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Week ending February 24, 2008

ONE in three nurses caring for older people on a mental health ward in Dartford have been assaulted at work, a national survey has found. The report on physical assaults in mental health wards across the country found the level of violence and its impact on staff and patients was “constant and intolerable”. The Royal College of Psychiatrists carried out the survey on behalf of the Healthcare Commission. Kent and Medway NHS and Social Care Partnership Trust, which is responsible for mental health services in the county, agreed with the watchdog and college and said it took every effort to reduce violent incidents. Peter Hasler, the trust’s director of nursing, said: “Our nurses do a great job in what everyone would agree can be a challenging role and they should be commended for their professionalism in dealing with all incidents.” The report found more nurses were assaulted on wards for older people, over 65s, with disorders such as dementia. Nationally 65 per cent of staff said they had been assaulted, some with serious injuries such as fractures and dislocations, and in Kent the figure was 29 per cent. But only one ward, Birch at Greenacres Hospital, was surveyed and the trust said it would be unfair to say whether the figure was representative of others across the county without carrying out a similar survey.

Prevention of Suicide in Kent

A Topic Meeting being held at the Trinity Foyer, 20 Church Street, Maidstone,

Kent ME14 1LY on Wednesday 20 February 2008 from 2.00 pm- 4.00 pm


1. Introduction and Welcome by Pat Still, Chair, Kent and Medway NHS & Social Care PPI Forum

2. Keynote Speakers:

a) Chris Morgan, Programme Lead, for Suicide Prevention,

South East Development Centre, National Institute for

Mental Health in England

b) Stephen Reynolds, Service Manager, Prison In-reach, Kent & Medway NHS & Social Care Partnership Trust

3. Tea Break and to collect in question slips

4. Question and Answer Session to Panel comprising:

Margaret Bell, Maidstone Samaritans

Chris Morgan, Programme Lead, for Suicide Prevention,

South East Development Centre, National Institute for Mental Health in England

Stephen Reynolds, Kent and Medway NHS & Social Care Partnership Trust

Jean Robinson, Survivors of Suicide by Bereavement

5. Stephen Finnimore – Summaries and any proposals from meeting.

6. Close of meeting and thanks to attendees by Pat Still.

Pay-off for bug trust chief

The NHS chief at the centre of a superbug outbreak in which 90 patients died has been given a major pay-off, despite health secretary Alan Johnson ordering the trust to withhold it.

Rose Gibb, who resigned days before Maidstone and Tunbridge Wells NHS Trust was criticised in a report on the outbreak of Clostridium difficile, is set to receive half her £150,000 salary as a pay-off.

The trust said it took legal advice before deciding on paying the severance deal but stressed Ms Gibb would only be given her legal entitlement of six months salary.

In ordering the trust to withhold the payment last year, Mr Johnson warned the trust that it could be acting unlawfully in agreeing a cash package for Ms Gibb.

The trust decision to pay Ms Gibb £75,000 has the support of the Department of Health and the strategic health authority.

But shadow health secretary Andrew Lansley said: “All Alan Johnson’s posturing about pay-off arrangements will offer no comfort to the patients and the families affected.”

The Healthcare Commission report into the outbreak concluded that C diff was definitely or probably the main cause of death for 90 patients after finding washing facilities were filthy and a shortage of nurses.

Campaign group Health Emergency described the payment as “a kick in the teeth for the friends and relatives of those who died.”

The Health and Safety executive and Kent Police and the Health are still reviewing whether there will be any prosecutions as a result of the C.diff outbreak.

SURROUNDED by the deep blue waters of the Pacific Ocean and dotted with palm trees and spectacular cliffs, Pitcairn Island appears picture perfect. The tiny British territory became famous through the romanticised story of Fletcher Christian and the other mutineers on the Bounty who settled there in 1790. But this week, the world was reminded of the tiny British territory’s recent, darker past. The Kent police officers that led a probe into child sex abuse claims dating back to the 1960s were given MBEs in the New Year Honours List.

An investigation by Detective Chief Inspector Rob Vinson and former Kent Police detective Peter George resulted in nine Pitcairners being jailed in 2004. They were given sentences of up to six years in connection with more than 100 offences. Heavy-handed On the island, the 50 or so residents, most of whom are direct descendants of the Bounty mutineers, are still struggling to come to terms with the trials held there and in New Zealand three years ago. The three men still imprisoned in Pitcairn’s six-cell jail – complete with two guards each – are a constant reminder of the trials. Most islanders feel that they were treated in a heavy-handed way by the British authorities.

The sex abuse case was triggered after allegations were made to Kent police constable, Gail Cox, who was stationed temporarily on Pitcairn in 1999. She uncovered evidence that underage rape and sexual assault had been an unspoken part of the island’s culture for generations.

DCI Vinson, 40, from Broadstairs, said he was proud of his success in the Pitcairn case – despite the criticism it received at the time of the investigation. In a report in June 2003, BBC journalist Michael Brooke, compared the huge cost of the investigation and resulting trials with that of Pitcairn’s expenditure. He said that the island cost about £250,000 a year to administer from a unit in New Zealand, which paid for transport and issuing postage stamps. “Compare this with the financial tap which gushes freely, courtesy of UK taxpayers, to fund this judicial process,” he said. “A Pitcairn logistics team, with swanky offices in Auckland and a chief residing in an Auckland hotel for two years, has built remand space on Pitcairn for six accused, plus accommodation for prosecution and defence lawyers. “Investigating officers from the Kent constabulary have winged to and fro between England and New Zealand in business class seats.” He said the cost ran into millions of pounds. At the same time, the island community desperately needed money to upgrade facilities. “No wonder the community feels it is being punished for the alleged sins of the few,” said Mr Brooke. DCI Vinson said this week: “Many thought that I was living it up in paradise, having so much fun. “But it was anything but. It was intense and exhausting work in great isolation in a place that could be volatile. This was my focus for more than six years. That commitment was personally not easy. “The real heroes were the victims who stood firm to tell their stories. This was the silent voice of Pitcairn finally heard and believed.”

The officer, who is based at Margate police station, first visited Pitcairn in early 2000. What followed were trips thousands of miles away from the familiar confines of his role in the Kent force and his wife and three children. To get to the island was difficult enough. Access was via a passing container ship and transfer by an unsteady rope ladder to the waiting wooden boat below.

A Kent Police spokeswoman said: “Once there, the island’s beauty, belied a challenging environment, not before widely revealed to the rest of the world. Unlawful and non-consensual sex was commonplace, an unspoken part of the culture for generations. “The police investigation was seen by many as part of a wider British conspiracy to depopulate Pitcairn. The women themselves were blamed for speaking out. ”More than 30 victims, both male and female, were interviewed on Pitcairn and in New Zealand, Australia, Norfolk Island, America and Britain. To add to the trauma, some were not only revisiting difficult times in their past, but had never shared their secrets with their families before.

The police spokeswoman added: “The relationships and allegations were often confused, ambiguous or incestuous, adding to the complexity of the case.” Kent Police’s Peter George, who worked with DCI Vinson on the Pitcairn case, was also awarded an MBE in the New Year Honours List. Secured The former detective inspector, who is now a civilian police worker, said: “Pitcairn became much more than just another job. It was a very difficult, but ultimately rewarding investigation. “I would like to pay tribute to the victims in the case who stood firm and gave evidence without which we would not have secured nine out of ten convictions.” Herbert Ford, director of the Pitcairn Islands Study Centre, in Angwin, California, last visited Pitcairn in September.

The Emeritus Professor of Journalism at Pacific Union College set up the centre in 1977 to combat “misinformation” about Pitcairn and says he is one of the few people to be trusted by islanders. Mr Ford said most Pitcairners felt angry about the way the trials were conducted. “It is the belief of more than three fourth of the Pitcairn people that the UK used a giant club to their head in the Pitcairn trials to handle a matter that if handled by the already existing – British-written – Pitcairn law would not have held all Pitcairners up to worldwide public hatred, ridicule and contempt,” he told this newspaper. One Pitcairner this week posted a sarcastic message on responding to our news item about the award of the two MBEs. The islander, called Melva and now hailing from Anchorage, Alaska, said: “Join me in extending congratulations to the officers, whose legacy is a mangled community (yours could be next).Way to go, Vinson.”

Kari Boye Young, from Adamstown, the capital of Pitcairn, wrote: “Brits are making sure the world will never doubt that your mission to destroy Pitcairn was unwarranted, there ISLAND SECRETS: Pitcairn Island, a tiny dot in the Pacific Ocean, harboured a culture of abuse which was brought to light by Kent Police

are medals left, right and centre.” The community on the island has been split by the trials, Mr Ford suggested. “About three families feel the Brits had/have a right to do whatever they want with Pitcairn – it is but a straw in the wind that can be blown by the UK in any direction it desires. “The minority group is shunned in a number of ways by the majority, and of course, the minority group doesn’t usually invite at least some of the majority to their doings.”

Paroled Two of the Pitcairners jailed in 2004 have been released to be detained at home, one of which is due to be paroled completely, said Mr Ford. Six New Zealand corrections officers guard the three. Weather permitting, the men are out most days working under guard, but when they return to jail they are kept secure by a 15ft high fence – even though there is little chance of escape from the island. Mr Ford added: “There is also a Scottish police officer and a Pitcairn police officer on Pitcairn, making it one of the world’s most heavily policed spots anywhere. “And, of course, it is impossible to get off of Pitcairn by ship without everybody knowing about it.

Kent on Sunday

New rapecharge for care worker

A MENTAL health care worker at St Martin’s Hospital in Canterbury has been charged with a second rape. The charge came after an alleged attack on a 39-year-old woman in Margate in the early hours of August 16. John Mendy, 32, of Sandwich Road in Ramsgate, is currently remanded in custody after being charged with the rape and serious sexual assault of a woman in Canterbury on November 15. He is due to appear at Canterbury Crown Court again on 21 January.

NHS bug trust board members leave

Three non-executive directors have resigned from the board of an NHS trust which saw 90 people die in a superbug outbreak - and another two are to go.

Maidstone and Tunbridge Wells NHS Trust said Bruce Sheppey, Gina Jennings and Simon Ingman resigned with immediate effect. All three joined last year.

Aaron Cockell and Jonathan Paine will leave at the end of the month. They are near the end of a first four-year term.

It follows calls for the board to be disbanded by Kent MP Hugh Robertson.

The Mid Kent and Faversham Tory MP called for the move while speaking at a rally which followed a damning Healthcare Commission report into two outbreaks of the clostridium difficile superbug at the trust's three hospitals.

'Awful chapter'

At least 90 patients died between 2004 and 2006, caused by a "litany" of errors in infection control, the report said.

About 500 people attended Tuesday's meeting to discuss cleanliness as well as proposed changes to hospital services.

Mr Robertson said: "I think the original board should go completely.

"If anything positive is to come out of this awful chapter it must be a real commitment, firstly, to stamp out C.diff, but secondly to put patients right back at the heart of the NHS."

But trust chief executive Glenn Douglas, who also runs Ashford and St Peter's Hospitals NHS Trust in Surrey, said work to restore confidence was under way.

"Together with the new interim chairman, George Jenkins, we intend to build the organisation up to one that is confident and [has a] positive future," he said.

On Monday, it was revealed that two healthcare assistants had been sacked from Maidstone Hospital.

A staff nurse and another healthcare assistant at the Kent and Sussex Hospital in Tunbridge Wells had also been disciplined over care standards.

The trust board includes five non-executive directors, who are members of the public living in the area that the trust serves, who respond to advertisements for posts.

The chairperson is appointed by the Secretary of State for Health and the other non-Executive members are appointed by the NHS Appointments Commission, according to the NHS trust website.

Two are sacked after bug deaths

Two healthcare assistants have been sacked from the NHS trust at the centre of a deadly outbreak of the Clostridium difficile bug, it was disclosed today.

One staff nurse and another healthcare assistant have been disciplined but will remain at the Maidstone and Tunbridge Wells NHS Trust, a trust spokesman said.

The sanctions come in the fallout from a Healthcare Commission report and as police and health and safety officials continue investigations into patient care at the trust. The two dismissed members of staff worked at Maidstone hospital and the others are employed at the Kent and Sussex hospital in Tunbridge Wells.

The action followed an investigation into care standards at the trust, the spokesman said. The commission's report revealed a catalogue of errors that allowed the bug to thrive in hospitals under the trust's management, contributing to outbreaks that were linked to 90 deaths.

A total of 345 people died while infected with the bug and more than 1,100 people were infected across a two-year period, prompting the health secretary, Alan Johnson, to apologise for the "truly scandalous" outbreak.

Boss of superbug-scandal hospitals is set to get six-figure sum - and so is her partner

By REBECCA CAMBER and LUCY BALLINGER - More by this author » Last updated at 13:04pm on 15th October 2007 The hospital boss at the centre of Britain's deadliest superbug outbreak looks likely to get her controversial pay-off despite attempts by the Health Secretary to block it.

Rose Gibb resigned from her £150,000 post as an NHS trust chief executive last Friday, days before it was revealed that at least 90 patients had died from clostridium difficile.

As it emerged that Miss Gibb's partner quit his own similar post with another trust last week, and may also be in line for a six-figure pay-off, Alan Johnson ordered Maidstone and Tunbridge Wells Trust to halt any payment to Miss Gibb.

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Rose Gibb: 90 patients died from C. difficile


Using his powers to intervene in the running of a "failing trust", Mr Johnson ordered that her pay-off - rumoured to be more than £250,000 - should be put on hold while legal advice was sought about blocking the payment entirely.

But legal experts warned that the Health Secretary may be powerless to stop Miss Gibb, who faces possible criminal charges as chief executive of the trust which saw the worst superbug outbreak in NHS history, from receiving the severance package.

Shirley Wright from employment law specialists Eversheds said: "There are specific provisions in the fixed-term contracts which chief executives are often on.

"There are also specific provisions for the termination of senior managers in the NHS and it is unlikely that Mr Johnson would be able to intervene to stop any pay-off in those circumstances."

Miss Gibb stepped down less than a week before the publication of a damning report into the ward conditions which allowed the infection to spread like wildfire through three hospitals managed by the trust.

In all, appalling hygiene standards across the hospitals contributed to the deaths of up to 270 patients and the infection of more than 1,100 in less than three years.

A Health Care Commission report said that too much focus on cutting debts and hitting Government targets contributed to the outbreak at Kent and Sussex Hospital in Tunbridge Wells, Pembury Hospital and Maidstone Hospital.

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Maidstone: The hospital at the centre of the scandal

As police began an unprecedented investigation into possible manslaughter charges, hospital staff attacked the trust for allowing Miss Gibb to resign.

Unison officer Simon Bolton said: "The staff all feel she has been allowed to get away with it - she has not been made to face the music.

"Miss Gibb had a reputation for not liking bad news and there were a lot of people saying there were problems but she was not listening."

It is unclear how much Miss Gibb is due to receive, but a person agreeing to leave such a position would commonly receive between two and three years' pay.

Trust accounts indicate that she received benefits of £5,000 and £12,500 in pension last year in addition to her salary.

Miss Gibb is being helped to fight her case by Managers in Partnership, the union for health service managers.

In a statement, the union said: "We have been representing the former chief executive of Maidstone and Tunbridge Wells NHS Trust with the employer.

"As things stand, for legal reasons, as Miss Gibb's trade union representatives, we are precluded from commenting directly or indirectly on the matters of massive public concern raised by this case."

• Days before Miss Gibb handed in her resignation, her partner also quit his job as a hospital boss, it has emerged.

Mark Rees had enjoyed the same £150,000 salary as Miss Gibb for more than four years as chief executive of Barking, Havering and Redbridge NHS Trust.

But on the morning of Monday October 1 he dramatically quit, announcing his decision before taking his coat and leaving.

It is rumoured that he too may be in line for a six-figure pay-off, although the trust refused to discuss the details.

Hospital sources yesterday described his departure just before his partner as a "coincidence", but privately many staff were puzzled.

Although the trust has long-standing debts and Mr Rees had recently ordered staff to make cuts of £ 2million a month, his resignation did not come at a time of particular crisis for the trust.

A source said: "The management knew he was thinking about leaving, but it was not reported to staff until the day. No one knows his reasoning."

Yesterday Mr Rees refused to comment at the £700,000 home near Cobham, Kent, which he shares with Miss Gibb, their two young children and Miss Gibb's 22-year-old daughter from a previous relationship.

Once one of the 20 most highly paid NHS bosses in the UK, he said his partner was seeking legal advice.

Previously Mr Rees was chief executive of Bromley Hospitals NHS Trust for ten years, where Miss Gibb worked as a director before moving to Maidstone and Tunbridge NHS Trust.

Minister blocks '£400,000 pay-off' for chief of hospitals where superbug killed 90

By DANIEL MARTIN - More by this author » Last updated at 22:41pm on 14th October 2007

The boss of the health trust where at least 90 patients died in a superbug outbreak could be in line for a £400,000 pay-off, it emerged yesterday.

News of the "golden goodbye" immediately prompted Health Secretary Alan Johnson to make an extraordinary intervention into the row over filthy NHS wards.

He ordered the health trust in Kent to withhold any payment to Rose Gibb, who was chief executive there during the deadliest hospital superbug outbreak in NHS history.

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'Golden goodbye': Rose Gibb, the NHS trust's former chief


Miss Gibb resigned her £150,000-a-year post less than a week before the publication of a damning report into the ward conditions which allowed the infection to spread like wildfire through three hospitals managed by the trust.

In all, appalling hygiene standards across the hospitals contributed to the deaths of up to 270 patients and the infection of more than 1,100.

As police began an unprecedented investigation into possible manslaughter charges, campaigners demanded to know exactly how much money Miss Gibb will receive after leaving her post last Friday.

Last night Mr Johnson stepped into the row, saying: "I have instructed the trust to withhold any severance payment to the former chief executive of Maidstone and Tunbridge Wells NHS Trust, pending legal advice."

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Infection outbreak: The Maidstone Hospital

Trust sources last night confirmed that Miss Gibb has been promised a pay-off of 'more than £100,000'.

One source said she could be paid as much as £400,000.

A pay-off of that scale would be in line with common practice that a person agreeing to leave such a position would receive between two and three years' pay.

A spokesman for the Department of Health said the Health Secretary had the legal right to require a trust to suspend payment to a former chief executive. Legal advice was being sought over whether any pay-off could be completely refused.

Officers from Kent Police are already reviewing whether mismanagement by chiefs at Kent and Sussex Hospital in Tunbridge Wells, Pembury Hospital and Maidstone Hospital amounted to a criminal act.

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Dirty conditions: Cups in a sink of a 'clean' utility room on Culpepper ward, Maidstone Hospital

Crammed : Beds sit so close they're almost touching

As Miss Gibb refused to comment from her £700,000 home near Cobham in Kent, it also emerged she had failed to honour a pledge made in 2004 to clean up her wards.

Her hollow promise followed an undercover BBC investigation in 2004 which exposed poor cleaning and infection control even before the first major outbreak began.

After the TV programme was screened, Miss Gibb promised to sort out hygiene in "six to nine months" - but nothing was done to stop the biggest recorded outbreak of C Diff the NHS has seen.

Despite assurances from the current management that the problem is now under control, Kent Air Ambulance yesterday announced that it had suspended all flights to Maidstone Hospital for the foreseeable future.

It said it had a "duty to patients" to avoid the hospital.

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Patient: Jackie Mason with a picture of her father, Joe Nixon, who died after contracting chlostridium difficile at Maidstone

Last night the trust continued to refuse to say how much Miss Gibb had received after she agreed to step down by mutual consent, saying the "financial arrangements are confidential".

"If it's true, we have a right to know how much taxpayers' money is involved and it would fuel the scandal even more if it turns out that senior managers have walked away from this carnage with their pockets stuffed with NHS cash."

He said people at the trust had told him that the pay-out was in the region of £300,000 to £400,000.

The undercover BBC investigation in June 2004 at the Kent and Sussex Hospital revealed bloodstained walls, overflowing skips of clinical waste and a "culture of laziness" among cleaning staff.

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Hazard: A container for sharp medical equipment is left open

Dirty: A toilet seat has stains on it

Microbiologist Professor Hugh Pennington said of the footage: "It is a dirty hospital, the worst I've ever seen."

At the time Miss Gibb said hygiene would be up to scratch within "six to nine months".

"That's six to nine months of intensive work around a range of areas around recruitment, refurbishment, cleaning standards, further investment in cleaning itself, and in putting local management back in to each of the hospitals," she said.

But despite her words, little was actually achieved because a little more than a year later - between October and December 2005 - the first major outbreak occurred.

The Healthcare Commission found that the board did not even realise there was anything amiss during this outbreak, meaning they could not put procedures in place to avoid the second outbreakin 2006.

The BBC undercover reporter, Danielle Glavin, posed as a cleaner for a week at Kent and Sussex Hospital. She was given just 45 minutes training before being put to work, and found that infection control systems were poor.

When she noticed that the A&E department was low on paper towels - vital for drying hands to ensure that infections are not passed on between patients - she was told it would be three days before a new batch would arrive.

The cleaners were supposed to wash the water jugs of patients with C. Diff with hot, soapy water. But Miss Glavin saw one simply swill them out in cold water before returning them at random.

Other examples of poor hygiene included a bloodstained gown left on a trolley in an A&E operating theatre for 24 hours, and ingrained streaks of blood on a resuscitation room wall.

The Healthcare Commission said the trust was so obsessed with meeting Government A&E waiting time targets that it took the eye off the ball on hygiene.

But speaking on BBC Radio 4's Today programme yesterday, Mr Johnson said: "To suggest that this particular incident reflects what's happening in the NHS across the country is absolutely wrong.

"There are nurses and clinicians across the country who have dealt with the targets but kept the highest safety standards."

A 'deep clean' at every hospital will help overcome the superbug crisis, Alan Johnson insisted yesterday.

His plan had been lambasted by senior doctors, who said it would not work and was just "pandering to populism".

Around £50million has been set aside so the walls, ceilings, ventilation shafts and fittings in every NHS ward can be thoroughly cleaned next year.

But a highly-critical editorial in the medical journal Lancet last week said the plan will have little impact.

"They would be better employed making sure doctors, nurses and visitors wash their hands properly, the proven way to stop hospital acquired infections," it added.

Cover-ups, lies and the cynical conspiracy that let a superbug claim 90 lives

By NATALIE CLARKE - More by this author » Last updated at 00:20am on 13th October 2007Most of the wards at Maidstone Hospital were dreadful, but there was one in particular that patients feared the most.

No one wanted to end up on Whatman. It was here that the Clostridium difficile patients were all heaped together to try to keep them away from other patients, in an attempt to prevent the virulent superbug spreading.

Something which should have been simple to do, one might think. Not simple enough, however.

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For four months, patients who did not have C. difficile continued to be placed in Whatman ward, surrounded on all sides by those who did.

What hope did they have? Some, inevitably, contracted the bug.

A total of 1,176 people contracted C. difficile over two-and-a-half years, between April 2004 and September 2006, at the three hospitals in Kent run by the Maidstone and Tunbridge Wells NHS Trust.

They are now at the centre of the worst superbug scandal in British history.

A report by the Healthcare Commission has revealed that of 345 patients who died after being infected with C. difficile, in around 90 cases it was most likely the main cause of death.

The Trust chief executive, Rose Gibb, resigned from her post on Friday of last week by "mutual agreement".

After sources indicated that Ms Gibb could be in line for a £400,000 "golden goodbye", Health Secretary Alan Johnson made an extraordinary intervention, ordering Maidstone and Tunbridge Wells NHS Trust to withhold any severance pay pending "legal advice" - although it is now suggested it may not be within his powers to do so.

So what had Ms Gibb done to deserve her reported £400,000 golden thank you?

Her response to the outbreak of C. difficile at the hospitals under her management was at least consistent.

It began with a conspiracy of secrecy, went on to bare-faced lies and ended with an almighty cover-up of the true extent of the crisis.

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Patient: Jackie Mason with a picture of her father, Joe Nixon, who died after contracting chlostridium difficile at Maidstone

On top of the lies that took place at Ms Gibb's behest, incompetence, mismanagement, laziness, and ineptitude all contributed to the worst single outbreak of hospital infection in this country.

This week Ms Gibb has remained behind the doors of her modern £700,000 four-bedroom property near the village of Cobham in Kent.

Interestingly, her husband, Mark Rees, recently left his post as chief executive of Barking, Havering and Redbridge Hospitals NHS Trust.

Ms Gibb and some of her colleagues are facing the possibility of an unprecedented investigation by Kent Police, who will decided whether senior managers should be prosecuted for criminal negligence or even manslaughter.

So how did it come to this? The Trust was established by a merger of Mid Kent Healthcare NHS Trust, and Sussex Weald NHS Trust in April 2000.

There were three hospitals under its umbrella - Kent and Sussex, Maidstone Hospital and Pembury Hospital.

When the outbreak began in 2005, the Trust had embarked on a programme to save £40 million over a period of three years, and was under intense pressure to reduce the number of beds.

The catastrophic breakdown of surveillance of the C. diff superbug can be traced back to the summer of 2005, when the leading infection control nurse, responsible for the Trust's database set up to record all cases of C. difficile, went off sick for most of the summer, before leaving that October.

Her replacement did not start work until four months later, in February 2006, and there was no cover provided in the period between.

It was during this time that the system for local surveillance of the bug "broke down completely".

Although it was never that good in the first place. Policies for the control of infection were on the Trust's internal computer system, but they were nearly all out of date and not all staff could gain access to the system.

It was mandatory to receive training about how to deal with Clostridium difficile, which is extremely infectious, with spores able to live on surfaces, door handles and toilet seats for days or weeks.

Between September 2005 and October 2006, however, only 51 per cent of clinical staff received such training.

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Dirty: A toilet seat has stains on it

There was even confusion over which individual was in charge of managing the infection control team.

Yet it was known that C. difficile is a major problem across the country.

There were 55,634 cases of C. difficile in patients aged 65 and over, and in England the

Health Protection Agency reported an increase of seven per cent in 2006.

In the autumn of 2005, the number of patients with C. difficile at Maidstone doubled to 50, but this went unrecognised by staff.

That December, a consultant physician raised concerns about the severity of infection in one of his patients who died. The Board promised a review into the case; it did not happen.

In the months that followed, patients with C. difficile were placed in open wards with nothing but a trolley between them and patients who were not infected. In these conditions, the bug quickly spread.

Meanwhile, there were not enough nurses to cope, and in the wards there was chaos. Often there was no attempt to maintain the most basic hygiene.

Patients suffering from diarrhoea who rang the bell because they needed to be helped to the toilet were told to "go in the bed".

They could be left lying in their own excrement for hours afterwards.

In other examples of horrendous practice, excrement was not washed away from bedpans, there were blood stains on trolleys, needles overflowing out of bins and buckets full of filthy water.

Half the staff were not even aware of the basic rule that to kill C. diff spores you have to use soap and water, and used alcohol wipes instead.

There was a shortage of commodes and basic supplies such as hand wipes, linen and bandages.

There were times when the patients were not given their medication, when charts were not completed.

In this despicable environment of filth and squalor the bug thrived. It was bedlam.

Many of the cleaning staff were agency workers who didn't relish the idea of cleaning up diarrhoea for £5 an hour.

According to one former agency worker, there was no real supervision of the cleaners.

"Often cleaners would come on shift and then disappear to avoid doing the work.

"People would come in off the street with no experience of working in hospitals and were taken on and told to clean up, but it was never properly explained how to do the work.

"The C. diff outbreak happened while I was working there, but I was not properly told about it.

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Crammed : Beds sit so close they're almost touching

"The explanation went no further than telling me I had to clear up properly because of what was termed 'that s**t bug'.

"The water jugs were not dishwasher friendly and were just hand-wiped clean. "There was a dreadful smell in the wards and the toilets were often filthy.

"The bins filled with waste, such as excrement, would be left for days before being removed. It was pretty appalling."

Another factor in the spread of the bug was the wide misuse of antibiotics.

Broadspectrum antibiotics which left patients more vulnerable to contracting infection - because they kill off friendly bacteria in the bowel that help protect against the superbug - were dished out, when a simple antibiotic less prone to leading to C. diff would have worked just as well.

The outbreak was finally recognised by the Trust on April 12, 2006, when they reported it to the regional strategic health authority.

It was decided then that the Whatman ward of Maidstone Hospital was to be used as a "cohort" ward, meaning that patients with C. diff would be placed there together.

Unfathomably, for the next four months patients who did not have C. diff were still also put in this ward and, of course, some of these subsequently became infected.

Among the Trust Board, there was a conspiracy of silence. Indeed, when the Trust finally released a statement two months later, in June, it was in response to a query from a local newspaper.

This statement was blatantly untrue, saying that patients already had the C. difficile bug when they were admitted to Maidstone Hospital.

The following month, Rose Gibb, the chief executive, repeated this lie at a meeting saying: "The recent outbreak had resulted from a substantial amount of patients being admitted to hospital with C. diff."

The minutes of another Board meeting reveal plans for a detailed discussion of C. diff to be held, unaccountably, in private.

There were a number of nurses who, until that point, had had no idea that patients in their wards had the bug until they read the story about C. diff in their local paper.

By now, every ward at Maidstone Hospital had at least one confirmed patient.

Concerned relatives began to attend board meetings but were fobbed off with more lies.

At one meeting in July last year, they were reassured the Trust's antibiotic policy had been properly reviewed in December 2005, when in fact no action was taken until April 2006.

First there were the lies, then the cover-up began. The Trust underreported the number of deaths, disclosing information only about deaths in which C. difficile definitely contributed, and failing to mention the deaths in which the bug had probably contributed.

The number of deaths quoted only included those after the outbreak was officially recognised in April last year, although there had been 31 cases in the six months before that in which C. diff appeared on the death certificate.

Ranjit Gosal, 71, was being treated for cancer when she caught the bug in May last year.

Her son, John Gosal, says she received "shambolic" treatment, with doctors prescribing antibiotics that made her condition worse. Only after her death was C. diff diagnosed.

Joseph Nixon, an 87-year-old veteran of Dunkirk, caught the superbug after a bowel operation.

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Dirty conditions: Cups in a sink of a 'clean' utility room on Culpepper ward, Maidstone Hospital

His daughter Jackie says the former policeman was appalled by conditions at the hospital, where "hour by hour his soul was being stripped".

"I ended up having to change my father's bed for him the whole time because otherwise he would be left lying in his own soiled sheets for three to four hours at a time," she said.

Emily Laming, 91, also died at Maidstone Hospital, after contracting C. diff.

Mrs Laming was admitted to the hospital in 2006 after she broke her hip in a fall - but caught the superbug while in the hospital.

Her daughter Patricia Grant, 71, a retired auditor, says: "She was 91, but fit and very active. They sent her to her care home with terrible diarrhoea.

"The care home sent her back because they couldn't look after her.

"The next time we went up there she was in an isolation ward. She couldn't have been more than five stone when she died.

"We didn't know anything about this disease, nobody told us she could die of it.

"They just said she had Clostridium difficile. I know she was old, but she could have died naturally, not in pain."

These are just a few of the many harrowing cases of lives cut short because of the negligence at the hospitals.

Furthermore, there was disturbing evidence of "false negative death certification".

Among a sample of 20 case notes studied by the Healthcare Commission, C. diff was not mentioned on the death certificates of 13 patients who had had a "significant" infection.

In four of the above cases, there was a high likelihood that C. difficile was the main cause of death.

Last October, the Healthcare Commission began a six-month investigation into the outbreak of the superbug.

The true extent of the scandal emerged this week following the publication of its report this week.

Soon afterwards, Kent Air Ambulance suspended all flights to Maidstone Hospital.

In response to the report, Trust Chairman James Lee said: "The Trust accepts the Healthcare Commission recommendations and has already taken action on many of them.

"We have appointed a new Chief Executive, who will ensure that the recommendations of this report are fully implemented."

Meanwhile, hidden away behind the doors of her luxury home, Rose Gibb waits to hear whether or not she will receive £400,000 for presiding over one of the most shocking chapters in NHS history, or whether instead she will be prosecuted for the manslaughter of scores of patients.

There is little doubt among the relatives of the deceased which course of action would be more appropriate.

Former boss at hospital where superbug killed 90 patients 'got huge pay-off'

Last updated at 15:31pm on 11th October 2007 The chief executive of the hospital trust at the centre of the Clostridium difficile outbreaks is rumoured to have been given "a massive pay-off."

Campaigners are demanding to know how much Rose Gibb was paid after stepping down.

Ninety hospital patients died in an outbreak of C difficile blamed on appalling hygiene standards. The superbug hastened the deaths of another 180 and infected more than 1,100 in three hospitals, a damning official report says today.

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Rose Gibb left Maidstone and Tunbridge Wells NHS Trust on Friday by mutual agreement

Police and the Health and Safety Executive have been called in to investigate the outbreak – the UK's worst-ever – at the Maidstone and Tunbridge Wells trust in Kent.

Rose Gibb left Maidstone and Tunbridge Wells NHS Trust on Friday by mutual agreement, the new interim boss Glenn Douglas has revealed.

The trust has refused to disclose how much money she received after leaving, with a spokesman saying today the "financial arrangements are confidential".

According to the trust's annual accounts, Ms Gibb was paid around £150,000 in salary in 2006/07, £5,000 in benefits and around £12,500 in pension.

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Infection outbreak: The Maidstone Hospital

Geoff Martin, of campaign group Health Emergency, said: "I have heard from Maidstone NHS staff this morning that chief exec Rose Gibb is rumoured to have received a massive pay-off from the trust.

"If it's true, we have a right to know how much taxpayers' money is involved and it would fuel the scandal even more if it turns out that senior managers have walked away from this carnage with their pockets stuffed with NHS cash."

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Dirty conditions: Cups in a sink of a 'clean' utility room on Culpepper ward, Maidstone Hospital

Crammed : Beds sit so close they're almost touching

Trust officials could face criminal prosecution after appalling hygiene standards contributed directly to 90 deaths.

Officers are reviewing whether mismanagement by chiefs at Kent and Sussex Hospital, Pembury Hospital and Maidstone Hospital amounted to a criminal act, Kent Police said.

The infection led to 345 deaths and more than 1,100 infections across a two-year period.

The worst two outbreaks were in the autumn of 2005 and early 2006, a damning official report revealed today.

The outbreaks at Maidstone and Tunbridge Wells NHS Trust were the worst yet seen in the UK.

Heath Secretary Alan Johnson, speaking on BBC Radio 4's Today programme, said: "It's a scandal. It's awful."

The Healthcare Commission found a shortage of nurses meant wards and washing facilities were filthy, and patients were left to lie in their own excrement for hours.

The body's chief executive Anna Walker said the trust was so focused on meeting Government targets and dealing with high levels of debt that it failed to deal properly with the superbug.

Quick and easy alcohol wipes, which do not kill C diff, were used to clean toilets rather than soap and water, which does eliminate the bug.

But the Government rejected any suggestion that Whitehall targets were responsible for the situation or that it was endemic in the NHS.

Mr Johnson said: "To suggest that in this particular incident, this reflects what's happening in the NHS across the country is absolutely wrong.

"There are nurses and clinicians across the country who have dealt with the targets... but kept the highest safety standards."

A Kent Police spokesman said: "We are in the process of reviewing the contents of the report given to us by the Healthcare Commission.

"Until such stage we have digested the contents of the report, we cannot say we are gong to fully investigate this. We have got to review it first.

"The purpose of the review is to see if any criminal acts have taken place."

He said if any criminality is found, police will gather evidence and liaise with the Crown Prosecution Service.

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Hazard: A container for sharp medical equipment is left open

Dirty: A toilet seat has stains on it

Former Bucks Fizz star Cheryl Baker, whose mother-in-law Doreen Ford, 77, died from septicaemia at Maidstone Hospital while infected with the bug, said she hoped the infection would now be properly fought.

"It's all being swept under the carpet, but the buck has to stop somewhere, and hygiene, training..." she told GMTV.

Dr Malcolm Stewart, medical director of the trust, apologised for the scandal.

He said rates of C diff in the trust were now lower than the NHS average last year.

He said: "C diff rates have fallen sharply following improved isolation measures, a £1 million cleaning programme, better antibiotic use and further campaigns on hand washing."

He said some staff had been "sloppy" and given erroneous impressions in presenting information about the outbreaks.

Trust chairman James Lee offered to resign over the findings but his offer was rejected by the board.

Acting chief executive Glenn Douglas took over his new role on Monday. He said: "I am not complacent and I will lead the drive to continue to improve the care for patients at Maidstone and Tunbridge Wells."

June 2007

Trust admits backtrack over psychiatric unit

22 Jun : Mental health chiefs have defended plans to scrap the acute psychiatric unit planned for the new £225million PFI hospital at Pembury.

What was it about this little girl's life that led to it ending with one shot from a police marksman on the streets of Sevenoaks?

21 Jun : Touching pictures of Ann "Tosh" Sanderson as a seemingly happy youngster have been revealed by a long-time friend.The heart-warming shots show Tosh as a child and teenager enjoying family life,......

Society must tackle 'last taboo' of mental illness

21 Jun : The leading charity for mental illness in the UK has called for more action from central Government following Tosh's tragic shooting in Sevenoaks.

No simple answer, says health expert

21 Jun : No-one can be blamed for not spotting that Tosh Sanderson's mental health problems had resurfaced, a Sevenoaks expert has insisted.

Tragedy puts focus onto mental health

21 Jun : It Is both heartwarming and upsetting to see Tosh Sanderson pictured as a youngster, happily playing with a dog and being part of family life.

'Poor mental health care to blame for tosh's behaviour'

21 Jun : The Girlfriend of a man who shot at a police officer in Sevenoaks last year has criticised the way people with mental health problems are cared for.

'Difficult to spot mental health relapses'

19 Jun : No-one can be blamed for not spotting that Tosh's mental health problems had resurfaced, a Sevenoaks expert has insisted.

Mental health services 'full of serious flaws'

15 Jun : "SERIOUS flaws" in mental health services have been exposed only a week after it was revealed the psychiatric unit planned for the Pembury PFI hospital has been axed.

Shooting last year close to the scene

14 Jun : Monday's fatal incident occurred just a stone's throw away from another shooting less than a year ago.In August 2006, depressed Roy Everitt, 40, shot at a police officer with what......

Website to focus on health of young men

8 Jun : A Website for young men has been updated and relaunched by East Sussex Downs and Weald Primary Care Trust for Men's Health Week - which runs from June 11 to 15.

No PFI mental health unit

8 Jun : Health bosses have scrapped current plans for a mental health unit at the new £225million Pembury PFI hospital.

No privacy for woman in mixed ward 1 Jun: A Pregnant woman says she was deeply upset by the lack of privacy in her mixed sex hospital ward.

May 2007

NHS trust chief is thrown out of angry couple's home

24 May: A Couple who have suffered a miscarriage in a hospital waiting room have slammed 

the NHS trust once again for its treatment toward them.

Homeopathy debate rages as service is threatened

18 May: A Heated debate took place over whether the NHS should continue to provide homeopathy services from a hospital in Tunbridge Wells

April 2007

Open verdict on woman found dead in her flat

20 Apr : A 45-year-old woman who suffered from mental illness was found dead in her flat at Crossways Community in Tunbridge Wells, an inquest heard.

NHS trust fears £5m overspend in struggle to clear debts

13 Apr: Maidstone and Tunbridge Wells NHS Trust has failed to break even for the first time in two years and is predicting a £5m deficit.

Attacker in plea to be spared jail

12 Apr : A Defence solicitor has asked for his East Grinstead client not to be sent to jail for a "bizarre" attack he cannot remember.Burhan Dilek, 24, of London Road, stood in......

March 2007

NHS forum comes under criticism for not answering enough questions

30 Mar: PATIENT Public Involvement Forum member Betty Howell came to the meeting with a special interest in the decision to create a specialist centre for emergency surgery at Kent and......

Open verdict on drug death

16 Mar : An Open verdict was recorded at the inquest of a woman from Edenbridge who died following a drug overdose.

Joyce Weller, 65, was found dead by her daughter, Maxine, at her......

Depressed man died from drink and drugs

16 Mar : A Depressed man from Tonbridge took a lethal cocktail of drink and drugs the day before he was due to be sectioned under the Mental Health Act

Self-harmer planned her own death

9 Mar : A former school cook from Rotherfield slashed her wrists and took a fatal dose of prescription drugs in a "covert and calculated act of suicide", an inquest heard this week.

Suicide verdict on stabbing

8 Mar : An East Grinstead man who had suffered from schizophrenia for 12 years, stabbed himself through the heart to end his life, an inquest at Haywards Heath heard on Tuesday.

State-of-the-art hospital finally gets the go-ahead

2 Mar : Government approval has finally been given for the state-of-the-art hospital for Pembury - which is set to be one of the best in Britain.

February 2007

£300m hospital gets go-ahead

27 Feb : The £300million PFI hospital for Pembury has been approved by the Department of Health.

No jail sentence for man who shot at a pcso

20 Feb : A Man who sparked an armed siege in Sevenoaks when he shot at a police officer has escaped a jail term.

August 2006

Woman blames rehab clinic for death of son, 44

17 Aug : An East Grinstead woman is blaming the recent death of her son on the London clinic that was treating him for heroin addiction.

November 2006

Knifeman arrested under mental health act

9 Nov : A Man brandishing a kitchen knife and chisel in East Grinstead this week was arrested under the Mental Health Act.