After my blog on the double standards of the Epsom and St Helier University Hospital Trust over its treatment of whistleblowers which included references to Dr Usha Prasad, I received an email from the communications team of the hospital group.

According to the team I had got everything wrong. The whistleblowing case had absolutely nothing to do with her dismissal. They said: ” It is not correct to say Ms Usha Prasad was dismissed for raising patient safety concerns. A disciplinary panel concluded that she should be dismissed for competency grounds, concerns around her practice/conduct and because relationships with key colleagues had broken down. This decision was upheld on appeal.”

Technically they are correct. But if you delve deeper it shows that this disciplinary panel was a completely flawed process – ignoring vital information and chaired by a person whose integrity had already been called into question and falls into a management playbook used by other trusts to get rid of troublesome doctors who raise unwelcome concerns about patient safety.

Even the conclusion of this disciplinary panel used a fake term. The chair concluded that she was ” unfit for purpose”. There is no such term in English employment law – a system can be ” unfit for purpose” but an individual cannot. And this has been raised at the highest level in NHS England by colleagues of her when they met Professor Stephen Powis, the national medical director, who could not explain such a term applying to an individual doctor.

Then there is the issue of competency. The big flaw in this is that after she raised her protected disclosure on patient safety the trust sent 43 complaints about her practice to the General Medical Council .These were organised by Dr James Marsh, then medical director of the Epsom and St Helier University Trust now Deputy Group Chief Executive Officer of the St George’s Group.

Dr Marsh chose close colleague Dr Peter Andrews, a fellow renal physician who worked on the same ward, to investigate the claims, and Dr Ian Beeton, a cardiologist in private practice at nearby St Peter’s Hospital as an “independent” expert. Dr Beeton works with Dr Marsh’s wife, a radiologist at the same hospital. They asked Dr Richard Bogle, the head of the cardiology at the Epsom and St Helier Trust, to file the complaints who also works closely with private cardiologist Dr David Fluck at St Peter’s Hospital.

When it came to the disciplinary hearing the trust brought in Dr David Fluck to sit on the tribunal to judge Dr Usha Prasad. He also worked on joint projects with Dr Marsh.

I leave you to judge whether this was a genuinely independent investigation without any conflict of interest. But when the complaint went to the General Medical Council and was seen by a genuine independent cardiologist in Teesside and formerly at the world famous Papworth Hospital every complaint was thrown out. In fact I am told the GMC looked at the eight most serious complaints and decided there was nothing to see. And not only was it thrown out by the GMC , it decided to validate Dr Prasad as competent to work in any hospital in the UK for the next five years.

This GMC ruling was brushed aside by the disciplinary hearing and ignored by the judge when it came to an employment tribunal hearing later. The only clue came at the tribunal hearing when Dr James Marsh claimed that the trust had higher standards than the GMC. Frankly this was insulting to both the GMC and the eminent cardiologist who thought differently.

The second charge against her is that she couldn’t work with colleagues. Certainly relations with Dr James Marsh did deteriorate over her decision to say an elderly patient who died because the trust did not act on a serious heart condition was an ” avoidable death” and should have been notified to the coroner and the Care Quality Commission. Dr Marsh wanted this conclusion struck out and she refused to do it.

But if this is correct this would apply elsewhere and it doesn’t. Her work at Pinderfields Hospital in Yorkshire and at St George’s is praised by the hospitals and there have been no complaints about her relations with colleagues.

Dr David Ward, a close colleague of hers at St George’s, said this: ” I am pleased to say that I worked alongside Dr Usha Prasad when she was a visiting Consultant Cardiologist at St George’s Hospital (now part of the united Trust with Georges-Epsom- St-Helier or GESH). I found her to be collegiate, knowledgeable in general cardiology, skilled in her specialised areas (echo, heart failure etc). She was well-liked by all staff with whom she worked (catheter lab, echo). I (or anyone in the cardiology department at St George’s) never had any concerns about Dr Prasad’s clinical skills or competence and I find it most surprising that St Helier have retrospectively (for that it what it amounts to) found reason to question her abilities, coincidentally or not, after she had raised concerns about patient safety. I suspect this, also known as whistleblowing, is the underlying motive for the profoundly vengeful and unjustified response by the Trust.”

Finally there is the question of the disciplinary hearing itself. It was chaired by Claire McLaughlan – a profile of her is here – who ran into trouble with a judge at a hearing with cardiologist Dr Mattu, who won his case, for omitting evidence and over an interview for Lewisham and Greenwich NHS Health Trust with whistleblower Dr Chris Day, whose case is still continuing. He found the record of the interview with him had been altered, missing key points. As he had a secret recording of it, she had no alternative but to apologise and change back the record.

One final point. Dr Usha Prasad told me the former CEO of the Epsom and St Helier Trust, Daniel Elkeles ( now chief executive of the London Ambulance Trust) was prepared to “stop” the disciplinary hearing if I was prepared to drop “all you have against the trust; an ET case of whistleblowing detriment and harassment, discrimination”. One wonders how many back door deals take place over patient safety.