Guest Post from Dr David Ward: Time to ban NHS trusts from sacking whistleblower doctors and health care workers

DR DAVID E WARD

This blog arose from the recent case highlighted by the Health Services Journal of Dr Susan Gilby, the former chief executive of the Countess of Chester hospital in giving evidence to the Thirlwell Inquiry about the resistance from senior NHS people she faced trying to admit mistakes there. This is the hospital where a nurse Lucy Letby was found guilty of murdering seven babies and is now trying to get the case reconsidered. The CEO ultimately left the trust in late 2021, shortly after Letby’s trial began. An employment tribunal this month found she had been unfairly forced out by the trust and Mr Ian Haythornthwaite, the former chairman because she had raised concerns about his bullying behaviour. He resigned after the verdict.

Dr Susan Gilby Pic credit: BBC

Dr Susan Gilby is brave. Her experience is in keeping with many others who have raised concerns including patient safety issues. Dr David Drew’s comments ( See HSJ 08.44, 25 Feb) are spot on: the whole play book is sanctioned from above (NHSE and probably higher). Some colleagues and I have spoken to NHSE on several occasions (including in person, at Wellington House, SE London). We have nothing to show for it other than placations and weaselly words. Action, there is none.

Regarding NDAs (anon HSJ 13.39) in relation to healthcare and the NHS, they should be banned. They are “lawful” means of concealing (potentially very important) evidence which therefore cannot be tested in court. That’s the raison d’être of NDAs, isn’t it? And this is England, in the 21st century! And yes, Sir Robert Francis tried but was evidently misguided (see his 290 odd recommendations!). Jeremy Hunt did nothing to improve the “status” of NHS whistleblowers; if anything he made it worse by ignoring the problem and trying to belittle them.

On the Lucy Letby case there are now several authoritative sources seriously questioning the safety of the judgment (see Google). Let us hope that these processes will be allowed to evolve openly and unhindered.

It is high time the NHS leadership, politicians (West Streeting MP, SoS Health, are you listening?) reviewed the whole process of the treatment of NHS whistleblowers (they are “canaries in the coal mine”, right?).

If Trusts were banned from dismissing a doctor (or any Healthcare worker) who has “blown the whistle” or raised patient-safety issues (not “because” they have raised those concerns as that is banned by PIDA) it would save £millions. It would avoid hugely expensive law firms (of course taxpayer funded in the rôle of defending a Trust), Employment Tribunals and all the disastrous personal and professional consequences these Tribunals’ ill-considered decisions may lead to. Another consequence would be to eliminate the unfair and unnecessary loss of competent and sorely needed highly skilled doctors, (see Dr Chris Day’s case, Health Service Journal and elsewhere – its beyond belief but true). Training a doctor takes years, dismissing them takes minutes.

Employment tribunal system unaccountable

The Employment Tribunal system is unaccountable (well, if it is, it is to another branch of the judiciary, the Employment Appeal Tribunal process; marking one’s own homework?). It is heavily biased and has no place evaluating or investigating “patient safety issues” which it doesn’t understand. Neither does it understand the modus operandi of the NHS and medical matters (I won’t rehearse those arguments here – but for a start no offences have been committed and no laws broken by raising safety issues). In fact, raising safety concerns is not only strongly encouraged by professional medical bodies, but also part of a doctor’s code of conduct.

Internal management of “whistleblowing” matters are unregulated and unsupervised by an independent body. They are akin to “marking your own homework” because they are directed by the Trust CEO and perhaps some “chums” who can be relied on to give a favourable opinion. This is hardly appropriate, is it? WB may lose their jobs, their careers, £0000’s. Their professional and personal lives may be destroyed all in a process funded by the taxpayer. How is that “fair and open justice”? It is not!

The last thing a WB wants to do is go to an Employment Tribunal presided over by a “dodgy” ET Judge who delivers questionable judgments and pay “dodgy” law firms £000s for a <3% of winning (whatever “winning” means; if it comes it usually does so at the end of a spiral of losing first ET, appeal at EAT, lose EAT appeal. A “win’ may mean the case is referred back to the ET and round and round we go! This is the gist of things anyway. No wonder dismissed doctors are strongly advised (not by lawyers of course) to give the ET circus a miss, save their hard-earned money instead of paying extortionate fees to law firms and take the less stressful path of getting on with their lives. (NB The Tribunal step could be all but eliminated at a stroke by banning dismissal of a doctor who has raised patient safety issues).

If a Hospital Trust doctor raises patient safety concerns, history tell us they are very likely to suffer serious detriments in the form of restrictions, disciplinary hearings, pay cuts, referred for MHPS investigations concerning contrived allegations of incompetence or whatever, and suspensions as part of a vindictive reaction of Trust management who have (for some reason) taken offence. Instead, should they not be promptly investigating and correcting the shortcomings, how they were raised and by whom? If these adverse rill-informed reactions can be stopped there is hope for progress. One consultant, a colleague, was submitted to a flawed MHPS process (using an external agency) which supported the Trust’s claims of “incompetence” by alleging the doctor was not “fit-for-purpose”. (Further information provided upon request). As far as I know the confabulated charge of “not-fit-for-purpose” does not exist in (English) Employment law, but it was accepted without question by the Trust and the doctor was dismissed. As the saying goes, “You pays your money and you takes your choice”, (Aldous Huxley, Brave New World). The Trust had achieved its aim – to secure dismissal of a “difficult” doctor through what can only be described as a “corrupt” process. I asked people at NHS England if the charge of not “fit-for-purpose” was legitimate. NHSE claimed it was. I’ve searched online and checked with lawyers and found nothing to support its legitimacy. Ten years later that doctor is still fighting for their career. (And no doubt many others).

New laws and regulations to deal fairly with whistleblowing issues are URGENTLY required! The whole process is corrupt and in serious need of a profound and far-reaching review. The current system is ineffective but, more importantly, it is destructive.

All those interested in WB, particularly in the NHS, should read Roger Kline’s LinkedIn article (see 07.29). https://www.linkedin.com/pulse/nhs-hr-leaders-what-would-you-have-done-when-susan-gilby-roger-kline-jlvfe/?trackingId=IT70HHjXTru3VkRS5nkaEw%3D%3D

Also see my blog about the role of Clare McLaughlan when she was questioned at the Thirwell inquiry.

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Can Whitehall promote innovation, efficiency and AI technology to help overcome the crisis in providing public services?

