• Uneasy reading 26 June 2018 | View comments

  • 25th June 2018 | By David Jolley

    This week we have been reading about deaths and care of patients in Gosport War Memorial Hospital https://www.theguardian.com/society/2018/jun/20/disregard-for-human-life-gosport-hospital-inquirys-key-findings

    The inquiry was chaired by Bishop James Jones who had previously chaired the Hillsborough Inquiry and is retired from his post as Bishop of Liverpool. I have not yet found a list of other members of the panel. Headlines describe hundreds of deaths caused or brought forwards over a period of 30 years by care a prescribing practices of a GP assistant. It is frightening and heart-breaking stuff. Whistle-blowers have been ignored, family concerns have been set aside.

    But I am not easy.

    There is also the story of worries about care of older people in North Wales https://gov.wales/about/cabinet/cabinetstatements/2018/tawelfanreport/?lang=en

    This story has received less attention in the national media. The Health and Social Care Advisory Service (HASCAS) http://beta.charitycommission.gov.uk/charity-details/?regid=1064523&subid=0

    Has undertaken a careful and independent analysis of care in a setting where concerns have previously been raised. http://www.itv.com/news/wales/2018-05-03/no-evidence-of-institutional-abuse-at-denbighshires-tawel-fan-mental-health-ward/

    Unlike a report from Donna Ockenden in 2015 http://www.wales.nhs.uk/sitesplus/documents/861/tawel_fan_ward_ockenden_internet.pdf

    HASCAS found there to be no evidence of institutional abuse and, indeed, described the care as ‘a credit’. (I am including the link to the Donna Ockenden report for, though it is marked ‘confidential’, it is freely available on the internet).

    So what was labelled ‘a scandal’ three years ago, is now understood to be nothing of the sort. This will be a relief to many professionals who have worked hard and honestly but found themselves scapegoated. It is felt to be a terrible betrayal by some families who have been convinced, and remain convinced, that their loved ones suffered as a consequence of poor or malicious care. www.bbc.co.uk/news/uk-wales-43962668

    It is a nightmare.

    We have to worry that people will be discouraged from working in a field which is already low in kudos. There has to be concern that patients will be denied effective palliative care and fruitless efforts to keep them alive will prolong or produce suffering and be wasteful of resources.

    I wonder if the ‘Choosing Wisely’ initiative of the Academy of Royal Colleges www.choosingwisely.co.uk/ can prove robust enough to support a calm and balanced resolution.

    Let us hope so.

    For the moment, I am more than uneasy with the immediate acceptance of the damning report on the care at Gosport War Memorial Hospital, though it will require some very brave people to raise the questions.

    In both these settings, the issues of time, resource and discipline to communicate honestly and openly with families and patients, and to record what is said and what is agreed and not agreed, emerge as basic. That is the first learning point for me.

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