Gosport War Memorial Hospital

Im shocked at the report. I live in the next road to this hospital and have used it lots for minor injuries, out patients, scans etc and it appears to be run well. It is shocking to read what was going on in the wards.

Hospitals are closed societies, DD has recently ended an extended period of constant contact with her local hospital and while she had excellent treatment and has made a good recovery, we did find that too often she was processed a bit like a sausage in a factory, fed in here, spat out there, not given information, just expected to conform to hospital requirements, while hospital staff seemed a law unto themselves.

Closed societies often develop perverse and dangerous behaviours and those who question or query these behaviours are pushed out, isolated and denigrated. It takes real courage to speak out in those circumstances.

We need to find ways of opening out these societies, which are present in many professions, not just medecine.

Clearly, the medical protocols at Gosport were profoundly wrong, but what I find deeply, and even more troubling, is the culture of cover up and denial by the civil service, the government of the day and the hospital administration. The only person who comes out of this with any credibility is Norman Lamb. When even the Minister of Health is given the runaround it’s clear that we are living in a very sick society.

Like Isabella, I am also a retired nurse and have refused to give medication if I was not happy that it was appropriate or necessary.
It seems that the use of syringe drivers was overdone but, the drugs were not always administered by syringe driver. A women interviewed on the news said that her father’s drugs were given by injection.
Just a side issue. I was annoyed, during a discussion on the report of the faulty syringe drivers, to hear that they are used to “save the nursing staff time”. No! They are used to keep a level dose of a drug in the patient’s system to avoid peaks and troughs of pain and effects of the drug.

I agree humptydumpty Certain types of people are very plausible and gain access to vulnerable people with the intention of doing harm. I have seen this in my work with adults who had a learning disability.

It seems protocols were not adhered to, or perhaps did not exist. As a retired nurse I have to say I refused to give a drug on several occasions knowing that the dosage or prescription was an error.

It seems there has been a total system failure here. Awful.

Indeed the Gosport situation hinges on the fact that the use of this choice of pain relief was inappropriate to the situation. That is what is concerning about it all.

The motive for these choices is very puzzling. Let us hope that the pressure on doctors to end bed-blocking played no part.

As an ex nurse I have seen syringe drivers used for pain relief and they nearly always hasten death. However I have never seen one used where there was not good indication that the patient required increasing pain relief and it was always after other pain relievers had failed or were no l9nger helping. The patients were all terminally ill. I have never seen one used for a broken arm for example and would have been shouting about it (as it seems some nurses did) had it been used that way on any ward I worked on.

Reading the report slowly but what I am reading is shocking with those least powerless to stop it being demonised for complaining and raising concerns. Awful.

I always try and see the good in people and don’t for one moment think that Jane Barton intended to kill with any malicious intent, rather looked at easing suffering but in a totally chaotic and indiscriminate way. She needs to be held to account as a professional person who has made the most terrible errors.

Keeping people comfortable and pain free is one thing but snowing them under with opiates so they die without good clinical evidence they need that pain relief is appalling.

I’ve seen two relatives on syringe drivers where death was a result of terminal cancer....the drugs which kept them pain free possibly shortened life by a few days at most but was preferable to extra rays fulled with pain.

That’s not what was happening at Gosport

I agree alreadytaken, I don't like the culture of prolonging life at all costs; but the point is, these people were not in great suffering...

I am sure the VAST majority of people in medical services are there to help people, and I have every respect for them.

Thanks alreadytaken my mum was well cared for but had agreed to a DNR and suddenly developed pneumonia and died very quickly. The doctor attending her was very young and hadn't (I think) seen many deaths. She was very upset to lose my mum.

Just seen I missed out a 0 - it was meant to be one in a million may be there for the wrong reasons, 999,999 are not.

There are checks and balances in the system designed to ensure that the 1 in a million are prevented from causing harm. What we need to know is what reason the doctor gave at the time and why the checks and balances didnt work.

trisher I'm sorry for your loss. Doctors dont like to lose patients who were enjoying life, however old they are.

My concern is that hospital staff will try too hard to prolong my life. I have observed that some people fight death and others welcome it as a friend that brings peace to a life that has no joy left in it. I dont want doctors to fight to save my life in all circumstances.

Whether you do an advance decision, an LPA or both it is important that you discuss with your relatives what you wish to happen.

I wonder about the role of the coroner service in these deaths and the complaints about them, When my mother died recently after an extensive time in hospital I was contacted by the coroner's office because she had originally been admitted to hospital after a fall and asked my views on the cause of death. There must have been some similar instances in these cases.
I must say that my mother had excellent care while she was in hospital and the doctor and nurses attending her when she died, were as upset as any of us about losing her and she was 95. These cases are upsetting but most medical staff fight for the lives of all their patients whatever their age.

