Friday, 12 August 2011

KGV SHAME! Conditions are appalling, shameful and third world

Having had a close family member who suffered from a severe mental illness for the better part of his life, before he died of natural causes in a psychiatric hospital in the united kingdom, I have little difficulty in understanding the plight of people who are either suffering with a mental disorder, or with members of the family who also go through much pain and anguish. Many families in these difficult circumstances go through tremendous stress practically on a daily basis.

So when I was approached by a close relative of a patient at the KGV hospital who asked me if I could listen to a story regarding this relative with a view of making the story public. I was in all honesty surprised, but listening to this person I immediately began to understand what Alex was really asking for (Alex is not this persons real name, but with a family member as a patient at the KGV, Alex did not want the real family surname revealed) Alex in fact was looking for a receptive ear, and also to be listened to and hopefully understood, but also for the truth to be made known to the public. Ultimately what Alex wished was to ‘to improve the living conditions at this important public medical institution’

Alex came across as a genuinely concerned individual, as one would be I expect, when anxious about the welfare of a loved one. Clearly this was evident during our discussion. Alex close relative had been struck down by a mental illness and had taken up residence for treatment at the KGV, this had caused many sleepless nights in this household.

The main issue revolves around the condition and living standards at the hospital, something that Alex repeated many times was far worse than any ‘third world country’ being concerned for the welfare and well-being of a family member who is not only sick but psychologically vulnerable, must be the driving force in anyone’s mind, particularly in attempting to improve and change things for the better; Alex in this sense, was no different than anyone else in the same situation!

As I said Alex’s main complaint is about the conditions at the KGV. As matters were related to me, I also saw photographs taken illustrating what was being pointed out to me, they were shocking! Photos that would make most people cringe with horror and disgust:

‘How can our health services allow this to happen’ and how can this be happening in Gibraltar in the 21 century!

This is the full account of what ‘Alex’ had to say:

The KGV’s all in one ‘acute ward’

The acute ward is situated on the first floor of the KGV hospital; the ground floor is taken up by long term KGV residential patients. However it is the acute ward where members of the community are admitted suffering with psychological problems of different kinds and of varying degrees.

One of the first issues regarding the hospital refers to how all patients admitted end up in the acute ward. All admissions to this ward are made ‘irrespective of the sex, age or the type of mental illness a person is suffering from, be it drug related, psychological or behavioural issues or even depression’. The latter point of people admitted with depression will surprise many people, I know I was!

“I cannot understand”, Alex said “how people with a range of different mental illnesses of varying degrees can be admitted to the KGV, these unfortunate people suddenly find themselves plunged in amongst other patients, all on the same floor”. Just where is the clinical or medical management in that? Mixing patients like this, not withstanding their condition, sex or age group must be unique to Gibraltar’s psychiatric ethos.

Sleeping – and young patients who find it difficult to integrate!

As far as personal sleeping arrangements are concerned, there’s nothing personal about it, although sexes are segregated. There is little or no privacy; patients are allocated sleeping quarters which are normally shared between 2, 4 or 6 patients of the same sex and in one room. I am told that patients of both sexes are wandering all over the ward floor and privacy of any kind is impossible. Also that ‘young men and woman who are sometimes 19 or 20 or over, find it difficult to integrate into this hospital environment’

Recently because of increased female admissions the acute ward staffs have moved round sleeping arrangements to make available additional room to cater for the increase in the female population. This is something I am told that has caused a lot of distress and disruption to the patients themselves, resulting in a further drop in the quality of the living standards in rooms.

Rooms in a dilapidated state, no wardrobes or cabinets for personal belongings

Bedrooms are in a sorry if not dilapidated state; bedrooms are the more private part of the ward, if you can call it that. Paint on walls has flaked off, there are holes and broken partition walls that have not been repaired. The look and feel of the sleeping rooms are cold, dull, shabby and not fit to house any kind of medical patient, never mind one with psychiatric issues.

Another issue that appears to be in line with the state of the sleeping quarters ‘is the total lack in many rooms of wardrobes and cabinets to store personal effects’.

Many patients are not able to properly and safely store their personal belongings, rooms look disorganised, messy and one not fit for a vulnerable people to cohabit, I was told that on many occasions clothes and other personal items have gone missing!

Showers used as store rooms

You would expect that shower areas would have some level of hygienic improvement, the story here is not much better. In fact showers are being used as store rooms, they have been stacked with ‘portable disability walking frames, chairs and other bits of equipment’ towels funnily enough are left (see photo) on the chair that’s on the shower plate itself, just in case the patient is able to remove all the obstructions from inside the shower. Although I’m told hopes are dashed again of having a shower because the water mixer in the shower is broken.

