There seems to have been substantial evidence to bring criminal charges following the deaths of hundreds of patients at Gosport War Memorial Hospital when there was an inquiry in June.
An inquiry in June last year discovered more than 450 patients died after being given dangerous levels of drugs, and Dr Jane Barton, the GP at the heart of the scandal, prescribed potent opioid painkillers to elderly patients.
Hampshire Constabulary previously investigated the hospital three times, but no charges have ever been made against them, or Dr Jane Barton.
Numerous patients who died had been transferred to the hospital to recover from surgeries, and former Assistant Chief Constable Steve Watts who led the third and biggest investigation into the 94 deaths said that he thought that the evidence was adequate to take the case to court.
He believed it was strong enough now, that it was strong enough then, and that he believes there was a determining public interest in doing so, but throughout the investigations, the Crown Prosecution Service (CPS) looked at viable charges of manslaughter and murder in relation to Dr Barton and some nurses who administered the drugs.
Yet, prosecutors determined there was not a reasonable possibility of securing convictions, and even though Mr Watts knew what the response of the families was going to be, and he knew what the response of the public was going to be, and recollected speaking to the prosecutors saying that it would finish up in a public enquiry and ultimately that the matter would go before a court.
Police in Hampshire handed the matter over to their colleagues in Kent and Essex who are now examining the evidence to determine if a fourth police inquiry is needed, and witness accounts provided to the police earlier are being investigated.
The police were told that they believed that diamorphine had been given continuously to patients by a syringe driver and that it did shorten patients lives, and one auxiliary nurse said that it got to the stage that every time Dr Barton came to the annexe, the nurse would think “who’s going to die now?”
In another statement, a staff nurse said that it appeared that most patients were going on drivers even when they were not in pain, and another nurse said they thought the drug was used to keep the waiting lists down.
Yet, former nurse Sheelagh Joines, who was sister on Gosport’s Daedalus Ward between 1993 and 1997, disagreed, and as far as she was concerned Dr Barton didn’t shorten any lives on her ward.
She said that they were nursed to the best of her ability and that they had what every patient was entitled to, a peaceful, pain-free, dignity – a dignified death.
But she further added that at one stage the ward felt like a dumping ground and that the patients were transferred to Gosport in the belief that they could rehabilitate them, which they tried, but that it quickly became clear that they were nursing care, and that they had damn good nursing care, but that they were not rehabilitated.
However, an inquiry discovered in June more than 450 patients died after doctors gave them dangerous levels of the drugs, and three earlier inquiries into 92 of the mortality by Hampshire Constabulary ended in no charges being brought against them.
But now there’s a new inquiry which is being led by Assistant Chief Constable Nick Downing, head of serious crime at Kent and Essex Police, however, the inquiry by the Gosport Independent Panel stated the quality of earlier police inquiries had been consistently poor.
It found whistleblowers and families were disregarded as they ventured to raise concerns about the regime of medication on the wards, which was overseen by Dr Jane Barton, and there was a disregard for human life of a substantial number of patients from 1989 to 2000.
Dr Barton retired after being found guilty by a medical panel of shortcomings in her care of 12 patients at Gosport between 1996 and 1999. But this is utterly horrifying, however, Hampshire Constabulary said it would step back from any future police investigations because families trust in the force had been destroyed.
The extent of the inquiry, which will begin in September, has not yet been decided, the force said, but Charles Farthing, whose stepfather Brian Cunningham died at the hospital said that earlier police inquiries had been a misuse of public funds.
This has all been utterly shocking and nothing has come out of it, and Charles Farthing wants to see criminal charges pressed.
In August 1998 ninety one-year-old Gladys Richards died at Gosport War Memorial Hospital where she was recuperating from a hip operation, she had suffered a haematoma, a mass caused by coagulated blood, but diamorphine was given through a syringe driver.
And in September 1998 Mrs Richard’s daughter Gillian McKenzie went to Hampshire police and claimed that her mother was prescribed too much morphine, but no charges were brought against the hospital.
In April 2000 another police inquiry was started after numerous families came forward with concerns, but again no charges were made, and the General Medical Council were further made aware of the concerns relating to Dr Jane Barton.
In April 2001 the Police Alert Commission for Healthcare Improvement (CHI) also looked into four more deaths and two others were drawn to the attention of the NHS Ombudsman, but they later suspended their inquiries. Then in June 2002 Mrs McKenzie urged the GMC to formally investigate Dr Barton and was told that there were no grounds for any action.
In July 2002 the CHI report reprimands the hospital’s administration in the prescript and control of diamorphine, and then in September 2002, the police began a third investigation and the Chief Medical Officer ordered an independent review into the deaths.
And in September 2006 the police files on 10 deaths were presented to the Crown Prosecution Service (CPS). However, in October 2006 the Crown Prosecution Service decided that there was inadequate evidence to prosecute any of the health professionals.
But then in May 2008 police reports were passed to the Portsmouth coroner, David Horsely, and in May, Justice Secretary Jack Straw announced an investigation into the 10 deaths. Then in April 2009 a jury inquest at the Portsmouth Coroner’s Court ruled that at least five of the elderly patients who died were overprescribed powerful painkillers that accelerated their deaths, but the police still did not re-investigate.
