Note from Robin on 8th January 2004: today I received the reply from Beverly Malone, dated 5th January 2004, to my letter below dated 28th April last year. I was a little confused by her "Thank you for your recent undated letter" (see below), but her letter went on to respond in detail, in a most positive manner, to point (1) below. On point(2) there is, as to be expected, less detail, and only the words, "I have looked into the second matter you raise and am satisfied that the RCN provided assistance to its members in this instance. Good quality patient care is at the heart of professional nursing practice and the RCN continues to support its members in all areas to promote this". I made regular 'phone calls, typically every month, to ask if the reply had been sent - since it may have been "lost in the post". On each occasion they were able to find my letter below, and I was assured that a reply would be sent. Perhaps in nursing there is something magic about waiting 9 months for something ? :-) If the RCN give permission for the whole text of the reply to be published, then it will appear on this page.
Note from Robin added on 17 February 2004: today I received a 'phone call and then an email from Miles Kennett, Organisational Development Project Adviser at the RCN. He has kindly provided permission for the reply to be published here and provided the text by email. You may now read it below.
22 Armitage Court, Sunninghill, Ascot, Berks SL5 9TA.
Tel/Fax 01344 620775
Our Ref: RCN1.RTF 28th April 2003
www.NHSCare.info (public information to all)
www.NHSCare.info/EvelynLovelock (now public)
Dr Beverley Malone, General Secretary, Royal College of Nursing,
20 Cavendish Square, London W1G 0RN
Copies to: "Eve Lovelock's Care" File, Web sites, Others as required.
Dear Dr Malone,
Subject: Care of Mrs Evelyn Lovelock and www.NHSCare.info
I have two reasons for contacting you, both of great importance to your members:
1) to provide you with information related to the publicity you may have seen in all the media when the NHS Ombudsman's report was published. This relates to what has been described as a £10 billion fraud by NHS and Social Services in getting families to pay for long term nursing care. You will find both simple to understand and detailed information on this subject on the web site www.nhscare.info. It is important that your members are aware of this subject since it may effect all of them, particularly if they are involved in the care of old people or those about to be discharged from an NHS Hospital into a nursing home. It is important that they do not find themselves implicated in any unlawful acts. They may also wish to make use of the amnesty explained on the web site.
2) I enclose my recent letter to the Ombudsman which includes a paragraph mentioning the Royal College of Nursing. I quote the paragraph from my letter:
"My work in speaking with others related to nhscare.info has uncovered evidence of what can only be described as "institutional manslaughter, murder or genocide". Please forgive what may sound extreme language: I will explain. I have informed both local police and New Scotland Yard special crimes unit that information is available on both unlawful activity which may already be categorized as criminal. e.g. major fraud and/or conspiracy. Falsification of medical records obviously can put the patient's health at risk, possibly even their life. However, the manslaughter term above applies to a practice that I understand may have been widespread within NHS hospitals and may even still happen today: the decision, without consultation of the patient or their family, to put up a "Nil by Mouth" sign above their bed, when they have no other source of food or water such as a drip. The result, of course, is that the patient dies within a few days, thus freeing the hospital bed for others. I understand that the Royal College of Nursing arranged that the rules permitting this practice were changed, since it was a source of conflict between junior nurses, responding to a patient's request for water, and the senior staff who had decided to put up the "Nil by Mouth" sign. I understand that this subject is outside your jurisdiction, as is any investigation on conduct of the Department of Health. However, I will be happy to put you in contact with the appropriate individuals if needed. Having put this topic on public record, I do not require you to pursue it: I see it as a "police matter" and will be happy if you confine yourself to the issues within NHSC4."
I shall be most grateful if you can provide me with more information on this subject.
(son of Evelyn Lovelock and executor of her estate)
text of reply from RCN follows:
Royal College of Nursing
20 Cavendish Square
Beverley Malone RN, PhD, FAAN
Telephone 020 7647 3778
Fax 020 7647 3434
5th January 2004
Dear Mr Lovelock
Care of Mrs Evelyn Lovelock and www.NHSCare.info
Thank you for your recent undated letter. As you have gathered from speaking to my staff, we have been looking into the matters you raise.
The RCN was very pleased that the Ombudsman report received such wide publicity. This report from the Ombudsman will be worrying for both nurses and patients. In general, people who need long term care are older people. The trauma and upheaval of moving from their home to a new environment at a time when they are frail and vulnerable is significant. Nurses want to assist the care of these people, without having to deal with the anxiety that the sale of a home to fund their care brings.
The RCN was a part of the Court of Appeal hearing to assert that all nursing care should be funded by the NHS. In the event, the Court of Appeal ruled wider than this. They stated that where the need for the accommodation was a health need, far wider than a nursing need, then the whole package should be funded by the NHS.
The RCN carried out a review of the eligibility criteria that were being applied across England and Wales in 2000. This found that 90% of Health Authorities were acting unlawfully in the way they assessed people for funding for long term care. It is worrying that the report from the Ombudsman shows how little has changed. It is no comfort for patients and their families to know that a complaint to the Ombudsman is needed to ensure that the right approach is taken to funding health care.
It is a matter of concern for our members that there is confusion about what aspects of health care are being funded by the NHS in care homes. The RCN has responded to the Department of Health consultation on the amendment to the continuing care regulations and will continue to work with the Government on this issue.
I have looked into the second matter you raise and am satisfied that the RCN provided assistance to its members in this instance. Good quality patient care is at the heart of professional nursing practice and the RCN continues to support its members in all areas to promote this.
Beverley Malone RN, PhD, FAAN