Friday, 11 January 2013

Liverpool Care Pathway - Shame, Shame, Shame!


Professor Irene Higginson has discussed the Liverpool Care Pathway in the matter of "where it has worked well and where it has worked badly".

It is, surely, to be expected that, "where it has worked badly", charges of corporate manslaughter shall be brought?

In the matter of the horrendous disaster that is reported upon here, it is, surely, to be expected that charges of corporate manslaughter shall be brought?

Individuals must also be held responsible and appropriate charges brought. Justice demands this.

This is The Telegraph -

Stafford Hospital: the scandal that shamed the NHS
Patients lying starving, soiled and in pain. Over-worked staff dogged by targets. Laura Donnelly tells how a culture of fear meant that ticking boxes trampled over the basic needs of the most vulnerable.

By the time Stafford hospital's failings were exposed by regulators up to 
1,200 patients had died needlessly Photo: PA

Laura Donnelly

7:20AM GMT 06 Jan 2013

It was the scandal that shamed the NHS.
Hundreds of hospital patients died needlessly. In the wards, people lay starving, thirsty and in soiled bedclothes, buzzers droning hopelessly as their cries for help went ignored. Some received the wrong medication; some, none at all.
Over 139 days, the public inquiry into the Stafford hospital scandal has heard testimony from scores of witnesses about how an institution which was supposed to care for the most vulnerable instead became a place of danger.

