Jessica Blackburn: The ambitious Capsticks lawyer with a mission to unsettle whistleblowers

Jessica Blackburn senior associate Capsticks Pic Credit:London Portrait photographer David Woolfall

Jessica Blackburn is the senior solicitor and driving force behind the bid by Epsom and St Helier University NHS Trust(ESHUT) to get record £180,000 costs against Dr Usha Prasad, the whistleblower cardiologist who was dismissed by the trust for her disclosures.

As reported earlier a hearing like this is extremely rare, as in 99.95 per cent of all employment tribunal cases no complainant pays any of the employer’s costs – much to chagrin of big employment law firms like Capsticks.

She was educated at the highly selective Wallington High School for Girls and graduated from the University of Southampton Law School in 2014. She took two postgraduate legal practice courses at the private University of Law in London and got a distinction. She was a trainee solicitor at RadcliffesLeBrasseur , a law firm now part of Weightmans. She took a job as a qualified solicitor with Capsticks in 2018 and was promoted to a senior associate three years later. A native English speaker, among the languages she has is elementary knowledge is Yoruba, a West African tribal language. She also played a senior role in Capsticks celebrations of Black History Month last year.

Claire McLaughlan ,chairs MHPS inquiries

At Capsticks she specialises in defending health trusts and the police and cites dealing with whistleblowers as one of her specialities. She is also involved in advising trusts running  complex doctor cases under the national framework, Maintaining High Professional Standards in the Modern NHS – internal hearings like the one already held by ESHUT over Dr Usha Prasad chaired by Claire Mclaughlan that came to the bizarre decision that she was “unfit for purpose”.( see my blog here and here.)

Her top tribunal case cited on her page is one heard by Judge Auerbach in 2021 between Mr Abgeze and Barnet, Enfield and Haringey Mental Health Trust ( judgement here) over the controversial issue of people’s rights in zero hours contracts. Mr Abgeze, who was on a zero hours contract, was suspended and then reinstated by the trust. But because he was on a zero hours contract he was unable to apply for shifts and claimed compensation. Judge Auerbach threw out his claim.

She writes: “This will be a welcome decision to NHS Trusts, and other organisations that have similar casual worker arrangements.”

Certainly as this week’s cost hearing approaches there is a big stand off between her and Dr Usha Prasad who under increasing stress and suffering health issues and asked for a postponement. But it looks like that either Jessica Blackburn doesn’t believe her (despite a doctor’s note) or does not want to believe her and doesn’t want her schedule for the historic case delayed.

Forensic details of Usha Prasad’s finances demanded by Capsticks for the health trust

This is the letter she sent demanding details of Dr Prasad’s finances to make sure she will be ready to pay the £180,000.

“We write in respect of the hearing to determine the Respondent’s costs application against you listed by the Tribunal for 23 and 24 August 2023. The Trust has incurred in excess of £150,000 plus VAT in legal costs in defending your claims (2 and 3), which were all dismissed.  

On 19 June 2023, we wrote to you in the following terms:

“As part of the Tribunal’s consideration of the Respondent’s costs application, the Tribunal may take into account your financial means. Therefore, please can you disclose by 23 July 2023, any evidence of your means if you intend to rely on this at the costs hearing, so that this information can be contained within the costs hearing bundle.”

To date we have received nothing. We are not clear whether this is because, if you are ordered to pay costs, that your position is that you would be financially able to meet any order made by the Tribunal, or, on the other hand that you have elected not to disclose any information. 

We remind you that under Schedule 1,  rule 84 of the Employment Tribunals (Constitution and Rules of Procedure) Regulations 2013, the Tribunal may (but is not required in all circumstances) take into account a paying party’s ability to pay. 

Ability to pay

84.  In deciding whether to make a costs, preparation time, or wasted costs order, and if so in what amount, the Tribunal may have regard to the paying party’s (or, where a wasted costs order is made, the representative’s) ability to pay.

If you intend to argue (or might do so, depending on the level of costs awarded) that you would not be financially able to meet the terms of any costs award, if so ordered, the Respondent requests you urgently provide supporting information and evidence of the same.  

This should include:

·         information about your present level of income and remuneration as well as of what you have earned since the liability judgment; any property you currently own (whether in whole or in part, whether land, buildings or otherwise), any investments, and the content of any bank / building society or similar accounts and any other information relevant to your ability to pay an award of costs. This information should cover assets worldwide not only in the UK. 

·         You should also provide information and evidence regarding your financial commitments such as rent/ mortgage. 

·         Evidence to support the information provided should be provided. 

·         As regards your employment related earnings, pay slips, P60s, tax returns or record of invoices paid through agencies or similar and any current or recent contract of employment, or for your services. 

·         As regards bank accounts, savings and investments, including ISAs, this should include copies of your recent bank (etc) statements. Downloaded statements or screenshots from a bank (etc)’s website are acceptable. 

·         The Tribunal will need to understand your current financial commitments, therefore if you have any loans, mortgages, or other regular payments made such as rent or utilities, documents in support of the same (e.g. mortgage statement, loan agreement/payment schedule, rent payments) should be provided. 

·         Where you own one or more properties you should identify the approximate current value of the property concerned and the balance of any mortgage. 

·         Please can you also confirm your current employment/engagement status, including whether the number of hours worked and whether that if permanent or temporary (and if so on what basis) and your residential address.

Threat judge will be told if she does not provide the information

The Respondent will draw this letter to the Tribunal if the information and evidence requested is not supplied prior to the hearing but where you contend (whether in writing, or at the hearing) that your means should be taken into account by the Tribunal. It is important that the Respondent understands your position in good time prior to the hearing. In addition, we urgently request confirmation of your position regarding your financial means in order to address this issue in written submissions, the absence of which is delaying completion.

We look forward to receiving confirmation of your position, together with the requested documentation where applicable, as a matter of urgency.”

When she sent the doctor’s note Jessica Blackburn ignored it. You can see what detail Capsticks want – and other whistleblowers facing cost hearings say they have not received such detailed demands.

I informed Jessica Blackburn I was proposing to write a profile of her. Capstick’s press office replied that she could not comment at this time.

