Gosport - what the hell happened?

[allthatmalarkey]

I'm reading about the 456 'unnecessary' deaths at Gosport War Memorial Hospital in the 90s and I feel like there's something missing in the story. Why would the doctors do what appears to have happened? I appreciate this is likely to come to be explained at some point, but can anyone shed any light right now?

Indeed. Have only read half the report but it seems indiscriminate use of 'end of life' prescribing in Gosport, which reads very much like very old patients being effectively 'put to sleep', whatever the intentions of those concerned, is the kind of thing that will make it extremely difficult to obtain drugs that may be necessary in other cases (like donajimena describes) where it may actually be beneficial to use these. It's the 'one size fits all' that seems so chilling. Maybe when staff see so many patients that aren't ever going to fully recover they lose hope too quickly and want to put them on an end of life conveyor belt? Just my impression from the report so far.

Pearltreehappy - er, yeah, dehydration really is a policy.

However, it took me years to begin to figure this out.

Because I really fell for the old 'oh, we're understaffed don't you know' trick, or 'we're really incompetent' and that's great, because you then start thinking 'hey, you just can't get the staff can you?' and you feel heroic about going in and giving the drink yourself. 'Hey, if it weren't for us, she'd be dead by now!!' Er, that's the idea bozo. You're at cross purposes.

When you realise what is actually going on, it's like when you see that second plane hitting the Twin Towers. Ah, okay. It's deliberate.

Don't know why you're so snippy about my claim. You have heard about the Liverpool Pathway I take it? Where the terminally ill are left to die without food or drink and the relatives forcibly prevented from helping them? Supposedly illegal now but a) You don't think cash-strapped services are going to miss a trick like that do you - they just make sure it goes on under the radar and b) Who gets to decide who is 'terminally ill'? That covers a multitude of sins, not just those at the end of terminal cancer. Someone with advanced Parkinson's can be called 'terminally ill' and it's guesswork as to how much longer they've got. Simply dehydrate them and bang! It's a self-fulfilled prophecy.

That's why my sister and I had to take it in turns over two years to visit expensive care homes day in day out to give my mother daily drink - very easy to do, but our pleas fell on deaf ears. The manager had been prepped with excuses and quasi medical explanations as to why it might not be a good idea, all set up by the Council no doubt.

Anyway, Gosport was not about pain relief. It was about killing people off to save money. Your issue - with which I have some sympathy - has nothing to do with it.

The State is about control. What you want, you can't have. If you want to relieve someone's pain, tough luck. If however, it is about finishing off your patients, well, by all means but keep it under the radar.

Arguably your reaction is just the one that allowed Gosport to go undetected all those decades. 'What? Rubbish! Of course it's not happening!'

Some poor sod like Noel Conway with MS is not allowed to end his own life. Why - it's not like the State gives a damn. Because it's about control.

You’re spouting absolute rubbish Newspaper. You’ve been reading way too many conspiracy theories.

Newspaper you could've looked after your own relative rather than placing them in an expensive care home with staff trying to finish them off

The mentality of it, bamboozles me

Years ago (back in the 1980s) I cared for an elderly lady who developed a blood clot in her leg. Her other illnesses were such that at that time she wasn’t able to have anaesthesia (it may be different now). The prognosis was poor and the consultant at the time made the decision to keep her pain free. Her pain relief consisted of a morphine driver pump in a low dose which was increased as she neeeded it. Definitely it shortened her life but she was pain free and at the time it was probably the only way of keeping her comfortable.

I wonder if this doctor was doing similar but in a very haphazard manner .

Ideally pain relief is the minimum you eyed to control it. It should be increased slowly and in line with the persons pain and illness.

Using it in a haphazard way and especially with elderly patients is very risky.

Hasn't this been.blamed on a retired doctor. I saw the report earlier in the week where she was being blamed for hundreds of deaths. Is it really all down to her or is she the scapegoat. There was no mention of other doctors being involved in any reports I saw - just her

Newspaper, my auntie went into the Liverpool Care Pathway when she was at the end of her life. She was most definitely NOT left without food or drink. She didn’t want to eat (except for ice lollies which wee all she could manage) and she had sips of water or tea when she wanted it. She died a few days after it was started...in fact her care did not change, it was simply decided not to start new medications and interfere with her.

Anyone denying someone food/drink on the LCP is applying it incorrectly.

Am further through the report now and it's clear this wasn't all down to one doctor. Was a whole team of doctors and nurses, and the managers too.

Interesting comment above re 'terminal' illness. With people living longer, is a patient with dementia who is 91 'terminal'? Apparently Gosford thought so, but another opinion in the report describes this person as not 'dying of something' so perhaps the dementia was not advanced? It makes very sad reading.

