Patient care so bad it’s a crime: Neglect of old in fifth of hospitals breaks law, says damning report
At least 20 hospitals where patients denied food, liquids and toilets
One in five hospitals is breaking the law in its level of neglect of the elderly, a damning report revealed yesterday.
The Care Quality Commission found at least 20 hospitals where care was so poor that patients were denied ‘the basics in life’ – eating, drinking and going to the toilet.
This was a fifth of the hospitals investigated by the Government watchdog. It warned that staff in some NHS trusts were ‘putting paperwork over people’.
On some wards inspectors saw frail patients rattling their bedrails or banging on water jugs to try to attract the attention of staff. On others, nurses had ignored doctors’ instructions to put dehydrated patients on drips and abandoned them without fluids.
The watchdog visited 100 hospitals between March and June to check they were meeting the basic standards required by law, which ensure that elderly patients are properly fed and treated with dignity. The inspections were partly triggered by a campaign by the Daily Mail and the Patients Association which exposed the appalling standards of care on some wards.
Inspectors monitored whether nursing staff were helping frail patients eat their meals and making sure they had enough water throughout the day. They also checked whether nurses responded to patients’ calls for help, assisted them to the toilet or helped move them to prevent bedsores.
Last week the watchdog announced it had found that 49 hospitals, nearly half, were not doing enough to ensure patients did not go hungry or thirsty.
Yesterday it unveiled its full report, which revealed that in 20 NHS trusts, the standard of nursing care was so poor it was in breach of the Health and Social Care Act 2008.
Inspectors found that in many hospitals the elderly were routinely forced to undergo the indignity of using commodes next to their beds because staff were too busy to take them to the toilet.
They also found that at meal times, nursing staff were so preoccupied giving patients medicines they forgot to feed them and trays were cleared away untouched. At Alexandra Hospital in Worcester, they found some patients had not been given anything to drink for more than ten hours.
Doctors resorted to putting some patients on drips or prescribing them drinking water in their notes to ensure they did not become severely dehydrated.
Dame Jo Williams, chairman of the watchdog, urged NHS trusts not to put ‘paperwork over people’. ‘Time and time again, we found cases where patients were treated by staff in a way that stripped them of their dignity and respect,’ she said.
‘People were spoken over, and not spoken to; people were left without call bells, ignored for hours on end, or not given assistance to do the basics of life – to eat, drink, or go to the toilet.’
The Mail’s campaign highlighted examples of elderly patients left screaming in agony, ignored by nurses who refused to give them painkillers.
Distraught relatives spoke of how they had turned up on wards to find their loved ones desperately thirsty and in some cases left for hours on a hospital bed without a mattress.
The 20 hospitals found to be breaking the law are being visited again to ensure they are making improvements. If they are still deemed to be failing, the relevant wards could be shut and the hospital fined.
The CQC has already closed one ward at Sandwell General Hospital, Birmingham, since its follow-up inspection. And James Paget Hospital in Great Yarmouth, Norfolk, has been given a final warning. Nursing staff had ignored doctors’ orders to put dehydrated patients on drips. Inspectors also came across a nurse telling off a frail patient merely for ringing a call bell.
It came as campaigners claimed that at least 12,000 fewer patients would die each year if the NHS matched the standards of other European countries. Despite billions of pounds poured into the Health Service since 1999, there has been no ‘discernible’ effect on death rates, according to an analysis by the TaxPayers’ Alliance.
It said more competition would produce better results for patients – as it has elsewhere – along with less interference from politicians.
Katherine Murphy, chief executive of the Patients Association, said the charity felt ‘overwhelmed with these dreadful and deeply depressing inquiries’ into hospital care. She said that in the last few months the charity’s helpline had seen a sudden surge of calls from relatives regarding appalling standards.
Health Secretary Andrew Lansley said: ‘Everyone admitted to hospital deserves to be treated as an individual, with compassion and dignity. We must never lose sight of the fact that the most important people in the NHS are its patients.’
Boy, 2, found dead after NHS doctors told parents there was ‘nothing sinister’ about his meningitis symptoms and sent him home
A two-year-old boy sent home from hospital was found dead in his bedroom just hours later, an inquest has heard. Lucas Wellstead was referred to Weston General Hospital, Somerset by his GP after developing symptoms of meningitis in January.
But medics told the youngster’s parents there was ‘nothing sinister’ about his meningitis symptoms, and he was discharged with paracetemol after five hours, despite his temperature rocketing from 37 to 40.2C (104F).
The tragic two-year-old was found lifeless in his bedroom the next morning and pronounced dead from septicaemia and pneumonia 16 hours after he was initially discharged.
Hospital staff today admitted wrongdoing during an inquest into Lucas’s death.
