Sunday, 6 June 2010

Scottish Government Rejects NHS Transparency

The Scottish government refuses to insist medical staff tell patients about mistakes.

Doctors and nurses in England will soon be legally bound to tell patients when they've made errors in their treatment but patients in Scotland will be kept in the dark. A Scottish government spokeswoman said: "There is no statutory duty to inform patients of mistakes or drug errors and we're not proposing to introduce one.

"General Medical Council guidance places a duty on all doctors to explain to patients who suffer harm and, where appropriate, apologise."

In Scotland NHS guidance places a responsibility on boards to let anyone know the result of the investigation, show that it has looked into the complaint and reply to all the points raised and offer an apology if things go wrong.

"The charity Action Against Medical Accidents' chief executive said: "How can patients make a complaint if they're not informed of a mistake?

It's very disappointing that the Scottish government does not appreciate the need for a statutory duty to openness and honesty with patients."

Margaret Watt, chairwoman of Scotland Patients' Association said most patients do not want to take legal action. All they want is an explanation, an apology and an assurance lessons have been learned. Doctors and nurses make mistakes. Why shouldn't they own up?

I support Scotland Patients' Association as it does some excellent work but I have no idea why Action Against Medical Accidents is classed as a charity because it appears to be only concerned with compensation claims. In fact its top sponsor is a cost consultant business.

That aside, this is a short-sighted decision from Nicola Sturgeon. We need to encourage openness between medics and patients and not the present system which requires writing lengthy letters, from both sides, and replies written in jargon only a legal expert would understand. A few years ago I complained to my local NHS and the process was horrendous. Not one reply was made within the time they stated and money was wasted sending me three letters telling me of the delays. My complaint wasn't a complex one either.

The medical profession will be relieved at Ms Sturgeon's decision but it's certainly not a good one for patients. According to a 2008 report, by Aberdeen University and Imperial College London, up to 90% of hospital errors are not recorded, including incorrect drug doses, misdiagnoses and prescribing wrong medicines leading to disability and death. Up to 50,000 patients in Scotland are affected each year, contributing to 5000 deaths.

Surely our doctors and nurses want our support, but how can we have confidence in them if they are not duty bound to tell us when errors are made? Is their concern to do with this new compensation culture which has appeared in recent years or is it the medical profession feels no responsibility for the care of their patients?


Joe Public said...

I'd like it when Governments admit to making mistakes.

Like flogging gold assets off cheap, or, starting wars for the wrong reasons.

BrianSJ said...

They are not 'our' doctors and nurses. They belong to the State.

JRB said...

I fear this is an opportunity missed.

Whilst I have every confidence in the medical profession, if it is to progress and improve in the twenty-first century then it must honestly and openly face up to its errors and mistakes when and where they occur. Then, they can learn from them and adjust practices to prevent their recurrence.
As we, the patients, are the sole users of such professional medical services, we have a fundamental right to be informed of its shortcomings as well as its successes.

As for Nicola Sturgeon and the Scottish Government, I fear they have been ill-advised, or, they independently have made an error of judgement.
It is a decision she may live to regret.

Quiet_Man said...

@ BrianSJ

And just whose taxes pay for the state?

This is very odd, I really don't see what the Scottish government have to gain from hiding the truth about doctors and nurses mistakes.

John said...

My experience of just 11 years is that I have every trust in the medical and specialist/dr/consultant/nurse chain. I do not trust the admin people who would surely punish a, say, nurse who informed me of something having gone wrong. They would be worried more about a comp claim than fact a error had been made. This is where attn needs be paid - whistle-blower immunity

subrosa said...

Admitting mistakes would improve relationships between the public and medics Joe.

subrosa said...

Sorry Brian, that wasn't mean in that manner. The 'our' related to Scotland's doctors and nurses. Many of my readers don't live in Scotland.

subrosa said...

Morning John. Indeed it does seem an opportunity missed. I can't see what the problem is unless they're too worried about this new compensation culture which has drifted from America in the past decade.

subrosa said...

No neither do I QM. We're usually ahead of the game in the NHS up here.

Jim Baxter said...

We'll probably see that any concern for more openness in government and any retreat of the state from interfering in people's lives will now be confined to England and Wales, whereas the opposite tendency will be shown from the mediocrities, Alex excepted, that infest Holyrood.

wisnaeme said...

I think that this is a missed opportunity by Nicola towards more open and accountable pratices in the Scottish NHS and it is regretable.
Where I perhaps may have reservations in revealing medical mistakes and proceedures to patients or the general public is on mental health issues of the patients concerned. Perhaps informing some patients suffering from mistakes or incompetence could be detrimental to their state of mind.Never the less, those responsible for those patients should be informed of what happened and why. The response and actions taken to redress "incidents" by the medical staff involved should also be made known to the general public but with the personal details and the identity of those patients affected protected.

I personally have suffered from "mistakes" made in drug prescribtions.

... and those mistakes could very easily have been life threatening.

subrosa said...

I think your opinion will be share by many John.

Is this the SG's idea of shielding managers rather than front line staff?

subrosa said...

Auch Jim, you may well be right. So many people hoped the SNP would introduce a wide open style of government too. They started well.

subrosa said...

It's a difficult balancing act wisnaeme. I'd like to think the NHS could do it though. There's a difference between 'I nearly killed you' and 'the medication I gave you isn't suitable. Let's look at the problem again'.

I'm not expecting doctors and nurses to go round repeatedly saying sorry, but I would like the system to be less wearing on the patient. In my own case I received endless pages of how things will be improved and only once was it mentioned how 'disappointed we are to hear of your experience'.

Demetrius said...

Ah, Mr. Whatsisname, just to put you in the picture there has been a slight technical error. We misread head replacement for hip replacement. Sorry you stll have the limp, but now you are legally blonde.

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