News of the National Health Service in the UK:


7 January 2014

A Unison rep, Charlotte Monro, worked for 26 years as an occupational therapist at Whipps Cross hospital in east London, recently merged with the Royal London and Barts. 


Barts, with a famously catastrophic debt, needs to save money fast: 1000 jobs are to go, with many staff downgraded. One saving is to merge two stroke wards, losing nearly a third of beds and a small specialist gym, vital to get stroke patients on the move. 

Monro, representing staff, addressed the local Waltham Forest council's health scrutiny committee to explain why this plan was inadequate. Local authorities are supposed to play a part in NHS accountability, responsible for public health and for integrating social services for returning patients to the community. 


But Monroe's appearance caused Barts managers to fire her for bringing the trust into disrepute with inaccurate information. "Inaccurate" is a matter of opinion: there are two sides in any reorganisation dispute.

Surely NHS staff have the right to speak to their local scrutiny committee? 


Managers searched for other reasons to bolster Monro's dismissal and came up with a complaint that, four months previously, she had consulted some of her members on what they claimed was a confidential plan. But most preposterous, they uncovered an ancient conviction for assaulting a policeman related to a demonstration back in 1979, claiming she had never registered it. 


Now they have upheld her dismissal on these old issues, but conceded she did have the right to speak to the scrutiny committee, although that's what triggered the disciplinary action.


Source (read more here at The Guardian)


More about Charlotte Monroe

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Julie Bailey. Heroine. Trying to save the NHS in the UK.

http://www.theguardian.com/society/2013/oct/27/julie-bailey-mid-staffordshire-nhs-whistleblower 
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More here: NHS Professionals Can and Will be Ruined for Whistleblowing.

Professionals Can and Will be Ruined for Whistleblowing.

An account of mobbing in the Natioanl Health System in the UK.


By Dr David Drew

David Prior, chairman of CQC, told the Health Select Committee this week that a ‘chilling’ culture in NHS hospitals discouraged potential whistleblowers from speaking out. In response Dr David Drew wrote to him, agreeing and giving a description of his experience of such a culture at Walsall Hospitals NHS Trust from 2008 to 2010 which ended in his dismissal. Dr Drew has not worked since. Here is part of his letter:

23 October 2013

Dear Mr Prior

Re: There has been a deafening silence from clinicians for too long.

I agree with your thesis that good clinicians speak up for patients and good leaders will encourage staff to speak up and will listen to what they say. Gold dust.

I was the senior clinician in the paediatric department and by 2008 had been head of department for 7 years. I was removed as head of department for daring to suggest a consultant I was managing had problems with competence. There was agreement in the consultant body with my view. The Trust failed to engage with this.

I raised serious concerns about mismanagement of the department. A Royal College of Paediatrics (RCPCH) review later agreed that the Trust executive had inappropriately appointed managers with no paediatric qualification or experience who were managerially aggressive (I used the word bullies) and sidelined senior frontline staff. The context to this was a cost-cutting exercise.

I also reported major problems with the child protection service which the Trust was not taking seriously. A child (Child K in the Local Safeguarding Children Board Serious Case Review) died following catastrophic mistakes in basic safeguarding. No serious attempt was made to address these mistakes. A nurse with no safeguarding experience was appointed internally to mitigate redundancy numbers. A subsequent appointee was bullied out of her post by managers. The CEO suggested she was not up to the job and that managers swearing at her could be excused as they were under stress.

Children were put at serious risk through changes to in-patient accommodation made without reference to clinicians. An antiquated ward heating system repeatedly broke down over 2 winters causing sick babies to become hypothermic.

Management failed to take these issues seriously. The CEO for example took 8 months to provide an unsatisfactory written response to my concerns about safeguarding.

In April 2009 as a result of this I was unceremoniously excluded from the hospital. Documents obtained by Data Protection Act showed the Medical Director claiming to NCAS that I needed excluding as I was obstructive, unmanageable, writing defamatory letters to a manager, thought to be psychotic, leaking information to the press about Child K, might interfere with any Trust investigation of my exclusion and posed a threat to staff and patients. If that sounds a bit crazy in itself it is exactly what the telephone transcripts show. He had not mentioned a word of this to me before excluding me and never did at any future date. Not a word of it was true.

The investigation into my exclusion concluded that I had no case to answer. The RCPCH review subsequently agreed that even if the allegations made against me had been true they did not warrant exclusion. I returned to work after 5 months.

