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94-Year-Old Becomes Case Study in British Health Care Woes


By: Sarah Lyall
New York Times, January 26, 2002


LONDON, Jan. 25 — The details of 94-year-old Rose Addis's long and unhappy stay in the emergency ward of a crowded London hospital earlier this month are already irretrievably murky, lost in a fog of claims and counterclaims.

But in the last week, Mrs. Addis has been transformed from an elderly woman with a cut on her head to the star of a boisterous political drama whose elements may or may not include medical neglect, racism, opportunism and widespread lying with a straight face. However inadvertently, she has become the latest high-profile example of the problems confounding Britain's creaky National Health Service.

It is hard to keep track of who said what in this war of words. But Mrs. Addis's family has accused the hospital in question, Whittington in North London, of mistreating and slandering her, and the government of invading her privacy. The hospital has accused the family of not getting its facts straight. The prime minister, Tony Blair, has accused the Tory Party of denigrating the National Health Service. Iain Duncan Smith, the Tory leader, has seized the moment to say that Mrs. Addis was treated worse than "a dog."

The mini-scandal began, as so many do here, in the pages of a newspaper. Earlier this week, The Evening Standard printed an article describing how Mrs. Addis — who arrived at Whittington Hospital with blood pouring from a head wound, the result of a fall — was found by her daughter in a chair in her emergency room cubicle 48 hours later, confused, unwashed and still wearing the clothes she had arrived in, now caked with dried blood.

Unfortunately for Mr. Blair's Labor government, such accounts are a dime a dozen these days (though they only rarely take on the dimensions of this case). The National Health Service is universally acknowledged to be underfunded and overstretched, and the chief complaints against it include neglect of elderly patients and long, doctorless waits in squalid emergency rooms. Newspapers like The Standard, which covers London, and The Daily Mail, a Labor-hating tabloid, habitually write articles offering particularly outrageous cases.

The government hates it when that happens, saying that it is pouring billions of pounds into improving the service and that it is not fair to treat individual cases as emblematic. But patients often say that when things go badly, the only way to focus the government's attention is to complain to the news media.

"People are tired of the long waiting lists, operations being canceled, and the situation in the accident and emergency wards," said Katherine Murphy of the Patients' Association, an advocacy group. "They feel if they complain and go to the press, something will be done."

Mrs. Addis's case struck a particularly sensitive political nerve. It also presented what seemed a perfect opportunity for Mr. Duncan Smith to score political points against Mr. Blair. Rising angrily to his feet in Parliament, Mr. Duncan Smith declared that Mrs. Addis's daughter had told him, "If my mother had been a dog, she would have been treated better."

By now two more aggrieved Whittington patients had come forward: a 13-year-old boy whose parents said he had to wait eight and a half hours to see an emergency-room doctor, even though he had a raging fever and a rash, possible symptoms of meningitis; and an 88-year-old man whose niece said she found him covered in vomit and excrement after a five-day hospital stay precipitated by a bad fall.

But not all was how it seemed, at least according to Whittington. Backed by government officials — one of whom called the families' accounts "fiction" — the hospital said the patients had received proper attention, even if the circumstances had not always been optimal.

In the case of Mrs. Addis, the hospital said it would have been unwise to wash her hair during her hospital stay because she had stitches in her head. And it said she was still wearing her bloodstained clothes when her daughter arrived because she had refused help from "certain" staff members — the implication being that she did not want to be treated by black nurses.

After that, all bets were off. Mrs. Addis's family accused the hospital of unfairly implying that she is racist. The Tories accused the government of cynically revealing confidential patient details for political gain, and disclosed that Whittington's medical director was a Labor Party member who handed out pro-Labor leaflets in the 1997 election.

Officials at Whittington accused the Tories of "cheap playground bullying." As for the prime minister, a speech he gave today expressing the government's commitment to improving public services was all but drowned out in the furor over the Whittington situation.

Mr. Duncan Smith did not get off scot-free, either, when it emerged that he had spoken publicly about Mrs. Addis without hearing the hospital's account. But even in the face of ridicule — "Iain Duncan Smith has been a complete fool," The Guardian said in an editorial — the Tory leader was unrepentant.

"I will always stand up for this sort of patient who has had an abuse," he told the BBC. "The simple fact is this: there is nowhere for them to turn." For good measure he added, "I think the general public will back me."

Somewhat belatedly, the British Medical Association urged both parties not to use patients as pawns. That came too late for the family of James Scott-Falkner, another of the Whittington Three, as The Daily Mail is calling them. James is the 13-year- old who waited to be checked for meningitis (he did not have it).

"I am not really amused about the high-level political Ping-Pong that has been going on," said James's father, Nigel Scott. "It is diverting from the problem of a hospital without enough staff. I would like to see what Tony Blair would say if he came to hospital with his son and had to wait for eight hours to see a doctor."

Of all the players in this drama, the only one who evokes much sympathy in the end is Rose Addis, whose case touched things off. She has been widely pictured in the newspapers wearing what appears to be a nightgown and looking frail and scared, with a cut on her forehead and a vacant, lopsided expression.

"In my opinion," Pat Martin, of Halifax, West Yorkshire, wrote in a letter to The Guardian, "questions have to be asked about what sort of family supplies photographs of their elderly relatives, wearing night clothes, to a newspaper."

 


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