NHS staff who neglect patients 'should be prosecuted'

NHS staff who neglect patients should be prosecuted in light of scandals such as Mid Staffordshire, experts said today.

Between 400 and 1,200 more people died than would have been expected at Mid Staffordshire NHS Foundation Trust, investigations in 2009 and 2010 found.

Poorly trained staff were too few in number, junior doctors were left alone in charge at night and patients were abandoned without food, drink or medication.

Some were left in pain or needing the toilet, or sat in soiled bedding for hours at a time.

Today, experts writing in the Journal of Medical Ethics said staff should be prosecuted for such a "gross dereliction of duty", as already happens in France.

"No care was taken to ensure that patients were fed," they said. "Basic standards of hygiene were not met, with relatives resorting to taking sheets home to wash."

At present, staff in England can face prosecution only if a serious error results in the death of a patient.

However, doctors and nurses caring for patients under the Mental Health Act and the Mental Capacity Act may be prosecuted for wilful neglect.

The researchers, from the University of Manchester's centre for social ethics and policy, say Mid Staffordshire is not the first example of "abysmal" NHS care and will not be the last.

In France, there are various sanctions but the "ultimate stigma lies in the criminal conviction itself, and the (staff) go about their duties in the knowledge that failure to protect the basic interests of their patients will be sanctioned by society".

However, the experts say staff covering a busy ward and unable to attend to all patient needs on time due to system failings beyond their control should not face the wrath of the law.

"Ill-treatment of a patient requires a deliberate course of conduct," they say.

"If wilful neglect was extended to the wider healthcare setting, liability would only ensue if the healthcare professional was indifferent to his/her patient's welfare."

Nevertheless, they urge the Government to consider creating a criminal offence of wilful neglect to hold individual NHS managers and workers to account.

"In the event of conviction, it would send a clear societal message to those with managerial and professional responsibility within the NHS that this sort of conduct is not acceptable and indeed undermines the very basis of the social contract on which the NHS was originally founded."

Chairman of the British Medical Association Hamish Meldrum told the BBC Radio 4 Today programme: "I'm not sure that creating new criminal offences for doctors or nurses would be top of my list, or on my list at all.

"I would much rather we focus on cultural change and try to sort out why these things happen, and change the culture that allows them to happen, rather than look at sanctions after these things have happened."

A spokeswoman for the Department of Health said: "Our recent White Paper set out our vision for a safer NHS - one where sub-standard care will not be tolerated. We intend to put safety back at the heart of the NHS.

"The purpose of the CQC's registration process is to ensure that providers meet essential standards of quality and safety.

"This includes ensuring that providers have sufficient suitably qualified, skilled and experienced staff, and patients are protected from the risks of inadequate nutrition and dehydration.

"Criminal prosecution of individuals who cause harm is already possible and staff who are subject to statutory professional regulation might also be referred to the relevant body such as the General Medical Council for an investigation into their fitness to continue practising."