Pawns in the political game?

Rose Addis's hospital care is anything but private

Three ordinary NHS patients have become pawns in the political battle over Britain's hospitals, a skirmish which has now seen intimate details of their medical care made public.

When 94-year-old Rose Addis entered the accident and emergency department of London's Whittington Hospital on 13 January, she doubtless imagined discussion of her treatment would be a matter for medics, not the prime minister.

Following a fall at her home, Mrs Addis was taken to hospital by ambulance suffering a gashed head, bruising and shock. Zena Gold says her mother remained in an A&E cubicle for a full three days, "distressed" and "caked with blood" from her injuries.

Debate was unusually fierce

"Abandoned in Casualty" said the headline in 21 January's Evening Standard. The paper's campaign ignited a fierce row over NHS care, prompting Health Secretary Alan Milburn to go on Radio 4's influential Today programme to dismiss descriptions of Mrs Addis's experience as "fiction".

The chief executive of the Whittington Hospital, Trevor Campbell Davis, also reacted angrily to the accusations aired in the popular London newspaper.

'Not abandoned'

In a letter to the Evening Standard, he said Mrs Addis could have been moved to a ward bed on Sunday, but A&E staff wanted to keep her under close observation. However, she was placed in a bed the very next day - and not after 72 hours, as Mrs Gold said.

This rebuttal was somewhat overshadowed by being published at the foot of the Standard's lead story: "Whittington left my uncle, 88, unwashed for five days in A&E."

The case of Sidney Hockley, who reportedly spent some of his 120 hours in A&E next to Mrs Addis, was said by the paper to highlight the lack of ward beds in the Whittington.

'Distressed' and 'unwashed'

Following an angry Prime Minister's Question Time - during which Tory leader Iain Duncan Smith demanded an apology be offered to Mrs Addis - a Downing Street spokesman gave a press briefing about the Whittington cases.

The spokesman gave details of the care received by the two elderly patients, dwelling on the allegation the pair's hygiene had not been sufficiently maintained.

The treatment of a 13-year-old boy seen by the Whittington's A&E staff was also disclosed to the assembled reporters, since his family too had gone to the Evening Standard with concerns.

Mr Blair's spokesman refused to explain where the information had come from and said no prior permission from the patients had been obtained.

Out in the open

A senior Tory source was said to be "astonished" that such intimate details were discussed in public, raising fears that patient confidentiality - a cornerstone of medical ethics - had been breached for political ends.

These concerns increased as officials from the Whittington explained to TV cameras the exact procedures employed to "repair" Mrs Addis's head wound.

However, patient confidentiality does not cover all areas of hospital treatment, says the British Medical Association's Nigel Duncan.

Are we any closer to seeing the big picture?

"Information about an individual's medical details are governed by patient confidentiality. It usually doesn't relate to the general standard of care a patient receives."

Doctors are therefore forbidden from disclosing medical test results or X-rays to others without the patient's consent, but are free to say how often bed sheets are changed.

The Despatch Box tussle between Mr Blair and Mr Duncan Smith - deemed "gladiatorial" by one disgusted Liberal Democrat MP - deepened with the accusation that the prime minister had not contacted the aggrieved families.

For his part, the Conservative leader was accused of accepting the allegations levelled by Mrs Addis's daughter (a constituent of his), without approaching the Whittington.

How much any of the Whittington case can tell voters about the state of the National Health Service as a whole is sure to be hotly debated in coming days.

However, discussion of exactly how often Mrs Addis and Mr Hockley were washed during their time in hospital will certainly strike few as a vital topic for public discourse.