Coverage of the appearance of the sacked former United Lincolnshire Hospitals Trust chief executive at the health committee, and today’s other news.
5.26pm: The commissioning board has published details of how to complain in the new system. It has become more complicated because of the division of of commissioning responsibilities.
5.15pm: Conservative MP Steve Barclay has responded to Sir David Nicholson’s correction of comments he made to the Public Accounts Committee.
The MP told HSJ: “It seems that David Nicholson is compounding one mistake on top of the other. I specifically asked the question a second time because I was surprised that Sir David’s statement directly contradicted a letter I had seen. He was emphatic on both occasions when asked.
“It is now clear he has made statements to a parliamentary committee which were completely untrue. In fact they were so untrue that he has now had to make a formal apology.
“Either he arrived at a parliamentary select committee woefully unprepared or he simply did not expect there to be any written evidence in the form of a letter sent to him in 2009 which contradicted what he said.”
4.03pm: HSJ has published a story on the correction by Sir David.
3.17pm: Sir David Nicholson has been forced to correct comments made to the Commons public accounts committee in relation to whether United Lincolnshire chief executive Gary Walker identified himself as a whistleblower, HSJ can reveal.
Sir David wrote to the Public Accounts Committee today, following yesterday’s hearing, and has accepted Mr Walker did ask to be considered a whistleblower. HSJ reported the conflict between Sir David’s comments and Mr Walker’s letter earlier today.
Sir David’s letter says that following the evidence at the PAC committee, the NHS chief executive “reviewed the correspondence” and now accepts Mr Walker’s version of events.
In the letter sent to Sir David in July 2009 Mr Walker said he was making making “protected disclosures”, and asked that the letter be considered in the context of the Department of Health’s whistleblowing policy.
3.10pm: Further evidence from the SHA - including a series of reviews stretching back several years - has been published on its website.
2.28pm: NHS East Midlands is now publishing its evidence to the Commons health committee relating to claims made by Gary Walker (see below). It rejects that he has any basis to claim he is a whistleblower. The evidence is available here.
1.49pm: The Mid Staffordshire Foundation Trust chief executive, Lynn Hill-Tout, is to leave the organisation. It comes as the FT is set to be subject to a special administration regime, which is likely to see it split up.
She said in a statement issued this afternoon: “It has been a great privilege to have had worked for the National Health Service and to have undertaken a wide range of rewarding roles in the most important and complex public sector service. Throughout my career I have worked with dedicated and talented people who have strived to provide the very best health care for their patients and communities and this is particularly true of my colleagues at Mid Staffordshire.”
1.11pm: The NHS Partners Network has published analysis of patient reported outcome measures for elective surgery, apparently showing strong performance by independent providers.
The network’s statement says: “Independent sector organisations which carry out elective hip and knee replacement surgery for the NHS dominate the top ten providers for improving patients’ quality of life (“health gain”) following the procedure, according to an analysis of patient reported outcome measures data published by the NHS Partners Network today.
“Of the top ten providers for hip replacement surgery, seven are from the independent sector. In the top five, four are independent sector providers. In the bottom 25, only one provider is from the independent sector. For knee replacement surgery, eight of the top ten are independent sector providers, and in the top five, three are independent sector providers. No independent sector provider appears in the bottom 25. “
12.59pm @HSJeditor tweets: Letter from @modernleader to David Nicholson says “I am a staunch advocate for…what you are trying to achieve”.
12.54pm HSJ has seen the letter Gary Walker sent to Sir David Nicholson in July 2009. At the Public Accounts Committee yesterday Sir David said Mr Walker had not identified himself as a whistleblower. However, the letter suggests otherwise.
11.53am HSJ political columnist Michael White gives his verdict on David Nicholson’s grilling by the Public Accounts Committee yesterday. “He’s not a man you need to feel sorry for, but in that hindsight moment I did.”
11.41am The hearing ends.
11.41am @nursingtimesed tweets: Gary Walker if I’d used public money and got ppl involved in doing bogus public reviews, I’d expected to be investigated
Mr Walker is referring to Sir David Nicholson, who he also claims has failed to improve the situation for NHS whistleblowers during his tenure.