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Usha Prasad: Whistleblower Consultant cardiologist faces record £180,000 cost claim from NHS health trust

Dr Usha Prasad

It is a fact that among the tens of thousands of employment tribunals held every year claimants do not have to pay their employers costs in 99.95 per cent of all cases.

Therefore it is absolutely extraordinary that Dr Usha Prasad, a whistleblower cardiology consultant at Epsom and St Helier University NHS Trust is facing a special costs tribunal next week for an astonishing £180,000 claim from her employer at the London South tribunal in Croydon.

Even in rare cases where costs are sought the maximum is £20,000 and the level of proof has to be very high. The claimant has to be seen to have been acted “vexatiously, abusively, deceptively or otherwise unreasonably” or has brought proceedings deemed to be misconceived.

Epsom Hospital part of the Epsom and St Helier NHS Trust

However it is looking like that where whistleblowers are sacked and go to an employment tribunal more and more judges have agreed to hold cost hearings so the public body can recover some or all of its costs. And lawyers acting for these bodies threaten huge costs against whistleblowers to deter them from proceeding further. This has been used against Dr Chris Day in his decade long battle against the Health Education Executive and Greenwich and Lewisham NHS health Trust over patient safety and , against Dr Duffy, author of ‘Whistleblowing in the Wind’. Non NHS whistleblowers also face this. More recently this involved a case against Alison McDermott, a management consultant, at Sellafield and the Nuclear Decommissioning Authority (NDA), who exposed a raft of bullying, harassment and other grave failings at the nuclear plant.

Alison then faced a £40,000 cost hearing – both bodies sought the maximum figure – with judge Lancaster refusing to accept she was a whistleblower- only to have his decision declared  ” unsafe” by a judge at the high court. He determined that the costs were unsafe and must be ‘quashed.’  HHJ Auerbach also  overruled Judge Lancaster and confirmed that Alison was whistleblower. A FOI has revealed that Sellafield and the NDA have spent an extraordinary sum – £660,000 resisting that she was a whistleblower.

Unbelievably Sellafield and the NDA have just sought to reinstate the cost hearing again with the same judge who made the ” unsafe” costs ruling which has already been thrown out by the higher tribunal. Which of course sends a chilling message to any would be whistleblowers at the most dangerous nuclear site in Western Europe.

In Dr Usha Prasad’s case the trust and its lawyers, Capsticks, have gone one step further by getting a hearing next week wanting the judge to order a £180,000 costs finding against her.

Now in researching whether this has happened before – the only case I found which is highlighted by the Association of Costs Lawyers is Gosalakkal v University Hospitals of Leicester NHS Trust, where the paediatrician who made a series of whistleblowing claims walked out of the costs assessment hearing and ended up being ordered to pay £82,000 to the trust. This went to appeal in 2019 and the judge was criticised for misunderstanding the whistleblowing nature of the case and the initial award was quashed. It turned out there was a breakdown of relationships among consultants there as well, a disciplinary hearing and he was dismissed. He left Leicester and got a new job in the United States.

Judge Heap ruled in April 2017 that she could do this citing rule 78 of tribunal regulations set in 2013 which allows her to exceed the £20,000 limit by having a detailed costs assessment or send it to a county court to decide. I am pretty sure Capsticks will be citing these rules and the case next week.

I am sure the Association of Costs Lawyers would have highlighted any higher settlement than this so this will make the Dr Prasad hearing a new record for tribunals pursuing whistleblowers for costs. The biggest sum ever awarded at an ET tribunal to an employer was £432,001.85 in a dispute between Copthorne Hotels and a Mr Tan who had withdrawn any whistleblowing claims.

The problem for Dr Prasad is that these hearings specifically rule out discussing the merits of previous tribunal hearings in her case. She has had enormous support from other practising colleagues at the Epsom Trust trust. You only have to look at a website to see the appreciation of her work at Pinderfields General Hospital in West Yorkshire to see pages of praise from patients. These were made while the case against her was being pursued by the Epsom and St Helier NHS Trust.

She has still to await the official result of an employment appeal tribunal hearing against her case claiming perversity and bias and error of law by the judge involved ( see below) and the trust has secured a costs hearing in just over five months while the average wait for the overloaded employment tribunal system to hear a case is now 335 days. She has been refused access to the judge’s notes to defend herself and her barrister who appeared for her previously is not available to defend her.

Judge Tony Hyams -Parish

The judge who heard her case Tony Hyams-Parish, threw out all “her allegations of victimisation, sex harassment, and sex and race discrimination” and ignored in his judgement the admission from the trust that it had failed to report to the coroner an ” avoidable death” of a heart patient treated by another doctor and tried to get her to change a report on the incident. My reports of this part of the hearing is the only record that it happened. See it here and here.

Capsticks have seized on this to write to her saying :” The Respondent has incurred very substantial costs indeed in defending the unmeritorious proceedings, of in excess of £150,000 plus VAT. The costs incurred correlate to the Claimant’s unreasonable conduct and the unmeritorious nature of her complaints.”

What is also missing is that the trust put in 43 complaints to the General Medical Council to build up a case against her.. Every one of those complaints was thrown out by the GMC after a highly skilled cardiologist looked at them and she was automatically approved to continue working as a doctor without any further revalidation.

The BMA despite receiving letters of support from her medical colleagues has refused to give her any financial backing to fight this hearing, citing that it did not have a 51 per cent or more chance of success. In my view that is short sighted as far as I can see the hearing is about the costs incurred by the trust in fighting a whistleblower case and if they do not challenge this, they are leaving all their members to be hung out to dry by NHS trusts.

Not to put to fine a point on all this my thoughts are this has all the hallmarks of being a ” Kangeroo tribunal ” next week where a litigant in person, an excellent doctor, is being arraigned by legal heavyweights with little chance of being able to defend herself. Let’s see if this is true next week

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Rishi Sunak: The Road Kill PM

” Dishy Rishi” or our new Maharajah Pic Credit : Lauren Hurley / No 10 Downing Street

Increasingly desperate about his poll ratings the Prime Minister has turned to dumping green policies as Europe burns. The Tories managed by just under 500 votes to hold Boris Johnson’s old seat of Uxbridge and South Ruislip and claimed that stirring up the introduction of new charges for the ULEZ ( Ultra Low Emissions Zone) being extended to all vehicles entering Greater London helped them hold it. Keir Starmer, the Labour leader, bought the argument.

