Your life in their hands
Reproduced from the
The need to acknowledge one of the biggest threats to patient welfare-the
medical profession itself.
In April 1997 Richie Williams should have been a
happy, lively 12-year-old. His cancer was in remission and he was having
his last dose of chemotherapy. Tragically, it all went wrong. A mix-up by
a doctor meant a toxic drug was injected into Richie's spinal fluid instead
of his bloodstream - a terrible, irreversible error that led to a slow and
Richie's story is just one of many examples used in Why Doctors Make
Mistakes, a candid exposition of medical mishaps and the causes behind
them. Medical errors have always made headlines but few people realise the
sheer scale of the problem - accurate figures are difficult to come by. However,
both British and American studies suggest. that around one in 25 patients
in hospital is harmed as a direct result of medical error. Most of these
will be minor, but around a third of mishaps result in some form of long-term
disability or death.
Translate these fractions into hard figures and the scale of the problem
quickly becomes apparent. There are approximately ten million hospital admissions
in the UK every year, which means, assuming a universal four per cent
risk of medical mishap, that as many as 400,000
people could be injured in some way by their doctors or nurses - 56,000 of
whom will be killed.
It's a risk that compares poorly with other
activities perceived as dangerous - flying, for example, scares a lot of
people but the actual risk of dying, which stands at around one in three
million per flight, is slim. Hospitals, on the other hand, don't scare
most people, though maybe they should! Data from the USA suggests patients
admitted to a typical acute care hospital have a one in 200 chance of being
killed as the result of a medical or nursing cock-up, and there is nothing
to suggest that things are any better here. Indeed, they may well be worse.
Decades of professional arrogance have meant that statistics like
these have been kept under wraps. Many of today's doctors and nurses prefer
candour to cover-up but are under increasing medico - legal pressure to keep
quiet. The growing tendency to sue nurses, doctors or midwives, or the hospitals
they work for, has meant medical mishaps are once again being swept under
the carpet, where they benefit no one.
Most medical mistakes are not the result of negligence. Some doctors and
nurses are walking disasters, but they are a minority. The vast majority
of blunders are caused by good staff who slip up, and the same old themes
often run through the accident scenarios. These include inexperienced staff
taking on too much, lack of sleep, procedures being done in the middle of
the night, new or locum staff unfamiliar with protocols, and intolerable
pressure on time and resources.
The more we talk about mistakes the more we learn from them, and the less
likely they are to happen again. It's not about blame; it's about making
sure that every step is taken to ensure tragic accidents like Richie's are
not repeated. Doctors, nurses and midwives are already addressing the issue
and it's become one of the Department of Health's priorities for change in
the NHS. But the healthcare professions are an unwieldy group - like a super
tanker, with a turning circle to match.
Given the fact that we have largely suppressed the problem in the past, I
am not sure we can be trusted to address the problem quickly or efficiently
enough in the future. I suspect major outside pressures will need to come
to bear, and programmes such as Why Doctors Make Mistakes will supply
plenty of those.
Dr Mark Porter co-presents
Watchdog Healthcheck Mondays
BBC1 and is on Jimmy Young, alternate Mondays Radio 2.