The two-year-old, who lived with mum Sian Eggins dad John Wellstead and their two other children in Locking Castle, Weston-super-Mare, was taken to his GP on January 20 last year.
Their local GP Cheryl Cottrell urgently referred him onto the seaside town’s hospital after spotting a rash on his neck and cheek, high temperature and cough. He was taken into their children’s Seashore Centre, where his vital signs were checked twice and he was assessed by consultant paediatrician Dr Phil Smith.
His temperature was recorded as 38 degrees, he had a heart rate of 152 beats per minute and a respiratory rate off 44 – all classified as out of the normal ‘range’. But he was released five hours later, at around 5.45pm, even though his temperature had risen to 40 degrees by this time. He was sent home with the paracetamol and a steroid for suspected croup.
His family said they were not given any advice on monitoring his temperature once home – despite the fact it was above normal before they left the hospital.
Miss Eggins described to the inquest, at Flax Bourton Coroner’s Court, near Bristol, what happened over the next few hours.
She said: ‘We got home and Lucas had a bath and put on his pyjamas. We read him a story and settled him down. ‘The next morning at about 8.40am, John came in screaming saying he had found Lucas lifeless on his bedroom floor.’
Paramedics were called to the flat and desperately tried to revive the toddler, but he was pronounced dead at Weston General Hospital, at 9.30am on January 21.
Nurses Rhea Toney and Elicia James, who were partly responsible for Lucas’ care at the hospital, gave evidence at the inquest. Ms Toney said that although the youngster’s temperature, heart rate and respiratory rate were ‘out of range’ that was ‘not unusual’ for a child who was distressed at procedures being carried out.
She confirmed she had taken Lucas’s temperature when he had arrived at the centre with his heart rate and oxygen saturation readings. Ms Toney added that medics often record similar observations in unwell children at the Seashore Centre.
But Dr Phil Smith revealed that in hindsight he would have re-examined Lucas instead of sending him home. He said: ‘In retrospect it would have been a good idea.
‘A number of things have now changed. Since Lucas sadly died we have changed our observations. ‘We do our observations every two hours and should any abnormalities, we do them more frequently.’
The inimitable Pat Condell again
Top British judge’s furious attack on courts for using human rights laws to defy Parliament
British courts are using Human Rights legislation to knock down laws rightly made by Parliament, a Supreme Court judge said yesterday.
Lord Brown launched a furious attack on other judges for making ‘highly contentious’ rulings and ‘frustrating’ Government policy decisions.
His comments came as his court, against his wishes, overturned a ban on marriage visas for foreign nationals wanting to marry a Briton when either is under 21.
The rule was designed to protect against forced marriages involving vulnerable young women.
But by a four to one majority, the Supreme Court judges said it was a breach of Article 8 of the European Convention on Human Rights – the right to a ‘private and family life’.
This has been used by terrorists and hardened criminals to escape deportation simply because they have family or social ties in Britain.
Lord Brown, the only judge to dissent, said in his judgment that the decision should be ‘one for elected politicians, not for judges’. He wrote: ‘Article 8 is a difficult provision which has already led to some highly contentious, not to say debatable, decisions. Upon that I am sure we would all agree.
‘In a sensitive context such as that of forced marriages, it would seem to me not merely impermissible but positively unwise for the courts yet again to frustrate Government policy except in the clearest of cases. To my mind this cannot possibly be regarded as such a case. ‘Unless demonstrably wrong, this judgment should be rather for Government than for the courts.’
The court heard forced marriages were most commonly found in Pakistani and Bangladeshi communities and were used as a way of getting around immigration rules.
The rule, introduced in 2008, was challenged by two genuine couples who were barred from marrying in Britain. Diego Aguilar, a Chilean student, married Briton Amber Jeffrey before the rule came into force in November 2008, when she was 17 and he was 18. But ministers refused him the right to stay in the country because of their ages.
Briton Suhyal Mohammed was prevented from bringing his young Pakistani wife, Shakira Bibi, into the country because both were under 21.
The High Court ruled in favour of the Government, but its ruling was overturned in the Court of Appeal. And yesterday the Supreme Court upheld the Appeal Court’s ruling.
One of the judges, Lord Wilson, said it was a ‘colossal interference’ with Article 8 rights to force couples to live separately, or force a British citizen to leave the country. Lady Hale, Lord Phillips and Lord Clarke also upheld the judgment.
Lord Wilson said the Home Office had failed to prove the restriction was justified, despite accepting it had ‘a legitimate aim in deterring the practice of forced marriages and is rationally connected to that aim’.