For the record two other reasons also contributed to counter that view. Despite ULEZ the Green Party polled 893 votes taking more than enough votes from Labour to deny them the seat. And the seat has a substantial Indian minority – who are thrilled to have an Indian PM – with many mothers dubbing him “Dishy Rishi” as they see him as a trailblazer for the future community.

But Sunak’s short term populist stance on these issues aimed at the “boy racer” motorist vote is going to have a devastating effect on the health and lives of ordinary people. In the space of a week the PM has signalled he is against ULEZ, against 20mph speed limits, against restrictions on cars in residential neighbourhoods and in favour of a massive expansion of oil and gas in the North Sea. If he gets more desperate I can see him dropping the ban of new diesel and petrol cars and promising the combustion engine will live forever in the UK.

Bill Esterson Labour’s business and industry spokesman Pic credit: Industry Forum

And none of this is good for long term planning for business to transition to net zero as Labour’s shadow business and industry spokesman, Bill Esterson points out. It could even damage our own car industry as every country we export is switching to electric cars.

As he says: “Over 70% of our car exports go to markets that have already set a phase-out date of fossil vehicles.

Other countries are committed to the transition away from fossil fuels. And they are keeping their commitments.”

All these measures will damage the health of people and cost lives. That is why I think he deserves the title of the Road Kill PM – the roads of the UK will not only be littered with dead wildlife but dead and injured children and pedestrians.

Take the ULEZ zone itself. This is as much a public health issue as an environmental one. Children have died in London because of it so Sadiq Khan is right to introduce it. And the Tories are hypocritical about the zone – it was demanded by Grant Shapps, as transport secretary as part of a cash settlement to bail out Transport for London during the Covid crisis. So it could be called the “Grant Shapps” ULEZ zone as much as Khan’s.

In France ineligible cars are BANNED not charged in Ulez zones

Also drivers chaffing at paying the charge should know that this initiative is not confined to the UK. If they drive to France on holiday they will find they are not charged but banned from driving in a growing number of big city centres and could be fined. And all eligible cars and motorbikes have to carry a clean air sticker or you cannot drive in France.

No wonder doctors have written Sunak and Khan to say.

“Air pollution affects every one of us from before we are born into old age. It not only causes respiratory conditions such as asthma, but also heart attacks, heart arrhythmias, strokes, child developmental disorders, lung cancer and dementia.

“Ulez works. It has already saved lives and prevented many illnesses and hospital admissions.”

As for reviewing 20 mph limits in cities including London. There is no question that will result in more deaths and injuries.

Road crash Pic credit: Brake, road safety charity

Brake, the road safety charity, says:

“A vehicle travelling at 20mph would stop in time to avoid a child running out three car-lengths in front. The same vehicle travelling at 25mph would not be able to stop in time, and would hit the child at 18mph. This is roughly the same impact as a child falling from an upstairs window.

The greater the impact speed, the greater the chance of death. A pedestrian hit at 30mph has a very significant (one in five) chance of being killed. “

Latest statistics for London show the number of collisions has reduced by 25% (from 406 to 304), and collisions resulting in death or serious injury have also reduced by 25% (from 94 to 71), demonstrating the huge impact of lowering speeds to 20mph on many roads.

But for Rishi Sunak to get his votes back and stay in power obviously a few more children or pedestrians killed or maimed every year are a price worth paying. Anyway he seems to go most places by helicopter.

Then there is the big boost to finding North Sea oil with 100 new licences to be issued by the government. Again this is going down the wrong track. The North Sea is not the only place being explored when I was in Namibia a big exploration was under way near Walvis Bay which could yield an enormous new field. At some point the big increase in electric vehicles is going to meet the burgeoning supply of oil and as demand for oil falls so will the price until it becomes uneconomic.

The security claim is rubbish too – since it will be traded on the open market. What is true is that Rishi Sunak’s family firm Infosys will personally benefit every time BP gets a licence as they signed a deal with the oil giant just before the exploration licences were announced. His wealthy family will see the petrodollars rolling in, the more BP win concessions. No doubt the cash will be hidden in some offshore tax account so we won’t know about it.

Next month Rishi Sunak will be in Delhi for the G20 summit and the press there is already very excited about him coming there. Politico Europe is already suggesting he will be mobbed by ecstatic Hindus. And the Times of India has heralded his arrival in Downing Street as a move from ” Empire to the Rishi Raj”. Others see this as revenge for Britain’s Imperial past ruling India. Now Rishi rules over the British people instead.

The choice of helicopters for Rishi Sunak from Maharaja Aviation

Given his penchant for exorbitant expensive helicopter rides over mundane journeys by rail or road I have found the perfect charter company for his travel. It is called Maharaja Aviation and runs a fleet of helicopters. He can fly like a modern fabulous wealthy maharaja across India dispensing baubles to the masses. And in the meantime he can forget the country he rules with its sky high mortgages and rents, sewage in the seas and rivers, food inflation and its demonising of other foreigners who try to seek sanctuary on its shores.

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A toothless quadriplegic prisoner, Tthe Lord Chief Justice and a boiled sweet

Lord Burnett, the Lord Chief Justice

Lord Burnett, the Lord Chief Justice of England and Wales (salary £275,534 a year) and two other Court of Appeal judges ( salaries £225,978 each) spent this week delivering a judgement on whether a prisoner could eat a boiled sweet.

In what must be one of the most lofty and byzantine judgements of the year a judicial review at the Court of Appeal threw out a request from a disabled prisoner at Liverpool jail to be able to eat boiled sweets.

The prisoner only known to the courts as JJ is a toothless quadriplegic inmate serving time until 2027 in the health wing of the prison. Lady Justice King delivered the verdict, which the Lord Chief Justice and Lord Justice Lewis concurred after spending time on a hearing and taking advice from the Royal College of Physicians.

