NHS hospital kills the elderly

When Edna Purnell was referred for “gentle rehabilitation” at a local healthcare unit after a hip replacement operation, her family thought she would be given exercises to get her back on her feet and sent home after a fortnight. Instead she was put to bed in a darkened room and put on a regime of morphine within a day of her arrival. Less than a month later she was dead.

This weekend the full story has emerged of Purnell’s death and her family’s subsequent campaign, which led to a series of investigations of the deaths of 92 elderly people at Gosport War Memorial hospital in Hampshire between 1996 and 2000. An inquest into 10 of the deaths was ordered earlier this month by Jack Straw, the justice secretary, as revealed by The Sunday Times last week.

The families allege that their relatives’ deaths were hastened by a regime of heavy morphine use and little or no food, drink or exercise. The inquest will be heard this autumn and is expected to raise serious questions about treatment of the elderly in Britain’s hospitals and care homes and the value attached to their lives.

Purnell, a twice-married extravert, had enjoyed an expatriate lifestyle across the world from Cuba to Hong Kong. She became frail only as she entered her nineties and moved into an old people’s home, where she had a fall in the late autumn of 1998. Despite her age she was considered fit enough for hip replacement surgery at the Haslar hospital, Portsmouth, and within three days of the operation she was out of bed and moving around.

Mike Wilson, Purnell’s 71-year-old son, says that she was well on the mend before she was moved to Gosport. Hospital records show she had not required even the mildest of painkillers in the five days preceding her transfer. “She was a fighter; she was out of bed, bright-eyed and bushy-tailed and moving around with a [walking] frame after the operation,” he said. “Two days after she got [to Gosport] she was like a zombie, in a completely trance-like state.”

Wilson said nurses told him the elderly could deteriorate quickly when moved but he became convinced that it was the sedation, not her underlying condition, that was the problem. “When I complained about the morphine, they said it was to help her sleep at night, but in fact they were giving it to her all day long as well,” he said. “She became extremely dehydrated.” By the hospital’s own admission Purnell was given little or nothing to drink.

Despite her son’s complaints, not only high doses of morphine were administered to Purnell, but also mida-zolam, a sedative three to four times more powerful. It is meant to be used only under close supervision because of its dangerous nature and the extreme variability of individual responses to it. As he became more concerned, Wilson began a diary chronicling his mother’s treatment. The diary and notes he has obtained from the hospital include a threat to have him arrested for trying to feed his mother. “If he tries to do this again the police should be called and he should be arrested on the technicality of assaulting his mother,” the notes read.

Purnell died in December 1998, three weeks after her transfer to Gosport. “It is my belief that, intentionally or otherwise, she was being deprived of the basics to sustain life,” Wilson said.

After his mother’s death Wilson delivered leaflets to local surgeries and health centres asking for other families with similar experiences to come forward. Complaints flooded in with stories of recovering patients referred for rehabilitation but given large doses of painkillers. Most relatives had been urged to go home or even to go on holiday in the final days of their loved ones’ lives. A series of police and other investigations petered out, although some experts continued to believe there were reasons for suspicion at Gosport.

Richard Baker, professor of clinical governance at Leicester University, studied the deaths six years ago. Baker, whose statistical analysis of mortality among patients of Harold Shipman helped to convict the Manchester GP of mass murder, believes there is a need for further investigation. “I hope this [investigation] does eventually get somewhere,” he said last week.

A spokesman for Hampshire primary care trust, which runs the hospital, declined to comment on specific cases but said: “Since a 2002 investigation and the introduction of new clinical procedures, the level of clinical incidents has been entirely normal for a hospital of this size.”

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Australia: Health bureaucrat gets the boot!

Sort of. Bureaucrats are almost totally protected from accountability, for some reason

THE senior health executive who employed the "Butcher of Bega" Graeme Reeves, despite being warned he was banned from obstetrics, has become the first head to roll over the scandal. The Greater Southern Area Health Service has suspended Dr Jon Mortimer from duty on full pay "pending the outcome of further inquiries" into the appointment of Mr Reeves, who is accused of mutilating hundreds of women while working as a gynaecologist and obstetrician.

A handwritten diary note by Dr Mortimer, who at the time was deputy director of medical services for Southern Area Health Service, shows an unnamed referee warned him that Mr Reeves "was not meant to do obstetrics". The discovery, tabled in the NSW Parliament, contradicted statements from Health Minister Reba Meagher that the health service failed to perform background checks, when it in fact did. "The [documents] show that background checks were carried out, but were then ignored or dismissed," Opposition health spokeswoman Jillian Skinner said.

Dr Mortimer is the first executive to be publicly reprimanded by NSW Health following the scandal which has rocked the health system since it was exposed by Channel Nine's Sunday program in February. Hundreds of patients have since come forward with claims of sexual assault, mutilations and botched procedures, including at several South Coast hospitals in 2002-03. Director-general of population health and chief health officer Denise Robinson, who was chief executive of SAHS at the time of Reeves's appointment, resigned this month, citing career opportunities elsewhere. Dr Mortimer's boss, Dr Robert Arthurson, remains in his position.

Mr Reeves was appointed as a visiting specialist obstetrician and gynaecologist at Bega and Pambula district hospitals after meeting Dr Mortimer and his colleague Kym Durance in January 2002. Dr Mortimer then chaired the five-member committee which recommended he be hired in March 2002. A handwritten note made by Dr Mortimer on the minutes of that meeting said "rego check" with a large tick over it. Yet Mr Reeves's registration with the NSW Medical Board was conditional and he was banned from practising obstetrics in 1997 following the death of a woman and a baby under his care.

It is unclear if his false assertion about holding current Visiting Medical Officer (VMO) appointments at Hornsby Ku-Ring-Gai and Sydney Adventist hospitals were checked at the time. The Medical Error Action Group has received 575 complaints about Mr Reeves, and its founder Lorraine Long welcomed Dr Mortimer's suspension. "It's absurd the people in public service are not doing their jobs," she said. Dr Mortimer did not return calls last week. His voicemail message said he was on leave.

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Australian public hospital 'a fire risk'

An audit of Mareeba Hospital and its nurses' quarters has exposed a litany of fire safety breaches that could force it to close. The Cairns Post reveals Queensland Health has been given until June 20 to make urgent repairs on Mareeba Hospital buildings described as fire hazards. Safety problems identified by the Queensland Fire and Rescue Service include faulty smoke doors in the hospital and inadequate fire safety signs, problems with locks and the lack of a fire safety management plan at the nurses quarters.

Of most concern is the nurses' quarters, with a source telling Cairns Post maintenance problems in the 60-year-old building breached the Building and Other Legislation Amendment Act, which was brought in as a result of the Childers Backpackers fire in 2000. Fifteen backpackers were killed in a horrific arson attack after they were unable to exit the burning building. "The accommodation for the nurses was not up to regulation," the source said. "It's a fire hazard."

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