11.38am Mr Walker repeats his allegation that Dame Barbara Hakin is guilty of misconduct because she authorised his pay off to protect herself.
11.33am Mr Bowles says: “I do not believe you can change the culture of the NHS without changing its leaders.” Mr Dorrell responds: “There is a tendency to identify this culture [of bullying and fear] with the personality of the chief executive but I was health secretary 20 years ago and it was often said people were scared of speaking out so I think it’s much deeper than the personality of one individual.”
11.31am Mr Walker says another executive has left United Lincolnshire with a gagging clause since he did.
11.27am Mr Walker claims the DH was a signatory and beneficiary of his compromise agreement.
11.26am Mr Bowles claims evidence from clinicians shows that after Mr Walker left the focus shifted from safety to meeting targets.
11.24am Rosie Cooper MP asking Mr Walker about whether he went outside of the NHS with his concerns. He says he stayed internally.
11.15am @nursingtimesed tweets: Dorrell asks which clause is gagging clause. Walker points to sections that say he and witnesses can not repeat allegations
11.14am Mr Walker agrees to the publication of his compromise agreement following the hearing.
11.11am Discussion about the extent of protection afforded by the Public Interest Disclosure Act. Apparently it protects disclosures of information but not allegations.
11.10am @HPIAndyCowper tweets: Employment judge ruled at a pre-committal hearing that Walker had made a prima facie protected disclosure.
11.08am @nursingtimesed tweets: SHA says Walker not whistleblower because he did not get found to be one in court. Walker dismisses this fact.
11.07am @ShaunLintern tweets: Walker says disciplinary panel transcripts were altered to remove any reference to me being a whistleblower.
10.53am Mr Walker claims Dame Barbara Hakin told him to resign and make up a story to his chairman that it was his decision to go. He says she tried to find him another job.
10.52am Mr Bowles says he wrote to Sir David Nicholson when the PCT failed to commission the promised capacity review.
10.50am Brigg and Goole MP Andrew Percy says he gets the issue over extra beds as it is a big issue in his constituency. He claims suggestions that hospitals need more beds are dismissed because they are against the direction of travel of moving care into the community.
10.43am Mr Bowles says Mr Walker has applied for 50 or 60 jobs in the NHS but not had even one interview.
10.40am Mr Dorrell asks why a general concern about bullying could not have been raised with the SHA without naming individuals. Mr Bowles says it would have been difficult. He says he raised it in very general terms with the SHA about pressure. “I too experienced it. What’s the pont of going to John Brigstocke [NHS East Midlands chair] when he lost it with me when I told him we would not meet targets until we had the extra beds?”
10.38am Mr Bowles said none of those who complained to him about bullying by SHA staff were prepared to let him raise it with the SHA because they feared it wold end their careers. The reaction of non-executive directors was “are we dealing with the mafia here?”. We persuaded Mr Walker to go above them to NHS chief executive Sir David Nicholson.
10.37am @ShaunLintern tweets: “It was only when we started to suggest that we might miss the targets that interest [from SHA] started and thats when it became personal” - Walker
10.23am Rosie Cooper asks why Mr Walker only submitted wrtitten evidence yesterday morning, not giving the committee time to digest them. Mr Walker said he had been out of the country and on his return had to distill 3,000 documents into a submission by himself.
10.19am Mr Walker said: “In order to run a safe hospital things had to be done [such as cancelling 700 operations] but all I was getting from the SHA was meet the targets.”
Mr Bowles said: “As a trust we were at the that tipping point [of starting to deliver substandard care]. We said we’re going to cancel operations to stay on the right side of that tipping point. I said I’m only prepared to meet thjese targets once we had a 100 new beds. The chair of the SHA said this was unacceptable. I raised the capacity issue with the PCT chairman whose response was everybody else is coping.”
10.16am Mr Walker says: “There were trolleys lined up side by side, so close you couldn’t get between them. The nurses came up to me and said we know it’s wrong but we were told to do it.” Mr Walker says they were told to do it by a manager who he later dismissed. This manager then tried to get Mr Walker dismissed, he claims.