But Lord Brown said the other judges had taken Article 8 even further than the European Court of Human Rights in Strasbourg. Similar age restrictions exist in Germany, Austria, Belgium and other European countries, he said. In Denmark both bride and groom must be 24 before they can wed if one is from overseas.
Dominic Raab, a Tory MP and human rights expert, said: ‘This is a patent example of the courts legislating to expand the right to family life. It goes beyond the European Convention, it goes beyond precedent in the UK or the Strasbourg Court and it is stricter than several other European democracies.
‘Yet again, unaccountable judges are substituting their view on what amounts to an effective immigration policy for that of elected law-makers, and on a wafer-thin basis.’
Immigration minister Damian Green warned that today’s ruling threatened to ‘put vulnerable people at risk’. He said: ‘This is another very disappointing judgment, which overturns a policy that exists and is judged to be consistent with the European Convention on Human Rights in other European countries.
‘The judges themselves agreed increasing the marriage visa age had a legitimate aim.’
‘Savvy’ parents will abuse new admissions rules, head warns
Which shows how hard it is for Brits to get their kids into a good State school
New-style admissions rules face being abused by “savvy” middle-class parents to force children into the most sought-after comprehensives, MPs were warned today.
An overhaul of the national admissions code could turn into a “huge bureaucratic monster” for schools as families use greater powers to flood head teachers with complaints, it was claimed.
The Commons education select committee was told that some parents already hired “QCs and barristers” to help them fight appeals after children failed to gain places.
But Rob McDonough, head of West Bridgford School, Notts, said that Coalition reforms – that allow families to make formal referrals directly to the national admissions watchdog – could lead to schools being inundated with large numbers of spurious grievances.
The comments come weeks before the publication of a new national admissions code dictating entry to thousands of state primary and secondary schools across England.
Under changes being proposed by the Government, schools will be able to effectively reserve places for the children of teachers and give priority to pupils from the poorest backgrounds.
In a key development, parents will also gain greater rights, including more time to lodge appeals. For the first time, families will also be able to shop a school directly to the Office for the Schools Adjudicator – the official admissions regulator – if they suspect head teachers of flouting national rules and selecting pupils “by the back door”.
But Mr McDonough warned that the move could lead to a flood of complaints from pushy parents. Giving evidence to MPs on Wednesday, he said: “Permitting everyone to go to the adjudicator will mean the system will grind to a halt.
“I can well envisage that a lot of parents out there – and particularly the savvy parents – are going to avail themselves of this new opportunity and see if it’s a means of actually another admissions route.”
Currently, parents can appeal against an admissions ruling if they believe children have been unfairly rejected. The appeal is normally heard by an independent panel of between three and five members of the public.
Mr McDonough – whose school is in a leafy suburb to the south of Nottingham – said he already had to “deal with a lot of very savvy parents” who turn up at appeals “with their QC and their barrister… to argue the prejudicial case”.
Under the revised, parents will also be able to complain directly to the official adjudicator, which has the power to force schools to rewrite their own admissions rules if they are unfair or lack clarity.
But Mr McDonough told MPs that parents “will make all sorts of referrals when actually our oversubscriptions criteria are perfectly legal and I can just see a huge bureaucratic monster coming into play”.
The proposed admissions code also allows academies and free schools to prioritise the poorest pupils. Children eligible for new “pupil premium” payments – those from families earning £16,000 or less – will be able to jump to the front of the queue for places.
But Mr McDonough said this system could also be abused by some parents.
“A lot of successful schools face, on a regular basis, fraudulent applications,” he told MPs. “And you could well have a situation of parents being eligible at one point in a child’s time for the pupil premium but then actually becoming no longer eligible but failing to inform appropriate authorities… because now there’s an incentive potentially of gaining a school place. “So there’s another means by which some parents can actually use the system for their advantage.”
A spokesman for the Department for Education said: “Under the new draft admissions code, ministers intend that to make it possible that anyone who considers a school’s admissions arrangements to be unfair or unlawful will be able to refer it to the Schools Adjudicator. “The fact is the adjudicator has always has the power to dismiss complaints about specific issues upon which he has already ruled.
“We have held an extensive consultation on the draft code and listened careful to the responses. The new code will be brought into force in February 2012, subject to the approval of Parliament.”
Tory peer: solution to obesity epidemic is to eat less
The simple solution to Britain’s obesity epidemic is to eat less, an eminent medic has claimed
Lord McColl of Dulwich, a Tory peer and former Professor of Surgery at Guy’s Hospital, warned that millions are dying from being too fat and that their health problems will “wreck” the NHS. But he said that it was “misleading” for politicians to claim that taking exercise will help people lose weight, when all they really need to do is eat less food.
