By JOHN ROBERTSON
An elderly man whose complaints about poor care forced NHS Shetland and the Scottish Ambulance Service to improve their practices has called for control over ambulance call-outs to be returned to Shetland instead of Inverness.
Retired Sullom Voe worker Stan Renwick, 78, of Leog, Lerwick, had five complaints about the poor treatment of his disabled wife Eileen, 80, upheld by the ombudsman last week, forcing apologies from the local NHS and the ambulance service.
He believes the Scottish Ambulance Service is more interested in saving money than people’s lives and he backs the community’s call for the return of a second emergency ambulance to avoid any repeat of recent incidents where Shetland’s only ambulance was unavailable because it was on another mission.
The Renwicks have been in the news because of the events which started in June 2006 after Mrs Renwick’s feed tube blocked one night at the Edward Thomason House care home where she lives. She is confined to a wheelchair after a stroke and is unable to speak or swallow.
Her problem sparked a series of calamities involving human error and system failures: the couple were left waiting for an ambulance that took four hours to arrive; Mrs Renwick had to go 20 hours without food or water and to end a very bad day there was no patient transport ambulance to return her home from hospital because it was after 5pm.
Two weeks later she was discharged from hospital by taxi to the wrong care home after Mr Renwick had been told she would be kept in hospital overnight. Later, she was expected to get from Lerwick to Aberdeen hospital herself on a normal flight.
After complaining to the organisations about their errors Mr Renwick turned to the Scottish Public Services Ombudsman for redress instead. “I just thought I was getting the run-around,” he said.
He suspects there are more people in Shetland who have endured unacceptably poor NHS service without complaining at all, let alone going as far as the ombudsman, who makes investigation findings public. After 34 years living in the islands he appreciates locals often do not like making a fuss. “Most Shetland people are placid and don’t like to complain about life. But sometimes you have to complain.”
On Tuesday he told their story once more, having been at the centre of national media glare last week and on the front page of The Shetland Times. The couple are not too enamoured of all the attention but had decided to waive their right to anonymity to help ensure that the NHS shortcomings were highlighted.
“I don’t mind as long as something good comes out of it,” he said. “You get publicity in the hope that it will benefit other people and try to prevent a repetition.”
Sitting in his wife’s spacious single room in ET House, as he does for over five hours every day, Mr Renwick is enthusiastic about the level of care she gets in the council-run home. It is also worth stating that the couple have had no problems with NHS services in Shetland since the unfortunate incidents nearly three years ago.
You hear claims that some elderly people move to Shetland to take advantage of the modern, highly subsidised care homes but that is far from the truth in the Renwicks’ case. They arrived in 1975 before the terminal at Sullom Voe was even built, living first in Mossbank then Vistavird in Brae. He was an inspector for the Ninian pipeline, which began production three years later. As he said: “I came to start the oil off.”
At first, workers’ wives were not allowed to get jobs at the terminal but the rule was later relaxed and Mrs Renwick got work in security administration, having been a private secretary in business before.
She laughed at the suggestion that they have lasted a long while in Shetland and points at a photo on the wall of the happy couple in their prime. They came from the Victorian seaside resort of Saltburn-by-the-Sea, near Middlesbrough, which, incidentally, is home to the Zetland Hotel, a once-famous and plush railway hotel which has now been converted to luxury flats. In her day she was a passionate angler, both sea fishing and loch fly-fishing, and displays some prize flies on her room wall along with family photos, including one of their daughter Jean, and pictures of seals and other animals. She loves wildlife and while she may be unable to enjoy the outdoor life much these days she devours nature documentaries on TV and DVD.
They retired in 1990 and built a house at Scatness at the Ness before she became ill in 2004 and went into care. When he was no longer able to drive he moved to Lerwick. Although partially paralysed and unable to talk, she is still very animated and quite nifty with her wheelchair, easily navigating the bright corridors of the home. He still gets about without a walking stick despite having had a stroke himself, which has affected his speech.
This week he was brandishing a letter which arrived on Saturday from NHS Shetland chief executive Sandra Laurenson offering her unreserved apologies along with an invitation to meet him to discuss the various actions taken to avoid any repeat of the “care failures”. He intends taking up the offer.
