204 comments By David Drew
I had a long conversation with Dave West on Friday. No-one reported my comment or complained about it. It was a proactive editorial decision. If HSJ had been better informed about this CEOs career the decision would have been to leave my comment up.
Thanks Anon at 15:10 on 1 August 2020. After I provided extensive evidence for my comment Dave West, news editor, agreed to me reposting it. I haven't had time to re-type it through family commitments. I pointed out the irony of David Loughton's strange act of whistleblowing given that he himself has made a career of opposing NHS staff who raised concerns about patient harm and fraud. I specified the cases of Mr. Alban Barros D'sa, Dr Raj Mattu, Professor David Ferry and Mrs Sandra Haynes-Kirkbright. All you have to do is Google David Loughton against these names to discover the trail of damage to staff and patients he has left behind. David West has asked me to post the links I have sent him. I haven't had time. He has them. I would have expected the NHS's foremost healthcare management rag to have been fully informed on this CEO without me having to educate them. So, censorship? Maybe? Maybe not. But it is at least clear that some are much more readily believed than others. Those with clout. Literal clout. I am posting this for the record. The story has moved on.
Thank you Andrew Vincent at 13:22. NHS Whistleblowers know as well as anyone that none of us serve only the patient and the public. I welcome David Loughton's exposure of the reality that all staff, including Chief Executives, work under. One of divided loyalty. And the importance of controlling bad news. Maybe this story, when we know the details, will help us better understand how power differentials distort clinical priorities. And help give patient safety the priority it dererves.
Hi Dave West at 10:00 You have prejudged the issue. You mean an allegedly defamatory claim. Unless there is evidence that the claim was untrue. The accounts of David Loughton's mistreatment of these Whistleblowers is in the public domain in the form of newspaper articles, ET judgements, independent reports etc. I never post anonymously. I hold to the account I have given.
The problem is not so much that the NHS has too many regulators as that it does not have enough good regulators. And from my own experience and that of others I include PHSO in that opinion.
In criticising other regulators RB is speaking from a position of considerable weakness. His report has found “inconsistency in complaint handling across the NHS, leading to variable outcomes for people who complain,”
But these are exactly the complaints many level against his own office.
My own experience of complaining (3 against CQC, 1 against NHS Improvement and 1 against NGO) is of a ponderous, inefficient and biased process that never gets anywhere near to holding regulators to account for their failings. In cases where families have made a formal complaint to PHSO and I have been able to advise I have found the same. Social media is likewise teeming with the same opinion.
JC is right to suggest the office of independent patient safety commissioner. If that means a fair, independent and intelligent process that listens to patients, families and staff, investigates exhaustively and comes to the right conclusions. I have little faith that any existing regulatory body can guarantee that. Whether the new commissioners office would be able to is moot, especially given the toxic politicisation of patient safety that continues to hold it back.
In many cases of patient harm providers, regulators and PHSO make things worse rather than better, retraumatising the bereaved and condemning them to many years of frustrating and ultimately pointless struggle.
I've no particular knowledge in this area but isn't it strange that Ireland has an app that's up and running. It cost a twentieth of what ours cost. The one that fell before the first fence that is.
Dear Anon at 3 July 2020 17:15:
Of course clinicians are not without the faults you mention. I do not "neglect" that. But in Alison's articles this week the specific issue has been why some trusts are less transparent than others over the reports of invited reviews. The HEFT report published online in 2010 is, as I say, open about clinician behaviours and their potential adverse impact on patient care.
Thank you for your comment. I cannot for the life of me understand why it has to be made anonymously. You are able to address me personally by name. I do not know who you are. What are we afraid of?
It appears that a culture of transparency has its origin at the top of the organisation. Here is a good example from my book. It compares the behaviour of Dr Mark Newbold at HEFT (complete transparency) and Sue James at Walsall (secrecy and fear).
"Only three months earlier, Dr Martin Ward Platt, also recommended by the Royal College of Paediatrics, had completed his report, “Review of Services for Neonates and Children at Heart of England Foundation Trust (HEFT)”. This Trust bordered Walsall and had significant problems with its paediatric services. In contrast to the Walsall report, which was delivered into the hands of a CEO and Chair that had already failed us badly, the HEFT chief executive published his report on the internet. This was despite its containing such alarming statements as “some of the relationships between consultant staff at Good Hope Hospital, Birmingham, are so dysfunctional that there is potential for patient safety to be compromised.” Nothing was confidential and there was no scope for a cover-up."
Ethical leadership is a neglected category in the NHS.
