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>From www.wsws.org
WSWS : News & Analysis : Europe : Britain
Five-fold increase in deaths from drug prescription errors in
Britain’s hospitals
By Mike Ingram
3 January 2002
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A report by the Audit Commission—a government-appointed watchdog that
monitors health and local government standards—notes that 1,100
people died in hospital from medication errors and adverse effects
from medicines in 2000. This was more than a five-fold increase on
the 200 deaths in 1999.
The commission paints a devastating picture of the way medicines are
managed in Britain’s hospitals. In addition to the tragic human
costs, the problem is costing the National Health Service (NHS) £500
million a year in l
onger hospital stays.
In one hospital, a cancer drug was over-prescribed by 1,000 times the correct dose.
Other errors detailed include a woman with breast cancer who was prescribed the
sleeping tablet temazepam rather than the correct drug ta
moxifen.
As well as the increase in such “accidental” deaths, the report says the most common
cause of problems with patients is complications arising from medication. “Most errors
are caused by the prescriber not having immediate
access to accurate information about either the medicine —its indications,
contraindications, interactions, therapeutic dose, or side effects—or the patient’s
allergies, other medical conditions, or laboratory results.”
Recommending the increased use of computer technology, the report says hand-written
prescriptions or patients’ notes contribute to the errors, as they can be illegible,
incomplete or use inappropriate shorthand. “Many err
ors could be eliminated through the use of computer technology—a national approach is
needed to introduce these systems,” the report states.
Also pinpointed is insufficient medical training regarding drugs; errors were most
likely to happen when new doctors began work in hospitals. The report states that
7,000 individual drug doses are administered each day in
a typical hospital, and estimates that spending on medicines runs at £1.5 billion a
year—46 percent of total hospital running costs. Pharmacy costs amount to a further
£300 million per year.
The commission insists, “Medicines are now so central to patient care that pharmacy
services need to be seen as a core clinical function, not a technical support
service.” But as with every other area of health, the NHS i
s extremely short of pharmacists. The report found that one in six posts were
currently vacant and “one half of all hospitals in the UK are unable to provide all
their intended pharmacy services because of staff shortages
”.
The report is only the latest in a string of such documents highlighting one or
another crisis in the NHS. Whether it is longer and larger waiting lists, rising
deaths from mistakes in surgery, or drug errors, the underly
ing cause is one and the same. Firstly, the NHS was systematically starved of funds
throughout 18 years of Conservative governments and, secondly, nothing substantial has
been done to reverse this trend since Labour came
to office in 1997. Rather the problem has been compounded by the government’s
insistence on imposing targets for the numbers being treated at a time when services
are being either starved of funds or sent out to tender in
the private sector.
To reverse the spiralling trend in unnecessary deaths in hospitals and provide an
adequate health service for all requires the massive injection of public funds. This
would mean launching a programme of recruitment and tr
aining, to substantially increase the number of doctors and nurses, as well as
enabling the building of a modern IT infrastructure, with a patient’s medical history
available to all medical staff at the touch of a button.
Instead, the commission proposes to tackle staff shortages through the introduction
of “more flexible working patterns” and “redesigning and enriching jobs to focus on
clinical pharmacy.” However, the prerequisite for th
is is that the present low wage rates within the NHS are raised substantially.
The report also calls for the introduction of automated dispensing and the outsourcing
of “non-core services, such as manufacturing.” Outsourcing invariably means further
privatisation, eating into NHS budgets and placing
the onus on private health care corporations to cut costs in order to maximize their
profits, often at the expense of patient care and safety.
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