Monday, 6 August 2012


Victim of atomised medical care?

Perhaps because the Olympics have driven almost everything from the British media, perhaps because an inquest has still not concluded, what looks to be a truly terrible story has been reported in just two newspapers, the Daily Mail and the Independent. This is from Liz Hull's account in the Mail

The parents of a 12-year-old NHS patient claim she was left for so long by staff that rigor mortis had set in by the time anyone realised she was dead...

Emma Stones, who had cerebral palsy and a mental age of five, was admitted to hospital with flu-like symptoms last year...

But staff failed to diagnose a bacterial infection because they were too busy to carry out basic blood tests and neglected to check on her properly, an inquest has been told.

Her parents, Mike Stones and Tracy Futcher, claim Emma was left alone in a room at Tameside General Hospital, in Ashton-under-Lyne, Greater Manchester, for hours without proper care and died overnight after developing blood poisoning without anyone realising.

Her father said that when they arrived at the hospital at 8.30am the next morning after being called there by staff, a doctor said: ‘Emma’s heart has just stopped, she has just died.’ But Mr Stones, 59, who was Emma’s full-time carer, said yesterday that by then she was already ‘stiff as a board... They took a chance with my daughter and left her. They haven’t a clue when she died. I went to kiss her on the forehead and she was ice cold, as though she’d come out of a fridge...

'I felt her limbs and she was as stiff as a board and they tried to insult my intelligence by saying she had just died'.

Evidence given to the hospital’s internal inquiry by the nurse who found Emma’s body suggested that rigor mortis had already set in.

The Coroner will deliver his verdict today.

A general point

I know nothing of the facts of this particular case. I am enthusiastic for the principles that underlie our National Health Service, and appreciative of the sums that have been spent on my own medical treatments over the years, and I respect the individual skills that I have been directed to me .

But I do know that people can die as a result of neglect and unfocussed medical care under the NHS and, as I drift into old age, increasingly see the extra-ordinarily problem-centred nature of care and treatment provided, rather than patient-centred care, a triumph of management over humanity. I know that the situation is not uniform and that most individual health workers whom I have met do 'care'. I appreciate what medical, nursing and technical staff mean when they have have this gently pointed out to them from the patient's point of view, and answer 'It's the system'.

Sure, the service can be extraordinarily transparent now, and staff will immediately answer questions asked them, openly and honestly. One has of course to know what should need asking and often the responses bear the whiff of 'guidelines', and questioning beyond these is not always as welcome. I appreciate the revolution in information-management (not just in the NHS) from the days of frightening secrecy to patients' 'being their own case-managers'. I also recognise that there are subjective factors here that need be more explicitly confronted, like the mental competence to undertake this role, not least when one is sick and stressed, and confused by the whole unfamiliar situation...

I conclude that the service is being let down that by a systemic problem stemming from a particular model of what constitutes health, sickness and treatment, and I try to resist concerns for my own future – for our universalised health care means that it can happen to anyone. The implicit model appears to be that man is the sum of his parts. There is no need even to consider some metaphysical element, such a simple, additive, non-systemic way of thinking is enough on its own to point the way to reductionist thinking, and to reductionist treatment and its organisation. In acute situations, atomised care can kill. In chronic ones, as can happen with lifelong disability – it may mean an unsatisfactory jumble of unrelated interventions, bitterly defended if questioned.

That Emma's lonely death, and her parents' experience of this, might have been made less dignified and even more distressing by such a factor following a life with cerebral palsy, I find particularly poignant.


Hull. L (2012) Parents' horror after daughter, 12, lay dead in NHS hospital for so long that rigor mortis had set in, Daily Mail, 5 August

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Anonymous zimuzondu said...

That such could happen in a "developed" country like U.K, I shudder to think what could happen in a country like mine where her leaders have made sure that it remains a "developing" one! I can imagine the child struggling to call for attention and the monster CP not letting her. Really a pity.

Monday, 6 August 2012 at 21:16:00 BST  
Blogger Andrew DSutton said...

Never mind the economics, you are right, it is a terrible human situation.

I do know what country you think of and it would be wrong for me to guess, but I sometime think my own is is a state of decline in certain respects, not least in that institutions that might possible try to be human, and could if left to themselves could be succeeding as a matter of course, are now being 'managed' in such away that it is very hard for them to do so.

It i not just old people and children who may resonable fear for their very lives if they are admitted to hospital in the UK, or to other kinds of 'caring' institution too.

Tuesday, 7 August 2012 at 21:24:00 BST  

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