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Going for a Barton


Posted by Dr No on 20 January 2010

goodbye4.jpgLanguage, they tell us on Radio 4’s ‘I’m Sorry I Haven’t a Clue’ is constantly evolving. If Clue should ever find itself down Gosport-way, it would find that ‘Going for a Burton’ - the WW2 euphemism for taking a shufti – has evolved into ‘Going for a Barton’ – meaning admission to the town’s War Memorial Hospital, and subsequent death while under the care of the visiting Diamorphine Queen, Dr Jane Barton.

The ongoing story of the Diamorphine Queen has been well covered by Rita Pal and others, including affected relatives. At its heart, it is one of a unfettered doctor initiating a zealous programme of ‘anticipatory prescribing’ of opiates and other powerful sedatives to patients, whether they needed the drugs or not. The disinhibitory effect of this cavalier prescribing led inexorably to unnecessary deaths. No one knows for certain how many, but the figure runs to tens of not hundreds of affected patients.

Barton, on the face of it, has Shipman written all over her. This, surely, was the kind of meat the revved up patient-patting, doctor-bashing General Medical Council wanted to get its teeth into. Barton would surely herself soon be heading for a Burton.

But – bizarrely – not a bit of it. The Council has been dragging its heels. Concerns about the Diamorphine Queen and her over-zealous prescribing were first raised nearly twenty years ago. Since then, despite the concerns, she has been allowed to continue to practise. A formal complaint to the Council was dismissed in 2002 on the grounds that there was no case to answer.

Only last year – eighteen years after the first concerns were raised – did the General Medical Council finally commence Fitness to Practice proceedings against Dr Barton. Even today – Dr No has just checked – she remains registered and able to practice, with only the most trivial conditions:

• no diamorphine prescribing (no problem - lots of other opiates left to play with)

• diazepam within normally recognised (BNF) limits (ditto – lots of other benzos left to play with).

GMC shafting is a three pronged process. The first involves the Panel deciding whether it finds the allegations against the doctor proved; if they do so find, then the second stage is to decide whether the impairment amounts to serious professional misconduct; and if they do so find, then the third is to decide what sanctions – which can range from nothing to erasure – should apply.

The first prong has already been inserted into Dr Barton. A number of the allegations against Dr Barton have been found proven. We are now at the second stage: was her practice impaired, and if so, to the extent that her it amounted to serious professional misconduct?

Now, the most striking aspect of the GMC’s handling of Barton’s case so far has been their apparent hesitancy in taking forward Barton’s case. Whatever the reason for this tardiness – there has been speculation of an inner protective circle operating behind Council doors – the delay flies in the face of the GMC’s own claim that it’s role is to regulate doctors, and ensure good medical practice

So it will be interesting - maybe even revealing - to see what happens next. To Dr No, the allegations found proven – described in the Notice of Hearing here – are, despite the Council’s mealy-mouthed words – most serious. Will the Council continue to duck its responsibilities – or will this time it be not her patient, but Dr Barton, that goes for a Burton?

2 comments:

I have been following the case of Dr. Barton and am more than dismayed in finding out that patients who were not dying were injected with very high doses of morphine via a syringe driver. In one case the loading dose was 135mgs. morphine.

These patients, from what I know were elderly, receiving a state pension and not contributing financially to the state.

On the other hand in my fathers case, he was dying and NEEDED a little bit of morphine to relieve his anguish but was refused this. His syringe driver held only 10mgs. And it was never titrated/gradually increased in the 55 hours that it was in situe.

Is this a financial thing?

Kill off the elderly, and those that are going to die anyway, don't waste NHS funds in administering appropriate terminal sedation?

TomsAnguish

Two important themes come together in Barton:

(1) whether an "inner circle" of protected (from GMC action) doctors exists. Dr India gets it in the neck; Dr Wasp flies off free. Or not: that is why this case is important - because of the message it will send out.

(2) The over-zealous use of opiates and benzos to "clear the departure lounge". If the GMC don't find Barton guilty of Serious Professional Misconduct, then the message is clear - over-zealous prescribing is OK in their book...