In what must have been a very expensive case -since it was an appeal from another high court judge – barristers from top NHS lawyers Hill Dickenson and DAC Beachcroft to defend the prison’s healthcare company, Spectrum community Health. who were caring for him in jail while JJ was in the health wing. JJ had his own barrister, Aswini Weereratne KC.

Lady Justice King pic credit: Law Gazette

Lady Justice King said: “JJ is quadriplegic and without teeth. While his cognitive and communication skills are unimpaired, his physical capacity is limited to pushing a button with one finger. Since 2016 he has been bed-bound and wholly dependent on care staff for all his personal cares and for feeding. He is nursed in a supine position.”

“As a consequence of JJ’s condition, eating food poses a risk of death or serious injury by choking or aspiration. Some foods pose a more significant risk than others. Until 2021, JJ ate a mixed diet of soft and non-soft foods. Meals would be sent to his cell and he would decide whether he was capable of eating them. He would regularly supplement his diet with snacks bought from the prison canteen, including non-soft foods such as boiled sweets.”

Prisoner goes on hunger strike over the denial of boiled sweets

There have been several instances of him choking on food but JJ insisted that he would take responsibility for himself and still wanted to suck boiled sweets.

The care company however were worried about his choking. They called in a therapist who decided that he should only eat soft and bite sized food once his supply of boiled sweets ran out. JJ wanted to choose what he ate and when this was not allowed went on hunger strike only taking high energy fluids to stay alive.

The judge said: “JJ’s approach was, and is, that he could exercise his basic freedom of choice to decide what he will eat, being fully aware of the risks.”

Do not resuscitate me says prisoner

Spectrum wouldn’t agree to this so in December 2021 JJ signed an Advance Decision to Refuse Treatment. In this, JJ confirmed that food refusal was to apply even when his life is at risk and that he does not wish to be ventilated or to have cardiopulmonary resuscitation (CPR). It follows that in the event that JJ choked or aspirated as a consequence of eating a boiled sweet which, as he is quadriplegic, would have been put into his mouth by a carer, neither that carer nor any other medical professional on the ward would be able to intervene to give JJ lifesaving CPR.”

In July 2022, JJ brought a claim for judicial review, contending that Spectrum’s refusal to feed him foods of his choice was irrational, discriminatory, in breach of his common law right of autonomy and his Article 8 right to physical and psychological integrity.”

It went to court and he lost and the judge refused an appeal. But it was decided as the issue was a compelling one it should go to the Court of Appeal.

Here the key issue was elevated to whether a patient can refuse to follow a clinician’s treatment and the fact that prisoners cannot choose what food they can eat – only what the prison choose to provide.

Also a bombshell ruling that as Spectrum was regulated by the Care Quality Commission if a nurse gave JJ a boiled sweet and he choked to death would he or she be prosecuted for gross negligence manslaughter?

Liverpool prison where JJ is held

JJ filed a statement to the court : ” In it he describes how he has little or no quality of life. He is completely bed-bound, lying on his back for 24 hours a day, and is unable to do anything for himself other than call for help or control a television. He concludes his statement by saying that he has lost almost everything in his life and ‘being able to eat what I want represents my last shred of humanity and dignity. I want o be able to cling on to it for as long as I can’.

But the judges rejected this saying ” It may be that in certain different medical circumstances the balance would come down in JJ’s favour but not, in my view, in this case. JJ cannot feed himself. He cannot obtain boiled sweets from the prison shop, unwrap them and put them in his own mouth. The provision of boiled sweets in circumstances where JJ cannot even put a sweet into his mouth is different; it is treatment or care carrying with it the considerable risk that on any given day, giving JJ that boiled sweet may cause him to choke to death and in circumstances where JJs advance decision would prevent all but the most basic life-saving intervention on the part of the person who had given him the boiled sweet.”

So what would happen if a friend came to visit him at Liverpool jail? Presumably the prison will have to confiscate any boiled sweets to comply with the Lord Chief Justice’s ruling. We hear of drugs, illicit mobile phones and porn being smuggled into jail now in this case the judiciary’s top judge has extended it to boiled sweets. Given JJ’s brain is the one part of him not impaired It is over the top.

For highly intelligent people the three cold hearted Court of Appeal judges lack any empathy or humanity in this case. Their judgement is more concerned with avoiding liability for the company and the prison if JJ dies rather than granting him a boiled sweet to make his limited life more pleasurable.

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Revealed: the damning figures that show the NHS can’t cope with patient demand

St George’s University Foundation Trust’s A & E department Pic credit: health trust

If you thought the NHS was at breaking point and want to know why – the National Audit Office have today provided a handy fact and figures guide to the decline of the country’s most cherished service.

A new report from Parliament’s financial watchdog charts the scale of both the failure of the NHS to respond to emergencies fast enough and the unprecedented demand from the public to use its facilities in the 13 years the NHS has been run by the Tories and the coalition government.

These are the startling figures:

711,881 A&E patients waiting over four hours from arrival to be admitted, transferred or discharged in December 2022, an all-time high. Since fallen to just over 550,000 in March this year.

90,998 ambulance handovers to A&E taking longer than 30 minutes in March 2023, equivalent to 25.9% of all ambulance handovers

32.0m reported number of appointments in general practice provided in October 2022, an all-time high, compared with 27.1 million reported in October 2018

92.3% general and acute hospital beds occupied during Q4 2022-23,representing record levels

88 seconds mean time to answer 999 calls related to health issues in December 2022, an all-time high

July 2015 the last time the NHS met its target for 95% of A&E patients to be admitted, transferred, or discharged within four hours of their arrival

8.4 million 111 calls answered within 60 seconds in 2021-22, compared with 11.2 million to 13.3 million between 2014-15 and 2020-21

1.27 million full-time equivalent NHS staff in February 2023, compared with the most recent low of 0.96 million in June 2013

£21.5 billion estimated annual cost in 2020-21 of providing the services reviewed in this report

Big variations in different regions in England

Delving deeper into the figures there are big variations in different regions of the UK. For example those being admitted, treated and discharged from A&E within four hours varied between 67.9 per cent in the East of England to 75.9 percent in the South East – both noticeably lower than the standard 95 per cent treated in that time just after the Tories got into power in 2011.