The consultant I had originally complained about was repeatedly being reported for bullying, making trainees afraid to speak out, being unsupportive and not attending calls out of hours. The managerial bullying was worse. One consultant had found a new job and others were talking of leaving. I wrote a comprehensive disclosure to the CEO and said that if she failed to act I would consider my obligations under the Trust whistleblowing policy discharged and I would go outside the organisation. The Trust Chair then met me with my BMA rep and agreed to commission an independent review of the paediatric department through the RCPCH.

The 3 person review panel sat in early 2010. The following facts about the review are now clear:

  • The 3 panel members were gagged by the Trust.
  • I wrote to the panel chair before the review started stating that I was a whistleblower, gave incontrovertible evidence of protected disclosures to the panel at interview and yet the report, without giving any evidence, said that I was not a whistleblower.
  • The report was highly critical of Trust senior management. It was suppressed by the CEO. Even the Trust board did not see it.
  • Dissemination of its findings were left entirely to the CEO. I was disbarred from having any part.
  • The review chair refused my written requests to see the RCPCH policy his panel was working to.
  • No panel member was willing to attend either an internal disciplinary or an external legal proceeding to be cross examined on the review. The review was put beyond scrutiny.
Immediately the report was given us the CEO asked me to agree to all its findings. [When I disagreed] the CEO asked me to resign. I then received an appointment for a disciplinary hearing with date, time, place and the names of panel members. I can perhaps be forgiven for thinking this was “here’s one I prepared earlier”. The hearing was a blatant breach of Trust policy as no investigation had taken place. It was stood down only after BMA representations.

The review chair was then appointed as head of the paediatric department. This was helpful in his planned career move from paediatric nephrology to management. 


The CEO told me my position was untenable.

The CEO offered me a 6 figure sum, well above my contractual entitlement, and a good reference if I left immediately. She told us that because the SHA was involved in the offer I would have to sign a gag.

The offer I called a bribe and refused it. As a result the disciplinary procedure was restarted against me. I was finally dismissed for “gross misconduct and insubordination” in December 2010 after what my BMA rep described as a kangaroo court.

I did my best at all times as a doctor. I kept faith with my patients, my professional code and my conscience. At my disciplinary hearing the Trust solicitor is on record as saying.“This hearing is not about the loss of a job. It is about the end of a career.” This was followed by the disciplinary panel chair who was the Director of Nursing who added, “…and never being able to practice medicine again.” There was no doubt in their minds of the consequences of my dismissal. This may give a clue as to why medics and nurses are sometimes reluctant to speak up.

My book “Little stories of Life and Death @NHSWhistleblowr” includes this material but in a more narrative form and will be published soon. Meanwhile I will publish this letter on my blog in the next couple of days, not to embarrass you in any way but to raise the profile of NHS whistleblowing.

Yours Sincerely

David Drew


Follow Dr David Drew on Twitter or read more about the NHS scandal here 

The Care Quality Commission is accused of suppressing an internal review could have saved the lives of mothers and babies.

By Laura Donnelly, Health Correspondent
18 Jun 2013

http://www.telegraph.co.uk/health/healthnews/10128886/Cover-up-over-hospital-scandal.html



Regulators deleted the review of their failure to act on concerns about University Hospitals of Morecambe Bay NHS Trust. Police are investigating the deaths of at least eight mothers and babies. There have been accusations that midwives colluded to hide errors. The trust, which faces at least 30 civil negligence claims, will also be subject to an independent inquiry in public.

James Titcombe, whose baby son Joshua died there in 2008, after staff failed to treat a simple infection, said the cover-up was “appalling”.

When issues were brought to its attention in 2011, an internal review was ordered into how the emerging scandal had gone unnoticed. The resulting review was so damning that bosses decided it should never see the light of day.

The report describes a CQC official saying that he was ordered by a senior manager in March last year to destroy his review.

One senior manager said: “Are you kidding me? This can never be in a public domain nor subject to a Freedom of Information request. Read my lips.”

It was not until September 2011 that the trust was finally warned that the failings were so serious that it would be closed down without major changes. By then the trust had the highest mortality rate in the country, with 600 “excess deaths” in the previous four years.

If you are concerned about the death or illness of your baby in the neonatal Unit of Westmead Hospital, Sydney between 2000 and 2009 you may alert us using the Alert Form below.

