Failings that allowed the Gosport hospital scandal to happen are probably being repeated at other NHS services but not being identified because of the Department of Health and Social Care’s “desire not to know”, a leading expert on hospital mortality has claimed.
gosport war memorial hospital
Professor Sir Brian Jarman from the Dr Foster Unit at Imperial College London said that mortality data of the kind that would alert officials to a similar scandal was not being properly assessed at the department.
A public inquiry into 800 deaths due to excessive opiate use at Gosport War Memorial Hospital this week found that nurses had raised concerns but been ignored by senior staff at the hospital.
Speaking on BBC Radio 4’s Today programme on Thursday Sir Brian was asked if it would be a surprise to find the kind of practices at Gosport happening elsewhere in the NHS. “No, not a surprise at all,” he replied. “I think it’s likely.”
Sir Brian also related the difficulties he had had getting anyone at the Department of Health and Social Care to receive emails with mortality rates that the Dr Foster unit had collated.
“I did send various emails to Department of Health and tried to get someone to be willing to receive our alerts and they were not willing. Eventually they gave us the name of the person and then when we were about to send it to them they said she’d now left. So it’s very difficult.”
He added: “The thing behind all this is really that there’s a desire not to know.”
The problem with mortality statistics was exacerbated by an NHS culture that left potential whistleblowers scared to come forward, he said.
Despite government rhetoric about empowering whistleblowers nothing had really changed in recent years, he said. “I think the current Secretary of State is a very caring man…he has expressed a desire to help whistleblowers. This was a problem at Gosport. I don’t think it has (changed).”
New structures had been put in place but they had not had the intended effect, he said. “There are ways of alerting at each trust. They have a guardian for whistleblowers. But the actual whistleblowers say (they) are fired, gagged and blacklisted.”
“Nobody dares whistle blow in the NHS,” he said.
The Royal College of Nursing declined to comment on Sir Brian’s claims. But responses from nurses to Nursing Times’ story about Gosport War Memorial Hospital appeared to echo his views.
One nurse described having complained about the same practice at another hospital. “I went through hell at the hands of doctors and nurse managers. I reported to the police who said ‘they were old and would die anyway,’ the anonymous poster said.
“The RCN did nothing. Eventually the outcome was that I was given an option of being sacked or taking early retirement +10 years enhanced plus I had to keep my mouth shut.” The poster wrote that “just as at Gosport the patients were elderly, they were given opiates and were denied food or water. I suspect this went on in many hospitals.”
Another poster wrote: “As a former RCN officer I have had to represent whistleblowers who were terrified of repercussions from other staff. One case involved a nurse questioning palliative care practices in a small hospital, she had a trumped up charge against her following her challenge and was facing a disciplinary.”
The whistleblower was attacked by another nurse and verbally abused by ward staff, including the sister, the poster wrote. The case was like “unpeeling an onion” with new issues continually arising, the poster added. “This poor practice went right up to a totally weak senior nurse/hospital manager who ‘didn’t want any trouble’. Several of the bullies took early retirement, my nurse was completely exonerated but had become ill.” She left nursing.
A Department of Health and Social Care spokesperson said: “We want NHS staff to feel supported to speak up when they have concerns – that’s why we legislated in May this year to protect whistleblowers from discrimination when applying for jobs and every NHS organisation is required to have a Freedom To Speak up Guardian – there are now over 560 in place.”
“But we know more needs to be done to further improve safety, which is why every hospital now publishes an estimate of the number of preventable deaths to help deliver safer care in future.”