158 comments By David Drew
For many years NHS trusts have squandered huge sums intended for patient care on silencing staff who raise concerns about patient care and safety. The advice of trust solicitors, gratefully received by the board, is at the heart of this scandal. Once the more obstinate staff who refuse to back down or accept a pay with gag (NDA) settlement are dismissed the trust is committed to further open-ended expense in the tribunals and courts. Irrespective of the rights and wrongs no-one is ever called to account either for the financial waste or lost learning opportunity. In the case of Dr Raj Mattu this amounted to £20 million according to an undisputed newspaper report. Meanwhile the phoney war against whistleblower victimisation continues.
When working as a doctor with Hilltribe refugees in Northern Thailand I was one day driving between camps. Passing through a small town I hit a cyclist who came out of a sideroad at speed. A large and angry crowd quickly gathered. Against advice I jumped out with my medical bag to attend to the casualty. The crowd became still. A Thai man said something that sparked the crowd (uncharacteristically) into hysterical laughter. I asked my translater what had been said. "Look at that Farang (foreigner). First he tries to kill him. Then he tries to save him." First they drive you crazy. Then they help you push in the queue to get a remedy. Crazy? Or what?
Why the need for "Whistleblowers" in an NHS Safety Watchdog that ought to be completely transparent about its problems and its failings?
Jeremy Hunts legacy? The most transparent health service in the world? Yesterday we had a CCG doctoring a report to conceal "avoidable death". Today CQC airbrushing out of history the failings of a provider clearly needing improvement. And yet CQC is still allowed to commission its own "independent" investigation. CQC is bringing regulation into disrepute.
That's fair comment Anon at 15:17. The retraumatisation caused to already grieving families by such dishonesty is hard to imagine unless you have been personally involved. The "public servants" responsible for this do not appear to give a damn about the years of pain they are inflicting by their actions. This is the attitude that lies at the heart of the suffering meted out to so many who embark on the NHS complaints system. Years and even decades of frustration, anger, disappointment, heartache. The NHS was not conceived with this in mind. Clearly it has fallen into the wrong hands.
Well done Paula and Tom. And well done Barbara Keeley. One more blow against the pretence of fair play and transparency in the NHS. It might now be appropriate for someone to ask Simon Stevens to ensure independence in all investigations commissioned by NHS trusts and regulators. It might also be time to have a look at why draft reports spend so much time at the Department of Health before publication. And what redaction they undergo during that time. It's not so long ago that Jeremy Hunt was waxing lyrical about black box thinking. If you want to make flying safe you can't rewrite the facts. Ditto healthcare.
Interesting, Kevin Riley. Both Sir Mike Richards and Tom Kark have told me personally that we cannot afford to be too hard on NHS CEOs as we already have a shortage of people wanting to do the job. So, that fits. My own complaint to CQC under FPPR involved the avoidable homicide of a child which was covered up by the trust for 8 years until I helped the father to expose it. CQC had all the evidence but helped sweep it under the carpet. The truth will out. I have no doubt of that. But too late. The CEO took the opportunity to take early retirement and do business elsewhere. With dignity.
A great opportunity to understand lack of progress on NHS Bullying. See Anonymous comment at 01:05 "For all their faults - Unions don’t say there is bullying without good reason." 6 likes, 6 dislikes. Comments & like/dislikes largely show partisan bias. Pro-management based on personal recommendation and reliance on policy. Pro-staff more likely to argue on actual facts & evidence. Opaque reviews with limited scope and of questionable independence are not the way to resolution. Or reconciliation. Patient care depends on workplace harmony.
“We have to get it right because at the same time we also need to be able to encourage more people and people of great calibre into positions of leadership within the NHS. So getting the balance right so that this strengthens the system and encourages people in is what I would be looking for.”
This makes no sense. Why should the prospect of directors being struck off for acts of Gross Misconduct deter high-quality individuals from applying for such posts? Competent, ethical individuals have nothing to fear. They should be reassured rather that they will be swimming in shark-free waters.
We may hear no more of this recommendation. Until next time.
Suspending judgement until report published.
"He will also recommit government to doing more to support whistleblowing doctors and nurses, the DHSC said."
Dr Chris Day is trying to get his case heard in full after he withdrew following a ruinous costs threat. One of the Morecambe Bay whistleblowers started crowd funding for her tribunal yesterday. Dr Beatt is still waiting for his remedy hearing after Croydon NHS spent years squandering huge sums fighting their indefensible behaviour. Francis reported 4 years ago. But Kark has uncovered the need for more whistleblower support. The many egregious examples given to Kark of whistleblower mistreatment warrant something stronger than this.
Organisational DoC became statute 27 November 2014. Since CQC has detected only one breach in more than 4 years it is clear that this legislation was not needed. Unless of course CQC has been unable to see what goes on in front of its eyes on a daily basis.