Similarly among ambulance response times there were wide variations. In 2021-22, the mean Category 1 (life threatening incidents like strokes and heart attacks) incident response time for the London ambulance service was 6 minutes 51 seconds compared with 10 minutes 20 seconds for the South-West ambulance service.,

In the same year the mean Category 2 incident response time for the ambulance service in the Isle of Wight was 26 minutes 20 seconds, compared with 1 hour 1 minute 57 seconds for the South-West ambulance service.

Some other points emerge why this is happening. The growing elderly population and general population increase in the UK is increasing demands on the NHS and effects of the Covid pandemic has left its mark.

More staff recruited but more off sick from stress

The government can claim it has recruited more NHS staff, including GPs and ambulance drivers. But this has been offset by more staff going off sick and more staff leaving the NHS because they can’t cope with the workload. I should not think the government’s attitude to keeping down pay rises in the middle of a cost of living crisis has helped either.

The government is promising a great £2.5 billion recovery programme and has allocated the extra money. But the NAO report says:

“More people than ever before are receiving unplanned and urgent NHS care every day. To support these services, the NHS is spending increasing amounts of public money and employing record numbers of people. Nevertheless, patients’ satisfaction and access to services have been worsening, suggesting there is no single, straightforward solution to improving what is a complex and interdependent
system.”

The real test will come next winter -since the government is promising much better services by March 2024. If it fails it will just add to the multiple problems facing this government and increase the distrust between the public and politicians.

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Fresh revelations on the national role of top NHS law firm disclosed in the latest hearing in the long running Dr. Chris Day whistleblower case

Dr Chris Day

A preliminary two day employment tribunal hearing has led to fresh revelations about the national role of one of the NHS’s top law firms, Hill Dickinson, that acted for Health Education England against whistleblower junior doctor, Dr Chris Day, in a case that has now been ongoing for 8 years and was also against the South London Trust Lewisham and Greenwich NHS Trust.

Day alleges Hill Dickinson failed to disclose over 200 commissioning contracts between Health Education England and NHS Trusts around England including a contract with Lewisham and Greenwich NHS. The significance is that these contacts proved Health Education England’s status as a second employer of junior doctors.

This is something that Health Education England and Hill Dickinson spent 4 years denying, between 2014 and 2018, at huge expense to the taxpayer in order to argue junior doctors out of whistleblowing protection.

This was in order to stop Dr Chris Day’s case ever being heard. The Tribunal were told that not one of these contracts was disclosed in the litigation and were obtained in 2019 by a freelance journalist, Tommy Greene who was writing about the case in the Telegraph. The scandalous focus of the hearing was that Hill Dickinson profited from not disclosing the contracts in litigation arguing that it was fanciful for Day to assert HEE as an employer of doctors.

Tommy Greene freelance investigative journalist Pic credit: Twitter

The Judge was told that Tommy Greene had also found that Hill Dickinson were paid handsomely to draft the very contracts that were not disclosed most notably the one between HEE and Lewisham and Greenwich NHS Trust.

The Judge was referred to a complaint to the legal regulator from Sir Norman Lamb and Tommy Greene that set these details out.

 SRA Complaints Sir Norman Lamb (54000doctors.org)

And a debate in Parliament where the 2 MPs Justin Madders and Sir Norman Lamb further explored the matter;

Sir Norman Lamb

Justin Madders stated;

“Health Education England effectively sought to remove around 54,000 doctors from whistleblowing protection by claiming that it was not their employer.”

 Sir Norman Lamb stated;

“Is the hon. Gentleman aware that the contract between Health Education England and the trusts, which demonstrates the degree of control that Health Education England has over the employment of junior doctors, was not disclosed for some three years in that litigation? It was drafted by the very law firm that was making loads of money out of defending the case against Chris Day. I have raised this with Health Education England, but it will not give me a proper response because it says that the case is at an end. Does the hon. Gentleman agree that this is totally unacceptable and that it smacks of unethical behaviour for that law firm to make money out of not disclosing a contract that it itself drafted?”

Dr Day has fought an eight year battle with the Lewisham and Greenwich NHS Trust and Health Education England over protected disclosures about patient safety in the intensive care unit at Woolwich Hospital which associated with  two avoidable deaths.

He recently lost a case against the trust despite it being revealed that hundreds of emails and documents had been withheld from him including notes of a crucial trust broad meeting which discussed and decided the fate of his case. Some 50,000 emails involving his case were also destroyed by a senior trust official, David Cocke, during the hearing. He was also due to be a witness in the case but never gave any.

This new hearing has been brought by Dr Day over ” wasted costs” in an earlier hearing after he was pressed to agree to a settlement with the trust which exonerated the NHS or face huge costs which would have lost him his family home.

Day was arguing that had he known the truth he would not have agreed to three separate compromise agreements made with the NHS, one of which protected all lawyers in the litigation from wasted costs stemming from misconduct and another that paid Day a £55k contribution of his legal costs which was only a fraction of what he spent resisting the false arguments in this case on HEE’s employer status.

At this hearing Day asserted that the  settlements should be set aside after new information came to light following a freedom of information disclosure to investigative journalist Tommy Greene. The Judge at the hearing was also taken to references made by Tommy Greene and Sir Norman Lamb to fraud and other offences based on a legal opinion that had been instructed by Tommy Greene.

SRA Complaints Sir Norman Lamb (54000doctors.org)

In this hearing the Judge only had to decide whether Day’s wasted cost claim against Hill Dickinson was strong enough to progress to a full hearing where Hill Dickinson would be subject to a disclosure order for all relevant documents and emails relevant to this dispute. Hill Dickinson argue the settlement agreements should prevent the case progressing to full hearing.

Andrew Allen KC

The hearing revealed that Hill Dickinson were paid to re-draft contractual agreements for 200 other trusts as well as Lewisham and Greenwich. The contract with highest values was revealed as £79m. As Andrew Allen argued: “The LDA disclosed nearly three years after the 2015 strike out hearing,(an outdated LDA not drafted by Hill Dickinson), showed that the 2nd Respondent[ Health Education England] was responsible for substantial terms under which the Claimant”. This was a position that had been plainly denied on multiple occasions in several courts. Andrew Allen KC continued;

” The entire basis for the strike out application had been false. The argument run by the 2nd Respondent that it was ‘fanciful’ to suggest that the party which substantially determined the terms and conditions of the Claimant’s engagement was or could have been the Respondent was completely wrong.”