Decisions about which patients to treat were left to receptionists, inexperienced junior doctors put in charge of critically-ill patients, and nurses switched off equipment because they did not know how to use it.
Desperate relatives told the inquiry, chaired by Robert Francis QC, how patients were left so dehydrated that some began drinking from flower vases.
By the time the hospital's failings were exposed by regulators, in 2009, up to 1,200 patients had died needlessly between 2005 and 2008.
It happened in simple terms because managers attempted to cut costs and meet Labour's central targets, so they could achieve the coveted "foundation status" for Mid Staffordshire NHS trust – enforcing 160 job cuts as they tried to succeed.
Now a public inquiry, which opened more than two years ago, is attempting to address fundamental two questions. How was it that the regulatory and supervisory systems which should protect all patients failed so catastrophically – and what is to stop it happening again?
Mr Francis and his team have heard from 290 witnesses, and considered more than one million pages of evidence, in an inquiry which has so far cost almost £13 million. Repeatedly, the evidence has led to one question – whether a "culture of fear" means that the demands of the NHS hierarchy take precedence over the most basic needs of patients.
The inquiry heard that at Stafford, NHS targets ruled supreme.
Orders were cascaded down the management hierarchy, from the executive board, to the operational managers, to the senior nurses and matrons; nurses and doctors who failed to meet them were threatened with the sack.
It led to junior nurses and doctors abandoning seriously-ill patients to treat minor cases who were in danger of breaching the four-hour Accident & Emergency (A&E) waiting time limit.
For the same reason, patients were often moved out of casualty soaked in urine or covered in faeces, because the target – to admit or discharge patients within four hours – was under threat.
Meanwhile, nurses were instructed by senior nurse colleagues to falsify waiting times, and to claim that patients had been seen more quickly than they were.
During the hearings, one young nurse, Helene Donnelly, told how she tried to speak out but said: "I'd seen people die, needlessly I think in some cases, but certainly with a lack of dignity or respect, and that was so distressing to me ... it wasn't just once or twice that happened, it was relatively frequently."
After she made a complaint, other staff threatened to physically harm her.
Despite an internal investigation into the concerns raised by Mrs Donnelly in 2007, no changes were made, she said, and she was left to work with the colleagues she had accused of malpractice. She left the following year, and took a job at another NHS hospital.
Dr Christopher Turner, a specialist registrar in Stafford A&E which is now a consultant, described a culture of bullying and harassment towards staff, especially nurses. He witnessed nurses leaving meetings in tears, after being told that their jobs were at risk if the four-hour target was breached.
Often, patients who were approaching the time limit were put in a clinical decision unit – a "dumping ground" where they received inadequate care, but which allowed nurses to claim that the target had been achieved. An emergency assessment unit was frequently misused for the same reason, becoming so chaotic that staff nicknamed it "Beirut".
NHS managers staffed the hospital so thinly that there were never enough consultants to properly supervise junior doctors, who took much of their instructions from the senior nurses and matrons who enforced the targets.
At nights it was worse. After 9pm, the most senior surgeon left in charge was often a junior doctor, with little experience of emergency surgery.
Many of the nurses had never been shown how to use basic life-saving equipment, such as cardiac monitors, which identify whether a patient is deteriorating; some turned them off.
When patients arrived at A&E, there were not enough nurses to assess them. In fact, the task was left to receptionists, who took decisions based on a "gut instinct".
Meanwhile, on the wards, patients – most of them elderly – were left in agony and screaming for pain relief, as their loved ones desperately begged for help.
The human toll was dreadful. In the course of 18 months, one family lost four members, including a newborn baby girl, after a catalogue of failings by the hospital.
Kelsey Lintern, 39, from Cannock, in Staffordshire, lost first her six-day-old daughter Nyah, then Laurie Gethin, her sister, 37; Tom Warriner, 48, her uncle; and finally Lillian Wood-Latta, 80, her grandmother.
Nyah had to be delivered in January 2007 by Mrs Lintern's mother, Shirley, because a midwife was not attending - after another had tried to give Mrs Lintern a painkiller to which her notes said she was allergic, a potentially fatal error.
Nyah was born not breathing, she was resuscitated, and discharged after two days, despite the family's fears she was still seriously ill. Four days later, she died, with a post-mortem disclosing four holes in her heart. Mrs Lintern said it might not have been possible to save her child, but that the hospital should at least have realised there was a problem.
Three months later Mrs Gethin died of lung, bone and lymph cancer, at the age of 37. It had taken 18 months to be diagnosed, despite clear symptoms, and only been detected when she was scanned at another hospital.
