Dying Without Dignity: a report on end-of-life care that shames the NHS

The name says it all. ‘Dying Without Dignity’ is the parliamentary health ombudsman’s report into over 300 complaints of the neglect of terminally ill patients by the NHS.

The BBC this morning highlights two horrible examples. One mother had to call an A&E doctor to come and give her son more pain relief because staff on the palliative care ward he had been on had failed to respond to her requests.

A 67-year-old man’s family learned of his terminal cancer diagnosis through a hospital note – before he knew himself. This ‘failed every principle of established good practice in breaking bad news’, says the report.

Julie Mellor, the ombudsman, uses uncompromising language:

‘Our investigations have found that patients have spent their last days in unnecessary pain, people have wrongly been denied their wish to die at home, and that poor communication between NHS staff and families has meant that people were unable to say goodbye to their loved ones.’

The Department of Health has acknowledged that these are shocking cases, but its statement is not very reassuring:

The five priorities for end of life care we brought in emphasise that doctors and nurses must involve patients and their families in decisions about their care, regularly review their treatment and share patients’ choices to make sure their wishes are respected. NHS England is working on making these priorities a reality for everyone who needs end-of-life care.

‘Working on making these priorities a reality’ is jargon. It’s the language of an organisation that faces systemic failure in this area. People die of a huge range of diseases and conditions, so we can’t point the finger at therapeutic failure in just one area of the NHS.

The report identifies bureaucratic blunders; incompetence in pain management; the insensitivity of doctors; and sheer callous laziness on the part of nurses who are too busy to deal with patients in agonising pain.

And all this at a time when nurses are threatening industrial action if their pay and conditions are threatened by Tory reforms – a warning that health secretary Jeremy Hunt describes as ‘ridiculous’.

Mr Hunt was appointed to his position in 2012 and has kept his job in the new government. Perhaps it’s time for him to join the dots between the stroppiness of the nurses over pay and conditions and some (though obviously not all) of the failures identified in ‘Dying Without Dignity’.

As innumerable family members of desperately ill patients will tell you, for every cheerful, efficient and compassionate member of the ward staff there is someone with an attitude problem – that is, someone who should never have been appointed in the first place and should have been sacked long ago. That, surely, is one of the fundamental problems identified by the ombudsman’s report. Platitudes about ‘best practice’ will get us nowhere while the NHS refuses to recognise this fact.