Letter Of Complaint To Keith Ford Chief Executive Of Mayday Hospital
5 November 2003
Keith Ford CPFA
Chief Executive
Mayday University Hospital
530 London Road
Croydon
CR7 7YE
Dear Keith,
Mayday/Purley Hospital Patient Iris Perkin
I am sorry to have to be writing to you to complain, but I am not at all happy with the care that my mother has received while she has been a patient under the care of your NHS Trust.
One would hope that the elderly would always be treated with respect and consideration, but I have to say that the experience that I have had with my seventy-nine year old mother, while she has been treated at Mayday would appear to indicate that this is not always the case.
My mother has been suffering from mild vascular dementia for the last couple of years and on the 5th October, although perfectly mobile, had a fall at home fracturing her hip. She was taken by ambulance to Mayday Hospital and operated on a couple of days latter. Although my father and I never got to speak to the surgeon who operated on her, Dr Diggory, who we were told was the consultant geriatrician who would be responsible for my mother's care told us, that there was a risk that my mother's dementia could worsen as a result of the operation. Nevertheless he said that if it were his mother he would go ahead with the operation, so my mother was operated on a couple of days after she had been admitted. The day after the operation my mother looked to have made a good recovery and the nursing staff, who are completely stretched and have my complete admiration for what they have to do, had got her sitting up in a chair. During the days that followed her condition slowly improved and then on the morning of the 20th October Dr Becky Borham a Senior House Officer spoke to me on the phone and said that my mother had made a good recovery and that they were starting to consider the next step in my mothers rehabilitation and that this might involve a transfer to Purley Hospital. When I asked why this needed to be done and when she would be moved, Dr Borham said it was because there was pressure on the acute beds at Mayday and that the clinical opinion was that my mother needed less intensive care and as my father, who is also in his seventies and undergoing medical treatment for a number of conditions was unlikely to be able to give my mother the rehabilitation help she would need, she would not be able to return home immediately. Dr Borham went on to say, that before any decisions were taken about moving my mother I would be fully consulted about what was going to happen to her and that the Care Manager would speak to me to discuss my mothers care plan. Later that day when I visited my mother Dr Borham told me, that there had been a complete change of plan, as my mother had taken a turn for the worse and now had a urinary tract infection and that a new x-ray had shown that my mother now had several new fractures to her hip. I asked how that this could have happened and Dr Borham said that although no one had seen her fall, or recorded that she had been picked up after the fall, they were making the assumption that this is what had happened and that there was now no question about transferring my mother out of Mayday in the foreseeable future, as they would not be operating on the new fractures and instead would keep her in bed for a period of about six weeks to allow the fractures to repair themselves. My mother therefore continued to be an inpatient on Fairfield Two ward and we heard nothing more for a couple of weeks. My father and I taking it in turns to go to the ward each evening to feed my mother and give her medication in order to assist the nursing staff who are clearly at full stretch dealing with all the dependent geriatric patients in their care.
On Thursday 30th October it was clear that my mother had contracted another urinary tract infection and that she had been prescribed antibiotics which were being fed to her intravenously and when I visited her she was also being given oxygen and was in a very poor state. The next day when I visited I asked, to speak to a member of the medical staff who could inform about my mother's condition and waited over an hour before a Senior House Officer from the Accident & Emergency Department came up to see me. It was immediately apparent that he had never even met my mother before and had no knowledge of her medical condition and so could tell me anything about her long-term prospects for recovery. I told him that I could come in at anytime to see a member of the medical staff, who did know something about my mother's medical condition and he suggested that I speak to the consultant Dr Diggory and suggested that I wait till the following Monday when if I asked the nurses they would get Doctor Diggory to speak to me.
