Page last updated at 19:01 GMT, Tuesday, 25 August 2009 20:01 UK

Answers plea over hanged patient

Sylvan Money
Sylvan Money was supposed to be checked regularly by staff

The mother of a woman who killed herself while in the care of a hospital said she was still looking for answers five years on from her death.

Sylvan Money, 26, from Presteigne, Powys, had been on suicide watch when she died using a nightgown cord at Bronllys hospital near Brecon in 2004.

Powys Local Health Board (LHB) was accused of failing to ensure she was not exposed to risks to her health.

It admitted breaching health and safety laws and will be sentenced next month.

Richard Tyrrell, representing Powys Local Health Board (LHB), pleaded guilty on its behalf before Llandrindod Wells magistrates.

A maximum fine of £20,000 could have been imposed by magistrates but the penalty may be higher now the case has been sent to crown court in Merthyr Tydfil.

The LHB has already agreed to pay £40,000 towards the cost of the Health and Safety Executive (HSE) investigation and court costs.

The prosecution, which was brought under the Health and Safety at Work Act, accused the LHB of failing to ensure that Ms Money was not exposed to risks to her health.

Carol Horne
I still have many, many unanswered questions and I know that the truth is still there to be told to me, and nobody will tell it to me
Carol Horne

The court heard she was admitted to the mental health unit of Bronllys Hospital in January 2004 after she attempted suicide.

The LHB admitted failing to provide a safe environment and failing to act on warnings about the risks.

A coroner at the 2006 inquest into Ms Money's death found 36 errors had contributed to her death.

Geraint Williams recorded a narrative verdict contributed to by neglect.

This hearing was told that Ms Money was on 15-minute suicide watch when she was first admitted to hospital, but was downgraded to half-hourly checks within days.

At the time of her death she was not checked for more than an hour following a breakdown in the rota system.

Four members of staff at the psychiatric unit were sacked after she died.


After the case, Ms Money's mother Carol Horne said she was pleased with the decision.

"I feel a little bit relieved," said the 59-year-old, who lives in Anglesey, north Wales, with her husband Nigel.

"I was very apprehensive that magistrates would have dealt with it here and that would have made me very angry. I would have considered it offensive, actually.

"I'm delighted it will go to crown court. I don't think anybody could see through things as complex as this case at this level.

"It has taken me five years to understand it and I work in the NHS."

She added: "I still have many, many unanswered questions and I know that the truth is still there to be told to me, and nobody will tell it to me.

"One of the big things, as a general view, is that the little people took the blame. The people on the coal face didn't do their jobs right but I think they were failed by their managers and they didn't have systems of safety in place."

The failure for which the HSE prosecuted the health board was the presence of ligature points in the psychiatric unit at the time of Ms Money's death.

Dale Collins, prosecuting, told the court this was despite a risk assessment carried out three years earlier in 2001 which identified a "high likelihood of injury to patients" through such ligature points.

The LHB will be sentenced on 18 September.

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