A Patients Right to Know

Until 2015 there was no legal duty for the medical profession to tell patients or their next of kin about errors or incidents that may have caused harm.  Before then patients were not routinely told when something had gone wrong and many mishaps went unrecognised because some patients accepted their condition as “bad luck”.

This happened to Colin.  His life fell apart when he suffered a severe, disabling stroke leaving him paralysed, wheelchair-bound, brain-damaged and dependent on fulltime care.  He lost his job, aged just 39 years old.  His stroke was entirely avoidable.  He had been in hospital a month before with pneumonia and had developed an infection in his heart.  Had his doctors carried out a planned ECG his condition would have been properly diagnosed, treated and his stroke avoided.

His wife complained to the hospital. They responded, in writing, and made no mention of any error or mistake.  Their seven-page letter was, sadly, a smokescreen of detail that failed to mention the crucial error.  In fact, a consultant involved even said “I do not believe I would have changed any part of the care given to him”.

After the involvement of the legal team, the hospital eventually admitted its error. Colin received substantial damages enabling him to receive much needed 24 hour paid care at home, adapted accommodation and compensation to try and restore some quality of life for him.  Without his family’s persistence the truth would never have emerged.  Colin’s wife not only had to manage the family in crisis but also had to struggle with and against misleading denials of fault by the hospital.

Medical accidents are unfortunately more likely than we would all like to think.  There are estimated to be over 1 million patient safety incidents in English Hospitals each year and half of these are thought to cause avoidable harm or injury.

The Department of Health estimates that 1 in 10 NHS patients will be unintentionally harmed and yet the NHS reports receiving only 5000 clinical negligence claims a year – only 1% of those harmed.  The compensation culture is, in my view, a myth.

There is now a positive duty on the medical profession as a whole to be open and honest with patients when things go wrong.  This is known as the duty of candour and under its guidelines it is clear that patients should expect a face-to-face apology if they have suffered avoidable harm.  All NHS and private healthcare organisations should, therefore, admit to any mistakes candidly, and as soon as possible.

The test now is how individuals and organisations in healthcare respond to this and whether it will lead to a change to a more open culture.  I certainly hope it does so.