Local GP fails to diagnose illness; patient dies

One of a record 4,000 complaints against the NHS this year.

Mr. B had been a patient of Dr. L's (names cannot be published) for some 25 years and had been treated by him for hypertension for most of that period. Nevertheless Dr. L, from the Hammersmith and Fulham Primary Care Trust Area, didn't bother monitoring Mr. B blood pressure, instead just issued repeated prescriptions.

Mr. B condition was deteriorating and Dr. L concluded that he had a depression, prescribing a wide selection of medications to treat fever, coughing, wheezing, abdominal pains and headache. Eventually, the GP admitted Mr. B to hospital with suspected pneumonia. Mr. B died two months later. He actually had a cancer (Trousseau's Syndrome), concluded the post mortem.

Complaints against the NHS are soaring because cases like that. The Health Service Ombudsman, Ann Abraham, published last week her Annual Report for England 2002-03 with Mr. B's story among others. Another GP in the Hammersmith and Fulham PCT area simply removed a patient from her list, without any discussion, after he had complained about the service provided by the surgery.

The patient then went to Health Service Ombudsman. Not only him but a record of 3,994 people had had problems with the NHS this year. This is about 1,330 more complaints than last year (2,660) or an increase of 32,5%.

Deaths, including of kids, as a result of inadequate care and treatment, inadequate management of labour, inadequate nursing care, inadequate post-operative care, inappropriate detention in a mental health ward, delay and inadequacy in treatment, inadequate care and treatment provided by ambulance crew, failure in supervision and management of a patient, unsatisfactory and inadequate complaint handling, unsatisfactory out-patient consultation, poor communication… The list goes on.

Only 30% of the total number of complaints received were able to be considered for investigation. The rest had either not been through the NHS complaints procedure (as required by law) or were about matters outside the Ombudsman's jurisdiction. 179 investigation reports were issued and around 75% of the complaints were upheld. Almost 90% of complaints concerned the care and treatment given to patients and often matters had been made worse by poor complaint-handling by the Health Service organisation involved.

The main themes emerging from the Ombudsman's investigations during the year included, once again, the need for effective communication between professionals and with patients and their families; the care of people with special needs; funding for the long term care of elderly and disabled people; the care of people with a mental illness; and delays in diagnosis and treatment. A common thread running throughout the range of complaints investigated was the importance of referring patients, when appropriate, to a senior clinician and the seeming reluctance of junior medical staff to do so.

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15th March 2004