DIARY

    Tom Good evening Dr York, thanks for speaking to us tonight. I�m sure you�re very busy in the Casualty department normally so we appreciate you finding time for us.

    Dr York(smiling) That�s not a problem Tom, my colleagues will be working hard back at St Jude�s.

    Tom Well, we organised this interview to talk about the accident black spot by the new cinema complex but I�m sure you�ll understand if we begin by talking about the breaking news story out of St Jude�s today. As I�m sure you are aware, the Health Watchdog have released their report in to the tragic case of Penny Green, a young lady who was sent home from your Casualty department and later died of meningitis. Have you any comment?

    Dr York(surprised) Eh, we�ll Tom, as you say I�m not really here to talk about that case, besides which I�m not comfortable discussing the details of individual cases in a public forum.

    Tom I hope you�re not trying to hide behind a claim of patient confidentiality, the case is in the public arena now and people will want answers.

    Dr York(calm) Tom, I�m not trying to hide anything and have taken part in the enquiry in to the case at every stage but I still don�t think it is appropriate to discuss this case in this way. The public trusts us to maintain confidentiality and that is what I will do unless instructed otherwise by Miss Green�s family.

    Tom That�s a laudable attitude doctor, but unfortunately the public cannot trust your department to make a simple diagnosis of meningitis in a young lady. A tragic error that resulted in her death.

    Dr York I�m really not comfortable talking about this now.

    Tom I�m sure you�re not, doctor, but you are in charge of a department that has made a fatal error and the public in Jaemtown want to know why this happened and how you will ensure it doesn�t happen again. One presumes that the doctors involved will no longer be working?

    Dr York I think it is unlikely that anyone will be loosing their jobs Tom. We all can make mistakes in any job and being a doctor is no different, I�m sure you�ve made mistakes in your line of work.

    Tom I have, yes, but I�ve never killed anyone because of one! Every parent in the country is aware of what to look out for in meningitis, why is it that your doctors can�t manage what the general public can!

    Dr York Making the diagnosis of meningitis is not always as simple as the media make out. It can be very difficult to spot the difference between early meningitis and a dose of �flu or a urine infection for example.

    Tom That may be the case, but I understand in this case the young girl�s mother knew that there was something wrong and your doctors ignored her pleas for help. Is this normal practice, to ignore the concerns of a parent?

    Dr York(irritated) That�s unfair, Tom. We are always careful to listen to parents concerns but we cannot admit every patient who presents with a temperature or who is unwell just in case they have meningitis. We have to try and be a little more focused than that but unfortunately, despite careful practice, there is always the risk that a patient will be sent home with early meningitis.

    Tom So you admit that you are taking risks with the children of Jaemtown, sending them home without excluding meningitis?

    Dr York(irritated) Again, Tom, that�s unfair. We make a diagnosis on the balance of probabilities and if we discharge a child we rely on the parents seeking further help if the patient deteriorates.

    Tom So you are blaming Mrs Green for her daughter�s death, that is quite a statement Dr York.

    Dr York(angry) That is not what I said and you know it Tom! Our doctors do their best in very difficult circumstances and unfortunately a tragic mistake happened, if I could change that I would. I have every sympathy for the family of Penny Green but unfortunately this type of incident will sometimes occur despite all our efforts. I do not think there is anything to be gained from continuing this interview at this time but once I have had a chance to read the report fully and discuss it with my colleagues I would be happy to speak to you.

    Tom Once you have your story straight, thank you Dr Elizabeth York. So there you have it folks, Dr York insists these things just happen, what do you think? Are you happy with doctors who make educated guesses about our children�s health? Phone us with your views or e-mail us at the usual address.

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CORRESPONDENCE

Dear Mr Chancer,

Thank you for your letter of 3^rd June in which you allege an assault by one of the Accident & Emergency staff upon yourself. Following your complaint we have had the opportunity to investigate your claim further as you suggested. I am now writing to inform you of our findings.

We confirm that an incident took place on the night in question and that one of our staff nurses felt the need to remove someone from the A&E waiting room. This course of action was taken to prevent injury to the patients waiting to be seen as it was felt a fight was about to break out between two groups of men. Staff on duty that night recall the incident clearly and state that our nurse politely asked the men in question to calm down or to leave the department. At this time one of the men was seen to square up to the nurse and become verbally aggressive. The exact content of the outburst involved a number of profanities but essentially questioned the ability of the nurse to remove him from the department. Further more there was a strong suggestion that this man was intending to attack the nurse in an attempt to teach him a lesson. It was at this point that our nurse performed a standard restraint and removed the man from our department.

As you were not booked in as a patient we cannot confirm that you were there that night but if this incident is familiar to you then we would be happy for you to be identified by our member of staff as the man involved above. You should be aware that this hospital has a policy of prosecuting anyone known to have committed any act of physical or verbal abuse against a member of staff on duty. This is in accordance with the national policy of zero tolerance towards assault on healthcare workers.

I look forward to hearing from you if you are able to help us further.

Chief Executive

St. Judes

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Dear Dr York,

Re: Capital project for modernisation of the A&E Department.

Following our meeting I can confirm that we have received written confirmation of a �2,000,000 capital grant to re-engineer our emergency services. It has been made very clear that this must enable the Trust to meet the emergency care targets in the NHS plan. There must be a strong emphasis on streaming for minor injuries and on the swift management of patients requiring admission. I have asked Mr. Robert Builder, the Director of Finance to convene a small working group to take forward the project as quickly as possible. We have been told that the money project must be finished in 18 months.

I am sure that you will wish to take a full part in this project.

Chief Executive

St. Judes

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