It has taken the ombudsman a very long time to deliver the results of the investigation. When they involve medical matters and more than one organisation it seems delays are inevitable. Last week’s findings dealt a blow to the reputations of both the Shetland NHS and the Scottish Ambulance Service. Both said they had taken on board the criticisms and had acted on them. “I’m pleased with the report,” he said. “It does vindicate me and my complaint.”
Despite the passage of time he still feels strongly about the way his wife was treated. He reserves his strongest criticism for the ambulance service. The order to pick up his wife from ET House had been placed at the request of a doctor at the Lerwick Health Centre and while it was for a “routine” call-out, allowing up to four hours to complete, the ambulance team less than a mile away in Lerwick was not busy at the time and could have come immediately. Instead, the emergency medical dispatch centre in Inverness failed to inform the Lerwick team of the request until the couple had been waiting nearly four hours.
He had expected the ambulance to arrive pronto, perhaps the same as most people would, and he was never told it might be hours, despite phoning the ambulance controller twice to ask what was happening when no ambulance had appeared.
When the crew did arrive they had not been told about Mrs Renwick’s battery-powered wheelchair and could not take it in the ambulance. She had to be transferred to a stretcher instead. Mr Renwick is not sure why she could not be taken in her wheelchair, given that it has a solid-cell battery, not one which might have posed the danger of an acid spill. The ombudsman was told that crews were not expected to take the wheelchairs because of difficulties with manual handling.
Mr Renwick’s dim view of the service was not helped when his wife was ready to go home from accident and emergency a few hours later – the patient transport service had packed up and gone home at 5pm, leaving him to track down and pay for a special taxi which was able to carry his wife in a borrowed wheelchair.
While the locally run NHS has made improvements since he complained he does not hold out the same hope that the Edinburgh-based ambulance service will honour its pledge to do so. “I don’t think you and I can do much about it. They have already decided what they are going to do. They are about number-crunching and saving money, not people’s lives. Don’t get me wrong: the ambulance crew are a great bunch and couldn’t be more helpful. They are let down by a bunch of bureaucrats whose geography was sadly neglected.”
He believes it might take a major incident to highlight the shortcomings of running just one emergency vehicle in Shetland. “One day there is going to be a big accident – either a plane crash or a ship in distress – and they won’t be able to supply ambulances.
“Until the whole issue is sorted, I and many others in Shetland have little faith in the Scottish Ambulance Service – a service it is not. It should be controlled within Shetland and not from the mainland hundreds of miles away.”
The service has since changed the way it handles doctors’ calls for ambulances but the ombudsman has ordered it to prove that its responses, and the appropriateness of its responses, have improved.
The Renwicks’ problems relating to NHS Shetland rather than the ambulance service include the lack of attention to Mrs Renwick’s welfare after she arrived at the accident and emergency unit of the Gilbert Bain. She waited an hour and a half before the surgeon came to clear her stomach tube. Mr Renwick recalled that a doctor had been unable to correct the problem and had to wait for the surgeon to finish whatever work he was doing first. He was annoyed because staff in the unit paid no heed to his protestations that his wife had not had any liquid or food since midnight the previous night. “The comment passed over their shoulder as if I never said it. It’s as if they didn’t attach any importance to it.”
The medical expert who looked into the matter for the ombudsman concluded that there was no reason why Mrs Renwick should not have been given liquids by some other means, perhaps by a drip, which suggested poor assessment by staff. Nursing staff told the ombudsman they would have weighed up the potential problems of giving intravenous fluids against the prospect that the tube was soon to be unblocked.
Two weeks later when she was taken to hospital again he was told she would be kept in overnight and he went off to get her nightclothes. He was still in her room at ET House and happened to look out the window and saw her being delivered by taxi to the wrong care home – Taing House next door. Mr Renwick had to intervene and bring her back to ET. “It left her rather distressed,” he said.
A month and a half later she needed to go to hospital in Aberdeen to have her tube replaced. She was expected to make her own way to the airport and travel on a normal fight without an escort. “I was so furious I went over to health board and asked to see a doctor about it.”
Summing up what he called the “blunders one after another” he said: “Everything surprised me about the whole thing. I hope now that NHS Shetland can see the errors that are happening daily and not just a one off.”
The controversial issue of a second ambulance is to be discussed by the NHS Shetland Board at its meeting this month.
A spokesman for the ambulance service would not be drawn on the detail of Mr Renwick’s claims. He said yesterday: “We have apologised to Mr Renwick and we have improved our procedures in line with the recommendations of the report to ensure their is better communication.”