Gareth Davies, head of the National Audit Office

Head of the National Audit Office raises pertinent questions about the future direction of Whitehall in annual speech

Anybody reading the latest tranche of reports from the National Audit Office and the Commons Public Accounts Committee could be forgiven for thinking the UK is living in a dystopian world. Indeed fiction writers could use their reports as a basis for a dystopian novel or a new TV series.

The problem is that it is not fiction, it is factual based evidence.

Never in my 40 years of reporting the NAO have I seen so many things run by Whitehall going wrong. Yes we have had scandals, waste of public money and even corrupt deals exposed by them. But the last tranche of reports almost beggars belief.

Simultaneously we have had the biggest backlog of building maintenance, totally £49 billion, the largest ever NHS waiting lists for operations, the Home Office admitting it has made 1000 mistakes and wasted tens of millions on acquiring sites for housing asylum seekers, half the local authorities in England on the verge of bankruptcy, outdated computer systems without proper security protection, record homelessness, and a huge backlog of people waiting for special education places or treatment in psychiatric hospitals.

Innovate or die

It is against this background that Gareth Davies, the head of the National Audit Office, addressed a well attended meeting yesterday in Parliament of MPs, peers, former permanent secretaries, academics and journalists.

While he did not use my journalistic hyperbole, his message was a simple one to Whitehall, innovate or die. And although the NAO is strictly non party political, there was an underlying message to the present government, sharpen your act or lose the next election.

As he put it: “we have a new Parliament and a new Government, but many of the same problems of rising demand and not enough money to quickly fix the gaps in key public services. We also face other challenges that risk causing widespread disruption, from global instability and climate change to public health emergencies and cyber threats.”

NHS needed fundamental reform

He was particularly critical of the department for Health and Social Care and the NHS, the biggest employer in the UK.

” Figures from NHS England in May last year showed it was still 8 per cent lower in productivity in 2023/24 than before the pandemic and much work is underway to address this.”

He went on later: ” In the last few months, our reports on supporting children with special education needs and NHS financial sustainability both identified the need for fundamental reform in the face of rising demand and costs, alongside unsatisfactory outcomes. This means tackling the causes of avoidable demand and allocating resources in a redesigned system where they can have maximum impact on outcomes.”

He is pleased that Whitehall is piloting AI but also warned that new technology is not the whole answer to greater productivity. He also emphasised that ministries need to employ the best skilled people – notably recently in the need for people with good computer skills and capable of negotiating good procurement deals.

He is also wanted Whitehall to concentrate on tackling resilience to protect the country. This included fighting cyber attacks and the risk of future pandemics. He revealed the NAO would soon publish a report looking at the international and domestic implications of protecting the UK from another pandemic like Covid 19 which came from abroad.

Civil servants must be less risk averse

Finally he wanted civil servants to be less risk averse and try out well managed schemes, dropping those that don’t work quickly.

His solution was summed up in four succinct points.

  • First, a clearly articulated risk appetite and a spread of investments, to maximise the chances of success in innovation
  • Second, harnessing new technology as I’ve already mentioned
  • Third, a culture of fast learning and evaluation, stopping failed experiments quickly and scaling up successes
  • Finally – and close to home for us – an accountability and scrutiny framework that encourages well-managed risk taking

” It’s no coincidence that innovation thrives in times of crisis, such as when lives are at stake. Organisations rapidly adjusted their risk appetites during the pandemic to meet urgent needs,” he said.

He pointed that Whitehall fears that they would hung up to dry by MPs and the press if they failed was now no longer true -instead MPs on the public accounts committee were now more critical of civil servants who failed to look at new ways of tackling problems rather than following safe bureaucratic procedures.

So what are the NAO doing themselves?  “our refreshed strategy from 2025 to 2030 takes fully into account the risk appetite set for the range of innovative projects. We will continue to look for and highlight positive examples of innovation, including where unsuccessful initiatives have been stopped in favour of more promising ones. As well as featuring these in our reports on departments and organisations, we will publish what we learn across government as part of our programme of lessons learned reports.”

AI is also coming to the NAO so auditors can spend more time making professional judgements on department’s performance and less time on manual exercises.

Talking to people who attended afterwards it was clear that MPs and academics are well aware that innovation is necessary or we will not be able to deliver public services to meet growing demand. MPs seemed especially aware that the NHS was not functioning properly – whether it was their local health trust – or the bureaucracy at the top. MPs have already publicly criticised the top management of the NHS for being complacent.

Over the next five years how Whitehall balances the money needed for innovation and risk taking against the perennial problem of working in a public sector which has been neglected for too long and needs ” first aid” to keep going will be crucial. Whitehall should treat the present state of public services as a national crisis which can only be tackled by radical innovation.

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My blog in 2024: Over 358,000 hits with a huge interest in pensioner issues and whistleblower injustice

Hits on my blog jumped from 219,000 in 2023 to over 358,000 last year. This will be an underestimate because it does not include thousands of additional hits on Linked In, particularly where I highlighted bad practices in employment tribunals and hideous unjust treatment of whistleblowers by NHS trusts and other state and private organisations including Sellafield and a Network Rail contractor.

By far the biggest interest was in a blog I wrote on the decision by Rachel Reeves, the Chancellor, and Sir Keir Starmer, the PM, to abolish the winter fuel allowance for all people claiming the state pensions – leaving it only available to a rump of pensioners claiming pension credit. This attracted an astonishing 187,400 hits on the site plus nearly 20,000 on Facebook and Linked In and reflected the fury among pensioners and the shock that a Labour Government should target people earning little more than £11,300 a year as its first priority for cuts. The ineptitude of this decision is not likely to go away and both well off ministers are still oblivious of the damage they have caused. The blog is here.

Throughout the year there was continual interest in the plight of the 3.6 million 50swomen who faced up to a six year delay to get their pension with tens of thousands of hits on stories detailing every twist and turn of this sorry saga. The year ended with total defeat for the WASPI campaign, when Liz Kendall, the new Labour works and pensions secretary, blocked compensation payments to any of the women despite a partial maladministration ruling by a weak former Parliamentary Ombudsman, Sir Robert Behrens. An older blog showing how much successive government’s saved by cutting Treasury contributions to the NI fund got another 2,444 hits this year.

IF ministers think this is the end of the story they are sorely mistaken as the fight by CEDAWinLAW will continue this year since they have international backing and ministers could have to face a call for arbitration despite the suspension of a potential court case.