On the Monday I was going to speak to Dr Diggory my Father rang me to say that he had received a phone call from the hospital ward to say that my mother was either that day, or the next being transferred to another hospital. He was distressed at this news because we had not been told about her condition or the long-term prognosis. I immediately rang the ward to try and speak to Dr Diggory, but was told that he had just left the ward and could not speak to me. I therefore rang his secretary who told me that she would give him the message that I was trying to speak to him about my mother. I also left a message on your answer phone to say that I was not satisfied with the way my mother was being treated. A couple of hours later I had a telephone call from a lady called Gwen from the Patient Advisory Liaison Service, who told me that she would go up to the ward to try and find out what was happening and get back to me. When she got back to me she told me that my mother was being transferred that day to Purley Hospital and that Dr Diggory would not be able to talk to me until the evening at the earliest, well after my mother had been transferred to another hospital. I said that I was not happy with that, as I had attempted since the previous Friday to speak to a member of the medical staff about my mother's medical condition and that I had been promised before she was moved that I would be fully consulted about her care plan. I said that I was now so dissatisfied about what was happening to my mother that I would now make a formal complaint about how my mother was being treated and report the matter to the media. I also said that if Dr Diggory was going to contact me in the evening I would actually be at the hospital from about 5.45pm, as I would be going in to feed my mother and give her that night's medication. About twenty minutes later Gwen phoned me back to say that because of my concerns they had decided not to transfer my mother to Purley Hospital that day. I told her that this was an equally wrong decision; as if my mother needed to go to Purley Hospital on medical grounds then that is where she needed to go. I told her that my concern was the fact that despite earlier promises to be consulted about my mother's medical treatment, these promises had not been kept and my mother was not being treated with the dignity that all elderly patients in the NHS deserve and was effectively being treated like a "sack of potatoes" and moved at will without any reference to her next of kin.
While I visited my mother at Mayday on the 3rd November, despite having said that I would be on the ward in the evening, Dr Diggory telephoned my home. My nine year old son answered the telephone and told Dr Diggory that I was not at home, when he asked for me. My son said do you want to speak to Mrs Perkin and Dr Diggory said, "No, I just want to leave this message for Mr Perkin. When Mrs Perkin goes down to Purley tell him she will still be under my care, she is likely to go into nursing home and that it was unlikely that she would ever be able to walk again". So this devastating piece of news was delivered by Dr Diggory to my nine year old son, who when he had last seen his grandmother she had been walking perfectly normally. My wife immediately telephoned Dr Diggory back to tell that she was happy that he had left that message with out nine-year old son.
Dr Diggory telephoned me the next morning and we had a very unsatisfactory conversation. He was clearly not prepared to discuss my mother’s clinical condition with me. Basically what he said to me was that patients with my mother’s condition often fall over and that basically he did not think that her hip would ever support her walking on it again. When I complained that he had communicated that message to my mother’s nine-year-old grandson, he said that was the trouble when you communicated by telephone. When I said that there had been no need to communicate by telephone as I had tried to see him for several days to talk to him about my mothers condition and could have come in to see him at any time, he simply said that, "This conversation is getting us nowhere". So I thanked him for his time and told him I would be making a formal complaint about the way that my mother was being treated and the fact that I have never had a proper conversation with any member of the medical staff since I spoke to Dr Becky Borham a week after my mother was first admitted to Mayday.
I don't believe that elderly patients at Mayday hospital are always treated with the respect and dignity that they deserve. The ward was dirty and although you could not fault the dedication of the nursing staff, there are simply not enough of them on the ward to ensure that dependent geriatric patients are properly cared for. These patients don't just need their broken bones mended they need to be helped with feeding and encouraged to drink enough to cut the risk of them picking up urinary infections and falling over again within days of them having had serious operations. The other question I would ask is why do some many geriatric patients have catheters in place, when before they came into hospital they had no problems controlling their bladders. Is it because the lack of funds in the NHS means that the ward staff simply can't cope with the risk that a few patients might "wet" themselves? I am not clinically qualified so I can’t answer the question myself but I think that it is a question that needs to be answered if the elderly are truly to be treated with the respect and dignity they deserve and which politicians claim they are getting.
To conclude I am requesting
that you arrange for me to have a proper appointment with a senior member of
your medical staff who can properly explain to me exactly what has happened to
my mother while she has been in the care of the Mayday Trust and who can also
tell me what the long term prognosis is for her. I am minded to make a complaint to the BMA about Dr
Diggory, but will wait to do so until I have considered your reply to this
letter.
Yours sincerely
Ian Perkin CPFA FRSA