The vast majority of people drawn to work in medicine are there because they are people pleasers. They get their kicks from people liking them and from doing good. Maybe 1 in 100,000 is drawn to medicine for the reasons you consider but lets not forget the other 999,999.

Given this case, also the Shipman case and that of a nurse who overdosed patients using insulin (and I'm sure there are more), I can't help wondering if some people are drawn to work in medicine because it gives them access to vulnerable people over whom they can exert power and, horrendously, perhaps the power to kill; in the same way that paedophiles can be drawn to such organisations as youth groups, the church, teaching and so on as these arenas provide a 'hunting ground'. I would love to be wrong.

compassionindying.org.uk/wp-content/uploads/2014/11/LPA03_-Advance_Decisions_and_LPA_for_Health_and_Welfare_v4.pdf

I posted about the LPA already because your post didn’t make it clear that you had actually drawn up an Advsnce Decision. For anyone who is interested the link above compares LPA and AD

my child is a trainee doctor and we are both well aware of the duty of a doctor to take an advance decision into account.

The final decision is always the doctors, with or without an LPA. In my view it is more powerful than an LPA. One authorises a person to take a decision for you, the other is a statement of what you, the patient, actually wished to happen. To go against it the doctor needs a reasonable belief that it was written under pressure or when the patients was not in a fit state to make the decision.

The advantage of an LPA is that it will cover a situation that you may not have thought about when writing an advance decision. The disadvantage is that it costs money.

This is an example of the training the GMC offers doctors about advance decsions. www.gmc-uk.org/-/media/ethical-guidance/learning-materials/themes/caring-for-a-patient-who-has-made-an-advance-decision-to-refuse-treatment.pdf?la=en&hash=43ABF49A5173AE8A7DC9013B4A9A13D6156E8F98

But already have you done an LPA for that? Next of kin have no legal rights per se and the final decision is the doctors without an LPA

Although concerned about what happened at the hospital I also fear this may mean that some people suffer when it's unnecessary.

I have been present at one end of life discussion for a relative and in another case was supporting a person who was party to such a discussion. In both cases the elderly person was in no condition to take part in the discussion. The doctor made it clear it was their clinical decision but they wanted to know if the patient had expressed any views on end of life care.

For one of the 2 I believe more pain relief was given than was essential in the full knowledge that it would shorten life. The entire family agreed this was right - and I would defend that decision to anyone.

We do not allow animals to suffer, we do allow humans to do so. Doctors have to take very difficult decisions and sometimes they get it wrong.

Personally I've given my next of kin explicit written information on end of life care - and my desire that in some situations I should not be given anything but palliative care.

This is a very emotional, and tricky topic.
Are doctors allowed to consult relatives when they make major treatment decisions? Or is it only when a relative has Power of Attorney for the patient?
I’ve been in this situation (as a relative) on three occasions with sudden end of life care decisions.
I know these patients at Gosport weren’t supposed to be at, or near, end of life but is the legal situation about consulting relatives the same?
That is do you need Power of Attorney?

Riverwalk I see where you are coming from and I am scandalised by this case and do not support voluntary euthanasia, but, this is not relevant to this situation as the majority of the people drugged into death were not terminal cases. They were just older people recovering slowly from recoverable medical problems that came into the hospital sentient, were drugged into a coma and within a a week or two died as a result.

Sorry Riverwalk but despite everything I still think that people with for example a degenerative disease should be able to choose the timing of their death.
It's such a personal thing and until you are affected its hard to understand the despair sufferers must feel.
That's not to say I am not appalled by what has happened at Gosport Hospital.

There was a lady on the Victoria Derbyshire show this morning talking about her grandmother who died at the Gosport Hospital in 1999. When they, her family, eventually were shown her hospital notes it was truly shocking the way she had been treated and the drugs that had been administered. I do hope these families get the answers they deserve and that those who are found to have done wrong are punished.

checks and balances sodapop?

It would need more than checks and balances - look what happens now, and in the past, when euthanasia (voluntary or otherwise) is still illegal!

I don't think the two are comparable Riverwalk as PECS said there need to be checks and balances.

Truly an unhappy situation for the families of the patients involved. I hope they find some comfort in the report findings.
Re euthanasia Riverwalk: I think that the issue is that concerns were raised because not enough checks & balances were in place to make sure the 'treatment' was what was wanted or known by patient/family. If very sick individuals want to make a choice about when they die that is very different from a maverick medic indisciminately overperscribing on purpose to hasten death of multiple patients.
It also seems one dynamic personality was able to push away and put down the whistleblowers. Hopefully current legislation would prevent such dreadful practice being hushed up.

Patients and their families must have confidence in the carers and professionals. Thank goodnes the majority are good people.