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How many avoidable deaths?

How many avoidable deaths?

Columnist Katie Musgrave considers how many people are dying in avoidable circumstances due to pressures in the health service, and whether this is a human rights violation

Last week, I met with up a friend whose dad died recently. We grew up together. Her dad was a force of nature; a charismatic Greek man who had everyone in fits of laughter almost as frequently as he lost his temper. She told me how shocked she’d been by his sudden death from an infection, before confiding how she worried it might have been avoided, if he had received better care in hospital.

She isn’t the first person to have discussed these sorts of concerns with me. I remember hearing the news of my own grandpa’s death. My dad had attended the hospital to visit his father, who was recovering from a urine infection. When he arrived for his daily visit (my grandpa had been in for a few days), my dad said to a nurse, ‘I’m here to see Mr Roberts’. She responded, unexpectedly, with the words, ‘I’m very sorry for your loss’. Such moments are never forgotten.

Having initially made a good recovery with IV antibiotics, my grandpa had died from acute pulmonary oedema after receiving IV fluids. He’d been looking bright and well just a day earlier.

At 97, my grandpa had been a keen supporter of the NHS. From a humble background, he’d been proud to serve in the RAF during the Second World War, even surviving being taken a prisoner of war after mistakenly landing in the wrong airfield. He was the main carer for my then frail 94-year-old grandma. He used to pop to the shops daily, and was deeply proud of his relatives (myself included) who worked in the health service. The NHS would look after him in his time of need, he told me. Until it didn’t.

I find myself wondering how many thousands, even millions, of families share the valid concerns expressed by my friend, and felt by my family. Was a stillbirth inevitable, or due to medical error? Could a loved one’s death have been avoided? Were we let down by the NHS?

In times of grief, how many of us have the will – or capacity – to raise patient safety concerns? With funerals to arrange, and the shock to deal with, it is invariably too painful to contemplate. And how many doctors and nurses are willing to highlight when things have gone wrong, as they so frequently do?

As the health service staggers from crisis to crisis – with all the ambulance delays, emergency department waits, and overstretched admission teams – we will undoubtedly have years more of this. 

Between hospital staff shortages, bed shortages, falling GP numbers and appointment demand, all the statistics across the UK are headed in the wrong direction. We bicker about funding, blame governments (after all, health is a devolved matter), but continue to defend the institution. What if there are fundamental weaknesses that mean we will continue to see continued overwhelming demand, poor access, and substandard care? What then?

The United Nations’ covenant on the right to life states, ‘The right to life is a right that should not be interpreted narrowly. It concerns the entitlement of individuals to be free from acts and omissions that are intended or may be expected to cause their unnatural or premature death, as well as to enjoy a life with dignity.’

When considering human rights, a state may commit violations either directly or indirectly. Violations might be intentionally performed, or may come as a result of the state failing to prevent the violation.

Of course, the NHS does not deliberately set out to harm anyone. Indeed, staff make enormous personal sacrifices to keep things going. However, more people are currently dying in avoidable circumstances than they should. Put another way, omissions are taking place that may be expected to cause premature death (and have been for some time).

Under the United Nations’ own terms, the British Government might reasonably be accused of committing human rights abuses in our country, against our population. This may be painful to contemplate, and difficult to solve, but it is absolutely essential to discuss.

Dr Katie Musgrave is a GP in Devon and quality improvement fellow for the South West



Please note, only GPs are permitted to add comments to articles

David Jarvis 23 June, 2023 6:41 pm

Much of this is very true but I do wonder how many suffer from the disease of externalising the causes of their ill health to a 3rd party rather than looking inward and accepting some responsibility. The health service is struggling but a big chunk of that work would be avoidable if people took ownership of their own lifestyle and looked after themselves better. The danger of a universal health system is infantilising the users into believing their health and wellbeing is the responsibility of the health service. Like driving with your eyes closed and expecting the insurance company to prevent the inevitable accident.

John Taylor 23 June, 2023 6:41 pm

As a retired GP I massively sympathise with families who have lost loved ones due to the chaos in the NHS and practising clinicians who despair as they observe this chaos.However discussing this chaos as a violation of human rights I think is not helpful.Surely the approach should be towards solving the ambulance problems, the onward social care paralysis and settling the industrial disputes of nurses junior doctors and consultants.Just saying.

Simon Gilbert 23 June, 2023 8:16 pm

Many clinicians: “The government is really bad at buying effective healthcare on our behalf.”

Also many clinicians: “We must keep a system where the government buys healthcare on our behalf.”

Dave Haddock 26 June, 2023 6:44 pm

Would being compelled to pay for a health service that is impossible to access in any reasonable time scale, hence having to pay again to be seen privately, be an abuse of human rights?

Carpe Vinum 29 June, 2023 3:24 pm

There are 2 sad aspects to this; firstly, the person(s) thrown to the wolves when there is a mishap with care which causes harm are the ones striving to do the right thing whilst working in a system which is stretched to breaking point and unsafe. The second is the sad fact that as these incidents increase in number, there is inevitably a sense of unease surrounding the death of any loved one that “maybe it was avoidable” rather than, as has been the case in years past, that someone died despite “everything being done for them”.