Guilty nurses go unpunished
But despite the increase, an analysis of statistics compiled by the profession's disciplinary body shows that hundreds of culprits are continuing to work unpunished, or being allowed to return to the wards relatively soon after committing their offences.
Between 1986 and 1992, the annual number of misconduct offences accepted by the professional conduct committee of the UK Central Council for Nursing Midwifery and Health Visiting rose from 291 to 586.
Of the 650 nurses accused of misconduct last year only about one-quarter appeared before a disciplinary tribunal. Half were struck off but most of the others - although found guilty - remained on the register.
UKCC figures also show that the majority of appeals for restoration to the register, lodged by those struck off for misconduct, have been granted in each of the past seven years.
Nurses caring for the most vulnerable patients - the elderly, mentally handicapped and mentally ill - make up the bulk of those found guilty. Although only one in 10 of Britain's 660,000 registered nurses is a man, most complaints involve male nurses.
Critics of the disciplinary system say that the official figures are merely the tip of an iceberg. They argue that many more complaints do not get past the UKCC's preliminary screening procedures.
The emergence of the figures comes as the longwinded procedures for dealing with nursing's 'rotten apples' come under increasing scrutiny.
Graham Pink, the NHS 'whistleblower' who last week won his case for unfair dismissal against Stockport health authority, was elected to the UKCC earlier this year. Last week he joined calls for a wide-ranging reform of its complaints investigation machinery and described the body as 'completely useless'.
Two case histories illustrate Mr Pink's criticisms.
In October 1988, Philip Donnelly was jailed for two years for sexually abusing two 13-year-old boys while he was nursing director at Booth Hall Children's Hospital, Manchester. It took the UKCC nearly two years to find him guilty of misconduct. He was not struck off.
Last month, the UKCC restored Feroza Leeming to the nursing register after 16 months, much to the anguish of the family of an elderly patient unlawfully killed while in her care. Mrs Leeming lied to police about the circumstances surrounding the death by suffocation of Bridget Brosnan, 70, at Lister Hospital, Stevenage.
She later lied about a conviction for conspiracy to pervert the course of justice when applying for a nursing job with Bloomsbury and Islington health authority. Mrs Brosnan's children are trying to raise funds for a High Court challenge of the decision to re- register Mrs Leeming.
The Prevention of Professional Abuse Network (Popan), which advises victims of malpractice by health workers, detects growing public dismay at the apparent leniency of disciplinary tribunals and the slow pace of investigation by profesional bodies such as the General Medical Council and the UKCC. Jenny Fasal, one of Popan's founders, says it receives 100 letters a month from people asking for help.
'It can take years to pursue a complaint, only to find the offender is allowed to go on practising,' she said. 'Many people are so ground down by the whole business, and the way in which professionals and managers close ranks, that the complaints never get properly investigated or resolved.'
Graham Pink, 63, was sacked two years ago from his job as a charge nurse at Stepping Hill Hospital, Stockport, after complaining about dangerously low staffing levels on geriatric wards and poor standards of care.
The UKCC has not acted on his detailed complaints about the conduct of individual members of nursing staff at Stepping Hill, nor explained its inactivity.
'The UKCC is completely useless as it is,' said Mr Pink. 'In the view of many nurses, it is accountable to no one. It would appear to me they are failing in their duties to protect the public.'
The UKCC's 60-strong ruling council is dominated by the nursing establishment with only two members appointed to represent consumer interests. Nurses' misconduct cases tend to be heard almost exclusively by their peers.
Some changes are, however, under way. Under legislation passed last year, disciplinary tribunals are able to caution offenders as an alternative to removing them from the register.
Tariq Hassain, a UKCC assistant registrar, said that the complaints that were screened out before formal hearings tended to arise from minor shoplifting, damage to property, or domestic disputes. Cases involving serious allegations sometimes failed because of insufficient evidence.
'The professional conduct committee has to operate rather like a criminal court with the same kind of burden of proof required. Its decisions are open to appeal to the High Court.'
Mr Hassain said the council would shortly consider proposals for increasing lay representation on disciplinary hearings.
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