Dr Chris Day

The other big issue on this blog which attracted thousands of hits was the appalling treatment of whistleblowers particularly in the NHS. Trusts are spending hundreds of thousands of pounds employing expensive lawyers to hound and ruin the careers of doctors who expose patient safety issues which trust managers want to bury. By highlighting individual cases when they come before employment tribunals I am building up a bigger picture of injustice and even corruption in NHS trusts and exposing barristers and solicitors who are enhancing their careers and bank balances by pursuing consultants and doctors who are brave enough to stand up for patient safety in the NHS. These included last year cardiologist Dr Usha Prasad, obstetrician, Martyn Pitman; emergency doctor, Dr Chris Day plus nurses at the Lewisham and Greenwich NHS Trust. The latest Chris day blog is here

Alison McDermott

I also highlighted the on going scandal at Sellafield where whistleblower and management consultant, Alison McDermott exposed bullying and harassment which put nuclear safety at risk only to be pursued by expensive lawyers working on behalf of the management to silence and humiliate her. The behaviour of employment judge Philip Lancaster, who heard the case, is now under scrutiny as six women have brought complaints about his behaviour towards women claimants. The blog is here.

Northiam part of the site

One particular story which attracted interest was an in depth investigation into the running of a small parish council in East Sussex, Northiam, where a ruling clique of councillors harassed and pursued anybody raising questions about dubious practices that followed a loan of £1.4 million from Michael Gove, the former Tory levelling up secretary, to allow the council to purchase ta former Blue Cross animal sanctuary for the village. This now the subject of an investigation by the external auditor the council. It attracted over 10,200 hits – 8000 of them locally. The blog is here.

Protest outside Mary Hassell’s coroner’s court

Finally I turned my attention to the coroner service after one particular coroner, Mary Hassell, appeared to me to the cross a red line in her treatment of bereaved relatives who were either banned or censored from making statements at both her inquests. Both were heartbreaking cases- one involving a mother losing her only daughter 17 hours after being admitted to University College Hospital in London, the other involving the death of a TV journalist who had complained of domestic abuse by an ex partner who had a record of violence.the blogs are here and here.

Expect more investigations this year as I take up more cases.

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How Claire McLaughlan got promoted to review Lucy Letby in 2016 two years after the NHS was told she had to apologise for distorting whistleblower Dr Chris Day views in a major health trust investigation

Claire McLaughlan

Her role in the Lucy Letby case comes out in a savage cross examination at the Thirlwall inquiry

Claire McLaughlan may not be nationally known but has great influence in the NHS. She has become the “go to” person when health trusts want to deal with what they see as troublesome doctors raising inconvenient issues such as patient safety and helping trusts to discredit whistleblowers who do this. Her career has included being head of fitness to practise at the Nursing and Midwifery Council and as associate director at the National Clinical Assessment Service. Her work for NHS also includes being a lay member of the Performance Advisory Group and chair of the Performance List Decision Making Panel, which assigned people to internal NHS inquiries. . For more information I have written up her profile here.

She gave evidence last week to Lady Justice’s Thirlwall Inquiry, which is investigating what went wrong at the Countess of Chester hospital that led to the murder of babies by nurse Lucy Letby. She claimed she has great expertise in examining doctors, dentists, pharmacists and nurses behaviours and attitudes when they were facing complaints.

Lucy Letby Pic credit: BBC and Cheshire Constabulary

She was called to the inquiry as a lay reviewer appointed by the Royal College of Paediatrics and Child Health. She was asked to review the maternity department at the Countess of Chester Hospital. She was part of a team led by Dr David Milligan, a retired neonatal paediatric consultant; Dr Graham Stewart, a paediatrician from Glasgow and Alex Mancini, a neo natal nurse, representing the Royal College of Nursing.

The review, invited by the Countess of Chester medical director, Ian Harvey, came before the involvement of the police but after consultants who suspected Lucy Letby had been threatened by the management after they raised concerns.

Given her evidence that at one stage she was in a position to review 300 doctors including their competence while she was at the National Clinical Assessment Service it is rather remarkable that in two cases covered by this blog – Dr Chris Day, then a junior doctor at Woolwich Hospital and Dr Usha Prasad, a cardiology consultant at Epsom and St Helier Trust(now combined with St George’s), she has a history of distorting facts to the detriment of their careers. More of that later.

At the Thirlwall inquiry, Ms McLaughlan was skewered by the experienced barrister, Nicholas de la Poer, from New Park Court chambers who previously appeared at the Manchester Arena bombing and Grenfell Tower inquiries. In many cases, she couldn’t recall or answer his persistent questions.

Nicholas de la Poer KC Pic Credit: New Park Court chambers, barrister for the Thirlwall inquiry

From the start he challenged her about her statement that she was a “non practising barrister” – and what that meant she could have practised as a barrister in the past. He pointed out Sue Eardley, the head of health policy at the Royal College of Paedriatrics, “appears to have ascribed some considerable significance … to the fact that you were a qualified barrister when being asked about your experience of legal process. In fact, is this fair: your experience as a barrister would not have involved you engaging in any legal process,” he suggested.

His questioning effectively revealed that she had given a misleading impression to the Royal college in 2014 particularly as she had to change her description to being an unregistered barrister in later years.

She could not answer why the person who engaged her for 14 reviews for the college from 2014 had that impression.

It then emerged from her and other witnesses that prior to the review coming up to the Countess of Cheshire the team were never told that consultants had raised complaints that babies there could have been murdered. It was sprung on them 12 hours after they arrived.

This is significant because a review by a Royal College cannot take place if there is suspicion of misconduct or criminal behaviour. It has to be cancelled immediately but it wasn’t.

Claire McLaughlan’s response to this was that while doctors had raised this possibility, people said that Lucy Letby was a good nurse, therefore it should not have been cancelled. She later went on to attack one of the consultants who did.

“Well it is possible to be a good nurse and murderer?” was the lawyer’s response. She also claimed she was given false assurances by the trust.

Lack of empathy for the parents of the dead babies

The questioning was also revealing about Claire McLaughlan’s views on her role of safeguarding patients and the public interest. When quizzed about that she claimed she had a wider role and unlike other witnesses never expressed regret about the babies’ deaths and the effects on the their parents. She was rather vague about her own safeguarding training.

When it came to the crunch about the doctor’s concerns about the deaths of the babies she depicted Dr Steve Brearery’s concerns as a personal rather than a professional judgement. Cross questioned by the lawyer she insisted:

“In my opinion I cannot speak for the whole team. This was the personal view, feelings, interpretation of
one person regarding Ms Letby, it was not based on fact and was uncorroborated. Even now I would not consider his view as objective or impartial as he was too involved, too close to the situation and had a conflict of interest.”

