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Nurses should be open to charge of 'wilful neglect'

Nurses should be able to be charged with a new criminal offence of “willful neglect”, ethics specialists writing in the BMJ’s Journal of Medical Ethics have said.

The team of legal academics, from Manchester University’s Centre for Social Ethics and Policy, said nurses, doctors and managers should be able to face the criminal charges if patients are mistreated even if no deaths occur and no serious harm results.

Writing near the first anniversary of the Francis report into events at Mid Staffs hospital, the ethics team said nurses and other healthcare staff were only normally charged with an offence if a patient died as a result of their actions.

Staff can currently be charged with willful neglect in the care of mentally ill patients, or children, but the team argues this should apply for all patients.

They say that creating this new criminal offence would ensure that healthcare professionals “could be held to account for the sort of appalling failures in care revealed in the Francis report.

“In the event of conviction, it would send a clear societal message to those with managerial and professional responsibility within the NHS that this sort of conduct is not acceptable, and indeed undermines the very basis of the social contract on which the NHS was originally founded,” they say.

Readers' comments (14)

  • rovergirl6@hotmail.com

    whilst i believe this would be a good idea .it has its problem areas How do we prove who made the error when so many people are involved in all areas of care .for instance if a senior nurse asks another to perform the task .they actually make the error .the senior nurse is accountable in the eyes of the NMC .who do you take to court to uphold this new law.
    it is to me a very difficult grey area.

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  • The case of malnutrition and dehydration discussed earlier in the week,could surely act as an example of 'wifiul neglect' It is is a clear case of neglect pure and simple and one for which there is absolutely no excuse.

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  • Argghh!!!! Is anyone else feeling really infuriated about this?

    Before even thinking about targeting Nurses, the vast majority of whom WANT to give the care but are unable to because of conditions imposed on them, laws like this should be aimed solely at trust directors/execs, etc. THEY are the ones after all who impose impossible staffing levels and work conditions that often force neglect.

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  • Ok and lets hope the same charge could be brought against Doctors oh and social workers (who often seem to blame "the system"). Although how anyone is ever going to find the evidence to prosecute individuals is beyond me. I think we all know this is all talk and will never work.

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  • there are a few, but I suspect very few, caring doctors who will pick up a glass and offer to help a patient have a drink! I have ocasionally witnessed this and other small but highly important caring gestures.

    I was once helped by a senior registrar to change an extremely soiled bed of an unconscious patient whom he had come to see when I was on my own. I was initially very submissive and said no, no but he insisted and proudly pronounced that he had spent three months on a ward working as a healthcare assistant and was well versed in basic nursing care as well. what better training in awareness for doctors! In fact in Switzerland this is statutory and depends on a evaluation from a nurse at the end of their assignment.

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  • my comment above concerns basic nursing and hydration in general and is more relevant to several other articles here but less so to this one in particular. Apologies.

    It was just the mention of doctors above and thinking about hydration and neglect that triggered my remarks.

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  • The article Mike, does say doctors and managers too. We also have to be honest and say that not every nurse is a paragon of virtue.

    The words 'act or omission' were central to our old code of conduct - I'm not sure about the slightly strange new one!

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  • Sara, I know it does, and I also know that the article does include others too (noticeably, HCA's are absent though?). My point, although I admit in frustration I may not have put it across very well, is how many of us have - outside of our control or desire - seen or been part of what can be considered neglect, simply because of working practices which we have no control over? For example, how many of us have not been able to give a glass of water to one of our patients or helped feed someone or stopped to chat to someone who needs us because we had to get the meds out for 30 odd other patients whilst we were busy giving resuss on another with the knowledge that we had half a dozen subcut fluids/peg feeds/injections/etc etc etc to do as well? We are only human, and there is simply far too few staff for the number of patients. That is what it boils down to. I know not every Nurse is a saint, but come on, the vast, vast majority of us are trying our best in very difficult conditions, and not always succeeding. How can we as individuals be blamed for that? Where does this blame end? I mean, will we really get accused and sentenced to neglect for not having time to feed/change one patient, when we were busy seeing to 30 odd others alone and simply did not get to them in time? I would not put it past them to try. It isn't as if the NMC hasn't tried it in the past. No, working practices need to be blamed before any Nurse or Doctor for that matter.

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  • That is true Mike. It seems important for nurses to put their concerns in writing to managers, to keep a copy of those concerns, to ensure concerns are raised at meetings and the minutes reflect those concerns. It may seem tedious but could become your best defence and it seems the only way to ensure that the right people are held accountable.

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  • A very clear and concise definition would be needed of 'wilful neglect' if it comes into force so that everybody has a thorough understanding of its implications otherwise anybody could be acused of this offence during the normal course of their duties.

