Doctor defends drugs policy at deaths hospital

GMC Gosport hearing told: 'I was aiming to ensure the maximum comfort and dignity for my patients'

The doctor at the centre of almost 100 suspicious deaths at a Hampshire hospital said last week she routinely pres-cribed large doses of painkillers and sedatives because she "didn't want any of her patients to suffer unnecessarily".

Dr Jane Barton does not accept that the medication she prescribed to 12 patients at Gosport War Memorial Hospital between 1995 and 1999 contributed to their deaths, the General Medical Council was told. These patients came to Gosport either at the end or near the end of their lives, she said. They died because of their underlying medical problems, despite what relatives may have been told about the possibility of rehabilitation by other hospitals.

The GMC's Fitness to Practise Panel is investigating allegations of professional misconduct in relation to 12 elderly patients who died under Dr Barton's care between 1995 and 1999.

She rejected criticisms levelled at her during previous weeks of the hearing by a medical expert, Professor Gary Ford, some former colleagues, and relatives of the dead. The hearings heard she prescribed patients high doses of powerful painkillers and sedatives for no justified reason, contributing to their deaths – something she denies.

Dr Barton said: "It is quite inappropriate that a person should have to suffer. I was aiming to ensure the maximum comfort and dignity for my patients; this was not for my or the nurses' convenience."

When asked about her habit of anticipatorily prescribing diamorphine and the sedative midazolam, Dr Barton told the hearing: "Patients could have been with us a very short time when it became apparent to you clinically that they were reaching the end of their life ... this is not something you can measure or put into guidelines."

Dr Barton described oromorph [oral morphine] as a "very user-friendly drug" adding that in those days: "We were not as frightened of opiate use as we are now".

The Gosport GP said she'd felt "ideally suited to look after elderly patients at the end of their lives" when she took on the part-time hospital post in 1989, but by the time she resigned in April 2000 she was "sustaining an excessive and dangerous workload" because the patients they looked after were much sicker.

The panel saw copies of letters sent by Dr Barton to hospital managers at the beginning of 2000 about her concerns. By this point the police were already investigating deaths at the hospital as attempted murder.

After she resigned from Gosport, Dr Barton voluntarily agreed to stay away from the hospital and stopped prescribing opiates and benzodiazepines in her GP practice after she faced investigation by the NHS trust under the failing doctors' procedures, the panel was told. The trust would not confirm whether Dr Barton has ever faced any formal disciplinary investigations.

When asked about the death of Gladys Richards, 91, whose death triggered the first police inquiry, Dr Barton told the panel that there was nothing she would do differently.

Mrs Richards died in August 1998, three days after she was re-admitted from a neighbouring acute hospital where she was treated for a dislocated hip caused by falling from a chair whilst at Gosport.

Dr Barton claimed that the note on Mrs Richards' transfer letter which said the patient was "weight bearing" was "over optimistic" and that the morphine she prescribed "seemed a very appropriate starting dose for her symptoms", despite the fact she had written "no obvious signs of pain" in Mrs Richards' notes. She added: "I considered that there were potential hazards and side-effects to it but my over-riding priority was to make her as pain-free as possible."

Dr Barton insisted she saw all the patients being discussed every morning, but did not have the time to record what she did in the medical notes.

The hearing continues.

Additional reporting by Tim Persinko