Sections 4 and 5 of Findings and Recommendations Following Enquiries into Allegations Concerning the Care of Elderly Patients in Certain Hospitals
1. This Committee was appointed by the Leeds Regional Hospital Board during the period between 2nd and 18th August, 1967, and has been constituted as follows: —
- Mr. J. F. S. Cobb, Q.C.,—Chairman.
- Mrs. H. Slow, S.R.N., R.N.M.D.
- Dr. T. M. Cuthbert, M.R.C.S., L.R.C.P., D.P.M.
- Alderman A. E. McVie, C.B.E., J.P.
Terms of Reference
2. The terms of reference which the Chairman of the Leeds Regional Hospital Board directed to the Chairman of the Committee were: —
a) to investigate, so far as the available evidence permits, the allegations in pages 18 to 26 and 43 to 46 of ” Sans Everything ” in relation, respectively, to St. James’s Hospital, Leeds, and Storthes Hall Hospital, Kirkburton, Huddersfield;
b) to examine the situation in the geriatric and psychiatric wards in the foregoing hospitals at the present time ; and
c) to make recommendations.
3.After the foregoing terms of reference had been directed to the Chairman of the Committee, copies of statements made to “The News of the World” were supplied to him with a request that the allegations in such statements be also investigated by the Committee. The Committee’s terms of reference were therefore deemed to be enlarged to cover this request.
4.We sat for a total of eighteen days during the period between 9th October, 1967, and 4th January, 1968, and met for discussion on two further days. We received oral evidence from fifty-six witnesses (including witnesses making accusations, and those against whom accusations were made) quite apart from the very many Staff Members and Patients to whom we spoke during the course of tours of inspection. Due to the fact that most of the allegations investigated by us were between two and four years “old”, it was necessary to write many letters to possible witnesses, as well as to accused persons, who are now resident in other parts of the country, and even out of the country.
St. James’s Hospital (North)
5. Allegations relating to several male and female wards in the Geriatric Unit were made by a Nursing Auxiliary (still in Hospital Service) and by a Pupil Nurse (no longer in Hospital Service). In these allegations, one State Enrolled Nurse (no longer in Hospital Service) was named and accused as a person responsible for ill-treatment and harsh conduct: and one Sister (no longer in Hospital Service) was named and accused as a person who condoned the behaviour of the aforementioned State Enrolled Nurse: other unnamed, unidentified and unidentifiable nurses were accused by the aforesaid Nursing Auxiliary and Pupil Nurse of various acts of ill-treatment.
6.The accusations made against the aforesaid State Enrolled Nurse included assaults; the deliberate act of making an elderly female patient inebriated by means of brandy which had been issued to the ward; swearing at patients; mischievously and maliciously squirting spirit onto the bodies of elderly patients in order to give them shocks.
7.We reached the conclusions that:
(i) the State Enrolled Nurse had occasionally sworn and used intemperate language in the presence of patients;
(ii) no assaults, and no other allegations of cruel conduct or ill-treatment, were proved to our satisfaction against this Nurse or against any other (unnamed, unidentified and unidentifiable) nurse ;
(iii) It was not proved to our satisfaction that the Sister knew of the swearing by the State Enrolled Nurse ; accordingly we found that in no manner did this Sister condone improper conduct towards, or in relation to, patients.
St. James’s Hospital (South)
8.Allegations relating to one Ward (primarily for Female Ambulant Patients) in the Psychiatric Unit were made by a Nursing Sister (no longer in Hospital Service). These allegations were of neglect and inefficiency, over a twenty-one week period, on the part of certain members of the Medical Staff, on the part of certain Senior Members of the Nursing Staff ; and, by necessary implication, on the part of Hospital Officers responsible for various service departments.
9.It is stressed that none of the allegations were of ill-treatment of, or of deliberate acts of cruelty towards, any patient.
10. Although many of the acts and facts deposed to by the Nursing Sister were true, or were probably true there was some exaggeration and/or distortion of the facts by her. After hearing all the evidence, we were quite unable to reach the conclusion that any member of the Hospital Staff (Medical, Nursing or Administrative) had been shown to have been neglectful, or to have fallen short in the proper discharge of his or her duty within the Hospital; and towards, or for the benefit of, the patients. We concluded that if the Nursing Sister who made the allegations had demonstrated a little more determination and initiative, the Psychiatric Unit of this Hospital would never have been pseudonymously referred to in “Sans Everything”.
Storthes Hall Hospital, Kirkburton, Huddersfield
11. Allegations relating to four male wards in this Hospital were made by a Male Nursing Auxiliary (now in his fifties and who had no prior nursing experience) against five named Senior Male Nurses; and against many unnamed members of the Hospital Staff (Medical, Nursing and Administrative). The allegations which covered a thirty-two week period, were of serious violent assaults, with fists or weapons, against male patients of all ages, committed by four of the five named Male Nurses; and condonation, indifference and apathy on the part of the fifth Male Nurse; against unnamed Doctors and Charge Nurses, that they colluded and conspired to subject patients to physical violence; and against those responsible for the running of the Hospital—(the Medical Superintendent was specifically excluded on the fourth day of sittings at this Hospital)—that they had a mentality only slightly better than that of those responsible for Belsen Concentration Camp; that the Hospital was like Belsen because it was a “brutal, bestial, beastly place”—it was a “hell-hole”.
12. Quite apart from the fact that there was no documentary or other evidential support or corroboration for any of the evidence of the Male Nursing Auxiliary, who made the aforesaid accusations, we were quite unable to give any credence to his evidence; and, accordingly found none of his allegations against any named or unnamed member of the Hospital Staff to have been proved.
Present Situation—St. James’s Hospital
13. We found: that the standard of nursing in the Hospital, and especially in the Psychiatric Unit, is of a high order ; that the conditions and facilities for nursing in the Geriatric Unit, having regard to the age of the buildings and to the bed-complements of the wards, are sub-standard; that a great deal of hard work is performed, and a great deal of tireless devotion to duty and of kindness is shown by members of the Medical, Nursing and Orderly Staff, as well as by Working Members of two Voluntary Organisations, The Friends of St. James’s Hospital, and the Rosemary Fellowship.
Present Situation—Storthes Hall Hospital
14. Due in no small measure to the quality of the Medical Superintendent, and of the Chief Male Nurse, as well, of course, as of the Senior Nursing Staff, we consider that the atmosphere in the Hospital is vital, healthy and progressive.
Recommendations—St. James’s Hospital
15.St. James’s (North): we recommend: reduction in the bed-complement of the wards in the Geriatric Unit; the provision of better sanitary and day-room facilities ; and a review of the present nursing staff establishment, andaction in the light thereof ;
16.St. James’s (North and South): whereas we do not criticise the present administration of this Hospital, either expressly or impliedly by the making of this recommendation, we do recommend the giving of consideration to the means of co-ordination by which the essential service departments within the Hospital can be most effectively integrated.
Recommendations—Storthes Hall Hospital
17. We recommend a review of the nursing staff establishment; and, in addition, the making of improvements in the methods of selection and early training of those recruited as Nursing Assistant. We further recommend that, wherever possible, bed-complements of wards should be reduced.
(Signed) J. F. S. Cobb, Chairman.
(Signed) H. Slow, Member.
(Signed) T. M. Cuthbert, Member.
(Signed) A. E. McVie, Member. (whose signature is appended to this Report in respect of paragraphs 1, 2, 3, 4, 11, 12, 14 and 17 only; the signatory having been absent due to illness from parts of the Enquiry relating to St. James’s Hospital).
Dated this 13th day of March, 1968.