She went on to attack him for preparing a rota sheet showing who was on when a baby died.

“It’s not normally the role of somebody of that doctor’s status and experience to have any involvement,
is my understanding, in the rostering of staff. And therefore I would not have — I wouldn’t have called it
his professional role for him to take on the analysis that he apparently did of those rosters.”

Later when questioned by Lady Justice Thirlwall herself she claimed the document could have been manipulated because she had not seen the source of the material.

It was also revealed that she tried to get the report for ” balance” to say that some of the babies died because of congenital problems without any medical knowledge- but this was not included.

Frankly her evidence seems to betray a prejudice against doctors, a lack of empathy for patients, and it was obvious that her preferred solution would have been to treat it as an internal disciplinary matter run by the human resources department. This would have chimed with what the trust wanted to do as one non executive director said to ” contain it.”

She also seemed to suffer a loss of memory and recall about what documents she had seen and conversations that had taken place. There was also a rather bizarre incident about how she got hold of Lucy Letby’s telephone number. She couldn’t explain why and thought someone else might have put it there.

She has previous form with other doctor’s and consultants. One of the most egregious cases involves Dr Chris Day a whistleblower who is still fighting as ten year old battle with Lewisham and Greenwich Health Trust, after he reported two avoidable deaths in the intensive care unit at Woolwich Hospital.

She interviewed Dr Day on behalf of the trust and I’ll let his pleadings tell the story. The way she distorted the interview was sent to Department of Health, the courts and senior people at the top of the NHS who took no action.

Also evidence submitted by ,Dr Sebastian Hormaerche, a consultant anaesthetist, severely criticised Claire McLaughlan’s investigation and safeguarding in this case, not commenting on two serious incidents.

In Dr Usha Prasad’s case, a well qualified cardiologist who was popular with patients who was also whistleblower over an avoidable death at Epsom Hospital, was dismissed. Claire McLaughlan presided over an internal hearing and decided she was ” unfit for purpose.” No such ruling exists in employment law. To decide this she ignored the fact that the General Medical Council revalidated her to work anywhere in the NHS as a competent and well qualified doctor. But no doubt Ms McLaughlan thought that was just a personal rather than a  professional view.

One can only wonder how many other doctors have suffered from Claire McLaughlan.

The full day’s evidence from Claire McLaughlan and others is here.

Judge reserves judgement on whether a top legal firm should pay wasted costs for hiding documents that removed 54,000 English doctors from the UK’s legal whistleblowing protection in the Public Interest Disclosure Act

Dr Chris Day

The latest in the long saga of employment tribunal hearings involving whistleblower doctor Chris Day and his ten year fight for justice over patient safety following the avoidable deaths of two patients in the intensive care unit at Queen Elizabeth Hospital, Woolwich ended with a judge reserving her decision.

This particular hearing concerned the role of top NHS lawyers Hill Dickinson, who were paid public money to draft commissioning contracts each worth tens of millions controlling the employment of junior doctors at every NHS trust in the country. As a result some 100 people observed the hearing on line over two days – more than could be accommodated in any of London South Employment Tribunal courts.

Directly involved in the case is the now defunct body Health Education England (HEE) which used to fund, commission and govern the employment and training of all English doctors on their path to hospital consultant or GP at NHS health trusts before it was merged with the rest of the NHS bureaucracy as part of NHS England.

Hill Dickinson was engaged by HEE to draw up a series of contracts called Learning and Development Agreements which were drafted in 2014 underpinning the £2 billion commissioning relationship between HEE and NHS Trust that was concealed from the courts in Dr Day’s case until last  week’s hearing.

But the existence of these contracts — which exposed as false the denial from HEE made by Hill Dickinson that HEE had substantial influence over doctors – were kept from the courts during the long battle by Dr Chris Day over over the loss of his career and claims of deliberate concealment of patient safety issues,

Journalist’s Freedom of Information request was crucial

A freedom of information request put in by the indefatigable investigative journalist, Tommy Greene, resulted in the very LDA contract being disclosed that was in force during the time of Dr Day’s case between Lewisham and Greenwich NHS Trust and Health Education England . This came after Dr Day had agreed to no less than 3 separate settlement agreements one of which designed to protect all lawyers in the case from wasted costs arising out of misconduct. 

This week’s wasted cost hearing was triggered by Tommy Greene’s discovery in July 2019. The hearing had been delayed for over 4 years by the London South Employment Tribunal since Dr Day’s original application. Since all the way back in 2015 and the all the way up to the Court of Appeal in 2017 and down again to the ET in May 2018,  HEE and Hill Dickinson clung to the false factual submission that all contemporaneous documents showed Dr Day’s claim that HEE had substantial influence over the terms of engagement was fanciful.

The wording of the 2014 contract strengthened the power of the postgraduate dean employed by HEE who could end the career chances of an aspiring junior doctor who wanted to become a consultant as well as withdrawing money from a trust who was employing him. This included the power to delete a doctors National Training Number or as Dijen Basu KC, Hill Dickinson’s lawyer, admitted “a career death sentence”.

Yet HEE and Hill Dickinson powered by public money went all the way up to the Court of Appeal to argue that HEE had no substantial influence over a doctors career and that Dr Day’s claim that they did was fanciful. At the EAT level this resulted in Dr Day being threatened for costs for effectively defending whistleblowing for the nation’s doctors

Much of this week’s hearing was taken up with the semantics of whether these contracts really meant the HEE had the upper hand or whether the trust was still really the employer. The Court of Appeal had ruled that both the HEE and the trust were employers. Hill Dickinson admitted the ruling was a game changer but tried to argue it did not apply to Dr Day’s case as he had been employed under an earlier version.

Dr Day argued that if the documents had been shared by Hill Dickinson and HEE at the time of earlier hearings it would have saved taxpayers a fortune and him and his wife 10 years- hence the argument to claim back ” wasted costs” from Hill Dickinson because of all the legal fees spent.

Dijen Basu KC Pic credit: Serjeants’ Inn Chambers

Dijen Basu, barrister from Serjeants’ Inn chambers and a qualified doctor, cross questioned Dr Day about the difference between what is known as the ” gold guide” for junior doctors and the contract — implying he should have worked out for himself the existence of the hidden LDA contracts or could have used the Gold Guide himself to win the case.

