Sunday 27 December 2015

A Worrying Change

At the beginning of November 2015, two people were convicted of manslaughter. They were Isabel Amaro and Hadiza Bawa-Garba, and they were convicted of the manslaughter of Jack Adcock. But Isabel Amaro is a nurse and Hadiza Bawa-Garba is a doctor, and Jack Adcock was a six year old boy in their care.

Jack was admitted to Leicester Royal Infirmary, on Friday the 18 February 2011, with diarrhoea and vomiting, and breathing difficulties. Jack had Down’s Syndrome. He died eleven hours later after a cardiac arrest, due to Sepsis, secondary to pneumonia. This was a very ill child.

Both Isabel Amaro and Hadiza Bawa-Garba missed his deteriorating condition. He had abnormal blood results, high levels of urea and creatinine in his blood, and he was showing signs of septic shock. When he had a cardiac arrest his lips had turned blue. Dr Bawa-Garba had not contacted her consultant about his condition and when he arrested she stopped the crash team, mistaking Jack for another patient who was not for resuscitation.

This was serious misconduct and negligence by both these women, but was it manslaughter? Did these two women deliberately neglect Jack’s care to the extent that he died? There is no evidence of this.

We don’t know the full details of what happened when Jack Adcock died. How busy was the ward? (In her evidence Dr Bawa-Garba said that she’d not had time for a break) How many other patients where Isabel Amaro and Hadiza Bawa-Garba also looking after? How many of them were also very ill? How many other staff were on duty that day? Was the ward short staffed? (Isabel Amaro was an agency nurse so the ward was down at least one member of permanent staff)

Many of us nurses have been on duty when it has been busy and our unity or team has been short staffed. For many NHS nurses this is now a common working condition. This is the time when things can go wrong, drugs errors can occur, lapses in care can happen. Staff are pressured, stressed and short of time, with more and more demands being made on them. They are only human. As resources are squeezed and pressures increase more and more nurses and doctors will be working under these conditions. This is now the reality in Jeremy Hunt's NHS.

Negligence and misconduct should never be tolerated but is a manslaughter charge the right response? But our courts do not deal in the complicated factors that busy and under staffed units are being put through, and are they always the right place to deal with lapses in healthcare practice? They deal in the rights and wrongs of one person's actions, they rarely deal with complicated institutional failings (Because what else are the stresses being put on NHS staff today?)

When working on a busy and short staffed hospital ward do nurses now have to take care so that we don’t end up charged with manslaughter?

Drew Payne

Thursday 7 May 2015

My Political Wish for Friday, the Repeal of the Health and Social Care Act 2012

The Health and Social Care Act has failed and needs to be replaced. Unfortunately it has failed on so many levels that to effectively modify it would mean ripping it apart and starting again.

Its focus was all local with no strategic control; we saw the effects of this with last year’s winter crisis in A&E Departments (Which actually was a failure in healthcare across the broad and especially in social care). The “Better Care Fund” has taken millions out of Primary Care funding to pay for short falls in Social Care funding. Private companies have not produced any benefits when they have taken over running NHS services. Hinchingbrooke wasn’t the only time a private company “handed back” an NHS contract. Also, the Kings Fund has stated that private healthcare companies are more expensive to run; NHS spends 5-6% on administration where private companies spend 15-30%.

As a Community Nurse, I have not seen any of the promised benefits of the Health and Social Care Act, though our workload has increased as the number of patients we care for has increased (This has been seen right across the NHS).

Whatever replaces it needs to both meet the needs of local communities but also needs to have a strategic control; otherwise we will repeat what happened last winter. It also needs to bring Social Care back under the control of the NHS, because at the moment there are too many agencies involved in it and too many gaps between them.

Whatever replaces it needs to be well funded, not cooking the books with “efficiency savings” budgeted in. Healthcare costs are rising faster than inflation (Look at the price of medications) and the number of patients needing treatment is also raising. A measly 1% increase is actually cutting healthcare funding in real terms (The coalition government has imposed 4% cuts to NHS funding year-on-year, even with promises to “Ring fence front-line services”).