10.15am Health Policy Insight’s Andy Cowper tweets: Rosie Cooper asks very good question about how @ModernLeader was working with his clinicians at ULHT to address capacity issues
10.12am @ShaunLintern tweets: I sense Committee is trying to pick at Walker’s management style and how he handled the dramatic rise in A&E demand. Interesting approach
10.11am If you’re struggling to keep up with what happened at United Lincolnshire, check out HSJ’s timeline.
10.09am Mr Bowles claims NHS culture is to “fix people” and “cover up” problems rather than understand them and address the issues.
He adds: “There is this deeply ingrained culture of making things look good rather than actually being good.”
10.06am Asked about the culture across the East Midlands and whether other chief executives experienced similar pressure, Mr Walker says some would have agreed. He adds: “This isn’t proper management, this is bullying.”
10.05am @ShaunLintern tweets: Stephen Dorrell questions why Walker removed q of capacity review after asking for it for 6mnths. “In hindsight I shouldnt have done that”
10.03am Explaining his decision to comply with the SHA’s request not to mention the capacity review issue to the DH, Mr Walker says: “If you upset a strategic health authority, especially the one I was working in, there are repercussions.”
10.00am Mr Walker talking about ever increasing demand and pressure caused by failure of primary care trusts to reduce hospital activity. He claims he was asked by SHA not to raise the issue in a presentation to the Department of Health. He told the SHA he would meet the targets once they had opened another 100 beds.
9.59am @ShaunLintern tweets: If you can’t run an A&E then you can’t run a hospital - Dame Barbara Hakin said to United Lincs Ops director according to Gary Walker.
9.58am @nursingtimesed tweets: Dorrell asks for difference between engaged management and threatening behaviour
9.52am former United Lincolnshire chair David Bowles claims the trust did not get £11m of compensation it was due to an accounting issue because East Midlands SHA did not want to identify any organisations on its patch that were financially challenged.
Health Policy Insight’s Andy Cowper explains it thus on Twitter: The old double-your-deficit system is getting an airing. I’ve forgotten the acronym. David Bowles makes clear this was hidden deliberately
9.50am HSJ reporter Shaun Lintern tweets: Walker tells Committee he was threatened by Dame Barbara Hakin as more and more ops were cacelled due to over capacity issues
As more and more operations were cancelled more and more threats were made - Gary Walker tells Health Committee
9.46am Mr Walker claims he was told his decision to put the hospital on red alert due to the hospital being “full up” was an embarassment to health minister Ben Bradshaw. He asked for a capacity review but was told the SHA could not protect him if he didn’t meet the targets.
9.45am Nursing Times editor Jenni Middleton tweets: Gary Walker says went to Lincs as failing org, waiting lists “fiddled”, ext debt. He halved waiting times & cut hosp acq’d infctions
9.38am Health select commitee chair Stephen Dorrell opens the hearing by clarifying the scope of the committee’s interest in Mr Walker’s case. He says the hearing is being held in the context of the Francis report and looking at the culture of the NHS.
He said: “We’re not an employment tribunal and we do not intend to be drawn into a debate about what happened… It’s issues of policy that are of concern to us.”
He also reassures Mr Walker and David Bowles any evidence presented to the inquiry has parliamentary privilege but wil be made public.
9.15am: It also follows Sir David Nicholson’s appearance at the Commons public accounts committee yesterday. Sir David came under pressure on a number of issues, including gagging clauses. However, HSJ editor Alastair McLellan tweets: “….meanwhile. David Cameron gives his strongest defence yet of David Nicholson http://t.co/dWym81VWoN”
9.07am: HSJ editor Alastair McLellan puts today’s committee session in context. He tweets:Alastair McLellan @HSJEditorThe BIG question today is whether @Modernleader can produce the smoking gun that leads to David Nicholson’s downfall.
9.01am: HSJ Live will today cover the appearance of Gary Walker and David Bowles - former chief executive and chair of United Lincs Hospitals - at the health committee. They will be quizzed on their claims patient safety was put at risk by regional and national NHS managers.
8.05am: Good morning, as different components of the NHS fracture, merge and reform, it is vital that valuable staff do not become disengaged, say Mark Greenfield and Charles Marshall. On HSJ’s leadership channel they debate why employee engagement is the key to successful change