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A faulty production line

The Government must tackle the root causes of medication errors

Dr Kailash Chand

Dr Kailash Chand

Research, commissioned by the Department of Health and Social Care, shows medication errors may be responsible for about 700 deaths annually. It also warns that mistakes may contribute to 22,000 deaths a year – with the problem costing the NHS an estimated £1.6bn.

Jeremy Hunt, an accomplished media operator, told journalists: ‘This is not about blaming doctors and pharmacists and nurses who are working under a huge amount of pressure and stress, but it is about having checks in place and the right culture so that if a mistake is made people can be open about it and learn from it.’

But on the coal face, the tragic saga of Dr Bawa-Garba is concerning all health professionals, not just doctors, that their own written reflections might be used against them by employers and regulators, and fear, recrimination and blame will drive underground the culture of openness and transparency. Death, even where expected, will raise the prospect of a charge of manslaughter, driving recruitment away from ‘riskier’ specialties like emergency medicine, general practice and paediatrics.

If Mr Hunt wants the NHS to be the safest in the world then there are fundamental issues that need to be addressed. He needs to be much clearer about what extra funding and capacity his government will be providing so that NHS staff can to do their jobs to the best of their ability, without mistakes, and to really ensure our NHS is as safe for patients as it can possibly be.

Fear, recrimination and blame will drive underground the culture of openness and transparency

The health and social care secretary says mistakes involving medication, both in the NHS and globally, are ‘causing appalling levels of harm and death that are totally avoidable’. In reality, his mantra on safe staffing in the NHS post-Mid Staffordshire has a hollow ring to it, and indeed he has done the exact opposite with the NHS. Unable to recruit home-grown doctors and nurses, as in Britain’s Empire days the NHS is now looking to plunder other countries to provide its healthcare staff. Despite a pledge from Mr Hunt in June 2015 to increase the GP workforce by 5,000 by 2020, numbers have steadily been falling.

Overall spending on the NHS has risen by 18% since the 2005–2006 fiscal year, but the proportion of the budget allocated to general practice has dropped by 8% over the same period. In the past year, there has been a 15% decrease in applications for general practice training posts; practices are finding it increasingly difficult to fill vacant equity-holding partnerships and salaried posts, and they are struggling to hold onto the growing number of older doctors who are considering early retirement. A specialty that has historically had an admirable reputation for simply absorbing whatever it was asked to do is now struggling to deal with the growing expectations that are being placed on it.

In 2016, the Academy of Medical Royal Colleges, the independent organisation representing the UK’s 220,000 doctors, launched a campaign to reduce the harms of too much medicine, citing commercial conflicts of interest, defensive medicine, overprescribing and biased reporting in medical journals as drivers of harmful over-treatment.

We have a now-permanent crisis in hospitals; GP surgeries over-subscribed and at breaking point; and social care is severely under-funded.

If Jeremy Hunt is serious about making the NHS safest and best, he needs to address the root causes of errors, not just utter smooth words on the television and radio.

Dr Kailash Chand is a retired GP from Tameside and is honorary vice-president of the BMA


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Readers' comments (5)

  • There is a problem.
    What is your solution?
    How are you going to achieve this?

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  • The problem with the NHS is the eat all you want buffet free at the point of abuse.

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  • Unless everywhere I have worked is abnormal, the system where repeat prescriptions are passed to GPs in a large pile having been printed off by a non-clinical person and are then signed off at speed with little, if any checking of the patient records is extremely dangerous.

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  • He needs to be much clearer about what extra funding and capacity his government will be providing

    Surely he couldn't be clearer;absolutely none whatsoever,how could anyone possibly not understand that,does the BMA have no threshold of basic comprehension.

    Those ,like the author,who live in a deluded dream world where the bugle will sound,and the money come galloping over the hill,are the true architects of our current medical armageddon

    The money is not coming,no-one is coming,it is only going to get worse,and you created the problem

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  • Dr Chand tries to perpetuate the myth that Dr bawa-Garba's reflective entries were used against her: they were not. Stop trying to deflect attention from the root causes. While BMA is hung up on reflective journal entries, which wasn't an issue, they are deflecting attention from the real issues!
    Where was her support from her consultant and the BMA at the original court hearing?

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