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Guilty hospital faces large fine

A scandal-hit hospital trust is facing an unlimited fine for health and safety law breaches which led to the death of a diabetic patient.

The Mid Staffordshire NHS Foundation Trust pleaded guilty today to failing to ensure the safety of Gillian Astbury, who lapsed into a diabetic coma while being treated at Stafford Hospital in April 2007.

Magistrates sitting in Stafford committed the case to the town's Crown Court after ruling that their sentencing powers for the offence were insufficient.

The Trust pleaded guilty through its solicitor to breaching the Health and Safety at Work Act by failing to properly manage and organise hospital services, including its systems for record-keeping, patient information and communication between staff members.

The criminal prosecution was brought by the Health and Safety Executive three years after an inquest jury ruled that Mrs Astbury's death was contributed to by low staffing levels and other systemic failures.

The inquest also concluded that the failure to administer insulin to the 66-year-old amounted to a gross failure to provide basic care.

After its guilty plea to one count of failing to discharge its duties under safety law, the Trust submitted to the court that the case could be dealt with by magistrates.

But magistrates ruled that a maximum £20,000 fine was insufficient punishment for the offence, which involved "serious and systemic" failures.

Chairman of the bench Ian Jones told the court: "In making our decision we have taken into account various arguments that have been put forward.

"We considered the seriousness of the actions and the consequences, which resulted in loss of life.

"The defendant's actions fell well short of the expected standards over a substantial period of time.

"The bench have considered both the public interest arguments and the financial arguments put forward."

Mrs Astbury, from Hednesford, Staffordshire, died in the early hours of April 11 2007 while being treated for fractures to her arm and pelvis.

Stafford Hospital has previously been the subject of several highly critical reports, including a full public inquiry, which identified "routine" neglect of patients between 2005 and 2009.

Lawyers acting for the HSE said the "grave" matters should properly be dealt with by a Crown Court judge.

Outlining the facts of the case to the court, prosecutor Bernard Thorogood said Mrs Astbury's carer, Ron Street, had clearly told medical staff that she had diabetes at the start of her 10-day hospital stay.

Arguing for the case should be sent to the Crown Court, Mr Thorogood told magistrates: "Mrs Astbury came into hospital for care and, as a direct result of the defendant's failings, she died.

"The harm caused is of the highest level of gravity - the loss of a life.

"This is the only criminal case to have been brought in connection with the problems which everybody nationally knows about at the Trust.

"There is a public interest in such a sensitive and important matter being dealt with at the most senior level within the criminal jurisdiction."

Mr Thorogood added that the case concerned the exposure of numerous individuals, of which Mrs Astbury was one, to unnecessary risk.

Mrs Astbury, who had mild dementia, was being treated at Stafford after injuring herself in a fall at another hospital.

In the final days of her life, some hospital staff failed to make adequate records and conduct handovers properly, and she was not given insulin.

The Trust, which now faces an unlimited fine, is currently in the hands of administrators.

David Lewis, for the Trust, told JPs that the organisation wished to place on record that it was "very sorry" for the loss, pain and distress caused by its actions.

The Trust was not "awash with cash", Mr Lewis noted, and was running an annual operating deficit of around £11 million.

Sentencing in the case will take place on a date to be fixed.

In a statement released after today's hearing, Mr Street, a close friend and full- time carer of Mrs Astbury, said: " This belated Health and Safety Executive (HSE) prosecution of the Mid Staffs NHS Trust (MST) affords a small measure of justice to Gillian, so far denied to many of her numerous fellow victims of the abject complacency toward patient care evidenced at Stafford Hospital between 2004 and 2009.

"On Gill's behalf, I am grateful. But my personal gratitude is soured by the fact the responsibility to further investigate Gillian's death under terms of the Health and Safety at Work Act was passed to the HSE in January 2010, from the Crown Prosecution Service. Despite the damning inquest jury verdict in September 2010, HSE found, in my opinion, the spurious reason of the Francis Public Inquiry to delay commencing investigations until April of this year.

"The financial fine of the Trust is not the issue, as whatever the level of the fine it will only hinder the hospital which is otherwise trying to get back on its feet.

"My overwhelming concern is that the senior members of the Trust Board, who were responsible for implementing this system of unsafe work at the hospital whilst Gillian was in their care, have never been held to account.

"Today's acknowledgement of guilt by the Trust does little by way of justice against those individuals who permitted such unsafe practices to continue for so long."

Maggie Oldham, chief executive at Mid Staffordshire NHS Foundation Trust, said they had worked to improve the standard of care provided at the hospital since Mrs Astbury's death.

In a statement, Ms Oldham said: "Our thoughts remain with the family and friends of Gillian Astbury and we apologise for the dreadful care Ms Astbury received at Stafford Hospital in April 2007.

"We have been very open and candid and have co-operated fully with the Health and Safety Executive throughout its investigation.

"The Trust offered no defence to the charge which the Health and Safety Executive brought against it today and accepts the court's decision to refer the case to the Crown Court.

"Although of little consolation to Ms Astbury's family, we can assure them that we have done everything we can to put right those things which went so very wrong in 2007 and that the standard of care now provided at the hospital has improved considerably over the last few years, as has been recognised by many independent organisations and individuals."


From Belfast Telegraph