Dr Jane Barton is a retired GP who, according to the results of a recent inquiry, signed off prescriptions for opioid medications that led to the deaths of up to 650 people at Gosport War Memorial Hospital; 456 patients were found to have died as a result of these prescriptions, with 200 more being possible victims. James Jones, the former Bishop of Liverpool, conducted the review into the deaths and suggests that Dr Barton – now retired – was “brusque and indifferent” in the way she prescribed diamorphine.
This practice of overprescribing opiate drugs was reported to be linked to a “disregard for human lives”, as well as a “culture of shortening the lives” of patients. This all took place between 1989 and 2000.
What this was not
This overprescription of opioid drugs was not the same as the recent moral panic over the legitimate prescriptions of opiate painkillers that people in genuine pain receive. This recent outrage downplays the genuine needs of people with long-term and chronic pain, saying that opioids are overprescribed and prescription numbers should be reduced.
The recent moral panic looks at addiction issues and the strength of the medications and concludes that people should not receive opiate drugs for any length of time. As many disabled people have reported, this sounds fine in theory but in fact would have a massive impact on the quality of life of the people who use the drugs to manage their ongoing pain and, without them, would really suffer.
This Gosport scandal also does not appear to be anything like the Dr Harold Shipman deaths, where a murder-happy General Practitioner killed probably hundreds of patients with opiate overdoses, and became one of the world’s most prolific serial killers.
Finally, it does not look like Dr Barton was carrying out consensual assisted suicides. Many people who died were not terminally ill, and a lot of the families of victims expected their relatives to recover. They certainly did not anticipate their deaths, nor did they believe that their loved ones wanted to die.
So what exactly did go on in Gosport? And how was it allowed to happen?
In 2009, an inquest took place into ten deaths that had occurred at Gosport War Memorial Hospital and found that medication that was administered contributed “more than minimally” to five of the deaths, three of which took place in people who had not received the right medication for the symptoms they presented with. Dr Barton’s skills, as well as those of the nurses involved in the care of these patients, were described as “not adequate”.
The General Medical Council (GMC) investigated Dr Barton’s cases further, finding that the quantities of drugs she prescribed to elderly patients were “potentially hazardous”. She was found guilty of serious professional misconduct but allowed to continue working under certain conditions, a decision seen by many as too lenient.
Dr Barton was, by all accounts, overworked at her hospital job, and had more patients than she knew what to do with. Her colleagues, in particular those who were junior to her, were in an impossible position – whistle blowing does not always go well, especially in a massive organisation like the NHS. Should a manager have picked up on the discrepancies? A senior doctor? A pharmacist who was issuing the quantities of diamorphine that Dr Barton wrote out prescriptions for? Nurses had tried to report the issue almost 30 years ago but were not taken seriously and their concerns were dismissed.
Some commentators have blamed NHS targets for the scandal and, in a culture where NHS staff face tough government targets, you can kind of see how a doctor who was out of her depth and not managing her workload could screw up, whether deliberately or accidentally. But to screw up 456 times takes some work. The NHS government targets, such as seeing people with suspected breast cancer within two weeks of a referral, make life difficult for staff under pressure but reassure patients, and the problem is not the targets themselves but the inadequate funding of staff and resources to be able to reach those targets efficiently.
Families report feeling relieved that their suspicions have been confirmed, and devastated at the same time. Many are looking to the police and the Crown Prosecution Service to criminally charge Dr Barton and others involved, a matter that was beyond the scope of James Jones’s inquiry. The inquiry looked at police and coroners’ records as well as NHS documents, to establish as full a picture as possible, but is not able to call for – or dismiss the idea of – criminal charges for those involved.
Whatever Dr Barton’s motivations, the victims of this scandal deserve justice and their deaths should be investigated as with any unlawful or unjustified death. To go into hospital unwell but die because of the rash, ignorant or wanton prescribing practices of an incompetent doctor is not something that anybody should have to face.
Photo credit: Roger Blackwell