1. The Use (Misuse) of Syringe Drivers
Point 1 of 4 Topics presented to Norman Lamb - LibDem Shadow Health Secretary & Jenny Parsons, Chief of Staff to Andrew Lansley Conservative Shadow Health Secretary 30/3/10
The Use of Syringe Drivers in End of Life/Palliative Care
The Concept of Palliative Care began in the late 1980's. From this time we have seen the misuse of syringe drivers and I have viewed the Royal College of Nursing documents with regards to the Dr. Barton/Gosport case, that show that nurses were concerned by the over zealous use of morphine syringe drivers way back in 1991.
I do wonder if with the commencement of Palliative Care as a medical discipline, some Doctors, example being Barton, found this Palliative Care and the syringe driver practice rather fascinating. It probably was and is an excellent field of practice for some medical staff with certain psychological traits.
In the case of Dr. Barton I personally have seen some of the Controlled Drug Register of the patients that died at the GWMH. There was terrible abuse that happening to patients, which shows that patients who were not dying or terminally ill were commenced on morphine syringe drivers which contained between 20 and 200mgs of morphine.
Nurses at the time raised their concerns about how patients were being prescribed morphine who did not actually require it and the outcome – the patient died. But nothing was done about this. The Unit closed but the practice of the improper use of syringe drivers continued.
Of course this is in total contrast to my Father's Palliative Care Experience.
Although my father had needed 30mgs of morphine in 5 hours as he entered the dying phase, 3 days later on his penultimate day he was only allowed 5mgs of morphine over 22 hours.
The Palliative Care Consultant who wrote to me after I had raised my concerns, said that 'any distress that he felt on the 10th January 2006, could be dealt with through non drug measures, such as turning" although once I obtained the Medical Notes it clearly states that on the 9th January my Dad needed 5mg. Morphine as he was in pain when being turned'.
So my Father was denied Terminal Sedation although we were there and saw his distress and fear.
On the other hand in the case of Mr. Ralph Winstanley, where there is no record of him being terminally ill, in this instance, his wife at the time was able to mislead a Doctor in a phone call saying that Ralph was dying. A Dr. who had not seen or examined Ralph ordered Terminal Sedation via a syringe driver!
When Ralphs daughters obtained the medical records not only was it quite clear that he was NOT terminally ill, but the records show that he had a chest infection, but instead of being given antibiotics, he was started on a morphine syringe driver – and morphine and other terminal sedatives decrease respiratory function, which in an elderly patient with a chest infection could only produce one outcome – death!
It appears to me that all this is stemming from the Government and their fiscal policies. Do they have a policy about getting rid of the elderly? Elderly patients, and that's the over 60's, who are presenting with ailments and conditions seem to be a burden on the NHS budget. Then with the terminally ill is the guideline, 'They're going to die anyway so let's save on NHS funds and withhold morphine'?
I have now had the good fortune to have been contacted by a Palliative Care Consultant who found me through my website www.tomsanguish.com.
This Doctor has written quite clearly of his concerns about Palliative Care and how it is being practised in the UK.
May I now raise points made by him?
1. Lack of basic nursing care on wards - such as mouth care, nutrition and bowel care.
2. Lack of communication – Doctors and nurses – to each other, to other Doctors and most importantly to patients and their relatives.
3. Lack of pain control – drugs being withheld, not given on time or unacceptable delays in giving drugs.
4. Lack of dignity and respect.
5. Lack of management – no Senior Managers ever seems to visit the wards to see what chaos is going on daily.
He says 'If only the general public knew what was going on in a lot of the hospices. The Hospices are safe because there are no checks or balances – everyone 'expects" people to die in hospices and no-one knows whether their death rate is abnormally high or whether they are failing to rehydrate patients and therefore hasten death'.
In conclusion we know that medical staff were raising concerns about the use of morphine syringe drivers in 1991. We know also that the Sheffield University compiled a Report in May 2005 which concluded that the 'Elderly were being denied a dignified death'.
My Father certainly didn't have a dignified death. There was the lack of basic nursing care as noted in the Patients Association Report 'Patients not numbers, people not statistics" where my Father is Case No. 6. But it is very worrying that his morphine syringe driver was allowed to run dry. His prescribed morphine was refused, I had to call the Family G.P. to get anybody to come as Dad laid pulling at the sheets and when a Junior Doctor did arrive and administered morphine my Dad died 1 hour later.
We had never left my Father's side during the last 4 days of his life and we know the true state of affairs of the Palliative Care Unit at the Northern General Hospital, Sheffield.
I would ask you Mr. Lamb/Mr. Lansley if you can please request that the House pass the petition already set up at Number 10 'Elsie's Law'.
Bridget Reeves whose Grandmother, Elsie Devine died at Gosport due to the abuse of Controlled Drugs has asked her own MP An Keen to propose this but for the moment this request has fallen on deaf ears.
We must stop the Medical professionals from administering Controlled Drugs without the permission and signature of the Patient or Relative, thus stopping the misuse of morphine syringe drivers.
I would ask you Mr. Lamb to table an EDM calling for a Public Enquiry into the misuse of morphine syringe drivers. This topic has great significance for Mrs. Ann Reeves whose mother Elsie Devine died at Gosport and who is petitioning for 'proper usage of morphine syringe drivers'.
I would also like to remind you Mr. Lamb of your email to me dated 23/12/09 when you said 'There is a very real sense that it is very difficult to challenge failures in care" and therefore request that an EDM is tabled to look into the NHS complaints procedure, to look at how many complaints are successfully dealt with and the statistics to show how many 'serious" complaints are dealt with and what outcome there has been.
Added documentation to be given to Mr. Lamb hard copy:
a. Palliative Care Consultant Says
b. Elderly being Denied a Dignified Death
c. What has gone wrong in the NHS – By an NHS Palliative Care Doctor
d. A complete set of documents sent to the Sheffield Teaching Hospital 9/2/10