Shower products I was also told are stored in the shower area commune style i.e. Shower cream, shampoo and sponges etc, if a patient eventually gets into the shower he or she would use the shower products available, including I imagine the same shower sponges which somehow does not appear very hygienic to me!

One more thing about the showers and something that can be appreciated in the photos, the shower curtains really looks to have seen better days.

But there is also the ‘important matter of leaving in a psychiatric hospital ‘acute ward’ ‘wired coat hangers lying about’ inside the shower.

This is a potential safety risk, where vulnerable people may do serious injury to themselves or to others or even worse! So much for health and safety.

Donated furniture does not get repaired

Another matter Alex raised was regarding furniture items, furniture according to what I was told is difficult to obtain, as furniture items are donated and more often than not are second hand and not repaired! It is difficult to think what kind of mental care is being delivered in Gibraltar. How can people who are already suffering inside with their own mental ailment be treated in such undignified manner, it truly is appalling!

Medication by envelope

Come medication time at the KGV, Alex has another story to tell, because medication which should normally be handed out to patients in small plastic receptacles to ensure that meds have been taken safely, are frequently distributed to patients inside a normal ‘envelope’ because plastic receptacles are unavailable or have run out.

I will say that Alex had much praise for the staff at the KGV hospitals - who are constantly working, mostly under stress; the conditions of work don’t help. Many of the staff are overseas nationals, who are also over-burden by having to perform extra shifts because of the shortage of staff. It is not uncommon for staff at the KGV to perform overlapping shifts, this cannot be good in anyone books. How are staff members expected to be alert and attentive to the needs of vulnerable patients if they work continuous roll-over shifts!

GHA cannot get it right at KGV

The KGV hospital has been the subject of much criticism over the years, the nursing section themselves have been one of the biggest critics, particularly regarding health and safety standards not being complied with. There have been deaths at the hospital involving patients, fires have broken out, even nursing reviews have been critical of KGV.

The Gibraltar health care development team said in July 2003. That the ‘mental health services continue to be the poor relation of Gibraltar’s health service.’

This team was right, but the KGV are not the poor relation any longer, they are it seems the totally destitute and forgotten relations!

People with psychiatric problems cannot wait for government to build them a new purpose built facility. These are some of the most vulnerable people in society, who not only expect, but deserve the best possible all round care and attention; this is something that takes many forms. Even if a new psychiatric unit is to be built, it is no excuse to allow the standards at KGV to go rock bottom, with dangerous practices in certain areas endangering the health and well-being of patients in general.

Health and safety at the KGV has again been ignored, shower rooms packed with hospital equipment causing danger to patients, dangerous articles left lying around, and medication handed out in a manner which is unethical in any clinical manner, particularly in such a facility. Reports of under staffing and staff themselves stressed out and having to work double shifts or more because of staff shortages are not good!

It is pitiful that government allows such a deterioration of this important medical institution; the KGV hospital is an embarrassment to Gibraltar. Promise of a new hospital is no excuse in allowing standards to drop like this. Inpatients recovery is being compromised by the visible deterioration at the hospital.

The KGV hospital as this article suggests keeps on falling short in health and safety standards and risk management. The appearance of the KGV inside and out is imposing, ominous; it does not look like a place where people would go to get well. It looks like a place where people would go, and stay and remain for a long, long time!

Mental health services in Gibraltar should be just as important as physical health services such as those for cancer and heart disease and many others. But it’s not!

Friday, 5 August 2011

Concern Over Violence at Bayside Comprehensive

The scholastic year ended some weeks ago, with it, some disturbing reports received at Panorama regarding school discipline, perpetuated by acts of violence primarily at Bayside Boys Comprehensive School.

We put questions to the Department of Education and the RGP, and in an extraordinary develolpment, the Education department tried to play it down, while the police provided statistical evidence that confirms the concern over violence and other incidents, including drugs, at Bayside school.

The Department of Education & Training said that they can confirm that the Police have not been called to the Comprehensive Schools during the course of last term to deal with incidents involving violence, aggressive behaviour or disturbances. Any type of violent incident will be of concern to teachers and the Department of Education and Training. The Department of Education and Training, that is in daily communication with schools, does not have evidence to support the notion that there is growing concern about violence in our schools.

However, the RGP said there have been in the past year starting as from April 2010, six incidents of assault at Bayside Comprehensive School that have been reported to police, there has been one incident at Westside School also of assault.

A spokesman added: "We have also dealt with other incidents which do not fall under incidents of Violence, Aggressive Behaviour or Disturbances involving students, these incidents range from minor thefts, setting off the fire alarm and students found in possession of drugs. Due to Data Protection issues I am unable to give you any further details as to the said incidents." We understand that the teaching profession is concerned with the level of aggressive and violent conduct of some students particularly at Bayside school. We are also informed there have been incidents where teachers have been either physically or verbally assaulted, fights amongst students themselves has also increased. The seriousness of the matter has seen the presence of police outside the school gates on a number of occasions in order to prevent any violent behaviour amongst students breaking out!