In January 2008, Mr Warriner, died after his intestine was accidentally pierced in an operation for bowel cancer. Then Mrs Wood-Latta, 80, died hungry and dehydrated after suffering a stroke. The family said hospital staff failed to give her enough fluids.
All around the wards there were lapses. Patients were left without medication, food and drink, and left on commodes. Basic hygiene was neglected: a woman was left unwashed for the last four weeks of her life.
Relatives tried to keep their loved ones clean, scrubbing down beds and furniture and even bringing in clean linen. One consultant described how amid the chaos, it seemed at though nurses became "immune to the sound of pain".
For those whose relatives were deprived of care and even food and drink it was difficult to understand why there were so few nurses to tend to patients.
They could little imagine that in August 2005 in the hospital trust's executive offices, a board led by Martin Yeates had decided to embark on cost-cutting plans as it attempted to secure "foundation trust" status.
Foundation hospitals were a flagship policy for Labour, supposedly the best in the country, and given many freedoms from Whitehall, including over executive pay, and holding board meetings in secret.
The trust needed to convince Monitor, the regulators, that it could meet key targets, particularly the four-hour wait, on a lower budget.
The NHS trust was desperately short-staffed, with 100 vacancies for nurses alone, but from 2005 onwards it embarked on widespread job cuts. Between 2006 and 2008 160 nurses left the trust either through retirement or redundancy; £1.3 million was spent on redundancy payments.
The board's obsession about the project left executives blind to the impact cuts would have on patients.
Wards became more reliant on unqualified and untrained healthcare assistants, employed at much lower cost than nurses. On one floor of the hospital, the staff shortages became so extreme that two nurses were left to care for 40 patients.
In September 2007, Bella Bailey, 86, was admitted. Her daughter Julie became so horrified by the care her mother received, and the screams of agony from those left untended around her, that she and her family took turns every night by her mother's bed. Complaints fell on deaf ears. A letter to Mr Yeates was not answered.
Her mother died after eight weeks of suffering, Miss Bailey began campaigning to ensure no other family went through such torment.
After she wrote to a local newspaper to describe the family's experience, and to ask others to speak out, she was inundated with letters, and calls.
What nobody knew was that in April 2007 statistics had shown that death rates at the hospital were dramatically higher than elsewhere in the country.
West Midlands strategic health authority, which had responsibility for supervising the hospital, commissioned which took more than a year to decide – wrongly – that the flaws lay with the data not the care being given by the hospital trust.
As a result no action was taken to examine the actual quality of care at the hospital. In July 2008, a month after the report on the figures was produced, the authority's chief executive, Cynthia Bower, was promoted to run the Care Quality Commission (CQC), which would be given oversight of all health and social care in England and Wales.
By now, the trust's bid for foundation trust status had been approved in June 2007 by Andy Burnham, then a junior health minister.
Amid the celebrations when the status was granted the following February, the trust's chief executive Mr Yeates told local papers the hospital had made "the premier league" while all staff were given £25 Marks & Spencer voucher.
The authorisation was made by one regulator – Monitor, which is responsible for foundation trusts – without being told that another regulator, the Healthcare Commission, later replaced by the CQC, was poised to announce a full-scale investigation of the trust, because of its concerns. Within weeks of the celebrations, the year-long probe was under way.
It was another year, before, in March 2009, the scandal was finally exposed. By now, Mr Yeates, the chief executive of the trust, and Toni Brisby, its chairman, had already quietly stepped down.
The investigation into Stafford found that failings were such that between 2005 and 2008, there were between 400 and 1,200 "excess deaths" – in other words, up to 1,200 more people died than would have been expected at a hospital with a similar catchment area. In the regulator's last act, Sir Ian Kennedy, the chairman of the Healthcare Commission, described the findings as "appalling" – the worst that the regulator had ever uncovered.
Gordon Brown, then prime minister, said that what went on was "inexcusable" and a plethora of reviews and inquiries were announced - but crucially, not a public inquiry to establish how the systems supposed to supervise hospitals – the health authorities, and a labyrinthine regulatory system – failed so catastrophically.
In opposition, the Conservatives called for such an inquiry, which was also demanded by patients' group Cure the NHS and by a campaign led by this newspaper.
On 9 June 2010, just a month after the Coalition was formed, Andrew Lansley, then health secretary, announced that a public inquiry would go ahead, and now its findings are about to be sent to Jeremy Hunt, his successor.
For those who died or suffered its findings are too late; for the millions who depend on the NHS they will be absolutely crucial.

