‘Dr Opiate’ and the drugs that killed hundreds

“Do no harm”: Barton worked part-time at the hospital between 1988 and 2000. © Getty

What should happen to Dr Jane Barton? Yesterday an inquiry found her responsible for prescribing powerful drugs which “shortened the lives” of hundreds of patients in Gosport over 12 years.

“Please make comfortable,” wrote Dr Jane Barton when an elderly woman arrived on her ward at Gosport War Memorial Hospital in August 1998. “I am quite happy for nursing staff to confirm death.”

The woman was 91-year-old Gladys Richards, admitted to the hospital after a successful hip operation. She was walking, and Barton’s notes say that she was not in any pain. And yet she was given diamorphine, a powerful, opiate-based painkiller generally reserved for extreme cases.

A few days later she was dead.

The hospital told her family that she had died of natural causes, but in 2013 an inquest found that the drugs prescribed by Barton had contributed to her death.

Now we know that she was not alone. Yesterday an inquiry found that 456 patients at the hospital had died due to “dangerous doses” of the medication for no real reason.

Around 200 more patients may have been affected, but their medical records are missing.

The inquiry’s chair, Bishop James Jones (who also led an inquiry into the Hillsborough disaster), said there had been a “disregard for human life” and a “culture of shortening the lives” of patients, many of whom came in for rehabilitation.

Dr Barton may now face criminal charges. But Jones’s report did not stop there. It said that nurses had raised objections in 1991, only to be “ostracised”.

Barton was investigated several times, but the General Medical Council (GMC) did not bar her from working as a doctor, despite finding her guilty of “multiple instances of serious professional misconduct”. The families of people who died were dismissed by police as “troublemakers”.

Yesterday, in the House of Commons, Prime Minister Theresa May and health secretary Jeremy Hunt both apologised for the “deeply troubling” events.

“Had the establishment listened when junior NHS staff spoke out, had the establishment listened when ordinary families raised concerns,” Hunt said, “many of those deaths would not have happened.”

Now what?

Doctor death?

Dr Barton should go to jail, say many of the families involved. She oversaw a practice which ended with hundreds of early deaths. Some people have even compared her case to the notorious serial killer Harold Shipman, a GP who used the same drugs to kill at least 200 people throughout his career. After all this time, justice should finally be served.

That comparison is unfair, argue others. Senior doctors, the police, the GMC and coroners all failed to take the families’ complaints seriously. Barton is no murderer; she said she was doing her best for patients, and two earlier investigations said there was not enough evidence to prosecute her. She cannot shoulder all of the blame when the entire system is broken.

You Decide

  1. Should Dr Barton be prosecuted for the deaths of her patients?
  2. Which is worse: the actions of an individual, or an institution that ignores those actions?

Activities

  1. Imagine you have a short interview with Dr Barton. What three questions would you ask her about what happened?
  2. Research the effects of diamorphine and produce a short report on how and when it should be used.

Some People Say...

“Whenever a doctor cannot do good, he must be kept from doing harm.”

Hippocrates

What do you think?

Q & A

What do we know?
Dr Barton was a part-time clinical assistant at the hospital for 12 years. While there, she signed 854 death certificates. An earlier review (in 2003) found that 94% of her patients received opiates. Although yesterday’s report acknowledged that she was responsible for prescribing the drugs and that the drugs shortened the lives of patients, it did not suggest that she meant to kill anyone.
What do we not know?
Whether she or anyone else will face criminal charges. Back in 2010, she insisted that “throughout my career I have tried to do my very best for all my patients and have had only their interests and wellbeing at heart.” In 2002, her husband told The Sunday Times that “it might be more constructive to ask why a part-time GP was looking after 48 beds” at the hospital.

Word Watch

Diamorphine
A powerful drug, similar to heroin, derived from opium poppies. (See below.) It is used to treat moderate and severe pain. Although it is dangerous in large amounts, it can be used safely by doctors.
Opiate
A drug which comes from opium poppies. Some — such as codeine, morphine and fentanyl — are used for medical purposes. Others, such as opium and heroin, are illegal.
Hillsborough
In 1989, at a football match at the Hillsborough stadium in Sheffield, 96 Liverpool fans were killed in a crush due to overcrowding. It took many years for the resulting police cover-up to come to light, and for the deaths to be acknowledged as the result of negligence.
Criminal charges
Doctors can be prosecuted for gross negligence manslaughter if their mistakes lead to the death of a patient. It was not the place of the inquiry to recommend whether this was necessary; that is the job of the police and Crown Prosecution Service.
Harold Shipman
A GP who was convicted for 15 murders in 2000. It is likely that he killed at least 200 more people by giving them diamorphine, often in their homes.