In 2009 I made a number of protected disclosures to the chair (Mr Ben Reid, now at SaTH) of Walsall Healthcare NHS Trust as a result of which RCPCH conducted an invited review.
Nadeem Moghal, the review chair, (ex-MD at BHR) , failed to adhere to the college guidelines in conducting the review. The panel refused to take any evidence relating to my disclosures (safeguarding, patient safety, managerial bullying) and refused to interview my witnesses. Its report, without providing any evidence, concluded that I had not made protected disclosures.
The report was then vigorously suppressed. Apart from the chair and CEO the trust board was not allowed to see it. I then shared selected parts of the review with other clinical directors containing as it did conclusions pertinent to other departments. I was dismissed for Gross Misconduct & Insubordination as a result. Dr Moghal was appointed to the unadvertised post of Clinical Director of Paediatrics. A post recommended in his report.
I made a formal complaint to RCPCH about Dr Moghal's misconduct. The college informed me that Dr Moghal had signed an NDA with the trust and since he was legally bound to not speak about the report an investigation was impossible. The trust denied this. I later discovered that RCPCH had required Dr Moghal to sign the confidentiality agreement and that this was routine for all invited reviews.
Subsequently I took this through the employment tribunals. RCPCH refused to provide a witness to the conduct of its reviews. Dr Moghal failed to appear as a witness. The authoritative RCPCH report was used in evidence at ET with no opportunity for cross examination of its content. All evidence received by the RCPCH review panel was destroyed at Dr Moghal's instruction.
It is beyond doubt that RCPCH, through the agency of Dr Moghal, and complicit with the trust, managed to close the lid on a very dark and dangerous period in the trust's history, which the then board would prefer to be forgotten. Forever.
If this represents in any way the integrity (or lack of it) with which colleges oversee these reviews it may well explain, in part at least, why trusts are so reluctant to share their reports.
Here is the dark side of the NHS. Trust, CCG and lawyers (Bevan Brittan) all implicated in the cover-up of the avoidable death of a young man who had his life in front of him. Error is one thing but this is more than that. Without the relentless pursuit of the truth by Oliver's mother it is likely that, as the culprits clearly intended, this story would never have been known. Let anyone with a shred of empathy imagine the pain this family has been caused.
Hi Anonymous at 25 June 2020 12:04
This report deals with the situation at Walsall more than 5 years after I left. The report was commissioned by the trust under pressure from NHSI after I made disclosures about the situation there. The board had known about the very poor staffing in the NNU for many years but had of course tried to run the place on a shoe string.
The previous invited review by RCPCH in 2010 had been vigorously supressed. Even the board was not allowed to see it. Only the Chair (Ben Reid now of SATH) & CEO. After I leaked a small but important part of the report to other Clinical Directors I was arraigned for Gross Misconduct and Insubordination and dismissed. I have no regrets.
The Chair of the RCPCH panel, Nadeem Moghal, (late of BHR) was, after he handed over his report appointed Clinical Director for about a year. He supported the suppression of his report. I complained about the conduct and suppression of his review to RCPCH. They emailed me to say Nadeem had signed an NDA with the trust and as he was unable to co-operate there could be no meaningful investigation.
What is a very ordinary doctor with no interest in anything other than patient care to do in the face of such stonewalling.
I post this in my own name. I am not so ashamed of my views that I need to hide behind a veil of anonymity.
No need to look far for evidence that bullying by senior management is still rampant in the NHS. Including the comments below. Ruined professional lives. Patients harmed. Billions wasted. I have recorded my own experience in my book. Here's an excerpt:
"This was a disappointing outcome. The nursing staff in particular had put their necks on the line. The Trust had a harassment and bullying policy that clearly stated “The Chief Executive will take lead responsibility for ensuring the Policy is correctly implemented and that the trust takes effective action to tackle harassment/bullying in the workplace.” But here we were, eight of the most senior clinical staff in the department, with allegations of bullying so serious that we had gone to the Chief Executive herself, and she had blatantly disregarded the policy she was responsible for. The policy also gives a specific instruction: “Where it is clear there is a pattern of unacceptable behaviour within a particular area, a full investigation will be carried out.” What could possibly have been clearer than the allegations made by these clinicians? Again, the Chief Executive was able to breach the policy for which she had executive responsibility with impunity. There was no investigation."
When I raised this under FPPR with CQC the regulator made the trust concerned pay £200k for a QC led investigation that vindicated the CEO in question. PHSO later found CQC guilty of allowing me to be treated unfairly but so what. Nothing else changes. At some point the politicians are going to have to acknowledge the damage being done by bullying and make an attempt to address it. Everyone deserves better.
