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Your life in their hands

Articles written by Dr Mark Porter, reproduced from his weekly column in Radio Times. Hyperlinks inserted by GUiDE


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 bear.

patient's rights

Reproduced from Radio Times 30 September- 6 October 2000 by permission of the publishers, BBC Worldwide Ltd.
Visit Dr Mark Porter's Website at: http://www.drmarkporter.co.uk/