Extraordinarily Hill Dickinson claim that the lawyers representing Health Education England in the case did not know about the new agreement and even other lawyers working for Hill Dickinson didn’t know about it.

Andrew Allen KC said: “Had the Claimant known then what he knows now, he would not have entered into an agreement which could stop him applying for costs against Hill Dickinson. It is in the interests of justice to permit the Claimant to progress this application. His full skeleton argument is here.

Angus Moon KC pic credit: Sergeants’ Inn Chambers

Mr Angus Moon KC for the Health Education England argued that the non disclosure of the document was not relevant to Dr Day’s whistleblowing case. made no material difference to his case, and to throw out the agreement would break the finality of all agreements reached in courts. He also warned the press and the public reporting and observing the case that any reference to Hill Dickinson should not suggest that they had done anything wrong. He wanted Dr Day’s application struck out while Mr Andrew Allen, KC made it clear that this should not happen as the preliminary hearing could not investigate nor discuss the actions of Hill Dickinson without a full hearing at the tribunal.

Dr Chris Day’s Crowdjustice page explains more about what this hearing against Hill Dickinson was about with a link to the legal paper including Andrew Allen KC’s skeleton arguments. the link is:

https://www.crowdjustice.com/case/junior-doctors-whistleblowing-protection 

Dr Day has recently published a Linked In article explaining the twists and turns of his 8 years of whistleblowing litigation. The link is here.

Background note: Hill Dickinson is a 212 year old law firm, founded in Liverpool and now a big international firm. Its famous cases included acting for the White Star line, owners of the Titanic when it faced claims in the US courts after it sunk and for Cunard, owners of the Lusitania torpedoed by a German U boat in 1915.It also employed one of the first women to become a solicitor, Edith Berthen, in 1927.

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The economic horror yet to come: Shocking report from Barnardo’s on family poverty

Jeremy Hunt – cutting benefits in the cost of living crisis

Yesterday Jeremy Hunt, the new chancellor, announced the biggest Budget U-turn in history, throwing out nearly all of Liz Truss’s and Kwame Kwarteng’s tax cuts and announcing a big curb on help for those with rising energy bills.

But this only the half of it. In less than two weeks time big cuts will be announced for public expenditure in a wealthy country and there will be more grim news for the poor – whether pensioners or low income families whatever pledges are given for compassionate Conservativism. But what is the position now before the axe falls on public spending amid a cost of living crisis?

This is the answer given in a well researched report by Barnardo’s the children’s charity, drawing on work done by the polling organisations, Yougov, and the non Tufton Street think tanks, the Institute for Public Policy Research and IPPR North. See Barnardo’s press release here.

Barnado’s logo

More than half the parents contacted have ALREADY cut back on food for the family and one in five parents have struggled to supply sufficient food. Over a quarter of parents say their children’s mental health has been affected and one in five taken out new credit cards – boosting the profits of the banks just as curbs on bankers’ bonuses have been lifted. Sadly a quarter have had to sell some of their possessions to make ends meet and a small number have had to return pets to animal rescue centres because they can’t afford to keep them.

Among the professions, three out of five people are supporting a child, young person or family experiencing poverty and three in five practitioners have either given food or pointed families to food banks. The Mirror today gives a dramatic account from other charities backing up this food crisis.

Barnardo’s calls for more benefit help not less

The charity is calling for an extension of free school; meals to all families; help for all vulnerable children to be able to participate fully in school life; strengthen targeted social security payments to help young people and families manage better; improve mental health services to help children and introduce more family hubs to support people and children.

The problem is what journalists are hearing is likely to be the opposite – real cuts to social security – a mental health service starved of resources and no compassion to extend free school meals.

Banardo’s doesn’t cover issues facing pensioners but given comments on my site the most likely changes for them are the end of the triple lock, the raising of the pension age again- and using the excuse that families are struggling in work to say pensioners can’t have a good deal.

What can’t be exaggerated is that more and more people are being driven into poverty whatever the government says ( they claim the opposite). So unless you are banker or a very highly paid executive getting a big national insurance reduction or an MP or minister life this winter is going to be very grim.

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Whistleblower doctors fury over Roddis Associates suitability to run medical ethics courses for the Medical Defence Union

Doctors involved in high profile whistleblower cases have put in complaints to the Medical Defence Union over a day long virtual course in medical ethics run by a clinical management company that makes tens of thousands of pounds from NHS trusts challenging doctors who raise patient safety issues.

Tomorrow the MDU host a course run by Dr Mike Roddis of MJ Roddis Associates and Claire McLaughlan, who is also occasionally employed by M J Roddis, on medical ethics. I have already published a profile of Claire McLaughlan here.

Details of the course are here and the MDU is charging £249 a head (£149 for members) and it is already sold out.

The dispute over both Dr Mike Roddis and Claire McLaughlan involvement in the medical ethics issue comes from doctors who have been at the receiving end of reports written by both of them which are used by NHS health trusts to discredit whistleblowers at employment tribunal hearings. The work they do for trusts – in two recent cases – involve helping the trust to either downplay or dismiss the deaths of people in NHS hospitals.

This has led to highly critical letters going into the MDU from junior doctors and consultants including the Justice for Doctors organisation.

Dr Chris Day

One of the complainants is Dr Chris Day – currently awaiting the result of a tribunal covered by this blog into patient safety concerns at Woolwich Hospital, where two patients died in its intensive care unit because the Lewisham and Greenwich NHS Trust ignored national staffing guidelines for intensive care units.

Dr Mike Roddis and Claire McLaughlan produced a report for the trust entirely ignoring this.

Dr Day says that he is shocked that the MDU is employing two investigators implicated in the cover up of his whistleblowing complaint to lecture on medical ethics. Their report was heavily criticised by Dr Megan Smith, a consultant anaesthetist and witness at Dr Day’s employment tribunal hearing in June.

