Medical errors have always made headlines but
few people realise the sheer scale of the problem - accurate figures
are difficult to come by but both British and American studies
suggest that around 1 in 25 patients in hospital is harmed as a
direct result of medical error. Most of these, thankfully, will be
minor, but around a third of mishaps result in some form of long
term disability or death. Translate these fractions into hard
figures and the scale of the problem quickly becomes apparent. There
are approximately 10 million hospital admissions in the UK every
year which means, assuming a universal 4% risk of medical mishap,
that as many as 400,000 people could be injured in some way by their
doctors or nurses - 56,000 of whom will be killed.
A risk that compares poorly with other
activities perceived as dangerous - flying scares a lot of people
but the actual risk of dying, at around 1 in 3 million per flight,
is slim. Hospitals, on the other hand, donít scare most people but
maybe they should! Data from the States suggest that patients
admitted to a typical acute care hospital have a 1 in 200 chance of
being killed as the result of a medical or nursing cock up - and
there is nothing to suggest that things are any better here, indeed
they may well be worse.
Decades of professional arrogance have
meant that statistics like these have been kept under wraps. Many of
todayís doctors and nurses prefer candour to cover up but are under
increasing medico-legal pressure to keep schtumpf- the growing
tendency to sue nurses, doctors or midwives, or the hospitals they
work for, has meant medical mishaps are once again being swept under
the carpet,where they benefit no one.
Most medical mistakes are not the result
of negligence. Some doctors and nurses are walking disasters but
they are a tiny minority - the vast majority of blunders are caused
by good staff who slip up, and the same old themes often run through
the scenarios behind the accidents : inexperienced staff taking on
too much, lack of sleep, procedures being done in the middle of the
night, new or locum staff unfamiliar with protocols, and intolerable
pressure on time and resources.
The more we talk about cock ups the more
we learn from them, and the less likely they are to happen again.
Itís not about blame, itís about making sure that every step is
taken to ensure tragic accidents like Richieís are not repeated.
Doctors, nurses and midwives are already addressing the issue and
itís become one of the Department of Healthís priorities for change
in the NHS, but the healthcare professions are an unwieldy group - a
bit like a super tanker, with turning circle to match - and, given
that we have largely suppressed the problem in the past, I am not
sure we can be trusted to address the problem quickly or efficiently
enough. I suspect major outside pressures will need to come to