RUTHFULLY YOURS

Two days after this speech, an independent report revealed a different way in which the NHS is world-class. NHS managers covered up the unlawful killing of up to 650 patients at the Gosport War Memorial Hospital on the English south coast.

The NHS is not a stranger to mass medical malpractice. Three years ago, a report revealed the deaths of 19 mothers and infants at Morecambe Bay Hospital due to clinical incompetence. In 2015 the Francis Report into Mid-Staffs Hospital found “appalling and unnecessary suffering of hundreds of people” and warned of “highly concerning” reports of similar experiences elsewhere.

Last week’s report lifts the lid on the most horrifying NHS scandal. On Aug. 17, 1998, 91-year-old Gladys Richards was readmitted to Gosport for rehabilitation after surgery and treatment for hip dislocation at another nearby hospital. Although Richards didn’t mention any pain, Jane Barton wrote a prescription for high-dosage opioids and gave Richards a subcutaneous infusion. Dr. Barton explained that using a syringe driver was the kindest treatment available, and she continued, “the next thing will be a chest infection.”

Dr. Barton understood what she was doing. Richards’s death certificate records the cause, four days later, as bronchopneumonia, even though this was not the underlying cause of death. According to the report, mis-certifying deaths due to bronchopneumonia was linked to opioid usage without appropriate clinical indication. The report also found that bronchopneumonia-certified deaths rose at the hospital starting in 1993 and peaked in 1998—the same year Richards was admitted.

Richards’s two daughters reported her death to the local police, who started the first of three bungled investigations. “The doctor fully explained the procedure of placing a syringe driver in place and the eventual outcome,” one detective wrote, complaining to a colleague that he had no idea why “these two women are so out to stir up trouble.”

The investigations uncovered evidence of criminality, but it was difficult to call to account those responsible. When officials in London tried to find out what had been happening, local NHS managers complained of “headquarters interference.” Twelve clinicians wrote to Sir Liam Donaldson, the Department of Health’s chief medical officer, to say that Dr. Barton was being made a scapegoat: “Senior colleagues were not only aware of these practices, but had similar prescribing practices.”

One nurse told the police that the regime at the Daedalus Ward—“Dead Loss,” the staff called it—was geared toward euthanasia. Upon admission, one elderly woman was immediately put on a syringe drive. Her family insisted she be allowed to die naturally. She recovered sufficiently to be taken home. Brian Livesley, a physician at the Chelsea and Westminster Hospital, was brought in by the police to review the evidence. He said he would support allegations of manslaughter, assault and actual bodily harm.

The most damning evidence was that nurses had raised concerns in 1991 about indiscriminate use of opioids and syringe drivers. Eleven years later, the meeting notes resurfaced. “When I read the minutes, I felt sick,” a senior nurse recalled.

A handful of people within the system tried to broaden the investigation and publicize what was going on. Mr. Donaldson pressed for urgent action, telling ministers that a great deal of pressure had to be exerted from the center. At virtually every turn, the system beat them. The health secretary, Jeremy Hunt, eventually had to overrule official advice against holding an independent inquiry.

The report explains the almost identical dismissal of relatives’ concerns as a result of the “coincidence of interests” rather than conspiracy. When the state is a monopoly provider of health care, there is a political interest in suppressing bad news. In discussing whether to prosecute, one police officer noted the “perceived plight” of the NHS ahead of the 2001 general election. At a pivotal meeting of prosecutors closer to polling day, a government lawyer attacked Dr. Livesley and sabotaged the emerging prosecution case.

Proponents of socialized medicine condemn profit in health care, but a for-profit hospital does not have a financial interest in killing its patients. In the NHS, patients are a cost and troublesome ones can be put on a syringe driver, something a nurse told the police happened at Gosport.

“The NHS is drowning in bureaucracy,” a report noted in 2015. NHS bureaucracy drowned evidence of Gosport’s culture of euthanasia. Fifteen years ago, then-Prime Minister Tony Blair delivered a landmark speech arguing for pluralism in the delivery of public services. “Our aim is to open up the system,” he declared, specifically calling for private sector provision.

A January 2018 poll found 64% of respondents agreeing with Mr. Blair that it shouldn’t matter whether hospitals are run by the government or by the private sector and 58% agreeing that the NHS needs reform more than it needs extra money. By spending without reform and ruling out pluralism, Theresa May is out of step with a majority of voters. In doing so, she is taking health-care policy in Britain back to a darker age.

Mr. Darwall is author of “Green Tyranny: Exposing the Totalitarian Roots of the Climate Industrial Complex” (Encounter, 2017).