Lord McColl said in a Lords debate on Thursday: “In order for an obese person to lose weight – bearing in mind that most of them can’t exercise because they are so overweight – all he has to do is eat less. “I recognise it’s not the job of politicians to tell people how to live their lives but it’s surely the duty of government to speak the truth and give a lead. “By continuing to stress that exercise is the answer, politicians are misleading the public.
“The message is absolutely clear. This is the most serious epidemic to affect this country for 100 years. It’s killing millions. It will wreck the NHS for sure. The answer is simply to eat less.”
But Baroness Murphy, speaking “on behalf of well-rounded people”, argued it is as hard for obese people to lose weight by eating less as for heroin addicts to stop taking the drug. She said: “What we need is population solutions, we need to support people to eat less and we will need to tackle the food industry.”
Diane Abbott, a Labour health spokesman, claimed that the Government has made the problem worse by cutting school sports while allowing fast food giants and the drinks industry to write public health policies.
There is one sure-fire way not to become obese – just eat less
Coming from a line of curvy women, I possess no skinny jeans. Nor indeed skinny genes, according to the latest research. Thinness may be inherited from your parents, says a study by University College London’s Department of Epidemiology and Public Health, much like Jerry Hall and her model clan.
Pah! Don’t give me that old excuse: “I can’t help it – I am hereditarily doomed to have a large bottom, so I may as well eat cakes.” The only thing I have inherited from my ancestors is the ability to eat a lot and a joy in feeding others. I was stuffed with big helpings as a child – so much so that the dogs put on weight when I left home. None of this is to do with genetics.
It all seems fairly obvious – except to those who need to act to stop the obesity epidemic. The Government is dragging its feet on the issue, when lives and money (to the tune of billions) must be saved. This week, Lord McColl, a former professor of surgery at Guy’s Hospital, warned that unless we become decisive about the causes of obesity, it could wreck the NHS. It is misleading to claim lack of exercise is the cause, he said during a House of Lords debate, when all an obese person has to do is eat less. Hear, hear. Unless this glaringly obvious fact is exposed, the cost of obesity is certain only to fly out of control.
Want to cure that snack habit? Eat more protein as too little makes you hungry
This was a very small study over a very short time period so may be right but is far from conclusive
Too little protein in your diet makes you feel hungry and reach for fattening snacks, an international study shows. Eating more than the average amount of foods such as meat, fish, eggs and nuts can stop you gaining two pounds a month.
Researchers found that those whose meals were ten per cent protein consumed 260 more calories a day than those on 15 per cent protein. Eating more protein in the form of meat, fish, eggs and nuts can stop you gaining two pounds a month, say researchers
Not only did they eat more but 70 per cent of the extra calories they ate were between snacks between meals rather than at mealtimes. Raising consumption to 25 per cent – as advocated by the Atkins Diet – was no extra help in halting over-eating.
An average British adult eats around 12 per cent protein, but for many people this has gone down as a result of diluting their protein intake with lots of carbohydrates from processed foods.
The researchers from Cambridge University and the University of Sydney recruited 22 volunteers, all of a healthy weight and aged between 18 and 51, to live and eat in a science facility.
While the foods looked the same, they had different protein levels. Typical meals were a savoury muffin for breakfast, and tuna bake with salad for lunch and beef pasty or spaghetti bolognaise with vegetables and a dessert for dinner.
The amount of fat remained constant at 30 per cent of the total calories in a meal but the carbohydrate was adjusted to either 45, 50 or 60 per cent of the meal.
Volunteers all took the same amount of exercise – a one-hour supervised walk per day – and did the same activities to avoid them eating out of boredom or stress.
People who consumed ten per cent protein a day ate on average an extra 1,036 calories over a four-day period compared with those who ate a 15 per cent protein diet. Over a year that would be enough to gain two stone.
Each was asked to rate how hungry they felt at one-hour intervals and those who ate 15 per cent protein felt fuller two hours after a meal than those on the 10 per cent protein diet while at 25 per cent the difference was no higher.
Lead author Alison Grosby, of the University of Sydney, said: ‘The results show humans have a particularly strong appetite for protein, and when the proportion of protein in the diet is low this appetite can drive excess energy intake.’
For weight loss, nutritionists recommend arranging your plate so a quarter of your food is protein, a quarter is carbohydrate and half is vegetables.
Co-author Dr Susan Jebb, head of the Human Nutrition Research Unit at Cambridge said: ‘Eating a large amount of carbohydrate and fat, such as in fizzy drinks are a major risk factor for obesity and they dilute your protein content, so there is a case for a modest increase, although we are not advocating eating huge amounts of protein or cutting out carbohydrates altogether.
‘If what we found translates into the real world a 15 per cent protein intake would certainly be enough to prevent people over-consuming and help them lose weight.
The study is published today in the journal PLoS One.