gave up and got through the night, but next day we signed up with a private GP," she says.

The chest pains revealed a hole in her diaphragm, while arthritis has since resulted in her having five knee operations and surgery to both shoulders. In 2002, breast cancer led to a double mastectomy. She used an NHS hospital on two occasions and was infected by the superbug MRSA.

"The tissue on my knee suddenly split, and I had to go to Accident and Emergency," she says. "For four hours, I was left in a highly infected room with a totally exposed wound. For at least an hour I could see the doctor sitting gossiping with a colleague.

"When she came over her hair wasn't tied back, then she used the wrong kind of gauze to patch me up. I felt so angry. When I discovered afterwards that I had MRSA I was appalled, but I wasn't all that surprised."

Now, she and her husband, Des, who is 80, avoid the NHS. "I have a list of hospitals with lower infection rates that I would go to if I was desperate, but we avoid it when we can. I'm embarrassed and ashamed to admit it, but I had to put my health first."

Determined to use her public profile as Patients Association president to achieve better services, Mrs Rayner urges the NHS's political masters to learn from the values and standards she saw in the service's early years."

"Now, as the NHS is about to turn 60, Mrs Rayner offers hospitals a three-point prescription to return the service to robust health.

"Firstly I would get rid of the nurses' station on the ward. It is a hiding place for them to hang around gossiping. Secondly, I would get rid of the targets. Third, get rid of all the middle layers of management and all the deceit to meet targets that happens as a result.""

More than 30,000 hospital beds have been lost in the decade since Labour came to power, with record cuts in NHS wards last year.

NHS hospitals lose 32,000 beds in a decade

Extract from the Telegraph:

"More than 40 per cent of maternity units turned away women in labour last year because they had no room.

Meanwhile, ambulances have been forced to queue outside overstretched hospitals, treating patients in car parks just yards from accident and emergency departments. The new statistics, revealed in response to a parliamentary question by Ed Vaizey, the Conservative MP, show that almost 32,000 NHS hospital beds went between 1997, when Labour took office, and 2007.

More than 8,400 beds were cut in the year ending March 2007, the largest fall in 14 years. One in six beds has been closed over the decade. There are now 167,019 beds in NHS wards, compared with 198,848 in 1997.

The figures emerged as health authorities are drawing up plans which will see the likely closure of dozens of district general hospitals. The East of England health authority has admitted that two accident and emergency departments and a maternity unit could close.

Andrew Lansley, the shadow health secretary, said the Government's financial mismanagement had forced hospitals to make cuts which could risk lives. "These bed cuts were financially driven: the sharp rise in the numbers closed happened at a time when the health service was under desperate pressure to clear a massive deficit."

Katherine Murphy, from the Patients Association, said: "This is a national scandal. More than 30,000 beds have been lost at a time when demand is increasing."

In the same decade that the beds were cut, death rates from the infections MRSA and Clostridium difficile rose five-fold. Investigations into the biggest C. diff outbreak in Britain, which killed 90 patients at hospitals run by Maidstone and Tunbridge Wells trust in 2005 and 2006, found that overcrowding amid pressure to meet hospital waiting targets was a factor behind the infection's spread.

More than 2,000 maternity beds have been lost since 1997. Research by the Conservatives found that last year, 42 per cent of maternity units had refused to accept women in labour on at least one occasion."