Dr Day pointed out that it was Health Education and  Hill Dickinson’s case from the 2015-2018 that the Gold Guide made fanciful Dr Day’s claim that HEE had substantial influence and also made the point that the ” Gold Guide” was worded as mere guidance on how doctors should be dealt with by NHS Trusts while the LDA was a proper contract that gave HEE a right to sue any NHS Trust if the LDA terms were not met.

michael wright, partner Hill Dickinson

Michael Wright, a partner with Hill Dickinson, even tried to argue in the hearing that the new contract was not a contract because of the rule in the NHS that different branches never sued its each other so it couldn’t be upheld in the courts. He was rather shot down when it was clear that HEE had the power to withdraw all the money given to trusts if they broke the detailed rules over the training of junior doctors which is just as powerful.

In his witness statement to the tribunal Mr Wright said he first had no knowledge of LDA’s as they were drawn up by the firm’s commercial department not his department. When he did have knowledge he thought they were irrelevant which is his explanation why they were not handed over to Dr Day’s solicitors. After the Court of Appeal ruling which said both HEE and the trust were employers, he still argues that they are just a further extension of the ” gold guide” which is seen as guidance. Much of what really happened was clothed in secrecy as he claimed legal privilege not to disclose discussion that had gone on between Hill Dickinson and HEE.

Judge Kathryn Ramsden

Mr Basu also argued that Dr Day was out of time to pursue this case, which had already failed during a previous strike out hearing on wasted costs. See the Byline Times article on this. He said that the 2014 changes to the LDA came after he left, and urged the judge to throw out the claim because a three day summary hearing was not enough to deal with such a complex issue. He also appeared to suggest to the judge, Kathryn Ramsden, that if she ruled in Dr Day’s favour, she could be overruled by a higher court citing a House of Lords case. Is he prepared to go to Supreme Court over this?

Andrew Allan KC

It took Andrew Allan, KC, funded by supporters on Crowdjustice, o put in real context what Dr Day had had to put up with in his ten year struggle.

In his closing submission he said: “Whistleblowers in the NHS are stamped upon – it happens in case after case – in which extra hurdles are added to the already numerous hurdles in Part IVA
of the ERA[ Employment Relations Act] 1996 – the first is that you must be rich enough fund endless
litigation; the second is that you must have sufficient stamina to survive years of litigation – the second is that you must be perfect – because any imperfection will be seized upon and never let go – the tactic is to attack the whistleblower – they are obsessive – they are litigious – can’t let an injustice go – not the sort of people who get on in the NHS
” The skeleton argument on behalf of Hill Dickinson is a case in point – most of it is taken up in a partisan account of C’s [ Chris’s] litigation which – and frequently inaccurate – such as the comment about him having got nowhere in the EAT.. and is largely irrelevant a comment that C made about LJ Simler (as she was then) in 2020 is a favourite stick to beat C with – what possible relevance it could have to this application is unknown.
And it came back again in My Learned Friend’s oral submission –
These attacks are now routine – that C has had to prepare a ‘smears / misinformation document in anticipation of the same old points being trotted out.” See the smear file on Dr Day’s whistleblowing site on the hearing here.

Dijen Basu’s new smear against Dr Chris Day

And guess what ! At this tribunal a new smear against Chris was laid before the judge and Chris Day was not even asked about during his 4 hours of cross examination  by Dijen Basu so he could reply.
In his late submission to the tribunal Dijen Basu accused Dr Chris Day of failing to refund £55,000 he had received in an earlier costs ruling to his Crowd Justice Fund implying he had pocketed the money.

His submission said: “he accepts that he has raised £470,490 for the crowd funding of his legal costs through Crowd Justice Limited (www.crowdjustice.com) and he has failed to show a single penny
being refunded to Crowd Justice Limited on his behalf, e.g. when HEE paid him £55,000 in
respect of his earlier employment tribunal costs which shows £284,719.61 then received (mostly) from Crowd Justice Limited, the £55,000 from HEE and £3,700 from Dr. Day, being entirely gobbled up by legal fees and disbursements, none of which was a refund to Crowd Justice Limited).”

This allegation was refuted by Crowd Justice Ltd itself who pointed out that none of the money raised to Dr Day goes to himself and is instead paid directly to law firms recognised by the Solicitors Regulation Authority. I am told Hill Dickinson and its law firm were informed this allegation was not the case by Crowd Justice Ltd

Andrew Allan’s and Elizabeth Grace’s submission covers this and can be read in full here.

Yet Dijen Basu went ahead. Given he works as a leading barrister for Serjeants’ Inn Chambers, he should have known this himself. He also markets himself as the go to barrister for chief constables up and down the country for handling police work. I would have thought they might express a bit of a surprise that he chose to influence a judge by using what is false information in a tribunal case.

The next stage in Dr Chris Day’s long fight will be an employment appeal tribunal on July 1 and July 2 next year. He will appeal the extraordinary case where employment judge Martin ignored the destruction of 90,000 emails by a management witness during the hearing against his former employer, Lewisham and Greenwich NHS trust and took no action. She has since wisely retired. My report on the hearing that led to the appeal is here. My verdict on judge Martin’s case – the tribunal of the absurd – is here.

For a full list of legal submissions and witness statements see Chris Day’s whistleblowing site. The link is here.

The rest of my coverage of Dr Day’s case is here.

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How a leading teaching hospital and a coroner failed a young woman who was brain dead 17 hours after being admitted to A & E

Gaia Young

Case for a new inquest after coroner Mary Hassell failed to find adequate explanation for her death

This is an extremely tragic tale of what happened when a 25 year old healthy and talented woman, Gaia Young, was rushed to accident and emergency with severe headaches only to die of an unexplained brain condition and doctors have yet to correctly diagnose what was wrong with her.

The failure by one the country’s leading teaching hospitals, University College Hospital in London was compounded by an utterly abysmal inquest conducted by coroner Mary Hassell. She patronised and showed no empathy for her bereaved mother, Lady Dorit Young, who had lost her only child ,Gaia, and failed to properly investigate her death. The full story is on the Truth for Gaia website.

Now more than three years after her death there is still no explanation of what led to this terrifying and tragic event which is why there must be a fresh inquest that can get to the truth of what really happened.

Mary Hassell the coroner pic credit: Archant

Gaia Young was admitted to the hospital with a headache ,vomiting and became confused while waiting at the hospital after a perfectly normal day when she had gone shopping and cycling. Her sudden admission to A&E came at a weekend when many doctors are off duty and was seriously understaffed at the time. She had two CT scans of the brain which led to doctors deciding they would conduct a lumbar puncture to diagnose what was wrong.. The on call radiologist who examined the scan was not a specialist neuro radiologist and thought the scan was OK so a lumber puncture was a normal procedure..

