Putting patients first? Another example of the unaccountable NHS serving its own interests

The BBC is reporting that a hospital where a girl bled to death has refused to publish the findings of its inquiry for fear of “endangering the mental health” of staff.

Kettering General Hospital conducted a serious incident investigation following the death of 17-year-old Victoria Harrison, who bled to death on a ward after an appendix operation in 2012, but has said it will not be making the full report public despite an FoI request.

The trust has undertaken a public interest test with regard to providing a chronology of events.

It believes that Section 38 (1) (a) should be engaged as it is likely to endanger the mental health of individuals [staff] linked to the events leading up to the tragic death of Victoria Harrison, should the information be in the public domain.

The reason for this is due to the risk of colleagues and peers being able to identify the individuals [staff] involved in the incident, and placing the individuals concerned under additional stress and pressure in addition to that already experienced during the investigation and inquest.

Having made this response, Kettering General refused to say how many staff had been disciplined, or their rank, claiming individuals would be identified, but it did reveal that no staff were dismissed.

An artery had been damaged during surgery, with the surgeon rectifying the issue, but not all nursing staff had been told about the bleeding and a number of nurses – incredibly – did not routinely read medical notes of the patients, or when they did could not always decipher surgeons’ handwriting, the inquest was told.

The last written formal observations were taken nine hours before Miss Harrison was found dead by nursing staff.  It is staggering that Miss Harrison had texted her boyfriend to say she was in pain and bleeding, yet staff apparently did not know about it.  No surprise therefore to hear that the coroner said:

Windows of opportunity to treat Victoria were lost – had these been acted upon the outcome may have been different.

I believe her chances of survival would have significantly increased.

Yet despite these failings, the hospital is telling the public they have no right to know how the failings leading to a preventable death have been addressed.

How are residents, forced to rely on the ‘care’ provided at Kettering General, supposed to have confidence in how they will be treated and subsequently looked after?

The interests of the hospital staff are being put first.  This is another example of the public sector, the servant of the public, acting more like the public’s master in refusing to be held to account.  We are just expected to provide the funding and take pot luck when it comes to putting our lives in their hands.

Thoughts from outside the NHS bubble

From time to time the blogosphere has the ability to restore one’s faith in the capacity of social media to provide contributions of immense value.  One such contribution can be found on Cranmer’s website today, written by Rev’d Dr Peter Mullen.

It is a piece that speaks truth to sentimental delusion.

This blog rarely ventures onto the subject of the NHS.  My personal experience of the health service’s impacts on my family and friends is far more negative than positive and as Rev Mullen points out in his piece, the NHS has the same status in Britain as that of a cow among Hindu devotees.

The NHS cannot be criticised in any way without a legion of those devotees hurling bile filled invective at the person offering the criticism.  Never mind that among other failings, the poor and declining standard of care in the NHS resulted in the death of my mother, came within a whisker of ending the life of my wife moments after she gave birth to our precious son, and made the final days of her step-father’s life undignified and needlessly painful.

I have done battle with the Nursing Directors, Consultants and Managers, each of whom attempted to defend clear failings to the point of saying black was white, all because their primary concern was worry about a possible legal case for compensation, rather than a desire to correct the problems at source.  As I found, when all else fails and their argument has been comprehensively destroyed, the next things to be destroyed are the incriminating medical notes and ability to recall conversations held in front of witnesses.  All that could remain is blind faith in the NHS, which is why Rev’d Mullen’s description of the service as the National Health Church is so apt.

The NHS is not fit for purpose.  It is a bureaucratic behemoth, violently resistant to change, and imbued with and unwarranted self belief that is fuelled by those cheerleaders inside and outside it – many of whom have political motives for supporting what has been little more than a charnel house for tens of thousands of people in recent years, whose conditions would not and should not have resulted in death or long term suffering.

The people and businesses of this country are forking over £95.6 billion pounds of our money this year to fund the NHS in England – an organisation that has an unjustified sense of entitlement and expectation.  Entitlement to operate in its own interests rather than that of patients and expectation that people should not criticise it, because it comprises, as Rev’d Mullen so incisively observes, those who are described as ‘angels…wonderful…caring…tireless…salt of the earth’.

There are still NHS staff who don’t feel the job of providing care and comfort and affording dignity to patients is beneath them.  There are still doctors and consultants who recognise their job role is trying to heal patients by treating them for their ailments, rather than constructing departmental fiefdoms and playing politics.  There are even managers who add value to the NHS by trying to administer the hospital effectively so patients get the care they need and the taxpayer gets value for money.  But there are too few of each of them in the ‘modern NHS’.

There are better options for the use of our money to achieve the better medical outcomes.  But all the while the political class, media and National Health Church faithful continue to prop up this broken socialised construct, we will all be stuck with it or be forced to pay more of our money to go private in order to get the standards of care and treatment the NHS is supposed to provide but all too often fails to deliver – with far too many casualties paying the ultimate price in this pseudo-religious war.

The NHS reality for too many people

This is not a post anyone should have to write. It is an intensely personal posting because it concerns what is happening within my family right now. It is less of a story and more a need to simply get off my chest a current and ongoing experience of dealings with the NHS. Sorry if it seems a bit disjointed.

A couple of years ago a male member of my family was diagnosed with Alzheimer’s disease. As time has passed his memory and physical condition has progressively worsened as this awful illness has taken its toll. Recently it became clear he was unwell with a separate illness and in need of medical treatment. His wonderful wife, a formidably experienced senior nurse with over 30 years of service until she retired, suspected an infection and also noted symptoms of diabetes.

