Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 139-159)



  139. From your knowledge of other patients within your group and the common theme issue that I was referring to, is a major concern the fact that people had unnecessary surgery?
  (Mrs Dowling) Yes.

  140. Or was it a competence question? It was unnecessary intervention?
  (Mrs Dowling) I would say it was 50/50, unnecessary surgery and incompetence.

  141. Are we talking about hysterectomies or bladder operations?
  (Mrs Dowling) Yes, all of those.

  142. Thank you very much. Mr Elder, can you say a little more about your own background and concerns?
  (Mr Elder) I am not sure how far I can go into it because the two complaints I made are currently being considered by the Health Service Commissioner. Do you have any guidelines you can give me as to what I can and cannot say?

  143. I would say that it is in your interests to tell us what you feel is appropriate. Within our terms of reference, we want to learn of your concerns and why you feel this Committee needs to look at possible recommendations about changing the existing system. We are anxious to learn lessons from the experiences that you have had.
  (Mr Elder) I would not like in the process to throw a spanner in the works of the two complaints under consideration.

  144. I do not think that is a problem, from our point of view.
  (Mr Elder) Okay. My wife had a stroke and the GP on call was called. He admitted her to the local community hospital. That was in the evening and when I left my wife later that night I asked to be informed if there was any deterioration whatsoever, no matter how small or big. Quite reluctantly I left for reasons which are not worth going into at this stage. I was not informed about her deterioration at any stage, despite my request for this to be done. I was advised only when I phoned the hospital the next morning and this was some four hours after my wife had got into difficulties. At the time of my phone call, she had been in a deep coma for an hour. The duty doctor had not been called. He eventually arrived three hours later and even though he had been at the nearby casualty ward directly opposite he did not attend. For the four hour period of my wife's serious and increasing difficulties, no doctor had been called by the nursing staff whatsoever. The ward sister who had come on duty an hour or so before I phoned said that she was unable to tell me why I had not been informed; nor could she provide any answers to the rather simple questions that I asked. In mitigation, she said that she had not been on duty long enough to give me this information but that she would look into it and let me know. Four hours later I still had no answers. Six hours later my wife died almost before my eyes. It was clear that my concerns were not being taken seriously—that is to say, not until my unscheduled call at the ward about a fortnight later. Nothing materialised until a further three weeks following correspondence from me. However, a week prior to this, I approached the regional health authority who advised that I should take my complaint to the trust complaint manager. The trust, who were apparently unaware of my complaint, even though five weeks had by then gone by, acknowledged my correspondence and sent me a leaflet about the NHS complaints procedure. Until then, I had not been aware of the existence of a formal complaints mechanism. Following that, I tried to get some answers from the GPs concerned and I got no real answer. I had a couple of letters from the GP who was not even my wife's GP, who involved himself in the investigation. He passed on my correspondence to my wife's GP and there was no response. I contacted him and asked him if he could spare me a few moments. He said, "Yes, okay. Come and see me." I went to see him and after about three or four minutes he was telling me that effectively she had come to the end of the line; there was no hope and that was it. She had died. He kept jumping up and down in his seat, looking through the glass panelled door and I then realised that I was the first in a surgery queue. I was not told that. I thought he was seeing me privately. I thought it was a waste of time and after three or four minutes I just left. After that, I wrote a lot of letters and so on and there was a lot of stalling etc. About a year or so later, there was the first independent review.

  145. Of your wife's case?
  (Mr Elder) Yes.

  146. That was a full clinical review, was it?
  (Mr Elder) It was a full clinical, independent review to deal with the nursing element because there appeared to be some very serious questions to be answered.

  147. What was the date when this occurred? How far back are we going now?
  (Mr Elder) When which occurred?

  148. When your wife died.
  (Mr Elder) On 2 March 1997.

  149. I am trying to work out the procedures that applied because the procedures have changed somewhat obviously. You presumably pursued your concerns with the regional executive of the Department of Health to get this clinical review. I am trying to establish how you obtained this clinical review. What is interesting from our point of view is that you had pursued a particular course of action and received a particular response. We have taken evidence already in this inquiry in two parts of the country where very few people, in not dissimilar circumstances, seem to have had the opportunity to obtain a review of the kind that you are talking about. We are interested in apparent inconsistencies between one part of the country and another, within the same region.
  (Mr Elder) Having written to the chief executive of the regional trust in the end—this was about a month after my wife died—I was given a very detailed report of the circumstances in which she died. After some months, I then had the trust report signed by him and again it was, to a large extent, a whitewash really. I then said, "No, I cannot accept this". I gave the reasons for it and I said, "I would like the complaint to be taken to independent review." There was no hesitation in accepting it for review. This was in about September 1997. April 1998 was the review panel session itself. Meanwhile, there was a linked complaint, a further complaint, against two GPs. This was very strongly linked with the nursing element because the GPs were involved at the community hospital. This had to be a separate complaint. Originally, they were going to do it as a single investigation but they felt it was the wrong thing to do and it was round about October last year—

  150. It does not matter about the precise details. Obviously, you have given us a substantial amount of written evidence, which is helpful. I wonder if you could just concisely sum up the key concerns you have about what happened in your wife's circumstances as they relate to our terms of reference and the areas we are looking at. I want to give the other witnesses chance to set out briefly where they are coming from as well.
  (Mr Elder) During all this time, I had no real support. There was stalling as well and the investigation seemed to be unnecessarily protracted. Correspondence was delayed. I was not getting responses. I kept having to telephone them or write and say, "You said you would respond" and so on but anyway it did not happen. This was the case in both the complaints that I made. When the review occurred, there were many admissions made and the nursing staff were severely criticised, even castigated, because there were some very severe mistakes made. It was clear negligence, which was accepted in the review panel. Having done all that, they then said that my wife got adequate care and attention.

Dr Stoate

  151. You said you made complaints against two GPs. I was not quite sure why that was.
  (Mr Elder) There were two GPs involved, the GP who called at our home and the one who admitted her to the community hospital. My wife should have been admitted to the district general hospital, the acute hospital.

  152. You are making a complaint against the GP because you think he sent her to the wrong hospital?
  (Mr Elder) Yes.

  153. Why are you complaining against the other GP?
  (Mr Elder) That was the GP who was at the hospital and it took him three hours to tend to my wife when he was in the ward just next door.

  154. It was a community hospital run by GPs. Is that right?
  (Mr Elder) Yes.


  155. Could you briefly conclude where you are at now?
  (Mr Elder) The other review took place early on this year and again one of the GPs concerned was severely criticised. It came out in the report that my wife should have been admitted to the district general hospital. He even stated in the report that, given the situation again, he would have done so, particularly as at the time of her first stroke five years earlier her own GP had no hesitation in admitting her to the district general hospital. The second time around, particularly as by then she had had other difficulties associated with stroke, she should have gone there. Having criticised and castigated them, they said once again that she had had proper attention.

  156. The matter is in front of the Ombudsman?
  (Mr Elder) That is why I said, "I cannot accept this" and it was in both cases put to the Ombudsman.

  157. Basically, you have worked your way up the structure?
  (Mr Elder) Right the way through.

  158. You are now with the Health Service Ombudsman?
  (Mr Elder) That is right, yes. As a direct result of the first review, some major changes have been implemented.

  159. Locally?
  (Mr Elder) Locally, yes. I asked to be informed on 1 January of this year when they were due to be implemented but I have not heard. I wrote three months ago to the chief executive and he still has not responded.

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