Whatever replaces it needs to be legally sound. Over the years both the Conservatives and Labour have opened up the NHS to private tenders and contracts, this has brought the NHS under UK and EU competition laws. Repealing Health and Social Care Act maybe a legal nightmare and companies already with NHS contracts may demand millions in compensation.

Also, healthcare professionals, healthcare managers and patients need to be consulted about what replaces the Health and Social Care Act, it should not just be the idea of economists and politicians (as has happened all too often in the past). the Health and Social Care Act came as a shock to NHS staff and patients alike, it’s replacement should not.

Andy Burnham is talking a lot about “integration” in healthcare, but who is he listening to?

(This blog was originally written as part of the Nursing Standard’s Readers Panel, and appeared in an edited version in that section)


Saturday 2 May 2015

Vote, Vote, Vote, Maybe? (Part 6)

Further on yesterday's blog.

Yesterday afternoon I got an email reply from the Liberal Democrat candidate, Paul Reynolds. This morning, in the post, I received a letter from the Labour Candidate, Lyn Brown.

I suppose I should be happy now, four out of the five main candidates have finally replied to my email, but it all feels very hollow. How many of those replies would I have got if I hadn't badgered them through social media?

Yes, they are busy campaigning (So they say though I have seen very little of it in my area) but they are not doing it alone. They have assistants, other people involved in their campaigns, volunteers and an organised political part behind them. I emailed them with plenty of time, I spent my email out on the 5th April, and it was only when I started blogging about it, and sending links to those blogs directly to the candidates that I started to get replies from them, before that I hadn't even got an acknowledgement of my email.

As I posted yesterday, campaigning in my area has been pitiful, a handful of fliers pushed through our front door and that's all. I would love the chance to quiz these candidates face-to-face but I haven't see any local events or campaigning.

Is politics losing touch with the voters, is it being run just for the benefit of politicians or am I just getting too cynical?


Friday 1 May 2015

Vote, Vote, Vote, Maybe? (Part 5)

Events more on. The election is now only six days away and I move forward but only by half a step.

Lyn Brown (Labour Candidate) has confirmed that she will answer my questions but only by letter, because I’m one of her constituents (Which was only told to me yesterday). How long this letter will take to arrive I don’t know. I certainly don’t know if it will arrive before the election, and if it doesn’t then what is the point?

The silence from the Liberal Democrat candidate, Paul Reynolds, and the UKIP one, Jamie McKenzie, is almost deafening. I have emailed them again, asking for them to reply to me, but it is now twenty-six days since my first email and I don’t hold out much hope of a reply.

I have just done another internet search on Andy Uzoka (Christian Peoples Alliance) and Cydatty Bogie (Communities United Party) and I can still find no contact details for either of them. Are they even standing? And if so are they even serious candidates? It doesn’t feel like that the way the way they seem to be making themselves deliberately un-contactable.

I know I am sounding more and more cynical but that is the way I am feeling. When I started this I wanted to know my local candidates’ views and knowledge of the NHS and its issues. Now this has become a frustrating battle to get these people to just engage with me. They want to be my local MP, with all the influence, privilege and high salary (Especially compared to the average wages of someone living in West Ham) that comes with it, yet they can barely be bothered to acknowledge me, let alone answer my questions. Why do they think I’ll vote for them?

If this is the standard of people standing at this election then no wonder that people are so disillusioned with politics.


Thursday 30 April 2015

Vote, Vote, Vote, Maybe? (Part 4)

Seven days until the election and I’m still no further forward than after my last blog.

So far I have only had two candidates reply directly to my email, The Green Party candidate, Rachel Collinson, and the Conservative candidate, Festus Akinbusoye.

An assistant from the Labour candidate, Lyn Brown, emailed me six days ago wanting my postal address so Lyn Brown could post me a letter. He hasn’t responded to my reply that I wanted an email response because I wanted to read her reply soon, not later.

