NHS inquiry condemns hospital managers for abuse of elderly

An inquiry into a National Health Service hospital trust in which elderly patients were systematically abused over years has uncovered a web of mismanagement, incompetence and neglect that raises serious doubts about the protection of vulnerable people.

An inquiry into a National Health Service hospital trust in which elderly patients were systematically abused over years has uncovered a web of mismanagement, incompetence and neglect that raises serious doubts about the protection of vulnerable people.

Elderly patients in Garlands Hospital, Carlisle, run by the North Lakeland Trust, were subjected to "cruel and degrading practices" meted out by professional staff, because of an "almost complete failure of effective management", the inquiry, the findings of which are published today, concludes.

The first investigation by the Commission for Health Improvement (CHI), the government agency set up to monitor standards in the NHS, has found that the managers of the mental health trust allowed "unprofessional, counter-therapeutic and degrading - even cruel - practices" to flourish.

Patients in ward 21 of the hospital, who suffered from dementia and had physical disabilities and behavioural problems, were allegedly bullied, sworn at, tied to commodes while they ate and physically mistreated, the report claims. Alan Milburn, the Secretary of State for Health, must now decide what to do about the trust.

The scandal is one of the worst involving the abuse of elderly patients in recent years.

The report by the CHI, which has been seen by The Independent, is savagely critical of members of senior management at the trust. An internal investigation into ward 21 in 1996 uncovered the abuse and said it had stopped. But a second one in 1998, by which time the ward had been renamed Kielder House, found the abuse was continuing. The CHI accuses the trust of failing to respond to early warnings, or to act on the findings of its investigation.

Despite clear evidence of abuse, some staff still failed to recognise unacceptable practice when interviewed by the commission last summer, the report says.

The report has been nervously awaited by NHS managers, who are anxious about the commission's role as a watchdog. Ministers have presented it as a key plank in their strategy for rebuilding public confidence in the health service following the Bristol baby heart surgery disaster and other scandals, but managers fear if it acts as a hit squad it will undermine confidence.

The commission found cruel and degrading practices not only went unchecked but were even condoned when brought to managers' attention. It says that none of the external bodies supposed to monitor the trustprevented the abuse.

The report stops short of naming and blaming individuals, although it strongly criticises the consultant who was responsible for the patients allegedly abused. It says: "That the consultant is also the associate medical director and has joint responsibility for clinical governance across the trust compounds CHI's concern."

The chairwoman of the trust, Mary Styth, was sacked last year by the Government. The chief executive, Alan Place, was sacked last month, the director of personnel has been dismissed and other senior managers have received disciplinary warnings.