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The Battle of Margaret's Shoulder

How was her pain spun into a political storm? Does this farce say much about the NHS? Or does it say far more about politicians?

Ian Herbert,Andrew Grice
Friday 04 March 2005 01:00 GMT
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It began when Margaret Dixon's shoulder operation was postponed yet again, prompting her husband to complain to the ambitious local councillor. It culminated yesterday in an extraordinary political slanging match, as the Tory claims and Labour counter-claims became the first shots fired in fury ahead of the general election. It said more, perhaps, about the feverish pre-election atmosphere at Westminster than it did about the NHS.

The Battle of Margaret's Shoulder joins the ever-growing list of personal tales of NHS errors of neglect, like the tale of Jennifer's Ear highlighted by Labour during the 1992 election campaign, or the case of Rose Addis, championed by Iain Duncan Smith, the then Tory leader, two years ago. But like those cases, nothing is quite black and white - aside, that is, that Mrs Dixon should have been treated much earlier.

Labour declared yesterday that it was wrong to use a particular case to illustrate the general - though it had done just that with Jennifer's Ear, the party political broadcast which backfired on them 13 years ago - and John Reid, the Health Secretary, was at pains to turn the Tories' early success against them. He thanked Michael Howard for highlighting health as an issue - after a hastily arranged tour of the Warrington hospital at the centre of the affair yesterday, he claimed that all patients and staff agreed that the NHS was in a much better state than it was in 1997.

As the row intensified, Labour accused the Tories of turning Mrs Dixon's case into a "political stunt". The Tories denied that she was a mere pawn in the pre-election game. Mr Howard was at pains to stipulate that this was nothing to do with politics. Although her husband and daughter took tea with Mr Howard at his London home yesterday before delivering a protest letter to Downing Street, he insisted that he had not even asked Mrs Dixon or her family which party they favoured.

Last night the North Cheshire Hospitals NHS Trust challenged Mr Howard's account of Mrs Dixon's treatment, saying that her operation had been cancelled on three occasions, not seven. Amid scenes of near farce, Mr Reid declined Mrs Dixon's invitation to visit her in her home while a Tory press officer was there.

Mrs Dixon said: "To me it looks as though Dr Reid is making a damage limitation visit and the things that he is saying are not true.

"I have no axe to grind whatsoever with Warrington Hospital. I have cause to be very grateful to that hospital. I am not aware that the Tories are using me for political gain and as far as I am concerned I am not a political pawn."

So how has the story of an ailing 69-year-old who broke her shoulder last October achieved such prominence?

After leaving his wife's bedside at Warrington General Hospital on 30 November last year, an exasperated Ken Dixon told himself: "I'm not putting up with this any longer. I've got to do something."

Mrs Dixon had been due to undergo surgery on a broken arm which, owing to her diabetes, fragile heart, lungs and kidney, held out only a 30 per cent prospect of survival. But, for the fifth time in eight days, she was told that her operation must be postponed because there were no high dependency unit beds for her post-operative care.

Returning to his empty terraced home in Warrington, he picked up the only political leaflet recently to have been stuffed through his door. He found the mobile number for Fiona Bruce, a local councillor for six months and Tory prospective parliamentary candidate.

Mr Dixon did not even know which party had delivered the leaflet as he dialled up the number, not dreaming that the ensuing five-minute conversation would propel his wife's case to national prominence.

Within a day, Mrs Bruce, 47, had secured a 90-minute meeting with the hospital's managers. When it ended with the revelation that Mrs Dixon was to be sent home for up to a month, she got the family's story into the local Warrington Guardian. The headline on 12 December should have rung alarm bells for Labour: "I hold Mr Blair responsible for five delays to my mum's op." Ian Dalton, chief executive of North Cheshire Hospitals NHS Trust, admitted at the time that the trust needed more high dependency beds.

The NHS system graded Mrs Dixon and her arm as a lower priority than the cancer patients or road crash victims for whom high dependency beds are often used. But it lacked the sophistication to account for the emotional toll of Mrs Dixon's continual last goodbyes with her husband. Mrs Bruce peppered the hospital with telephone calls for weeks. Then, after the seventh cancelled op on 22 January, she called in the region's Tory MEP, Den Dover.

"Den wrote to John Reid on 24 January and we decided we would give him until the end of February to reply. When he didn't write back we decided to take it higher."

The link man was Chris Grayling, a Tory frontbench health spokesman. A former Tory candidate in Warrington South, he rang Mrs Bruce last week to see how things were going. She told him she had a "really problematic case".

On Monday, Mr Grayling called into Mr Howard's office in Parliament overlooking the Thames and urged him to raise Mrs Dixon's case at Prime Minister's Questions two days later.

Mr Howard decided to make the affair the centrepiece of his weekly Commons joust with Tony Blair. "A real case is worth 10 speeches or reams of statistics," one Tory aide said. "We have achieved real breakthrough with this."

Ministers were privately seething that the saga was still leading news bulletins last night. On Labour's carefully planned "grid" of daily announcements, yesterday was supposed to be dominated by a mini-manifesto on education launched by Mr Blair. Labour has earmarked next week as "health week" and yesterday's row may provide an unwelcome backdrop.

Three months on, Mr Dixon has certainly "done something". Some good came out of all the political heat: Mrs Dixon has a new date for admittance to hospital in three weeks' time, but the trust cannot guarantee a date for her operation.

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