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Bullying: the silent epidemic in the NHS


Roger Kline, 15 May 2013

One quarter of the staff in the largest employer in Europe report that they were bullied at some point in the previous 12 months. The rate of reported bullying has doubled in just four years. It is some three times higher than elsewhere in employment. Such bullying is held to be directly responsible, in part, for the largest ever UK healthcare scandal in which hundreds of patients died.


Read More Here


Part One of the Francis Report into NHS patient deaths 
Click here if you wonder whether there should be a similar inquiry into patient mismanagement and cover-up at Westmead Hospital in Sydney, Australia






By Laura Donnelly, Health Correspondent


10:01PM BST 18 Jun 2013


208 Comments


The Care Quality Commission is accused of suppressing an internal review that uncovered critical weaknesses in its inspections, which may have cost the lives of mothers and babies.


Regulators deleted the review of their failure to act on concerns about University Hospitals of Morecambe Bay NHS Trust, where police are investigating the deaths of at least eight mothers and babies. There have been accusations that midwives colluded to hide errors. The trust, which faces at least 30 civil negligence claims, will also be subject to an independent inquiry in public.


The regulator has come under fire in recent years for failing to protect patients and prevent a series of scandals, as it relied on “tick-box” systems which let hospitals vouch for their own safety.


Tonight the CQC apologised. It has announced plans for a more rigorous inspection regime and Ofsted-style ratings. None the less, the regulator is expected to become embroiled in a deepening scandal.


Wednesday’s independent report suggests that senior managers were more concerned about protecting CQC’s reputation than about the lives of patients when they ordered the suppression of the review. It concludes: “We think that the information contained in the report was sufficiently important that the deliberate failure to provide it could properly be characterised as a 'cover-up’.”


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Parents whose children died at the unit in Furness General Hospital have been given copies ahead of publication. James Titcombe, whose baby son Joshua died there in 2008, after staff failed to treat a simple infection, said the cover-up was “appalling”.

“If you cannot trust the health care regulators, the very people who are there to ensure minimum standards of safety, who can you trust?” he asked. “I think this symbolises what has gone wrong with the culture of the NHS. We need honesty and transparency but this was frankly rotten.”

The report, by management consultants Grant Thornton, was ordered by David Behan, who became chief executive of CQC last summer after his predecessor stood down.

It follows a campaign by Mr Titcombe and other families in Cumbria and Lancashire who lost mothers and babies at the hospital, where there were dysfunctional relationships between doctors and midwives and staff shortages.

Problems with the maternity unit emerged in 2008, but in 2010 the CQC gave the Morecambe Bay trust a clean bill of health.

When issues were brought to its attention in 2011, an internal review was ordered into how the emerging scandal had gone unnoticed. The resulting review was so damning that bosses decided it should never see the light of day.

The report describes a CQC official saying that he was ordered by a senior manager in March last year to destroy his review because it would expose the regulator to public criticism.

In the accounts of discussions between officials about what to do with the findings, one senior manager states: “Are you kidding me? This can never be in a public domain nor subject to FOI [a Freedom of Information request]. Read my lips.”

The official who had written the internal CQC report said to the Grant Thornton review team that he had been told his work must be deleted because it was damaging to CQC. He said he felt he was “being put in a very difficult position” and asked to do something that he felt was “clearly wrong”.

The report says the same senior manager “said that he felt very uncomfortable about the apparent weight that was being given in the meeting to the potential media impact and reputation damage his report findings might cause CQC. His view was that the focus instead should have been on patient safety and the protection of service users.”

The same official said he was then asked to write up a different review removing any references critical of the watchdog. “In effect, he had been asked to omit anything that could be considered damaging for CQC,” the new report says.

The original internal review had been ordered after questions were asked about why CQC had given the NHS trust a clean bill of health in April 2010 – registering it without any “conditions”, helping it to win elite “foundation” status later that year – despite serious concerns about the safety of its maternity services.

The decision was taken despite a number of serious incidents, including the deaths of babies and mothers, and a warning by the CQC’s regional director of “systematic failures” in the hospital maternity services which could lead to further tragedy.

It was not until September 2011 that the trust was finally warned that the failings were so serious that it would be closed down without major changes. By then the trust had the highest mortality rate in the country, with 600 “excess deaths” in the previous four years.

Since being appointed CQC chief executive last summer, Mr Behan has restructured his executive team, replacing all bar one of his six executives.

A CQC spokesman said: “We let people down and we apologise for that.”