In Alzheimer’s sufferers any infection can be disastrous and dramatically worsen the condition. The diabetes effects would also compound the condition. So his wife got an urgent GP appointment. After an examination it became clear he needed to go to hospital for treatment and he was admitted immediately. This is when the story takes a turn for the worse.

The initial hours after admission saw our family member put on IV drips to combat the infection and started on insulin as diabetes was confirmed.  He became increasingly confused and emotional which, of course, was devastating enough for his devoted wife. Nevertheless given her own prior experience of the NHS she had complete trust in the clinical team to do everything needed to help her husband. It’s the way she and her nursing teams worked after all. He was duly admitted to a ward, where he remains to this day.

Within a couple of days of her husband being sent up to the ward it became clear there was a problem and the standard of care in the hospital was nothing like the one she had provided during her career. Being used to ensuring the highest levels of cleanliness, patient care and dignity for those people on wards for which she was responsible, she has since been moved to tears of frustration by what can only be described as substandard care by less than capable staff. Her daily morning phone calls prior to visiting hours have always resulted in reassuring words from the staff that her husband had experienced a comfortable night and was ‘fine’. But upon arrival for her visits it was clear that has rarely been the case.

Our family member has been losing weight noticably in the last week because it transpires he has been difficult to feed and the nursing staff move on to other tasks.  Recent attempts to get some of his oral medication into him have also been unsuccessful and led to him getting into an agitated state and not taking the required dose at times – something I thought could not happen. These incidents are concerning enough, but what I am about to write has led to real anger among the family members.

In one of his more lucid moments a couple of days ago he recognised his need to go to the toilet and asked to go. His wife asked for help so she could move him to the toilet. However, she was told by the nurse on duty that he was wearing incontinence pants and to just leave him and let him soil himself. This is a complete abdication of a nurse’s duty to help a patient retain their dignity and as you could imagine his wife was shocked and furious. It is appalling and extremely distressing.

Earlier this evening saw yet another example of the depths to which the modern NHS has sunk. On arrival for the strictly controlled visiting hours she noticed her husband was showing signs of discomfort and a raised temperature. Having called the nurse and explained she was concerned and would like his temperature checked, she was told by the nurse: ‘No, it’s ok, we checked him earlier and he’s fine.’ at which point the nurse turned and started to walk away. Most people without medical training would have just accepted this on trust. Thankfully our patient’s wife did not, and with a raised voice demanded the nurse get a thermometer and take his temperature straight away. She is the matriarch of our family but a gentle and compassionate woman and it takes a lot for her to show the aggression she was forced to display. This should not have been necessary.

After a display of poor attitude – huffing and puffing – betraying the sense that this demand was unreasonable and an inconvenience, the check revealed this old, confused and sickly man is running a temperature of just under 102, indicating a deterioration of the infection or a new condition in need of attention. He was admitted to hospital to get better, but instead his condition has worsened and his wife is being forced to fight with clinical staff just to get them to do the basics of their job. Despite these family members having worked hard all their lives and paid their fair share into the system, this is how they are being treated by the supposed ‘envy of the world’. Her faith in the NHS has been destroyed.

As you can imagine, she is now terrified of going home and not being there to monitor her husband and his treatment, ensure he is getting food and being administered the necessary medication. She has now found herself in the middle of a battle to get basic care and dignity for her husband from the NHS nurses on his ward.  It really has come to something when a passionate and vocal supporter of the NHS finds it has become a shadow of what it was and what it claims to be and is begging to be able to take her husband home so she can give him the care he deserves and should be experiencing.

This is the tragic and unacceptable reality of today’s NHS for too many people. But too few families want to make a fuss or know how to stand their ground against the healthcare professionals they rely on to look after their loved ones when instinct tells them something is not right.  It shouldn’t be this way. Who is going to stand up for these people and ensure they get the standard of care they are entitled to?  This may just be a private family tragedy unfolding, but up and down the country many other families are experiencing similar. It’s a bloody disgrace.

When our servants are really our masters

In a comment thread on EU Referendum about the scandal – there is no more fitting word for it – of actions by authorities and social services being kept a legally enforced secret, even if an injustice has been perpetrated, that prevents even parents discussing any aspect of a family case, Dr Richard North drew parallels with his series of posts about the Battle of Britain, saying:

What is fascinating about the Battle of Britain narrative is that it demonstrates, amongst other things, that when officials are given control over information, they always abuse it, primarily to protect themselves from scrutiny.

Rarely has there been a more accurate comment.  Then as now, officials abuse their control of information and knowledge to suit their own interests rather than those of the public they are supposed to serve.  The latest incarnation of this insipid abuse hails from the NHS.

Threats, bribery, recriminations.  Ruined careers and destroyed reputations.  Good people forced from their jobs and even having to relocate overseas in some cases because they have been sullied by their vengeful superiors for speaking out.  And why?  To hide the truth from us and maintain deceptions.

It should be impossible in this day and age for public servants to abuse their control of information.  But the fact is it’s endemic.  It’s as if there is a peculiar mindset corrupting senior leaders in public organisations that necessitates the concealment of facts or effective misrepresentation of them.  Information is power and our servants believe the people must not be allowed access to either.  When they are able to do this they cease to be our servants and assume the role of our masters.