Liverpool Care Pathway – 'The End Of The Line'

Here follows a report in the Mail which Dr. Rita Pal cites in her post featured on Huffington Post -

Fury as doctor of death is told: Carry on practising

By SAM GREENHILL
UPDATED: 03:06, 30 January 2010

Grieving families reacted with horror yesterday as a doctor who gave lethal cocktails of drugs to 12 elderly patients 'to keep them quiet' was allowed to carry on working.

Relatives of the dead pensioners walked out in disgust as GP Jane Barton escaped being struck off the medical register despite being found guilty of serious professional misconduct by a General Medical Council panel.

But in an unprecedented move, the chief executive of the GMC stepped in to challenge the verdict of the independently-appointed panel.

Iain Wilson pictured outside the General Medical Council after the ruling. To his left is Ann Reeves and her daughter Bridget Reeves. Both families lost relatives because of an overdose of painkillers

Dr Jane Barton escaped being struck off the medical register despite being found guilty of serious professional misconduct

He said Dr Barton should have been 'erased' from the register and that the decision could be reviewed.

In highly-charged scenes inside the hearing, relative Iain Wilson, whose 74-year-old father Robert went into hospital with a broken shoulder but died of an overdose of painkillers, yelled at the panel members: 'You should hang your head in shame.'

Another relative shouted: 'You have done nothing at all to protect the public.'

Dr Barton's frail patients at the Gosport War Memorial Hospital in Hampshire were given cocktails of painkillers six times the recommended dose and lapsed into comas, the hearing in Central London heard.

She told one patient 'it won't be long now'. When patients became 'agitated'

they were given drugs in increasing quantities until 'they were agitated no more', Tom Clark, the lawyer for the GMC, said.

The panel had previously heard that Dr Barton gave the patients the drugs 'to keep them quiet' and that the two wards she ran became known as 'the end of the line'.

It has taken 12 years to reach a decision on the case. 

At one stage police examined 92 deaths, although no criminal charges were brought, and an inquest last year into ten of the 12 deaths concluded that five pensioners died after being given excessive doses of morphine. 

But Dr Barton remained free to practise, subject to restrictions on prescribing certain drugs, and has been working at the Forton Medical Centre in Gosport.

The GMC's fitness to practise panel found her guilty of 'multiple instances of serious professional misconduct' and said her behaviour was 'inappropriate, potentially hazardous and/or not in the best interests' of her patients.

Yet it allowed her to continue practising, subject to 11 restrictions including banning her from prescribing opiates by injection for three years

Panel chairman Andrew Reid said: 'Dr Barton failed to recognise the limits of her professional competence.' He said she was ' convinced that her way had been the right way and that there had been no need to entertain seriously the views of others.'

Elsie Devine, 88, and Robert Wilson, 74, both died from overdoses of painkillers
But he added: 'The panel was greatly impressed by the many compelling testimonials which detailed Dr Barton's safe practise over the last ten years and the high regard in which she is held by numerous colleagues and patients.' 

Niall Dickson, the GMC's chief executive, said afterwards: 'We are surprised by the decision to apply conditions in this case. Our view was the doctor's name should have been erased from the medical register following the panels finding of serious professional misconduct.

'We will be carefully reviewing the decision before deciding what further action, if any, may be necessary.' The panel was made up of four lay members and a doctor. 

The Council for Healthcare Regulatory Excellence, which is charged with overseeing the actions of professional bodies, is considering an official review. A decision on whether to appeal to the High Court could be made within a month.

The inquest was held more than a decade after concerns were first raised over the deaths at Gosport War Memorial Hospital in Hampshire

Hampshire Police also said they were reviewing the case and may bring criminal charges. 

Yesterday Ann Reeves, whose mother Elsie Devine, 88, was one of the patients who died, said: 'Let a judge and jury deal with it now, and let it all be exposed. The NHS has done its best to cover it up. 

People don't realise, but what goes on in hospitals is absolutely horrific.' Dr Barton, of Gosport, faced 15 charges relating to her treatment of 12 patients, record keeping and a failure to assess patients properly before prescribing opiates.

Chief Medical Officer Sir Liam Donaldson commissioned a clinical audit to examine death rates at the hospital, but the report has never been made public.

Dr Barton said in a statement that she was 'disappointed' with the conditions. 'I was faced with an excessive and increasing burden in trying to care for patients at the Gosport War Memorial Hospital,' she added.

The two wards that Dr Barton ran became known as 'the end of the line'. Are such wards uncommon, an exception, or are they to be found across the NHS (National-socialist Health Service)?

In 2003, my mother was in a ward with other elderly patients. She had collapsed at home. They said she had suffered a mini-stroke. 

Mum commented to me: “They’re all dying in here. I don’t want to stay on this ward.” Just that morning, she said, they had wheeled out the poor woman in the adjacent bed with whom she had been conversing the day before. It was most upsetting for her.

Although I forced myself to question her comment, I found I could not disagree with her observation. Each day I went in to visit her, I observed an empty bed there where a patient had been. A fresh occupant would soon follow. It was as she had said.

She told me that one ‘old girl’ had fallen out of bed. Mum had kept calling for someone to come but no-one came. They were “all stuck in their cubby hole,” she said. I looked across and, by my own observation, they were. Eventually, a nurse had come, apparently, not shocked or concerned, but offended by the nuisance of it.

And that is the long and the short of it. When you’re of a certain age, you’re a nuisance; you’re better off out the way, for your own sake as well as those who have the chore of looking after you. What ‘quality of life’ do you have left, after all..? But whose decision is that? What right do they have to play God?