The Liberal Democrat candidate, Paul Reynolds, and the UKIP one, Jamie McKenzie, have still not even bothered to acknowledge my email, let alone reply to it and answer my questions.

The two other candidates (Andy Uzoka of Christian People’s Alliance and Cydatty Bogie of Communities United Party) are completely unreachable, neither of them seems to have an email address to contact them on.

I feel so frustrated and sicken by all this. It really feels as if those candidates just aren’t bothered about my vote. Really, is campaigning so unimportant to them?

I was watching the BBC news last and they had a report on South Thanet, in Kent, where Nigel Farage is one of the candidates. There people are being bombarded by the candidates seeking their votes, there is wide-spread door-to-door canvassing and it seems almost daily campaigning in the streets.

Here, in West Ham, if you didn’t have the television on you would barely know there was an election coming. We have had fliers push through our front door (The Labour and Conservative candidates also posted me the same fliers I’d had pushed through the door) but apart from that nothing else. If there has been any local hustings they have been very quietly advertised. There is a large local Community Hub centre, two minutes walk from my home, ideal for a general Election hustings, yet there has been nothing there. No one, from any candidate, has canvassed me on my foot door. No one has been campaigning around here, not at the busy tube station or our new parade of shops. Nothing.

Is this because we don’t have a high profile candidate standing? Is it because it is a very safe seat? Is it because the sitting MP has to do very little work to get re-elected and the other candidates don’t stand a hope-in-hell of getting elected? Or is it a combination of all of the above?

Russell Brand famously has never voted. I used to pour scorn on him for it but more and more (after the way I’m being treated by these candidates) I am understand why people didn’t vote, especially when the candidates barely seem interested in my vote.


Sunday 26 April 2015

Vote, Vote, Vote, Maybe? (Part 3)

The saga of my attempts to get my local candidates to reply to my email and give me a straight answer further continues.

After Friday's blog things have moved on, but not that far. Today I came home from work (As a nurse I have to work weekends, and no 9% pay rise for me, unlike MPs) to find an email from the Conservative candidate, Festus Akinbusoye, but from the tone of the first paragraph my tweets to him galvanised him into replying.

That still leaves the Liberal Democrat candidate, Paul Reynolds, and the UKIP candidate, Jamie McKenzie, who haven't even acknowledged that I sent them an email, and the Labour candidate, Lyn Brown, who hasn't answered my questions.

21 days since I sent out my email, and only 11 days until the General Election, and only two candidates have replied to email and only after a bit of naming and shaming on social media; plus two other candidates (Andy Uzoka of Christian Peoples Alliance and Cydatty Bogie of Communities United Party) are completely unreachable. Am I asking too much, are these candidates ignoring me, or are these candidates so incompetent/too lazy to reply to me?

The media tells us that this election is too close to call, so I would imagine that candidates would be chasing any vote they could get, or is that only in marginal constituencies?


Friday 24 April 2015

Vote, Vote, Vote, Maybe? (Part 2)

Update on yesterday's blog posting. I've now had some responses to my email.

Firstly The Green Party candidate, Rachel Collinson, finally replied to my email yesterday. Unfortunately it took a shaming on tweeter to get her to reply to me, her excuse was that she's working 17 hour days, but she had not even acknowledged my email to her before yesterday.

Today one of the assistants from the Labour candidate, Lyn Brown, emailed me wanting my postal address so Lyn Brown could write me a letter. It is thirteen days until the General Election, I emailed her 19 days ago. I wanted an email response so that I can read it as soon as possible, not have to wait for a letter that might not even arrive until after the election. If she wants my address to know that I am a genuine constituent, fine, but we've had emails for over twenty years so why can't she email me her reply?

I sent a reply to her assistant saying this, now lets see how long it takes to finally get a reply back. There's 13 days to the election, at this will I even get to read her answers to my questions before then?