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  • if we r open to the charge of wilful neglect what happens when we are so understaffed that we cannot give the most basic of care needs... who is open tot he charge then???

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  • sara | 6-Feb-2011 10:53 pm
    That is true Mike. It seems important for nurses to put their concerns in writing to managers, to keep a copy of those concerns, to ensure concerns are raised at meetings and the minutes reflect those concerns. It may seem tedious but could become your best defence and it seems the only way to ensure that the right people are held accountable.

    Absolutely Sara, there is no better form of defence than a simple e-mail. Nothing better than a paper trail. I cannot understand why nurses don't utilise this valuable tool to notify of understaffing, all manner of complaint. You don't have to leave it to your Manager. Anyone working a shift that turns out to be understaffed should just personally shoot off an email to Administration. If you notice someone needing a glass of water or a meal or a bedpan and you cannot provide assistance because of understaffing, shoot either your manager or administration an email and they will probably respond by arriving on the ward and taking care of the patient themselves. No worries.

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  • Dear " ANONYMOUS".
    Please forgive me if I am miss-understanding you (I have a medical condition which makes it impossible for me to discern the complexities of language ), but I presume that you are being " IRONIC"? I have experience in both Mental health & General nursing, from "both sides of the fence", as an employee & as a patient. As an employee there was a culture of it NOT being appreciated when one refused to act in what I considered to be an unethical manner, & "A PAPER TRAIL" sounds great to those who have not worked in ANY hierarchal system, but in practice NO ONE BENEFITS, YOU WILL BE FORCED OUT, ONE WAY OR THE OTHER, & THEN JUST HOW THEN DOES THAT BENEFIT THE PATIENTS?
    AS A PATIENT IN THE "MENTAL HEALTH SYSTEM" one is more vulnerable than ever, just how can one dare to complain about anything?, even if it is about one's own concerns for the miss-treatment of another/other patients, one thing that I can promise you is that you WILL BE MADE TO SUFFER THE CONSEQUENCES OF YOUR DARING TO TRY TO "SPEAK TRUTH TO POWER", & IT CAN & DOES HAPPEN EVEN YEARS LATER.
    THE COMMENTS ABOUT HCA's are interesting having myself been abused repeatedly by one particular one in the Mental " HEALTHCARE SYSTEM", this person told one 17year old lad, during his first ever admission that "He would never amount to anything" now that might not seem any great deal, & he appeared to "laugh it off", but just how much damage did this do to him in the long term??, because it is much more than just a comment, it is an attitude problem that this so called HCA had, & all one can hope for at best, ( & I wouldn't wish such treatment upon anyone, especially that which this person subjected me to, & this was far from the only member of staff who had "An Attitude problem", to put it very politely, & MILDLY, some of the staff who were often in charge of the unit were very good at hiding their mal-treatment, from other staff, or were just very good "at getting away with it", because of their total power over you) is that one day they themselves will be frail & vulnerable & all be it too late to be of ANY good to THEIR victims, will at least know what it feels like to be totally "at the mercy of THEIR carers", unless of course they themselves become "mentally ill" whilst still of working age, & NOT with dementia, for the HCA aforementioned that person at least should have since reached retirement by now, thankfully, for ALL the future patient's sakes.
    I spotted the title about "Cameron's idea of jailing for wilful neglect", shame he does NOT apply the same responsibility upon himself & his "pals" the BANKSTERS etc!! If he did then the NHS would not be so short staffed & over stretched in the first place! & if we allow "TTIP" to go throw we can kiss what actually still remains of the NHS goodbye FOREVER.
    Then as for Social Workers, I was knowingly allowed (with the consultant's blessing, & under his apparent direction) severely psychologically abused by one, who was allowed to become an "Approved Social Worker", until he was finally struck off for sexually abusing at least one patient, he should NEVER have been allowed to get that far, I now realise from comments that were made to myself that these should have been VERY LOUD WARNING SIGNS that all was NOT well with his conduct, before I even became a victim. I have since learned that there were serious concerns about him BEFORE he even started his training, as he had started out as "Mental health care assistant".
    There is so much more that I could say, but to use the "euphemisms" on their website could just mark me out for further abuse in the future, though I fully expect that this will happen regardless, unfortunately with "Mental Illness" in particular one can not try to avoid it, like trying to lesson the possibility of lung cancer by giving up smoking, for example. To all those think that "using illegal drugs" cause some "Mental Illnesses", from my experience of meeting people who are "Mentally Ill", the Mental illness came first, & they were simply "self medicating" to help them with the symptoms that they were already experiencing.

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  • is mental health 'care' when patients are put in locked units in the UK punitive?

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