Upon Disgrace...

This is The Telegraph -

Stafford Hospital scandal: the victims who died needlessly

As many as 1,200 people died needlessly at Stafford Hospital between 2005 and 2008, as managers cut costs and slashed nursing numbers in a bid to meet government targets and win foundation status. Here are the stories of just some of the people who suffered appaling standards of care at the hospital.
Stafford Hospital scandal: the victims who died needlessly
Four generations of the same family all died. Left to right: Nyah Lintern,
Laurie Gethin and Lillian Wood Latta Photo: Collect

8:00AM GMT 06 Jan 2013

Nyah Lintern, six days, Laurie Gethin, 37, Tom Warriner, 48, Lillian Wood Latta, 80.
Four generations of the same family all died. Baby Nyah was not diagnosed with four holes in the heart - after a birth not attended by a midwife - and died at home in January 2007. Her aunt, Mrs Gethin died of lung, bone and lymph cancer. It had taken 18 months to be diagnosed, despite clear symptoms, and only been detected when she was scanned at another hospital. Mr Warriner died after his intestine was accidentally pierced in an operation for bowel cancer. Mrs Wood-Latta, 80, was hungry and dehydrated when she died after a stroke.
Arthur Peacham, 68, retired agronomist.
(Andrew Fox)
Finally admitted in January 2006 with intense back pain after going to A&E three times and being told it was arthritis. Put on a ward with 11 people already infected with Clostridium difficile, he contracted the infection. He was moved into a private room but it was filthy and his wife Gillian and her sister bleached it themselves. He died on March 19 2006 as a result of cancer of the spine, which the hospital had failed to diagnose. “He would have been here now if he had not caught C. diff,” his wife said.
Joan Morris, 83.
 (Andrew Fox)
Suffering a chest infection she was admitted in December 2006 but subject to appalling care. Food and water was left on a table instead of being given to her, she was rarely washed and was left on a commode for a day before her daughter moved her. Some of her notes were written on paper towels. Her grandson Marc Whitehouse, then a junior doctor, complained repeatedly - later giving evidence at the public inquiry despite being told that doing so was “career suicide”- but nothing improved. Mrs Morris died of a heart attack four weeks after being admitted.
Dorothy Harrison, 69.
(Hull News and Pictures)
After undergoing stomach surgery she suffered pneumonia and was moved to a general ward, where her daughter Denise said staff failed to administer medicines, left her on the lavatory for hours, and failed to check she was eating properly. Mrs Harrison sufferred two falls, and her health deteriorated dramatically - then she was admitted to the hospital’s critical care unit and contracted C. diff and died in January 2009.
Ellen Linstead, 67, retired dinner lady.
(Andrew Fox)
When Mrs Linstead died in December 2006, her body was so badly infected with C. diff and MRSA that she had to be buried in a sealed body bag. She was admitted for physiotherapy for the side effects of successful cancer treatment but within days contracted both infections. Her daughter Debbie Hazeldine had to clean faeces from under her mother’s nails and had to bring in her own blankets and pillows. On one occasion, Mrs Hazeldine arrived to find her mother screaming out because she had been left on a bed pan for more than an hour.because she had been left on a bed pan for more than an hour.
Nicola Monte, 44, former auditor.
(Andrew Fox)
Admitted with a bowel complaint, she was misdiagnosed, suffered a perforated colon, caught MRSA twice, as well as c. diff and E. coli, and was left malnourished. She said the hospital was dirty, samples were not collected and intravenous lines not administered properly. Mrs Monte, a mother of two children, eight and 11, has serious long-term problems from the infections and had to give up work. “My daughter was two-and-a-half before she ever put her arms up to me and called me mummy. They destroyed the life and the person I was,” she said.
Lyn Hill-Tout, chief executive of Mid Staffordshire Hospitals Foundation Trust, expressed regret at what had happened.
She said: “Sadly, we cannot undo the past or the harm that some of our patients and their relatives suffered as a result of terrible care when they were at their most vulnerable”
She said the Care Quality Commission had lifted all concerns they had about Stafford Hospital in July of last year, and that its mortality rates were now the second best in the region.