People with advanced dementia die due to losing their ability to move around so they can breathe properly, swallow safely and avoid aspirating fluids and choking on foods. They’re at huge risk of infections and tissue damage from pressure. You can treat the infections, give specially thickened fluids and a puréed diet etc., but you’re fighting against nature constantly in that antibiotics are regularly prescribed to deal with the infection and keep the individual alive. So, yes, a dementia patient is terminally ill.

25 years ago, it was much, much harder to force someone to remain alive for long periods without complications. The specialist equipment was much more basic and there wasn’t the culture of prolonging life in the way I’ve described above. It was accepted that people with these conditions died. Saying that, it wasn’t the usual thing to actively kill them. Things were a lot more blasé back then though.

Then we had Shipman, and everyone tightened up to the point where the terminally ill are no longer permitted to die and people are routinely aggressively treated so they remain alive, usually in pretty miserable circumstances and suffering pain due to the restriction of opiate based pain relief.

You are right peartree, there needs to be a balance.

My auntie wasn’t restricted but was clearly dying from cancer so it was much more straightforward.

The question with Gosport is why these patients were going on to syringe drivers without clear reason.

Was Dr Barton (and others) playing God and making a decision based on quality of life? Did she do this in a well meaning (if misguided and wrong) way? The answer seems to be yes fiven what the report is saying.

I think she’ll have been doing it out of quality of life evaluation. I highly doubt there’ll have been some sort of murderous plot going on.

I agree with @Newspaper and have direct experience of my own relatives being ill and dying after being denied fluids and food in Hosp.
My brother was 46 years old.

Okay, let's get a few things straight shall we?

Pearltreeishappy - firstly, you need to distinguish between building an argument - something I do - and simply refuting what I say, which doesn't tell us anything. That's not a counterargument, though interestingly those who work for the State i.e. the NHS and Social Services do follow that way of thinking - that if an allegation is made, it is true - and to negate it, you simply refute it. Then, apparently, it's not true. I am well up on that one, thank you.

I suppose you think that Hillsborough was just a conspiracy theory, right? What about the murder by opiates at Gosport - is that still a conspiracy or has that actually happened now it's been reported in the press. Please be so good as to let us know.

Didn't the Dept of Health suppress that report for a decade? Was that done by accident or was that a cover up?

I do find your attitude disturbing, but not unusual. You are making out that Dr Barton was doing this all by herself. Okay, she was responsible, but she was part of a team, one that closes ranks pretty damn quick. Unfortunately for your case, you appear to be part of that team, broadly speaking, in that you work for the State, I take it?

As for Wheelycote, I will give you the benefit of the doubt and imagine you are not trying to wind me up!

Once your parent is in a care home, that is it - especially if you did not know to get Lasting Power of Attorney in Health and Welfare (because nobody told you about it, and I am telling you now). You will not be allowed to get them back to the family home. You will be trapped, because - get this - the State is legally in charge of your parent's welfare. They are the decision makers, not you. That even applies if you are self-funding, in fact more so cos they want your money to subsidise their care homes. You are paying more for your parent than the Council pays for any of its individual residents, to the tune of several hundred a week.

So you are stuck - your parent is in that care home, you are forking out a grand a week, it won't be much different anywhere else, and if you leave them be they die through dehydration.

What's more, however, the Council is under no legal obligation to inform self-funders if the care home is failing! It can, however, stop you from moving your parent from that failing care home, usually on a trumped up Section 42 allegation charge against you, the relative, one that it won't even necessarily inform you of. Both Surrey's Reigate and Banstead locality Safeguarding team and Epsom & Ewell Safeguarding team did this to us.

But again - the dehydration policy is not 'failure', just to be clear. That is what they are intending to do - and you won't be informed about it.

That said, such Safeguarding teams will - verbally - make the kind offer on hearing of your dispute with the care home - a dispute about dehydration concerns incidentally, that you might like to get your parent back to the family home? That's nice, isn't it?

Turns out they make this offer - verbally, never in writing - so they can make out you are likely to abscond with your parent from the care home and get a court order stopping you from moving them. They can also authorise a fishing expedition against you to get dirt on you to have you barred from the home, barred from seeing your parent and, of course, barred from giving them drink. They can also take over the Deputyship, affording them total power! Result - parent dead, money saved, job done.

Anyway, pearltree, the cat is out of the bag according to yesterday's Daily Mail, in particular the comments by Professor Patrick Pullicino. Dehydration is used for the terminally ill. See the link below.

www.dailymail.co.uk/news/article-5871993/Doctors-giving-patients-killer-drug-overdoses-causing-early-death-UK-experts-warn.html

Sometimes, food and fluids can’t be given for various reasons. If a person is extremely ill or dying, extra fluids/and or liquid nutrition can cause a strain on the heart and kidneys and lead to fluid retention which affects breathing and is very uncomfortable. If a patient can’t swallow then they would need to be fed artificially. The ability to swallow and process fluids is frequently affected during illness.