As for the other three candidates, the Conservative (Festus Akinbusoye), the Liberal Democrat (Paul Reynolds) and the UKIP (Jamie McKenzie), I have heard NOTHING back from them. They haven't even an acknowledged my email.

Since I emailed the five candidates there have been two more candidates announced they're standing and wanting my vote, here in West Ham, Cydatty Bogie (Communities United Party) and Andy Uzoka (Christian Peoples Alliance); but I can't send them my email because they don't have email addresses were they can be contacted. Is it that they don't want voters contacting them?

Thirteen days until the General Election and only one candidate has answered my three questions. It feels as if they don't want to reply to me, what are they afraid of or am I is unimportant to them that they arrogantly ignore me?


Thursday 23 April 2015

Vote, Vote, Vote, Maybe?

In case no one has noticed, there's a General Election in just over two weeks. Well I intend to vote

My vote is special to me, I only get one vote and I want to use it well. To that aims I have emailed the five candidates that were then standing for election as the MP for my constituency (Since I emailed them two more, fringe candidates have stood and I will email then too). I’ve pasted a copy of the email below.

I asked the candidates three questions:

How would they protect the NHS as it faces increasing demands on it?

How would they recruit more nurses into the NHS? There’s already 20,000 empty nursing posts in the NHS.

How would they help the NHS become a community based healthcare provider, rather than a hospital based provider?

These are the five candidates I emailed:

Festus Akinbusoye, Conservative, email,, Twitter @fest4westham

Jamie McKenzie, UKIP, email (No Social Media)

Lyn Brown, Labour (Current MP), email, Twitter @lynbrownmp

Paul Reynolds, Liberal Democrat, email, Facebook page

Rachel Collinson, Green Party, email, Twitter @Rachel_shares

I emailed them all on the 5th April and since then... Nothing. I got am automatic email receipt from Lyn Brown saying that she was very busy and could take up to ten days to get back to me. That’s all the response I have received from all five of those emails

None of the candidates have answered my questions.

None of the candidates have responded to my email.

No assistant or campaign worker or volunteer or anyone from their office has responded to my email.


Is this how candidates view the people they want to vote for them? If so it is deeply arrogant and patronising. If my questions are too complicated or that they just can’t them answer then why can’t they say that to me. Instead they just ignore me and their silence speaks a thousand words.

So far, as of today, all the campaigning I have received for my vote is four, very brief leaflets pushed through our front door; one each from the Labour, Conservative, UKIP and Liberal Democrat candidates. Nothing more.

Do these candidates think that my vote is so cheap that those leaflets are all they need to do to receive it?

No wonder that people don’t vote.

I’ll keep you informed if they of these candidates to do reply to me, but I am not holding my breath waiting for their reply.


My email to these candidates:

Why Should I Vote for You?

Dear ______,

I live in the West Ham constituency and I intend voting at the coming election, but I am not sure who to vote for. I work as nurse, in the NHS, and I am very concerned about the state of the NHS. To help me decide who to vote I'd like to ask you these three questions:

The NHS is facing more and more demands, especially with an ageing population and the increasing cost of healthcare (the cost of new medications and clinical equipment). How would you ensure it stays fit for purpose, meets people's needs and is still based on people's clinical need?

The NHS has approximately 20,000 unfilled nurses' posts, which has a direct impact on patient care. The NHS is short of nurses due to people leaving nursing, many nurses have retired or approaching retirement, and that we are training less and less nurses each year, we now train 12% less nurses then we did in 2010. How would you reverse this and ensure there are enough nurses to provide the high standard of care needed?

For the last twenty years we have been told by different governments that the NHS needs to move away from the hospital model of providing healthcare and towards a community based one. Yet still the community remains the poor relation of the hospital, with much less staff and resources. I know this fist hand because I work as a District Nurse. How would you ensure that the community has the resources to deliver healthcare were people live and that the NHS does finally move to the model of community based healthcare?

My vote is important to me and I would appreciated your answers to my questions to help me decide who to vote for.

Drew Payne


Sent 5th April 2015.