Upon Disgrace...

This is The Telegraph -

Stafford Hospital scandal: the bosses who escaped justice
Managers at the heart of the worst NHS scandal in decades continue to be employed in key roles within the health sector.
Relatives of patients who died are particularly angered by the
case of Martin Yeates
 Photo: Andrew Fox
7:30AM GMT 06 Jan 2013

Only one of the NHS executives held to blame by the report of the Mid Staffordshire NHS Trust public inquiry for the suffering endured by patients has been disciplined by their professional body.
Despite being responsible for “appalling” standards of care at Stafford hospital, several have found senior positions elsewhere in the health service. Others have been employed by health organisations as external consultants and advisers.
Relatives of patients who died described our findings as “outrageous”. They are particularly angered by the case of Martin Yeates, the trust’s chief executive, who refused to give evidence, saying he was suffering from stress and might never be able to work again.
Mr Yeates is now chief executive of a publicly-funded charity which helps people with alcohol problems.
Although complaints about 70 doctors and nurses were lodged with professional bodies, none has been struck off. Katherine Murphy, of The Patients Association, said: “Patients want to hear that managers and executives are always held accountable where care is at an unacceptable level.”
Below are the stories of the Stafford hospital bosses who escaped justice:
The former chief executive
Martin Yeates, 53
Martin Yeates led Mid Staffordshire NHS Trust for four years, until an investigation uncovered up to 1,200 “excess” deaths amid an appalling catalogue of failings in care.
It was Mr Yeates who had earlier decided to lead the hospital on a cost-cutting programme in order to secure “foundation trust” status. This led to widespread job cuts and between 2006 and 2008, 160 nurses left the trust either through retirement or redundancy, with £1.3 million spent on redundancy payments.
As a result, nursing shortages and reliance on untrained health care assistants meant patients were left unattended or not cared for properly.
After the failings came to light Mr Yeates resigned, walking away in March 2009 with more than £400,000 and a pension valued at £1.27 million.
He subsequently said he was too ill to be cross-examined over the scandal at the public inquiry and refused to attend. In a written statement in October 2011 he said: “There are a number of people who would wish me to give my evidence personally.
For medical reasons, this is not possible. I hope that following receipt of my statement I will be allowed to move forward with my life. The personal cost to me and my family of being hounded by the press and certain campaign groups is irretrievable; I have lost my family, my career and my health. Nothing that I now say or do will get me back the job I loved.”
Mr Yeates and his wife Lynn sold their £600,000 converted barn outside Stafford, in 2010 and moved from the area. That year his solicitor, Andrew Hodge, said his client “would probably never work again” and described Mr Yeates as one of the victims of the scandal.
But Mr Yeates has now returned to the health care sector, with a job as chief executive of a Shropshire-based charity, Impact Alcohol and Addiction Services, which holds contracts with the NHS. It runs an addiction prevention project at Royal Shrewsbury Hospital and offers information, advice and counselling at GP surgeries.
Mr Yeates, above and right, began his new job last August. In November last year [2012] Mr Hodge said his client had not recovered from the mental health problems which left him unable to discuss his time at the trust, but did not prevent him from doing his job.
Approached last week Mr Yeates said: “I have apologised several times publicly, that is all I have to say.”
The former director of nursing
Jan Harry, 60
Jan Harry was in charge of nursing care at Stafford during a period of swingeing job cuts and disastrous changes to wards.
Mrs Harry, pictured right, was not called to give evidence at the public inquiry. But she told the first inquiry into the hospital, also chaired by Robert Francis QC, she could not recall the decision to axe 52 nursing posts, saying: “I was obviously at the meeting but this doesn’t stick in my mind.”
Neither could she remember the shortfall in nurses identified by a staffing review. “I can’t remember what the skill mix review — what came out of it,” she said.
Mrs Harry also said she had no major concerns about the care provided and that it was not her job to monitor standards on the wards — a claim later described as “absurd” by Dr Peter Carter, general secretary of the Royal College of Nursing (RCN).
Staff described Mrs Harry’s management style as “draconian”. Kath Fox, a bereavement councillor and Unison representative, and the RCN’s legal officer, Adrian Legan, both told the public inquiry that staff were too scared to speak out because of her intimidating manner.
Mrs Harry left the trust “by mutual agreement” in June 2006. But she soon found work elsewhere in the NHS.
A year after her departure she was hired by a consortium of hospitals in Dudley to run a cost-cutting programme as they prepared for foundation status.
After the trust won the status, in 2008, its inspection rating dropped from good to weak, and the following year it failed a basic hygiene inspection, though it has since improved.
Mrs Harry went on to work at the Salisbury Foundation NHS Trust, providing management support between December 2008 and May 2009.
Her nursing career only came to an end the following year when, as a result of her behaviour at Stafford Hospital, the Nursing Medical Council suspended her from working as a nurse for two years.
Allegations against her included a failure in her duty of care, failure to maintain a safe level of practice, poor infection control and prevention, and a lack of governance regarding patient safety and risk management.
Although Mrs Harry retired following the imposition of the two-year suspension, the NMC panel made a point of ruling that the sanction should stay in place when it reconvened in October last year.
It found that she “could represent a real risk to public safety” and could “put patients at serious risk of harm”. Mrs Harry refused to comment when approached at her home in Birmingham.
The former director of nursing
Helen Moss, 48
(Andrew Fox)
Dr Helen Moss, Jan Harry’s replacement at Mid Staffordshire, was criticised for not acting quickly enough to tackle the problems uncovered at the hospital.
She was made aware of staff shortages shortly after she joined the trust in December 2006, but her review of the subject was not completed until March 2008.
She admitted at the public inquiry that “in hindsight I didn’t report the problems to the trust’s board clearly enough”.
