A senior doctor has admitted that the NHS did not do enough for a 14-year-old who died under the care of a private hospital it sent her to and kept her in despite knowing it was understaffed daily, an inquest has heard.
The doctor, Dr Gillian Combe, has also warned that children’s mental health units across the country are struggling to staff their wards every day and that the NHS does not have the money to build its own wards.
Ruth Szymankiewicz died after self-harming while she was left alone at Huntercombe Hospital, also called Taplow Manor, near Maidenhead in Berkshire, despite requiring constant one-to-one observation, Buckinghamshire Coroner’s Court was told last week.
On Monday, Dr Combe, a clinical director for the Thames Valley provider collaborative, which is responsible for commissioning children’s inpatient mental health care for the area, gave evidence.
She told the jury there no other choice but to admit Ruth to Taplow Manor’s psychiatric intensive care unit (PICU) on 4 October 2021, despite a warning from her parents that this was not appropriate for her.
A month later, Dr Nishchint Warikoo Ruth psychiatrist at Taplow Manor, made a referral to the NHS asking for her to be moved to a different unit, as the PICU “environment wasn’t the best for [her]...but that there wasn’t any other suitable place”.
When asked about Ruth’s admission to the hospital, Dr Combe said: “We had concerns, I was in the [provider collaborative] we had the CQC, we were living and breathing trying to turn this hospital around but hospitals around the country were facing the same challenges…all the units were really struggling…it was a really stretched really difficult system.”
“We were really trying and I’m really sorry, what we did it wasn’t enough for Ruth but we were really trying so hard to come alongside as the NHS to help this hospital improve,” she said.
“We were in a situation where beds were closing across the country. We have seen mainly independent sector providers pull out across the country…there were really high level discussions we decided we would throw everything at Huntercombe Maidehead and we worked really hard.”
When asked if the provider collaborative was aware of the staffing issues at Taplow Manor, Dr Combes said: “Yes…absolutely they were struggling on a daily basis…there are training issues we don’t train enough nurses it difficult to recruit every day on my ward we’re struggling to staff up to the next day and this is happening all across the country. It is really tough all the time.”
She also revealed that the NHS had quality concerns over other PICUs across the country, and all were struggling with staffing.
Dr Combes admitted, “The NHS does not have the capital to build the hospitals for these young people that we desperately need. This is embedded in my lessons learned following the closure of the Huntercombe, it is a massive problem.”
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Source: The Independent, 12 August 2025
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