Her statement is here and there is a report on my blog here. She told the tribunal:

“You would not find an anaesthetist or ICU doctor in the country who would accept those ratios. There was a clear and present danger to patient safety – no question about that.”

Dr Usha Prasad

Dr Usha Prasad, a former consultant cardiologist at Epsom and St Helier University NHS Trust, has written in similar terms to the MDU.

She wrote; “Claire Mclaughlan was the Chair of the internal appeal panel, hired by Epsom & St Helier Hosptial and her involvement including one sided conclusion was greatly damaging to my career…

“I am shocked to find that the MDU are using the very same investigator implicated in the cover up of whistleblowing cases. The MDU is using them to present a seminar on medical ethics of all topics which is very worrying. “

Her case, among other matters, involved the ” avoidable death” “of a cardiology patient at the hospital which was not reported to the coroner.

David Ward and Jane Somerville, two distinguished retired consultants have written to the MDU about both cases.

“We are retired physicians supporting NHS whistleblowers. We are aware of the MDU’s invitation to Roddis Associates and Claire McLaughlan to participate in a meeting on the subject of Medical Ethics. We are alarmed and dismayed to say the least.”

” Ms Claire McLaughlan was hired by St Helier Hospital Trust to undertake investigations and chair a Maintaining High Professional Standards (MHPS) hearing for Dr Usha Prasad. The outcome, published in June 2020, recommended her dismissal from the NHS Hospital where she had been working as a consultant cardiologist for over a decade (and with numerous plaudits from patients and administrators). 

“Some spurious and non-legal reasons were included in Ms McLaughlan’s written judgement recommending dismissal (these are the subject of an 3 inquiries which we have referred to the to the Ministry of Justice, the Tribunals President Barry Clarke and to the National Medical Director, Sir Stephen Powis). Given what we know about the conduct of these companies who claim to “help” doctors, we are extremely concerned about their ability to present meaningful, honest and understandable concepts in Medical Ethics.”

Justice for Doctors complains to MDU

The organisation Justice for Doctors has also complained to the MDU. A letter from doctors Salam-al- Sam and Azhar Ansari said:

“We learned to our disbelief that the MDU has invited Claire McLaughlan to talk about the subject of medical ethics at a shortly coming meeting.

“We write to express our serious concerns supported by more than 100 members of a group of doctors and other professionals known as Justice for Doctors. Many members were victims of those who made a fortune from NHS money by destroying the livelihood and reputation of intelligent, hardworking, and committed doctors simply because they did not remain silent when witnessing bad practices, bullying, fraud, and similar despicable acts on the NHS premises. Roddis Associates and Claire McLaughlan were hired for a fee originating from taxpayers which is supposed to be used for patient care to complete the acts of abusers of power in our NHS.  We and members of Justice for Doctors urge you to reconsider your plan and ask you not to encourage such individuals to spoil the reputation of your good offices.”

The MDU did not wish to comment on the letters.

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A whistleblower consultant’s victory that exposes scandals at the Care Quality Commission and a hospital trust

Whistleblower Dr Shyam Kumar; Pic Credit: BBC

The victory by whistleblower Dr Shyam Kumar, an orthopaedic surgeon, against his unfair dismissal as an part time inspector for the Care Quality Commission is just the tip of an iceberg scandal at both the CQC and the University Hospitals of Morecambe Bay NHS Foundation Trust.

His victory – I am glad to say reported by the BBC, the Guardian and the medical press- was only possible by his persistence in the face of obstruction by the body that is supposed to hold up standards of medical care to protect patients and the collusion of a trust to protect its own reputation.

He told the BBC: “”The whole energy of a few individuals in the CQC was spent on gunning me down, rather than focusing on improvement to patient safety and exerting the regulatory duties,”

“I was perceived as a troublemaker within the CQC, or as a thorn in their side. That’s what I believe. And they just ignored it. And finally, people got involved.” 

The ruling at Manchester Employment Tribunal by Employment judge Mark Butler said he had received detriment for speaking out and awarded him £23,000 for injury to this feelings. Dr Kumar had not sought any other compensation.

The judge said:” There is evidence throughout this case….that the decision to disengage the claimant in this case (and the placing him on hold) has had a serious impact on the claimant’s reputation causing him injury to feelings. There were suggestions of misconduct by the claimant … where no evidence of this existed, and vague assertions of a breach of undefined values of the respondent … used in an attempt to justify the decisions made in this case, after the event” Instead the judge described Mr Kumar as a man with an untarnished reputation and expertise.

Dr X left a hip replacement patient never able to use her limbs

The detail of the concerns Dr Kumar found are deeply disturbing for patients. One involved Dr X whose two hip replacements on an elderly lady which overlooked the dislocation of her pelvis and she had to come back to accident and emergency unable to walk and his colleagues thought she would never be able to use her limbs again. When he raised this with the CQC and said a back review of Dr X’s cases should take place he was told the trust did not want to do this for reputational reasons.

When the Royal College of Surgeons did their own review much later into Dr X they found 26 out of 46 operations were matters of concern.

The judgement said:

a. some surgeries undertaken by Dr X were not completed to an acceptable
standard
b. some of the surgery and quality of care provided by Dr X was unacceptable.
c. some clinical decision making to undertake surgery by Dr X was
inappropriate.
d. in some cases there was either no or a lack of evidence of a “Duty of
Candour”

Dr Kumar was thanked by the associate medical director of the trust , Mr Damian Riley in 2021 for his work.

But at the time of the CQC inspection Dr Kumar faced a barrage of criticism from CQC officials, was effectively suspended from his job, and subject to racist attacks including being accused of being ” a traitor to his community ” for raising issues about Dr X’s competence by another trust doctor, Dr Sinha.

At a CQC focus meeting Dr Kumar was even falsely accused of deliberately creating NHS waiting lists so people would have to go privately – making extra money for doctors.

The CQC’s response was to side more with the trust than the whistleblower. This led Dr Kumar to write to the Chief Inspector of Hospitals, Professor Sir Mike Richards. complaining that “patient safety is being
significantly compromised by the behaviour of some CQC staff.” He also complained he had been bullied and obstructed by CQC officials, his professional independence had been undermined and his whistleblowing concerns ignored.

