A chilling report reveals the killing of the vulnerable under the auspices of the National Health Service

It had, said the Guardian columnist Polly Toynbee, “all the hall-marks of routine extermination of the inconvenient”. According to last week’s independent report on the Gosport War Memorial Hospital from 1998 to 2000, at least 456 people died of a medically administered diamorphine overdose.

As horrifying as that number is the testimony of nurses in the ward, including the auxiliary nurse Pauline Spilka. She recalled one patient who was mobile and mentally alert – but also disliked by the management. “I remember having a conversation with one of the other auxiliaries… We agreed that if he wasn’t careful he would ‘talk himself onto a syringe driver’.” One day she came into the ward and her fears had come true. The previous day, she said, he had been fine.

Theresa May has expressed concern, and the health secretary Jeremy Hunt called the report “truly shocking”. It suggested that nurses felt unable to challenge the process, and consultants were reluctant to intervene. Whether anyone will face charges is so far unclear.

Critics of the NHS have suggested, perhaps opportunistically, that it shows systemic weaknesses. Evidence of a broader pattern is anecdotal, but there are many such anecdotes, not to mention the failures of the Liverpool Care Pathway.

Defenders of the NHS, which is celebrating its 70th anniversary, have been quiet about the scandal – or, in the case of Toynbee, bizarrely suggested that the story reinforced the case for the legalisation of assisted suicide. In truth, the incidents show how lightly vulnerable lives are already treated, even without putting the power of killing into the hands of doctors and nurses.

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