Gosport inquiry to be handed to another police force

Hampshire chief constable admits that investigations into hospital deaths were not fit for purpose

HUNDREDS of deaths at Gosport War Memorial Hospital are to be investigated by a new force after Hampshire’s chief constable admitted its inquiries were not fit for purpose. Officers are to hand over future investigations to another constabulary after a damning report found that it had failed to properly examine multiple reports by families and whistleblowers that doctors were giving patients dangerously high levels of opioid drugs.

Olivia Pinkney, the chief constable, said the force “cannot hide” from the “considerable damage to confidence” after the severe criticism it received in the report of the Gosport Independent Panel, which found that more than 650 people’s lives were cut short as a result of the prescribing regime at the hospital.

Three police investigations between 1998 and 2010 did not result in any prosecutions and police were criticised in the report for failing to properly consider pursuing charges against the hospital or individuals.

The announcement came after Jeremy Hunt, the Health Secretary, said that the “blame culture” in the NHS must end to prevent another scandal where whistleblowers are ignored.

The inquiry, led by the Rt Rev James Jones, the former Bishop of Liverpool, found that nursing staff first raised concerns nearly 30 years ago, but their fears were “silenced” by management, it revealed.

In the report, Dr Jane Barton, the clinical assistant, was held responsible for the policies which led to the deaths of 656 patients.

She was found guilty of “multiple instances of serious professional misconduct” by the General Medical Council in 2010, but was never prosecuted.

Chief Constable Pinkney apologised for the distress caused to the families and said: “The force has always acknowledged that the first two police investigations were not of a high quality.

“The report makes clear … that the third did not look widely enough.”

Robert Logan, whose father, Robert Wilson, died at Gosport hospital, welcomed the decision to hand over future investigations to another police force.

Meanwhile the daughter of Sylvia Giffin, who was one of three nurses who warned hospital bosses in 1991, said her mother was silenced. Penny Wilson claimed to the Daily Mirror that her mother was “bullied” after raising her concerns, which led to her health deteriorating.

She said: “Other nurses agreed with my mum and the others but they were frightened and wouldn’t step forward and say it.”

Sylvia died in 2003, aged 64. The report detailed how she had tried to raise her concerns.

Plans to mark the 70th anniversary of the National Health Service had been going quite well until this week. The Labour Party launched a competition to design an NHS birthday card, with Jeremy Corbyn judging entries. A celebratory protest (against cuts) is planned in London. Theresa May has offered a birthday present: some £20 billion of extra funding with no strings attached. If the NHS is a national religion, as Nigel Lawson famously said, then its birthday next month would be a day of worship. But the news about Gosport War Memorial Hospital casts things in a rather different light.

It now seems that at least 450 patients died after being given dangerous amounts of painkillers, at a time between 1989 and 2000 when the hospital was operating what one nurse called a “culture of euthanasia”. The inquiry, chaired by Bishop James Jones, told a story that is depressingly familiar. Older patients being “made comfortable” through injections and dying soon afterwards. Nurses who tried to blow the whistle – only to find that the hierarchy did not want to know. Relatives of patients who complained, only to be dismissed as troublemakers. All of them failed, utterly, by every part of the system.

The pattern that we saw in the NHS Mid Staffs scandal, revealed by the Francis Report five years ago, is on display yet again. Not just the fatal neglect of patients, but the way in which the NHS system closes around itself when challenged. It has taken 27 years from concerns first being raised for the truth to be published – but it would be a grave mistake to see the Gosport report as historic.

The NHS has long had a default sense of denial. Scandals take years to come to light, so they can be dismissed as freak events with little or no relevance to the present. This was true of the Bristol Royal Infirmary scandal of the mid-1990s, where babies died at the hands of a shockingly bad heartsurgery unit. Culture change can be hard to introduce to an institution which, with its 1.4 million employees, is the largest bureaucracy in the Western world. If there were mass failures going on in a hospital today, leading to hundreds of needless deaths, would we know?

The Stafford Hospital scandal came to light, in no small part, due to the work of Sir Brian Jarman of Imperial College, London. His research looks at patient deaths in various hospitals, and he spotted NHS Mid Staffs as an outlier. His work was dismissed as a “statistical issue” by the local health authority and he is by no means confident that it would be any different today. Whistle-blowers, he thinks, are still fired, gagged and blacklisted because, as he said yesterday, there is a “desire not to know”. He blames the way that the NHS is organised: as a highly centralised bureaucracy.

This was the intention when it was created. William Beveridge told this newspaper in 1942 that his health service would be so centralised as to take Britain “halfway to Moscow”. Nye Bevan said that if a bedpan was dropped in Tredegar Hospital, the sound should reverberate around Whitehall. A fine idea but, 70 years on, we have learnt that 450 people could die prematurely in Gosport due to systematic malpractice and it reverberated nowhere. Instead, the truth took quarter of a century to emerge. So if the problem is the system, not the amount of money poured into it, who will change it?

Just as Labour created the NHS, Labour has done most to try to reform it. The most promising agenda for its modernisation was put together under Tony Blair by Alan Milburn, his Health Secretary, who set out to reverse this centralisation. Milburn was fond of saying that if a bedpan was dropped in Tredegar, it should echo in Tredegar and nowhere else. The NHS should be a means of paying for care, not providing for it, so it was time to invite private clinics into the system. They’d have a reputation to keep, or lose, so had an incentive to offer outstanding patient care. Why shouldn’t the poor have the same choice of hospitals as the rich? Choice, the Blairites argued, means power. Patients caught in a failing bureaucracy tend not to have much power.

How radical such talk sounds now. When the Tories pledged the extra billions for healthcare this week, there was no Blair-style talk about liberalisation. To carry out a surgical operation on the NHS requires nerves that no Tory leader seems to have. Jeremy Hunt has been a dedicated and successful health secretary and sought to present himself as the patient’s champion. But this is no substitute for giving patients proper power, through choice.

The brief flourishing of Blairite reform did leave a legacy, and a few private clinics in the system. Research has shown that patients are likely to receive better care (and are less likely to die) in areas with a genuine choice of hospitals. When my father was referred for a hernia operation in Bath, he was amazed to find himself in a Norman Foster-designed private clinic – as an NHS patient. That hospital, run by Circle Healthcare, now stands as a memorial to what might have been – had the trajectory of reform been kept up.

The problem with reforming a bureaucratic empire is that such empires tend to strike back. One doctor tells me that all help given to independent clinics “has had to be forced from the top, against resistance” and that help from on high has now been “effectively withdrawn”. The feeling among those who run private clinics is that politicians don’t have the energy to wrestle with the system and even Simon Stevens, the NHS’S chief executive, is no longer keen on the reforms he helped design when working as an adviser to Blair.

The Tories lost a good chance, this week, to talk about proper reform. How protecting the NHS is about more than money – and whether Gosportstyle failures may be repeated if the National Health Service remains trapped in such bureaucracy.

But this Conservative government is choosing its battles and it has decided not to fight for the future of the National Health Service. Which is a shame. At its 70th birthday, it really deserves better.