As hospital defends staff, the work never stops

The Whittington Hospital issued a renewed defence of its care of Rose Addis yesterday as the political storm surrounding the grandmother's stay in casualty raged on.

Senior managers met her family to discuss the case, but the hospital criticised Iain Duncan Smith, the Conservative leader, for raising it at Prime Minister's Question Time. Alan Milburn, the Health Secretary, held a private meeting with staff at the hospital to express his support

Professor James Malone-Lee, medical director of the Whittington, said members of staff had been, "very, very distressed" by the affair.

He said: "We have an incredibly well-tried system where constituency MPs can contact our complaints department in response to a patient's claims. This is the norm.

"For this to appear in the House of Commons like that without any contact from the constituency MP really was appalling. I have never known anything like this in all my time in public service.

"It did huge harm to staff. It's very frightening when senior politicians engage like that over patients you thought you had looked after well."

Inside the hospital's accident and emergency unit yesterday the metal benches in the waiting room were thronged as usual with patients waiting to be called for treatment in one of a series of cubicles painted NHS regulation pastel green.

The unit treats a minimum of 200 patients a day in a busy corner of north London, but it was perhaps unsurprising the name of 94-year-old Rose Addis was on the lips of those holding bruised limbs and sore heads. Aware they were now sitting in perhaps the most politicised accident and emergency ward in Britain, many were eager to talk about their experiences.

Ron Adams, 52, a builder nursing a foot badly bruised in a fall, said: "I've been waiting a couple of hours to be seen.

"You get the feeling that no matter how fast they go, the staff will never end up with an empty waiting room. It's a constantly dripping tap.

"I came here a couple of years ago with my daughter and it was eight hours before we left. The nurses were polite but with the best will in the world they just can't see people quickly enough. This place needs to be twice the size and have four times the staff if it's to run like a patient would like it."

Yesterday, the Whittington casualty unit, a tidy modern complex built six years ago amid the hospital's remaining Victorian buildings, had to make do with a total of 90 staff.

The A&E payroll consists of 50 nurses, three short of the 53 allowed in the hospital budget, along with 20 doctors of various grades and a further 20 auxiliary staff including porters. At any one time around half that number will be on duty. Together they must deal with 73,000 patients a year.

The sick are treated in five different treatment zones, including a major trauma area, a major injuries area, a resuscitation room and a specially designed area for children.

An observation ward containing four beds, where hospital managers say Mrs Addis was placed shortly after her arrival, sits alongside the casualty treatment area.

Patient watchdogs confirmed that long waits in casualty were among the top sources of discontent for users of the hospital.

A report by the Government's Commission for Health Improvement on the Whittington published two weeks ago remarked on the hospital's friendly atmosphere and the way staff communicated with patients. But it also noted concern about casualty waiting times, reporting that in August 2001, "93 patients had waited between four and twelve hours, which was a significant increase on previous months". Trolley waits of more than 12 hours had been reduced, with just three such incidents since March last year.

The hospital, which serves a deprived, multi-ethnic part of north London, is known to have problems, many stemming from inner city deprivation, but it is not regarded as one of the worst performers in the capital.

The local Community Health Council says the level of complaints about A&E services is, "unlikely to be much worse or better than other London hospitals". While a survey of NHS hospitals last year by CHKS, an independent company specialising in measuring health care, found the Whittington was among the top 40 in Britain.