The court upheld his protective disclosures. The judge also took a strong line in allowing the press access to all the documents in the case and also restricted an attempt by the CQC lawyers to restrict reporting of the Royal College of Surgeons report on the grounds that families had to be told first. The judge granted a very short restricted reporting period and was never challenged again.

The CQC in a statement said: “We accept the tribunal findings and have learnt from this case. We have already improved many of our processes and will continue to review these based on the findings to ensure we make any further necessary changes.”

Much wider issues than just this case

But there seems to me a much wider issue here about the behaviour of this particular trust and the role of regulation. This is not the first time this trust has been found wanting. There is the case of Peter Duffy, a consultant surgeon, working for the Morecambe Bay Foundation Trust. Faced with failures at the trust in the emergencies department he expressed concern for two patients who subsequently died from kidney sepsis.

One would have expected the Trust to have remedied the situation. Instead they turned on him rather than admit any failings. As he told Matthew Syed on Dispatches: ” I was on the receiving end of allegations of bullying, abuse and racism. And so what I hoped would be an attempt to raise standards became an investigation of myself”.

He was eventually proved right after an investigation disclosed multiple problems but not until after a five year toxic battle and now practices in the Isle of Man.

Inquiry chair Dr Bill Kirkup Pic credit: gov.uk

There is also the 2015 inquiry report by Dr Bill Kirkup into Furness Hospital, run by the trust over the deaths of babies and appalling maternity care.

As he says in his introduction: “The result was avoidable harm to mothers and babies, including tragic and unnecessary deaths. What followed was a pattern of failure to recognise the nature and severity of the problem, with, in some cases, denial that any problem existed, and a series of missed opportunities to intervene that involved almost every level of the NHS.”

There is a disturbing pattern that repeats itself. Whistleblowers, whether doctors or families, raise serious life and death issues, are ignored, denied justice, bullied and attacked, using the power of the state to buy expensive lawyers to try and crush them -only for them to be proved right in the end. With the Dr Chris Day case due to report this month following an extraordinary employment tribunal hearing where evidence was destroyed, it remains to see whether this pattern can start to be broken .

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DWP ignores the Parliamentary Ombudsman and refuses to compensate 118,000 disabled people hit by benefit maladministration

Worry precedent at the Department for Work and Pensions

The Department for Work and Pensions has set a worrying precedent for millions of people hoping to get compensation if civil servants get their benefit and pensions payments wrong or don’t inform them correctly by refusing to pay them a penny.

The decision also shows up the weakness of complaining about maladministration to the Parliamentary Ombudsman, Robert Behrens, in cases involving the ministry as it ignores his rulings.

The PHSO’s strong Youtube video on this case

This particular case involved 62 year old Ms U, who lives alone in London borough of Greenwich -one of the few authorities to still have a welfare rights service – who was on incapacity benefit and was moved on to the new employment and support allowance in 2012. This is aimed to be paid to people who cannot work because of severe health problems and is paid at two levels. The lower level is based on a person’s national insurance contributions and the means tested higher level which include premiums and access to other benefits like free prescriptions in England.

Ms U should have fitted into the second category. Ms U suffers from paranoid schizophrenia, arthritis, hypertension, and Graves’ disease an autoimmune condition. But she was wrongly put in the first category. As a result she lost access to free prescriptions and missed out in getting her home insulated under the Warm Homes scheme.

Ms U couldn’t afford to heat her home

Her representative said:” She could not afford to heat her property and could not afford to buy appropriate food to keep healthy. He said Ms U had poor mental health during that period and highlighted links between paranoid beliefs and depression and economic deprivation.

As far as her physical health was concerned, her hair fell out and she lost a lot of weight. Her representative said that since 2012, Ms U’s health had declined markedly: she had recently had a bypass operation, had deep vein thrombosis and poor blood flow in her legs and was due to have a toe amputated.”

Her underpayment went on for over five years from May 2012 to August 2017 before finally her arrears which then added up to £19,832.55 were paid. But she felt she was also entitled to compensation as the error had been committed by the ministry. The Ombudsman agreed in a report she had suffered an injustice and said the Department should pay her £7,500 compensation and interest on the lost benefit of over £19,000.

NAO report forced the department to find 118,000 other cases

She was not alone. An investigation by the National Audit Office found that some 118,000 disabled people had suffered the same fate prompting anger among MPs on the Commons Works and Pensions and the Public Accounts Committee at this huge error. Some £600m has had to be paid in arrears.

The Ombudsman also recommended that the rest of the 118,000 should also get compensation for maladministration and the department should take a proactive approach to deal with this.

It has now emerged that the department has refused to do this – despite the Ombudsman’s recommendation. I am indebted to Professor Robert Thomas at Manchester University and CEDAWinLAW who spotted this in a freedom of information request two days ago. See @RobertThomas223 and his tweet thread of August 5.

He said in a series of tweets:

“This issue is important because @dwp underpaid these people their benefit entitlements and many will have suffered injustice as a result. @PHSOmbudsman recommended that @DWP proactively compensate them. It refused. Affected people must approach DWP instead.

“But many people lack the confidence, stamina and knowledge to seek redress from government. Also, this is a largely vulnerable cohort of people. The result: unremedied injustice because of @dwp

“The underlying issue is, of course, money and almost certainly HM Treasury’s refusal to fund compensation. But the DWP can present itself as being fair: “anyone can contact us” while also knowing that few affected people will actually do so in practice. “

Sir Stephen Timms, chair of the Commons Work and Pensions Committee

Since seeing this I have contacted Sir Stephen Timms, Labour chair of the Commons Works and Pensions Committee, to see if, as they promised the Ombudsman, the DWP had alerted him to the decision. Initially he said he could not recall getting this and promised to investigate what has happened.

There is another big issue. This could impact on the Waspi campaign and the all party state pension inequality group of MPs to get compensation for women through a report from the Ombudsman. If after the Ombudsman says compensation is due the DWP follows this practice for the 3.8 million – six people will get compensation and the remaining 3.6 million still alive will have to write individual letters outlining their case to the ministry for any money due which will take even more time to resolve. You have been warned.

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