NHS England’s interim deputy chief executive Dame Barbara Hakin has been cleared of acting in a “bullying” and unprofessional manner by the General Medical Council, HSJ can reveal.
Dame Barbara – who is also the organisation’s chief operating officer – was accused of disregarding patient safety in a drive to ensure trusts met performance targets during her time as chief executive of the East Midlands Strategic Health Authority in 2009.
However, following a year-long investigation into 17 separate allegations, GMC case examiners ruled the case should be closed as there was no realistic prospect of finding Dame Barbara’s fitness to practise as a doctor was impaired in relation to any of the claims.
The allegations were made by Private Eye journalists Andrew Bousfield and Phil Hammond and relate mainly to Dame Barbara’s treatment of former United Lincolnshire Hospitals Trust chief executive Gary Walker.
In a document explaining the reasoning behind the decision, seen by HSJ, the case examiners state: “It is clear there were frank exchanges of views about the trust’s performance [between Dame Barbara and Mr Walker]. A fitness to practise panel would be bound to make due allowance for the robustness of conversations which may need to take place between senior and experienced managers in these circumstances… we found insufficient evidence that this amounted to bullying or unprofessional behaviour.”
The case examiners, one of whom is from a medical background and one from a lay background, also found “no evidence that Dr Hakin’s conduct put patients at risk” and noted she had taken steps to assure herself that patient safety was a priority at the trust through an external review.
They supported Dame Barbara’s argument that the trade-off between hitting targets and ensuring patient safety, as presented by Mr Walker, was a “false dichotomy”.
During an appearance before the Commons health committee earlier this year, Mr Walker told MPs that Dame Barbara had told him that if he did not resign from the trust his “career would be tatters” and suggested he construct a story to tell his chair that he had decided to leave voluntarily.
In her evidence to the GMC, Dame Barbara acknowledged she had said it would be “detrimental” to Mr Walker’s career if he continued in a job which was beyond his capabilities but said this was intended to be “supportive” advice. She said it was Mr Walker’s decision to construct a story to tell his chair and she had merely indicated she would not “go out of her way to contradict him”.
The case examiners concluded these allegations would come down to a case of Mr Walker’s word against Dame Barbara’s if considered by a GMC fitness to practise panel. It added that the NHS England director’s account was “more credible”.
They said: “Even assuming Mr Walker’s account is preferred (which we doubt), we are doubtful that this allegation crosses the threshold of bullying or that impairment would be found, particularly in the absence of evidence to demonstrate that patient safety was at risk… Advice, even if bluntly given, that continued failure to meet targets in these circumstances would put a chief executive’s career in jeopardy could hardly have been unexpected.”
The GMC investigation found “some support” for the core allegation, that Dame Barbara told Mr Walker the four hour accident and emergency and 18 week waiting time targets must be met despite his concerns that to do so could compromise patient safety. However, they noted she denies Mr Walker raised any concerns about patient safety and, crucially, there was no evidence that patient safety was at risk.
Mr Bouncefield and Dr Hammond also alleged that an email sent to all East Midlands chief executives in March 2009 implied the consequences of less than 99 per cent compliance with the four hour A&E target would be “considerable and personal”.
However, the case examiners found a “plain reading of the email” did not support Mr Walker’s suggestion that “it meant there would be unjustified personal consequences to him if his trust did not achieve its targets”.