The first attempt at the lumbar puncture, was done by a doctor under supervision who had done very few lumber punctures, did not work. So it was decided to attempt a second one which sadly led to her death as the brain was ” coned ” – pushed into the neck. Just before this the neurologist registrar was concerned when she saw Gaia’s CT head scan. She worried that the CT might show brain swelling and consulted with a neuroradiologist and consultant neurologist at Queens.
It emerged later that a specialist neuro radiologist could see subtle differences in the CT scan that meant there could be raised intra cranial pressure. If that was the case a lumbar puncture would not be undertaken because it was too dangerous . Also if she had a fundoscopy – a eye check that examines the retina and the back of the eyes – it would have showed raised intra cranial pressure. That did not happen.

University College Hospital

The tragedy is that University College Hospital is a centre of excellence and has access to top class neurologists. And nearby is University College, London whose faculty of brain sciences is judged to be the best in Europe and will get new facilities shortly. That this happened in a part of London where there is such expertise in the study of the brain is doubly tragic.

After considerable pressure from Dorit Young, university College Hospital says it will do a further investigation but has only just started it. A statement from the hospital said: “We understand the sudden death of a loved one has a lasting impact and offer our ongoing sympathies to Gaia’s mother.   

   “In 2022, we agreed to commission a range of independent experts – a neurologist, neuro-ophthalmologist, neuro-intensivist and neuro-radiologist – to explore further the circumstances surrounding Gaia’s death. We agreed with Lady Young the scope of the reviews and the experts who will undertake them. In August 2024, she consented to releasing some of Gaia’s medical records but further consent is needed so the reviews can begin. 

“We are committed to learning from external opinion and scrutiny and will share the reports with Lady Young. We have already developed new clinical guidance and training following our internal investigation.”   

It is the failing of the inquest held in 2022 that has added so much stress to Dorit, Gaia’s mother. The coroner is an independent judicial officer, appointed by the local authority, whose main role is to decide the cause of death. In this case Mary Hassell failed. Part of the problem is that nearly all coroners are not medically trained so they could find evaluating medical evidence beyond their skill set. And hospital trusts are aware of this and could decide to limit evidence available at an inquest. It is up to the coroner to probe that evidence to get to the truth. She is also expected to allow the bereaved to participate in the hearing.

Not only did that not occur at Gaia’s inquest but the coroner positively blocked Dorit’s request to bring independent medical evidence from a neurologist by refusing to hear it.

Instead the evidence concentrated on the findings by the post mortem of how she died and not on the original cause of why she died.

As she says:” Professor Al-Sarraj’s report [ he did the post mortem] is detailed and descriptive of the brain injury as a secondary event; it does not provide an explanation of a primary event. It provides a description of the pathology of tissue at the time of death; it does not necessarily provide an explanatory
pathogenesis in time but rather the description of an end point. Accordingly, the cause of death remains unknown.”

Independent expert barred by the coroner

When the inquest was held there were no independent experts giving evidence other than the two pathologists; there were no independent clinicians to give evidence on the care provided. The hospital was permitted to investigate itself in an independent judicial process; there was no external scrutiny.
The coroner backed the trust opposing her request for an independent neurologist and other experts to attend.Instead it left the trust to choose its own experts and this did not include a neurologist.

Before the inquest was held the hospital wrote to Dorit saying:
“The purpose of the serious incident investigation is primarily to review the care of your daughter and to identify any learning. We do not have the same purpose as the Coroner who needs to determine the cause of death.”
As she said; “This denotes an astonishing lack of medical curiosity for a leading clinical and research
institution. It is crass. I am surprised that UCLH consider that it does not need “to determine the cause of death”; this position conflicts with the papers which considers the risk for the recipient of a liver from brain dead donors.” Gaia’s organs were donated.”

Worse was to follow at the hearing. Dorit wanted to make an impact statement on her daughter’s death. This was refused by the coroner. It is on the Truth for Gaia website.

In it she says “It felt like Coroner Hassell favoured her ‘local’ hospital; she breached principles of proper inquiry and natural justice. I am still waiting to receive the Court approved list of documents upon which it relied in reaching its judgement. If the Coroner had taken my submission into account, her inquiry might have taken a proper course in considering a differential diagnosis, but the one-day hearing barely scratched the surface of the complex medical issues of Gaia’s death. This predictably led to an inconclusive determination, adding nothing to understanding how Gaia died, nor whether her death was avoidable.”

She wanted to publish the transcript of the hearing. Again the coroner refused threatening her with contempt of court and imprisonment if she did. The coroner was overruled by the chief coroner.

The coroner declined to comment after I put the complaints about her behaviour to her.

Dorit wrote to the Attorney General complaining about the handling of the hearing by the coroner and the failure to produce a witness statement that was subsequently available after the inquest. Officials replied that this” may amount to a reason to seek a fresh inquest.”

Lessons do need to be learned from this whole debacle. For a start procedures at the hospital should be changed even if this was a rare case. A decent coroner would have recommended some. But overall it shows up the weakness of a system whereby a hospital can first say it’s not their job to investigate the original cause of a death but a matter for the coroner and then not present enough evidence for the coroner to reach a judgement. Both the coroner and hospital have failed Dorit. This is a case of miscarriage of justice – people have a right to know the cause of death of a loved one and the public need to know to get a remedy should there be a repetition of this tragedy in similar circumstances.

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How come an NHS Trust can win a national diversity award when its ethnic minority staff are reporting bullying and discrimination?

This weekend Lewisham and Greenwich NHS Foundation Trust won a national award for its diversity and inclusion just after a still to be published national staff survey reveals a high level of dissatisfaction about discrimination and bullying among its employees.

The trust which has one of the highest proportion of ethnic minority staff in the country is one of the Excel HPMA award winners. The award is sponsored by a major law firm, Mills and Reeves, which deals with personal injury cases including medical negligence. It is one of a number of law firms sponsoring national NHS awards. Other sponsors include Capsticks for NHS innovation; Bevan Brittan for digital analytics; Browne Jacobson, for employee engagement; and Hill Dickinson for excellence in culture and talent. Ironically, three of the firms are involved in persecuting whistleblowers revealing patient safety issues – two, Capsticks and Hill Dickinson, were leading lawyers for the Lewisham and Greenwich Trust in the continuing ten year battle with Dr Chris Day, who highlighted two avoidable deaths in Woolwich Hospital’s intensive care unit. His long running case resumes at an employment tribunal later this month.