In January 2010 Dr Jane Barton was found guilty of grave professional misconduct by the General Medical Council but wasn’t struck off, but she retired shortly after, and in the August, the CPS then said that there was inadequate evidence to prosecute Dr Barton for gross negligence manslaughter, but the families of the victims reprimanded the decision.
In April 2013 Coroner David Horsley determined that painkillers and sedatives given to Gladys Richards at GWMH more than significantly contributed to her death, and he gave a narrative verdict at the end of her inquest.
In August 2013 the Department of Health (DOH) published a clinical review of care covering the period 1998-2000. The review concluded that practice of almost routine use of opiates before death had been followed in the care of patients and that the practice had almost unquestionably shortened the lives of some patients.
In July 2014 the government announced an inquiry into the deaths of dozens of patients at GWMH to be led by the former Bishop of Liverpool, the Rt Rev James Jones, who led the Hillsborough inquiry, and in December 2014 Care Minister Norman Lamb said that there were pending questions that lingered about the care of the patients who died, and the police investigated those deaths of the 92 patients but didn’t bring about any prosecutions.
In November 2016 the government said the report’s publication had been pushed back as a consequence of the larger amount of families now in contact with the panel, and in June 2018 an independent panel report showed that patients died after being given strong painkillers inappropriately at Gosport War Memorial Hospital.
But what exactly was the decisive turning point that helped expose the scandal at Gosport War Memorial Hospital in which hundreds of patients met their untimely deaths?
A panel of objective experts started by studying the mortality of 163 patients, but what they discovered prompted them to examine more than 2,000 deaths between 1987 and 2001, and research unveiled that 71 patients in the initial group had been given strong painkilling drugs without proper clinical evidence, and this discovery made the panel very concerned.
One of the patients was 91-year-old Sheila Gregory. Admitted in 1999. She was given diamorphine for no apparent reason and died a day later.
Diamorphine is the medical name for heroin, and it’s generally stored for patients suffering intolerable pain, sometimes in their closing hours before death, but like 62 other members of the group, the cause of Ms Gregory’s death was listed as bronchopneumonia.
Helena Service was the oldest patients to die. The 99-year-old was given diamorphine through a syringe driver, pumping the dose at a fixed flow into her body, but the inquiry judged that she was one of those given opioid painkillers without proper medical justification.
The rationale provided for administering diamorphine was that she was restless, and Ms Service died two days after she was admitted on 5 June 1997 from congestive cardiac failure, according to hospital reports.
More than 450 patients died after being given strong painkillers inappropriately at Gosport War Memorial Hospital, and taking into account the absent records, an additional 200 patients may have undergone a similar end to their lives.
The report determined that there was a disregard for human life of a great number of patients from 1989 to 2000.
Doctors are expected to preserve life and cause no harm, and the Hippocratic Oath, penned 2,500 years ago, includes the line: “I will use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep them.”
But a report published found more than 450 patients died earlier than they would have after being given strong painkillers inappropriately at Gosport War Memorial Hospital.
So, who is this doctor who actively shortened her patients’ lives? She is Dr Jane Ann Barton, now aged 70, who graduated from Oxford University in 1972 as a Bachelor of Medicine.
She became a GP and served at Forton Medical Centre in Gosport, and was employed for five sessions a week as a clinical assistant in the Department of Medicine for Elderly People at Gosport War Memorial Hospital from 1 May 1988 until her departure on 5 July 2000.
While at the hospital she was accountable for the care of people occupying 44 beds, but during her 12 years at the hospital, Dr Barton signed 854 death certificates, and of the patients she treated, 94 per cent had received opiates, with limited evidence of the three analgesia steps recommended in palliative care, which was non-opiate, then weak opiate, then strong opiate.
And a former health minister has attacked the NHS of closing ranks following the deaths in hospital of elderly patients from alleged overprescribed painkiller drugs, and that the NHS and elements of Whitehall had refused to face up to the hard and harsh realities.
It’s really horrific and there’s been an extremely systemic failure with the closing of ranks and a feeling that ordinary people merely weren’t being listened to at all, plus there was an unwillingness by the NHS to face up to some extraordinarily grave accusations about what had occurred in the hospital.
The former minister remembered his response when he was told by the Department of Health officials in 2013 when an email was forwarded to him on holiday in France, that a public enquiry should not be held.
He was incandescent about this so instantly sensed that there might have been a collusion to cloak this up while he was out of the country.
To this day he doesn’t know whether it was a cock-up or a cover-up but it was pretty explicit in his mind that there must on no account be a statement made the following day.
Nevertheless, we shouldn’t disregard all the good that most staff that work for the NHS do, but of course, it’s these other kinds of people who give it a bad name and should be held responsible for their actions, and we should further recognise that it was NHS nurses that blew the whistle on the drug policy so we should not tar them all with the same brush because we do have some excellent nurses that work in the NHS.
Sadly, it takes so long for the truth to come out, and it will probably take more years before we become cognizant of what’s actually going on because these kinds of scenarios are continually swept under the rug, and then everybody closes ranks.
The one thing that we should remember is that drs are not Gods, they’re human beings, and we should trust no one because human beings make mistakes or decisions that end up taking lives because they really do think that they are God!