15:41. Can you not see the irony of an anonymous defence of this Trust as a paragon of transparency? You cast doubt on the findings of the report. You claim no costs threat was made but provide no evidence. What on Earth would Dr Day hope to achieve by applying for the settlement to be set aside if there were no truth in his claims?
Hi Anon at 11:45. Correct. Dr Day has applied to set aside the settlement. If successful his claim will resume at ET and the respondent's 14 witnesses will be cross-examined. Meanwhile however, MPs Norman Lamb & Justin Madders have written to Matt Hancock. They suggest that no more money beyond the £700,000 already spent opposing Day should be wasted. They have requested a Public Inquiry. The ongoing ambiguity surrounding NHS whistleblowing given the inadequate legal protections requires some form of public scrutiny. Especially given Francis's failure to ensure victimisation is stopped. I hope Mr Hancock takes note.
To pick up on a point from Anon at 9:33. The "use of disciplinary processes to silence critics and the collusion HR departments have with managers in sustaining this is toxic." This is widespread in the NHS. The Verita report on Amin Abdulla's suicide illustrates it perfectly. And again, a good but BME (and gay) nurse who was literally bullied to death. The 95 (I imagine 965 is a typo) disciplinaries in 2 years in this trust looks high. Since exclusion, disciplinary investigations and hearings are well recognised tools for shutting good staff up Ben Travis (to be thanked for commissioning this review) should now organise independent scrutiny of each case.
Well done PHSO. As one of those who first complained to CQC about the Vasco-Knight appointment & the whistleblowers left to rot I provided hard evidence of gross misconduct. I can only describe CQC's response as dismissive. Even in their statement to today's Ombudsman report they do not seem to understand how badly wrong they are getting the regulation of this statute. It puts into question specifically all decisions in complaints under regulation 5 of whistleblower supression. Suggestions have been made today on Twitter of in-group/out-group bias involving the then chair of the CQC FPPR committee. In the small and insecure world of NHS leadership that looks quite possible.
Sir Ian Kennedy gave an HSJ interview 10 years ago on the malignant problem of bullying in the NHS, as he retired as HCC chair. In it he referred to the same problems encountered at Bristol in his investigations a decade earlier. Its worth a read as it demonstrates that little has changed except that the problem may have intensified and become more deeply ingrained. https://www.hsj.co.uk/news/workforce/bullying-permeating-patient-care-warns-healthcare-commission/2007581.article It is, unfortunately, not in the interests of those at the Department of Health and NHS regulators to allow too close a scrutiny of this problem as the evidence trail inevitably leads to their own doorstep. Francis referred to this as the "kiss-up, kick-down" culture in which everyone is looking out for their own progress/safety/survival. As Francis also said, patients rarely figure in such a dog eat dog world. There are people who understand this problem much better than I do and are able to prescribe remedies that will work. The medicines may prove unpalatable to those at the top. Sadly so, for staff who dread going to work in the morning. And patients who depend on them for their care.
In its 2013 response to the Francis Mid Staffs PI report the Health Select Committee stated specifically that disciplinary procedures and employment tribunals are inappropriate fora for dealing with NHS staff who raise concerns. This simple principle if applied rigorously would stop this waste of healthcare talent and the squandering of many millions by Trust boards to protect themselves. The Department of Health in its response to the Select Committee's report says all the right things but 5 years later has done nothing to protect whistleblowers. This is why they suffer in rigged disiplinaries (see Verita reports on Sandra Haynes-Kirkbright at Wolverhampton now in year 7 of illegal exclusion and Amin Abdulla at Imperial, dead) and as with Dr's Day, Beatt, Jesudason etc., in the Tribunals. I can only assume that DH, regulators & NHS leaders have no real interest in creating a just culture.
As someone who contributed to Chris Day's crowd fund on a number of occasions I count the money a good investment. I certainly do not want a refund. I know of no-one who does. I applaud him for the way he has stuck to his principles. There is a huge gap between law and justice in the way the NHS treats staff who raise concerns. That the problem is widespread in the NHS is now universally accepted but strangely the number of whistleblowers vindicated by law can be counted on one hand.
"In the decision, the tribunal singled out Dave Rosser, then the trust’s medical director, who has since been promoted to chief executive, for criticism as the “driving force” behind the dismissal.
The tribunal found Dr Rosser had an “apparent bias” that had led to a “sham exclusion” and the eventual unfair dismissal of Mr Reuser."
A CEO who acknowledges an employee has made PDs but thinks he's not a whistleblower? Given that Francis's main bastion in the fight against whistleblower suppression, the Speak up guardian, is directly answerable to Dr Rosser the future of safe reporting in this trust is in doubt.
The trusts answer, under Dr Prosser, is to throw more money at it with ever more expensive lawyers. This is about protecting individual and organisational reputations, not about learning from your mistakes. And certainly not about patients.
Whistleblower Ed Jesudason has posted these preliminary but useful thoughts on Chris Day's ET this morning: https://jesudasonappeal.wordpress.com/2018/10/17/a-hard-days-night/amp/?__twitter_impression=true