Look forward to English media capitalising on this later today at the briefing. Sadly, this misleading presentation of stats is entirely consistent with the obfuscation in Matt Hancock's and other minister's responses at the briefing. If we ran patient facing clinical services based on this kind of communication the public would have lost faith long ago. The government is insulting our intelligence. At a time of National Emergency.
My comment at 1543 "vexatious referral to GMC" intended. Not CQC.
It's quite clear that David Rosser has been responsible for victimising this whistleblower consultant and making a vexatious report to CQC. This is a well established pattern in the NHS. I met Jeremy Hunt and Simon Srevens in 2014 with 6 dismissed NHS Whistleblowers. He praised our courage and later commissioned Francis to chair the FTSU review. There was an explicit promise in this that Whistleblower victimisation would end. It hasn't. Covid has exposed this lack of culture change. Hunt, Stevens, and Francis remain silent. This inevitably results in lack of trust and outright cynicism about our great leaders and their true intentions. As for the useless National Guardians Office. Nowt left to say really.
Goodhart's law is an adage named after economist Charles Goodhart, which has been phrased by Marilyn Strathern as "When a measure becomes a target, it ceases to be a good measure." One way in which this can occur is individuals trying to anticipate the effect of a policy and then taking actions that alter its outcome. (Wikipedia)
No doubt this fiasco will come under detailed scrutiny in coming weeks. We must be protected from these politically derived distortions.
"The health secretary said staff should ”feel free” to publicise concerns such as PPE shortages." But they're not.
Almost 20 years on from the Kennedy BRI report and 5 years after Francis' FTSU review (a supposedly definitive investigation of NHS Whistleblowing) we are entitled to ask why.
Recently Sir Robert and National Whistleblower Guardian Henrietta Hughes wrote to Matt Hancock asking that he write to NHS CEOs reminding them of their obligations to staff who raise concerns. Mr Hancock ignored them.
There is a widespread view amongst NHS Whistleblowers that there is no political will to develop safe reporting. The health secretary's frequent resort to modal accessory verbs, (should, must, ought etc) shows his own intentions are not serious. This continues to pose a clear and present danger to patients and staff.
Thanks Nick at 2205. Applaud the public spirit of the doctor reporting this to CQC. And correct for CQC to progress it. But this from NHSI website:
NHS Improvement’s Non-executive Appointments Team offers a range of support in finding and developing the very best chairs and non-executive directors for NHS provider boards. We appoint and support NHS trust chairs and non-executives. The power to make, suspend and terminate these ministerial appointments is delegated by the Secretary of State for Health.
Surely, that is where the responsibility lies.
In March 2019 HSJ ran a piece in which Sir Robert Francis QC accepted that the Fit and Proper Person test has not worked and does not work. So why this charade? He added his own opinion that it is now time for a professional regulator for NHS managers.
The reference group on Kark's watered down recommendations has shown an understandable reluctance to make NHS managers accountable in anyway that staff or the public can use.
So good luck with this Dr A. On receipt of the foregone conclusion you will have the option of complaining through your MP to the Ombudsman. Who will tell you that you have suffered no injustice and under PCA 1967 he is unable to investigate. Just Culture?
Linda Fairhall: “I have been utterly humiliated, my life has been left in chaos and my professional integrity has been called into question, leaving my reputation irreparably damaged." That after a lifetime of selfless service to NHS patients.
Exactly 5 years ago Jeremy Hunt reported Sir Robert Francis' statement in his Freedom to Speak up report:
"Sir Robert said he heard again and again of horrific stories of people’s lives being destroyed—people losing their jobs, being financially ruined, being brought to the brink of suicide and with family lives shattered—because they had tried to do the right thing for patients. Eminent and respected clinicians had their reputations maligned. There are stories of fear, bullying, ostracisation and marginalisation, as well as psychological and physical harm. There are reports of a culture of “delay, defend and deny”, with “prolonged rants” directed at people branded “snitches, troublemakers and backstabbers”, who were then blacklisted from future employment in the NHS as the system closed ranks."
Little change there then.
The only exceptional thing about this case of whistleblower victimisation is that the claimant was successful at ET under the current inadequate PIDA legislation.
Sadly, Linda demonstrates once again that NHS staff often pay for raising concerns with ruined lives. That serves as a disincentive to all staff that no amount of propaganda from the National Guardian's Office can counteract. And the Trusts response, despite the ET's damning judgement, is to consider an appeal. More managerial madness.