The survey shows the huge difference between the UK breakdown of the current population as referenced by the Office for National Statistics. This stands as 84 per cent white and 16 per cent from ethnic minorities. It also varies enormously from the average picture of an NHS trust. 78 percent of staff in NHS trusts are white, only 43 per cent are white at LGT. Nearly 24 per cent are black British , African and Caribbean compared 14 per cent in average and Asian and British Asian are over 26 per cent of staff compared to nearly 4 per cent in the average NHS Trust.

One of the trust’s two major hospitals.

Given this breakdown when asked about whether staff were discriminated by their boss, the trust comes out as worse than average for a NHS trust and similarly in regards to career progression. Also there is a particularly bad result when they were asked how patients, relatives and the public treated them. Interestingly white people – who are a minority in the trust – had a significantly higher rating for satisfaction about future career promotions than ethnic minorities employed there.

Nor do the staff say they would recommend a friend or relative to have treatment in the trust’s hospitals – this is also below average.

When asked whether staff would leave the moment they found another job, some 20 per cent working there said yes – this compares with just over 15 per cent for the national average. And nearly a quarter of the staff said they would look for another job within 12 months – compared to just over a fifth on average.

Morale at the trust has got worse over the last year while there has been a slight improvement in the NHS as a whole.

However the 10 people employed on the trust’s board rate themselves as one of the best in the country.

There is also a big difference in morale among medical staff and ancillary staff. A BMA survey in 2022 produced some startling results

“Have you personally experienced any instances of bullying, harassment or discrimination within the last 12 months?” they were asked. 44% replied yes.

“If you have personally experienced bullying, undermining, harassment or discrimination in the past 12 months, did you report the incident(s)?”43% replied they had reported this and no satisfactory action had been taken.”

“Why did you not report any instances of bullying, undermining, harassment or discrimination?

42% replied they did not believe action would be taken. 26% replied they felt it would be held against them

All this suggests that this award must be more of a paper exercise than the reality there. I would have expected that the trust would be rated as one of the best in some instances. But this does not appear to be case. No doubt the media department there will praise the award to the highest level, executives will congratulate themselves and the law firms will delight in the glory. But it doesn’t look as though it was really deserved.

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Time to ask the Lord Chancellor to intervene to make employment tribunal transcripts available and release judge’s notes

Shabana Mahmood, Labour’s new Lord Chancellor

Please sign letter by whistleblower to Shabana Mahmood

Two years ago some 317 people agreed to sign a letter to Sir Keith Lindblom, senior president of the tribunals, calling for transcripts and recordings of employment tribunal cases to be made available.

Employment tribunals appeared to be one of the few legal proceedings where records were not kept and claimants and whistleblowers – often appearing as a litigant in person – were put at a big disadvantage against big corporate companies, NHS trusts, powerful public bodies like Sellafield, who employed expensive barristers, often using taxpayer’s money, to discredit employees and whistleblowers bringing cases against them.

The companies and public bodies could afford – unlike a litigant in person – to employ notetakers or paralegals – so they had their own records – so if a person appealed against a tribunal verdict – he or she was at a big disadvantage.

Within just seven days we had backing from well over 300 people – from a former economic adviser to No Ten Downing Street, Sir Adam Ridley, 80 medical consultants, numerous GPs, nurses, teachers, to a former deputy groundsman at the Chelsea Pensioners hospital, a lorry driver, an actor, writer and a poet. This suggests there is a wide ranging feeling that there is something wrong in the justice system.

Judge Barry Clarke, President of the Employment Tribunals in England and Wales

Barry Clarke, the head of the employment tribunals in England, responded to the letter by announcing, where possible, employment tribunal proceedings would be recorded, so they would be transcripts of the proceeding.

But now two years later this has proved to be a Pyrrhic victory – hence the need for a fresh letter. It has also reached an impasse with the top judges in the employment tribunal digging their heels in to prevent further change. Thus only an appeal to the Lord Chancellor can remove this obstacle.

What has happened is that where tribunals have recorded proceedings, obtaining a transcript, if a judge allows it, costs thousands of pounds, well beyond the means of most claimants.

Where there is no recording the only record of proceedings is the judge’s notes. Judges have jealously guarded releasing this to the public – but it is the only record a judge covering an appeal in the case will see.

First it took a considerable time for the judiciary to concede this was the official record – arguing it was a private and personal note. Now Barry Clarke has conceded this is an official record of the case but does not want this released to the claimant, the public or the press. This hardly fits with the image that Britain’s legal system is proud of its reputation for ” open justice.”

Alison McDermott

Alison McDermott, a whistleblower who challenged Sellafield over its toxic culture towards its employees, has drafted a letter to go to the Lord Chancellor. You can read her blog and the text of the letter here . All you have to do is text Yes to Alison if you want to sign.

Last time the strength of feeling of the need for change was very high. My blog on the campaign is here. It also lists the 317 who signed. This time Alison is not planning to publish all the names.

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Capsticks behind move to remove judge from tribunal hearing after he slammed NHS commissioning body for hiding documents from claimant

John Webster : NHS executive criticised by employment judge

UPDATE: Since publishing this article I have learned that no fewer than four Capsticks lawyers were involved in trying to remove the judge and that the firm was representing BOTH the Integrated Health Board and the NHS human resources firm. Both would have known that there were draft grievance documents that had not been disclosed to the tribunal.

The law firm Capsticks – which has a national contract with the NHS to handle employment tribunal cases – was behind an attempt to remove a judge from hearing a constructive dismissal case involving a senior official at a NHS clinical commissioning group in Norfolk.

The case – highlighted by BBC Norfolk yesterday- led the judge calling for disciplinary action to be taken against senior staff at the board for the way they treated and lied to the claimant.

Mr Clive Rennie, an assistant director, won his case for constructive dismissal against NHS Norfolk and Waveney Integrated Care Board – the successor body to the Norfolk and Waveney Clinical Commissioning Group who had previously employed him.

But not before the tribunal had spent days wrangling to get draft grievance documents which the group said did not exist while the author of the documents, NHS human resources manager Steve Stavrinou, sat at the back of the hearing, not saying a word.

He had been called in by the commissioning group to prepare the grievance papers from NHS Arden and Gem Support Unit which provided HR Services to the group. At first the existence of the draft papers were denied and then excuses such as the managing director being on holiday were used to deny the judge’s order to deliver them.