Dr Moss said she had not realised the level of cuts at the hospital in the six to nine months before she took up her position.
She told the inquiry: “I’d just like to say that I’m really sorry for patients and families that received poor care in the trust, and it was only ever my intention to improve quality of care whilst I was in post in the organisation.”
After the Stafford scandal she moved to East Midlands Strategic Health Authority in 2009, on secondment as associate director of training. Her salary of around £100,000 a year was paid by Mid Staffs.
Dr Moss, pictured right, who qualified as a nurse in 1987, went on to be a management consultant for Ernst and Young, specialising in the health sector. She did not respond when asked to comment.
The former medical director
Valerie Suarez, 56
Dr Valerie Suarez told the public inquiry she could not cope with the demands of her job as medical director of Mid Staffordshire Trust at a time when hundreds of patients were dying unnecessarily.
She admitted vital audits were not carried out, that emergency staffing levels were low, and that there was too much emphasis on financial considerations rather than patient care.
She was in charge when a 2007 report by the Royal College of Surgeons, warning that surgical procedures were “dysfunctional” and needed to be checked, was not acted upon.
Dr Suarez, pictured right, told the inquiry: “It was hard to do both jobs. I had no formal management qualification for the medical director role.”
She said: “As a trust, we have always seen finance dominate the agenda. I sought to fight against that, but, knowing where we are now, it’s clear we didn’t push hard enough.”
She also said that nobody had raised concerns with her about the quality of service or staffing levels in A&E when she took over as medical director, adding: “Clearly that shouldn’t have happened and I genuinely apologise for that.”
Dr Suarez resigned as medical director in March 2009, but continued to work as a consultant pathologist for Mid Staffs, before retiring last week. She declined to comment.
The former health authority chief executive
Cynthia Bower, 57
(Julian Simmonds for the Telegraph)
As head of the West Midlands Strategic Health Authority Cynthia Bower was ultimately responsible for Stafford hospital.
During her time in charge evidence emerged about serious failings in patient care at the hospital. But the health authority rejected the alarmingly high death rates as a statistical error. She later said Stafford “wasn’t on my radar”.
Mrs Bower, pictured right, spent 19 years of her career working in and managing children’s homes. She went on to work in senior roles for a variety of NHS organisations in the West Midlands, before becoming chief executive of the health authority in 2006.
After quitting in 2008 Mrs Bower became chief executive of the Care Quality Commission on a salary of £203,500, but resigned in February last year, amid severe criticism of the regulator’s failure to police hospitals and care homes.
In November 2011, while still chief executive of the CQC, Mrs Bower was appointed as non-executive board member of the Skills for Health organisation, which works to improve staff skills in the health sector, for which she receives an honorary payment of £7,000 a year.
She said: “I’m not in a position to talk about the inquiry or its report. I’m doing a few things, but it’s nothing I care to talk about.”
The former chairman
Toni Brisby, 68
As chairman of Mid Staffordshire NHS Trust it was Toni Brisby’s job to oversee the cost-cutting decisions being taken by Martin Yeates and his board of directors.
The former law lecturer, antenatal teacher and marriage guidance counsellor said the trust board was addressing Stafford’s problems when the Healthcare Commission exposed serious failings at the hospital in its 2009 report.
During her video-link evidence to the public inquiry Miss Brisby said the only complaint she recalled was a patient who “didn't like the amount of sauces being put on her food”.
Miss Brisby, above right, left Mid Staffs, where she earned up to £45,000 for a three-and-a-half day week, in March 2009, at the same time as Mr Yeates.
She went on to run a management consultancy which advises on strategy in the health care sector. Clients of Toni Brisby Associates have included the Health Education Authority and NHS trusts.
Miss Brisby writes a blog advising people how to keep active and healthy into middle and old age. She did not respond when asked to comment.
The former finance director
John Newsham, 58
(John Robertson)
John Newsham, who was Mid Staffordshire’s finance director for more than a decade, presided over its attempts to cut costs in its drive towards NHS foundation status.
He admitted at the inquiry that the trust’s attempt to save £10 million in order to break even could have led to staff shortages. At the time there were more than 208 vacancies, 100 of which were for nurses.
Mr Newsham, above right, said he “couldn’t remember” if anyone on the board had challenged the proposal to immediately cut agency staff in the light of a report in August 2005, which identified staff numbers as being among the hospital’s pressing problems.
Mr Newsham took early retirement in 2007, at the age of 53, shortly before the trust gained foundation status.
He said he had been assured patient safety would not be compromised by the savings. However, he admitted he did not realise the impact of the cuts on patients, saying no one reported problems to him.
“Hindsight is a wonderful thing. My office was off-site and I was cut off from what was happening on the wards. But I was given assurances that the cost cutting measures would not have a detrimental effect on patient care,” said Mr Newsham.
The former director of operations
Karen Morrey, 50
Karen Morrey, director of operations at Mid Staffordshire from 2006 until 2009, accepted responsibility for a failure to thoroughly investigate patient complaints.
At the earlier Francis inquiry she also admitted “risk assessments” about the impact of job cuts were inadequate.
She was put on paid leave in July 2009, before leaving the trust in November that year and founding KMC Futures, a healthcare management consultancy firm, with her partner, Mike Court.
Mr Court worked as an interim foundation trust manager at Worcestershire Acute Hospitals NHS Trust and was Mid Staffs’s director for improving patient experience, on a salary of between £85,000 and £100,000.
Ms Morrey, above, returned to the NHS in January 2010 and is employed by Dudley Group of Hospitals as a contractor in a “service development role”. Last year she also became a director of Staffordshire Women’s Aid, set up to provide advice and support for women.
She refused to comment when approached at her home in Stafford.

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