David Prior, the chairman of the CQC, said: “CQC’s chief executive, David Behan, was absolutely right to commission an independent report into CQC’s handling of the registration and subsequent monitoring of University Hospital Morcambe Bay - and absolutely right to publish it in full. The publication draws a line in the sand for us.

“What happened in the past was wholly unacceptable. The report confirms our view that at a senior level the organisation was dysfunctional and the board and the senior executive team has been radically changed.”


Gagged NHS whistleblowers will be allowed to speak out, Sir David Nicholson says.

By Peter Dominiczak, Political Correspondent for the Telegraph (UK). 18 Mar 2013.

 www.Full article at www.telegraph.co.uk

Hundreds of whistleblowers are now free to come forward with damaging disclosures about the NHS after their gagging orders were retrospectively lifted, Sir David Nicholson has told MPs.

Sir David, the embattled chief executive of the NHS, told MPs on the Public Accounts Committee that whistleblowers who have been gagged will be written to and told they can finally speak out.

However, he revealed that 44 so-called “compromise agreements” have been issued to NHS staff in the last financial year at a cost of £1.3million to taxpayers.

It raises the prospect of previously silenced whistleblowers disclosing an avalanche of damaging revelations about hospitals and the NHS.

Details about whistleblowers being gagged emerged in the wake of the Mid Staffs scandal, where up to 1,200 patients died needlessly.

Figures showed that in the three years up to 2011, a total of £14.7million of taxpayers’ money was spent on almost 600 compromise agreements, most of which included gagging clauses to silence whistleblowers.

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Sir David, who was appearing before MPs on the Public Accounts Committee, was accused of being complicit in a “pernicious culture of paying people off”.

The Government announced last week that NHS gagging orders are to be outlawed.

Dame Barbara Hakin, the former head of the NHS in the West Midlands, has been accused of blocking an external review of mortality rates at United Lincolnshire NHS Trust, and effectively forcing the resignation of the hospital’s chief executive after he raised concerns.

She is facing a General Medical Council investigation into her conduct


Three out of four whistleblowers who raise concerns of wrongdoing at work with their managers have their claims ignored claims Rajeev Syal Here. 

Files of 1,000 [health care workers in the National Health Service in the UK] who approached a whistleblowing helpline for advice also showed that 15% (one in six) were eventually sacked from their jobs while many others were bullied, ostracised or victimised.

Cathy James, chief executive of the charity Public Concern at Work which runs the helpline, said that the findings show that the legislation meant to protect whistleblowing in Britain needs to be reviewed.

"Ministers and employers say it is vital for an open and transparent workplace culture, but ask the whistleblowers and the story is starkly different: they are gagged in the NHS, arrested in our police forces and blacklisted in many industries.

"The findings demonstrate why speaking up in the workplace may seem futile or dangerous to many individuals. They [employers] are still shooting the messenger and overlooking crucial opportunities to address concerns quickly and effectively," she said.

The researchers found that the typical whistleblower who approached the helpline was a skilled worker or professional who has been employed for less than two years. A third of the whistleblowers surveyed were from the health and social care sectors.

Nearly three quarters of those approaching the helpline claimed that the wrongdoing harmed customers or patients outside the workforce.

The analysis found that 74% of whistleblowers who called the helpline said that after having complained to their line manager about a serious concern, nothing had been done as a result of their complaint.

Whistleblowing legislation is currently being reviewed and a government consultation held to investigate whether the Public Interest Disclosure Act 1998 is failing to protect those who speak out from being victimised, harassed and even sacked by their employers.

The employment relations minister Jo Swinson has put forward amendments to the legislation, followed by "a call for evidence" by the government to examine whether the act is, as campaigners claim, not "fit for purpose".

Critics have claimed that the proposed amendments will still leave workers exposed and that changes to legal aid will make it much more expensive for whistleblowers to take their cases through to tribunals or courts.



The Francis Report into up to 1,200 unnecessary deaths at Mid Staffordshire NHS Foundation Trust exposed a catalogue of neglect and abuse when it was published on 6 February 2013.

The inquiry also revealed a management culture in which health care professionals and other staff feel afraid to raise concerns about standards -- not least after some were punished for doing so.

At Public World we believe that the report, and especially its emphasis on the need for this culture to change, could trigger real improvements in the NHS. But only if the right lessons are learnt and health care workers are empowered to act upon them in transparently accountable ways.

Read more:

http://www.publicworld.org/projects/duty


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