Nobody should be denied fluid or nutrition if they want it and are able to take it. Some can only manage sips and some ice cream, but that’s fine. Medical and nursing staff should not be depriving a patient simply because they’re on the pathway - this would be a misuse of the end of life pathway.

I once had a family that kept asking me to set off their parent’s peg feed pump. They were appalled when I gently explained that the person was coming to the end and that giving pump feed would be distressing, cause nausea/vomiting and the person would be unable to process it which would lead to abdominal pain/discomfort and fluid retention. They eventually understood and the person died around an hour later. Forcing feed into them would have been cruel.

Medical and nursing staff are used to identifying when a person is coming to the end of their life and will adjust treatment and care accordingly. If this process is mishandled by uncaring or inexperienced staff then things will go wrong, but I’ve personally never seen this happen. What I have seen are misunderstanding relatives insisting upon inappropriate treatment and care and the denial of opiate based pain relief - I said in a previous post, I don’t know why anyone would do that, but it happens more often than you’d think.

It sounds as though what has happened is that staff at that hospital were making quality of life judgements and tailoring the care they gave accordingly. This is a very difficult issue and they may have overstepped the mark and ventured into euthanasia territory.

Oh dear me, the daily mail? Very credible I must say

These are the people who campaigned for the liverpool care pathway to be abolished. What they have done is ensure that people are dying in pain now. This is happening every day and in every care setting. Pain is not being treated due to the lack of objective examination and reporting that is going on.

People like pain, people like their relatives to be in pain, that’s the only conclusion that I can reach.

As I said upthread, my mother was repeatedly denied pain relief in her final hours because of Shipman and the (one off particularly cruel and horrid) nurse refusing to listen, because she arbitrarily declined to provide pain relief in case she was labelled “a Shipman” (direct quote).

I won’t go into detail, it’s too distressing and I wouldn’t want to trigger distress in anyone else reading. But the upshot is that I haven’t slept without medication for over a year, I have PTSD, I have flashbacks, I had a very strong Christian faith which is absolutely gone now, and I shall never, ever forget the way my gentle, kind and lovely Mum left this world. It was beyond horrific.

Pearltree, I knew you would make a swideswipe at the Mail.

Yes, the Daily Mail is credible when it comes to adult social care, because it is following a campaign on the issue, and I respect it for that, despite its other faults.

Presumably if it campaigns for better treatment of animals in factory farms, you'd dismiss it because it's the Daily Mail?

If the Daily Mail campaigned to end the Liverpool Pathway that is a good thing. Again, for the record, dehydration is used by the State as a means of shortening someone's life. It is not a question of whether you find the Daily Mail credible. What about Professor Patrick Pullicino, a consultant neurologist at East Kent Hospitals University Trust, is he credible? Or is he about to face the anti-whistleblower treatment?

I find your sign off: "People like pain, people like their relatives to be in pain, that’s the only conclusion that I can reach" to be wholly despicable.

If that is the only conclusion you can reach, you seriously need to find another profession. It will also save you jumping on this thread to 'hold the line'.

I read the Mirror's report on the families' stories. Gobsmacked doesn't really cover my response.

It's a far bigger potential scandal than Hillsborough imo and I'm knew people with family affected there. The deliberate cover up there occurred after a mismanaged situation where I would say "there but for the grace of God."

As reported with Gosport it's the apparent, possible INTENT.

The faulty morphine drivers mentioned by the BBC yesterday is as convincing a tale as the spy who may have zipped himself in a holdall from the inside..

So is it all going to blow over now? Nobody charged? These investigations cynically rely on the public having short memories. The bravery of whistle blowers is punished. The organisation covers it's tracks . Until next time.

There was a ludicrously one sided piece on BBC news tonight with a former nurse shown in silhouette with wringing hands, saying it was all done for the best motives. Felt like the message was that's all sorted now folks, let's get back to lauding our NHS.

There was an article in the Sunday Times but it's behind a paywall. Otherwise the Mirror told some of the families' side of things.

No MPs seem to be taking it on, or if they are they are not getting the coverage on the TV and radio.

I suspect more will be going on behind the scenes and wouldn’t be surprised to see much much more about this in the future.

Just been reading about this today. Bloody shocking.

So is it all going to blow over now? Nobody charged?

Hampshire police have removed themselves from the investigation as previous failures mean that their relationship with the families of victims is damaged beyond repair. Another police force (I don't think we've been told which one) and the CPS are now reviewing the evidence to identify possible charges.

Here's a response (by Rowan Kohn):

Syringe Driver

Hold tight
It's one hell of a ride
You're going gentle into that good night
Ready or not.

Override
When I was young
I thought I'd live forever
Wait a minute - why are you taking me this way?
I need to get home.

Override
Don't worry guv
I know all the short cuts
You don't want to get stuck in traffic now
You don't have much time left.

Trigger warning
In my mind this morphs into
A machine that pumps a baby full of food until her heart stops.

Ride Over