Long-stay patients ejected by hospital `lost will to live' when ejected from

Mental health/ trauma of closures

THREE mentally ill women died soon after being forced under the Government's Care in the Community programme to leave the long-stay hospital where they had spent most of their lives, and their former nurses believe their deaths were due to the trauma of the move.

Staff at Dovenby Hall Hospital in Cumbria, which is due to close in March 1996, maintain that the three, who had spent a combined 163 years in their care, suffered a drastic decline in their health when they were sent to private nursing homes.

West Cumbria NHS Health Trust, which administers Dovenby, has asked the regional health authority to lay on special counselling to help staff overcome feelings of guilt at the deaths.

"We need to reassure them that they are in no way to blame and have informed the North Cumbria Health Authority of the need to counsel those most seriously affected," said Nigel Woodcock, chief executive of the trust.

Before all three left Dovenby, they received detailed medical check-ups and were given a clean bill of health.

Agnes Anderson, 81, who had lived at Dovenby for 47 years, was discharged on 3 February this year and died less than two weeks later, on 15 February.

Belle Norman, 75, who had lived at Dovenby for 56 years, was discharged on 25 January this year and died on 10 March.

Betty Crewdson, 67, who had lived at Dovenby for 60 years, went to a nursing home last spring, dying eight months later.

According to the official accounts, two of the women died of bronchial pneumonia and the third of a heart attack.

Nurses at Dovenby do not blame the nursing homes but allege the three women never recovered from the trauma of leaving the hospital.

All three suffered from learning difficulties. Neither Betty nor Belle could speak properly, said one nurse, "but Agnes could and pleaded not to be sent away. But they sent her all the same and she was dead within 12 days."

Away from the institution where they had lived for so long and, according to the staff, were like members of one large family, they became confused and depressed.

One of them, Ms Norman, went off her food and weighed barely four stone when she died. "Belle shouted out all day long, she was a very boisterous person, but she stopped eating, stopped drinking," said a senior Dovenby nurse who saw her shortly before she died. Her spirit was broken, she added.

Staff were not allowed to accompany the women to help them over the shock of leaving. "They went for the day, then went for an overnight stay and were then discharged within the same week," said a Dovenby staff member. "After all that time at Dovenby they were tipped out, to people they did not know."

The former home of the wealthy Ballentyne-Dykes family, Dovenby is a classic, old-style, long-stay hospital, now being phased out by the Government.

At one time it held 400 patients; by 1990 it was down to 260; today it houses 130. By this time next year, almost all of them will have gone - many to private nursing homes, paid for by the NHS.

Those who died were among 16 over-60 patients to leave in the last year. Before they leave, patients are assessed by social services and independent advocates speaking on their behalf.

Dr Joan Munro, North Cumbria Health Authority public health director, and a member of the team co-ordinating Dovenby's closure, said it was "far too emotional" to say they died as a result of leaving. "What we have are people from the patients' side and from the staff side who have been together a long time. As with any such parting, there is a bereavement- type process going on."

Dr Munro added: "No doubt there is emotional distress involved for both the patients and the staff." Asked about Ms Anderson's pleading not to go, she said: "That has been said. I cannot say if it is true or not."

None of the deaths could have been foreseen, said Dr Munro. They had not been the subject of coroners' inquests.

She said that in any closure programme of this size "there are bound to be hiccups", though these could not be predicted.

The chief of North Cumbria Health Authority, Robin MacLeod, said the authority disputed the allegation that the three women died as a result of leaving Dovenby, although he added: "It is a very difficult situation when you put such people into the community."

Dale Campbell-Savours, MP for Workington, whose constituency contains Dovenby, plans to take the deaths up with the Department of Health.

"This isn't about deplorable conditions in homes, it's about people being removed from the environment in which they have lived for most of their lives," he said.

He added that Dovenby "may well be the tip of the iceberg nationally".