PANORAMA has been investigating. We have been informed that another concern, apart from the violence factor, relates to matters of drugs, here again we are informed there are similar concerns and where some parents who fear the general drug abuse problem currently affecting Gibraltar has spread to senior schools.

The lack of discipline in some students, again at Bayside, has seen some of them expelled due to their behaviour, although details of these expulsions are not known, but our understanding is that during the course of the year there have been some students sent home for contravening school rules.

Of all the issues connected with the education system, the one that causes most concern for educators and parents alike, and the one over which most doubts exist, is the effectiveness of school discipline, an issue that’s never really surfaced on the rock! Are schools worse off today as regards discipline than they were, say, 20 years ago? Have children become more difficult to handle and teach? Is the school environment peaceful enough to allow teachers to teach and students to learn? What, exactly, does discipline imply? In fact do we really have a problem that needs addressing?

The New Oxford Dictionary of English defines discipline as "the practice of training people to obey rules or a code of behaviour, using punishment to correct disobedience". School and classroom discipline is both preventive and remedial and schools make use of their sticks and carrots to create a safe and orderly atmosphere in which students can learn and interact with each other.

In today’s society teachers are finding maintaining order in class hard and exhausting, which makes teaching those who want to learn difficult and those who refuse to learn almost impossible. Teaching today is not an easy task. Not that it has ever been so, but today there are added constraints that make a teacher's life that much more taxing.

Taking a brief look at our society, one can note certain rapid changes, especially over the last two or three decades, which hinder the task of the teacher.


The respect for people in authority has been weakened to the extent that some our children think nothing of challenging and even ignoring all forms of authority in school at home and out in the streets. They think they have a right not only to question all orders and regulations coming from any source, but also to reject what does not appeal to their way of thinking.

The so-called 'youth culture' is changing very rapidly and drastically, to the extent that young people cannot keep up with its demands - on their time - in their style of dress and in the type of music they listen to and in the quality of relationships they engage in.

Some teachers have recognised a lack of disposition and motivation to learn in some students, especially on Fridays when they are gearing up for the weekend and on Mondays when they start unwinding after a hectic weekend. And all this time, the poor teacher is expected to teach his or her subject regardless.

Despite the popular impression that being a teacher is all about pleasantries such as longer holidays and shorter working hours, the reality of their situation tells a different story. Teachers are by no means enviable part-timers. In fact they have one of the most demanding jobs of all - particularly in terms of the mental strain that is part and parcel of their profession.

Of course, not every teacher suffers stress. But there is concrete evidence that teaching is one of the most stressful jobs possible. Many surveys (not in Gib) assessing the stress levels of various jobs constantly indicate that teaching came out top

While policy-makers do their job we all have a social responsibility towards all children. We all have a moral obligation to guard children from the transmission of harmful behavioural patterns, to keep their environment morally healthy, even if it is not easy to clean our surroundings.


Society has changed greatly we constantly hear of rising crime and violence in Gibraltar fueled by drug and alcohol abuse, youngster at 14 years being sent to prison for supplying drugs, others as small as 12 years arrested for burglary and so on. Sadly more and more of these disturbing stories of young people getting involved in crime are being heard, mostly with drug or a drug and alcohol connection.

Many people think, including some teachers, that these negative social issues in society have made there way into the school classroom. There’s no doubt that something effective has to be done to eliminate it or at least get it under control!

Government for their part have reacted to the growing concern of crime and anti-social behaviour stemming from youth behaviour, with a piece of new Criminal Legislation it is proposing, known as an "Anti Social Behaviour Order" more commonly known in the UK as (ASBOs) the new legislation will allow prosecutors to apply for ASBO orders which in the UK can be used against anyone who is 10 years of age or over and has behaved in a manner that caused or was likely to cause harassment, alarm or distress to someone or some people who do not live in their own household.

An ASBO stops the young person from going to particular places or doing particular things. If they do not comply with the order, they can be prosecuted. This proposed new legislation is to be included in the New Criminal Procedure and Evidence Act, it is yet to be debated and approved by Parliament.


Our understanding is that there are some students who have serious problems, whether at a social or psychological level. These students have to be taught and have to be supported. However, their right to education and their integration in our schools cannot occur at the expense of the safety and well-being of fellow students and teachers.

Let’s hope that proper processes are put in place to improve matters before the next academic year. The sinister signs are there, the evidence has been confirmed - the Government must not try to sweep these serious problems under the carpet because the problem will simply snowball and Gibraltar will be the loser on a bigger scale.