Your life in their hands

Reproduced from the RT Logo

The need to acknowledge one of the biggest threats to patient welfare-the medical profession itself.

Mark Porter 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 painful death.
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.





Chaos Quantum Logic Cosmos Conscious Belief Elect. Art Chem. Maths

Email:Radio Times 30 September - 6 October 2000   File Info: Created 15/10/2000 Updated 17/8/2001 Page Address: