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SECTION 2: SOME LONG STAY WARDS', 1970-75
B. Birch Ward

2.26 Mr. Weston worked on this ward as a Student Nurse for three months at the end of 1971. It was at that time a long stay ward for 26 patients run on rigid authoritarian lines, and presented an extreme case of the old type mental hospital regime very much alive in St. Augustine's without any attempt being made to deal with it. After the 1972 reorganisation it became a male psychogeriatric ward for 24 patients, but its way of life did not change until Mr. K, a Charge Nurse, whose attitude had dominated the ward for nearly 12 years, left the ward shortly before retiring.

2.27 The Charge Nurse who in 1971 worked the other shift suggested that there should be more flexibility, but Mr. K maintained that his method was the only practical one, and his view prevailed. There was strict rationing of cigarettes and sweets, which. were kept in locked cupboards, and they were often distributed on a reward system rather than by entitlement. The more handicapped patients were not given jam or marmalade because it was feared that little would have reached their mouths. Bovril and Horlicks at times did not reach. the patients. Stocks of new clothing and shoes were seldom used because the patients "would only wear them out". Although there was football and cricket in the courtyard on occasions, with walks at weekends, and although a few of the patients sometimes went to the social club,the life of the ward was regimented. Patients were shepherded about in groups. Windows were not opened or shut, and curtains were not drawn, unless the Charge Nurse gave the order. Books and games, such as draughts, were only available to certain patients for fear that the more disturbed ones would chew or tear them up. Some patients did simple jobs in the Industrial Therapy hut close to the ward and, at times, two patients did rug making while others painted shells and stuck them on flower pots and boxes. There were two ward outings each year. There is, however, no doubt that the patients were chronically institutionalised and that far more could and should have been done to occupy them. Guidance was urgently needed to help staff to escape from the only method of nursing that they knew in this difficult ward. They undoubtedly achieved 'results' in giving the ward an orderly ward appearance, and a letter from the Group Secretary on behalf of the Management Committee complimenting them on this in 1971 must have confirmed the diehards and tended to silence the doubters.

Incident 30

2.28 Two students did ask their Tutor that they should not be sent to this ward for training and their wishes were met.

2.29 The second paragraph is expressed in over-emotive language. Factually however, it is a substantially accurate description of the ward when Mr. Weston worked there.

2.30 The third paragraph exaggerates the position.

Incident 33

2.31 This is substantially accurate.

Incident 34

2.32 Paragraph 1 is a substantially accurate account of the ward at the end of 1971. To another witness the Charge Nurse said that some of the undistributed provisions had been given to other wards that were short.

2.33 So far as the second paragraph is concerned, while it is true that money, cigarettes, sweets and the pay sheets were kept locked away, we have been unable to determine whether or not the other allegations are well founded. What is certain is that the method of dealing with provisions on this ward lent itself to abuses which it would be very hard to detect and prove.

2.34 It is correct, as alleged in the third paragraph, that Mr. Weston complained of some of these matters to a senior nurse. When she found that she was unable to satisfy him with her replies she referred them to his Nursing Officer and Senior Nursing Officer, who at that time was also Acting Principal Nursing Officer.

2.35 Mr. LI the Senior Nursing Officer, and Mr. M, the Nursing Officer, arranged a ward meeting at short notice at which Mr. Weston was to be asked to voice his criticisms. Neither of them spoke to him in advance and he only knew of the meeting shortly before it began. He raised all, or nearly all, of the matters set out in Incident 34. The remainder of those present seemed to have united in seeking to persuade him that he was misguided. No notes were taken of his serious allegations and no further investigation of any of them was made. Mr. Weston stated that as he left the meeting he knew that "the whole bunch were corrupt and that corruption started at the top". This unsubstantiated belief was an unfortunate outcome of an ill-prepared and ill-conducted meeting, This Senior Nursing Officer and Nursing Officer dealt with later complaints on Hazel and Elm wards in a similarly inept manner, but they undoubtedly meant well, and we will consider their reasoning when we report on those wards. Suffice it to say at this stage, that; we doubt whether open discussion is the best way of dealing with allegations of this kind. If, however, such an approach is to be used, the meetings require very much more preparation and greater skill in handling than they received. These meetings must have deterred other staff from putting forward complaints. Mr. M was anxious to assure us that he had, and still has, the utmost confidence in the way that Mr. K ran Birch Ward.

Incident 25

2.36 This is true. Mr. K had no intention of behaving unkindly, let alone with cruelty. Counselling and guidance should have been given.

Incident 24

2.37 Mr. 0 and Mr. P had been very close friends in Ash Ward for about seven years before the 1972 reorganisation. Mr. 0 had assisted the nursing staff in the care of several patients, but in particular he helped with Mr. P who was bedridden and hardly intelligible in his speech to those who did not know him well.

2.38 At the time of the reorganisation, Mr. 0 was sent to Heather Ward and Mr. P to Birch Ward, Mr. 0, to begin with, visited Mr. P when he wished, but he liked things done in his own way, and we are sure that on occasions interfered with the routine of Birch Ward in a manner which was unacceptable to the Charge Nurse Who is now deceased. Moreover he sometimes upset Mr. P by saying such things as "You don't want me any more", and "You don't like me now". Dr. 17 Mr. P's Consultant, then issued instructions that Mr. 0 was not to be permitted to enter Birch because he upset Mr. P. Mr. 0 wrote to Dr. I asking permission to visit his old friend, but this was refused. Eventually Dr. Ankers suggested that Mr. 0 should obtain the help of the Heather Ward Medical Officer. This he did and a compromise was reached under which Mr. 0 was permitted to visit Mr. P at times which did not interfere with the running of Birch Ward,

2.39 The relationship of these two close friends was handled unsympathetically. We were given no explanation as to why they had to be sent to different wards save that they were under different Consultants, The system should not have been so inflexible. If, however, it was necessary to split them the difficulties which developed should have been foreseen and prepared for. A ward meeting should have produced a satisfactory solution instead of the cold instruction from Dr. I. Commonsense did not return until the intervention of the Heather Ward Medical Officer. We can understand that the separation of Mr. 0 and Mr. P and the events that followed must have appeared inhuman to Dr. Ankers.