Judge Postle’s judgement, which was published yesterday, reveals that suddenly there was an application to make him recuse himself from the tribunal. The request came from Capsticks, who were the solicitors for both NHS Arden and Gem Support Unit. and for the Integrated Care Board

Until then, as the judge noted, the person from Capsticks had not been present at the tribunal to hear the proceedings but called for the judge to go.

Alistair Kernohan – Capsticks

Alistair Kernohan of Capsticks,, was in fact the partner, based in Leeds made his case by email.. Un fact Capsricks came to hearing mob handed. Both Miss Whiteley and Miss Aslam were present all the time. They were then joined by Nicola Butterworth, who sat the back of the tribunal. According to Capsticks website. ” Nicola undertakes a broad range of employment litigation work, including unfair dismissal, discrimination and whistleblowing claims. She advises pre-claim and at all stages during the litigation process. Nicola is undertaking a regular secondment at one of the firm’s clients, working closely with the HR team.” Looking at the judgement it looks like the judge did not know she was also there.

Mr Kernohan said: “Employment Judge Postle has demonstrated the premature formation of a concluded view in the Claimant’s favour without properly considering representations from the Respondent and before the Respondent has been able to put forward its evidence.

“Employment Judge Postle’s inappropriate conduct, tone and disparaging comments towards the Respondent and its representatives, has crossed the line between what is tolerable and what is impermissible, to the extent that his comments would give an appearance to the fair minded and informed observer that there is a real possibility that the Employment Judge will carry into his judgment the scorn and contempt his words and behaviour convey.

“Employment Judge Postle has made unnecessary and inappropriate criticisms of the conduct of the Respondent and its representatives which he has expressed in absolute terms, which failed to leave open the possibility of him considering an explanation, despite not having heard or in some cases even invited evidence or submissions from the Respondent’s representative.

“Employment Judge Postle has allowed and facilitated inappropriate conduct of the proceedings by the Claimant’s representative, allowing such conduct to go unchallenged despite representations made by the Respondent or even, on occasion, failing to allow the Respondent the proper opportunity to
make representations.”

Marsha Robinson and Neil Ashley of Paladin pic credit: East Anglia in Business

The judge asked Mr Neil Ashley, Mr Rennie’s counsel to comment and records it in his judgement

He told the court: “It is important that we are astute enough to identify that any evidence that such an Application made can be used as a device for a party which finds itself in difficulties because of the
quality of its case.
Mr Ashley went on to say that he has been practising for 24 years and he had never seen such deplorable conduct on the part of the Respondent’s Solicitors. He stated that rarely has he seen such a
‘car crash’ of a case presented before a Tribunal.
Mr Ashley went on to say that at the outset, the Tribunal was told by a Solicitor Advocate that there was no drafts of the Investigatory Report and none had ever existed. This was echoed audibly by
Miss Aslam, Solicitor.”

“Two Officers of the Court sat here and told the Tribunal that a 20 page perfectly polished Report had never been the subject of any drafting. This is absurd to the extreme and obvious to us all that it cannot be and no doubt Miss Whitely ( the board’s solicitor) made the statement recklessly and off the cuff without any thought to what she was saying. It was, to my mind, utterly untruthful.”

Miss Whitely did not want to make any comment to the tribunal, relying on Capsticks, to deliver the blow.

The judge and his two members of the tribunal then discuss the matter and unanimously rejected Capstick’s claims.

“There was no disparaging comments towards the Respondent or its Representative, it was simply a case of asking, what is happening about the third party Order for disclosure, concerns about prevarication, delay and the frustration of the Tribunal that the Respondent / its Representative, were doing nothing to advance the process in getting disclosure from the third party.”

The judge went on to be highly critical of John Webster, then director of strategic commissioning at the CCG, who reneged on a promise to allow Mr Rennie to leave and lied to him about the outcome. “Clearly, there had been a conspiracy all along going on behind the scenes,” The judgement stated the tribunal had “found him disingenuous, unconvincing”.

He was also critical of Mr Stavrinou.” Truth is alien to him.”

The successor body has now apologised to Mr Rennie. Mr Webster is now stepping down as deputy chief executive of the Cambridgeshire and Peterborough NHS trust.

Doctors who follow this blog will be interested in the role of Capsticks here – given they have also played a prominent role in recent whistleblowing cases – in Dr Chris Day’s case against Lewisham and Greenwich NHS Health Trust where 90,000 emails that could have helped him were destroyed by a NHS trust witness at the time of the hearing and in Dr Usha Prasad’s case where they initially tried to pursue her for £180,000 costs.

Unfortunately the judges in these cases sided with the trust and took no action over completely unacceptable behaviour or ignored evidence. We need more judges to take a stronger stand against Capsticks bullying tone as Judge Postle did in this case.

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Historic conference at the Royal Society of Medicine on Patient Safety paves way for campaign to protect whistleblowers from trusts in the NHS

Yesterday a conference of doctors, patients and journalists held at the prestigious Royal Society of Medicine in London highlighted the appalling treatment of doctors by NHS management who raise patient safety issues to protect patients. Examples were given from doctors who had been dismissed after they raised patient safety issues and how trust managers spend unlimited funds on lawyers to make sure they lose employment tribunal cases, sometimes even aided by the judges hearing them.

The conference arranged by Justice for Doctors, a new organisation representing many of the affected doctors, coincided with a series of articles in The Daily Telegraph, which showed that these are not isolated cases but involve doctors right across the country and is a national problem which trusts are trying to hide.

One of the main organisers is David. E. Ward,, a retired cardiologist from St George’s Hospital, South London, who has already written two guest blogs on this site. I have included his planned closing statement to the conference as a fresh blog from him as it succinctly sums up all the issues that were raised.

By David Ward

First, I would like to thank all the contributors to this historic meeting. In a way it is a celebration of all those oppressed whistleblowers who have spoken up for patient safety.

I would personally like to thank my friend Professor Somerville who has been a driving force behind this and many other ideas to stand up for whistleblowers. Jane and I have been trying to set up a second meeting about Patient Safety for 5 years following the first one in March 2019 when we re-enforced our personal campaign to expose – and do something about – the appalling treatment of doctors who speak up for patient safety also known as ”whistleblowers”. During our campaign we met the Justice for Doctors group who helped to organise this meeting

In the past 3 decades a Hospital Trust with its senior management has accrued the powers to destroy a doctor’s career by imposing restrictions, suspensions, referrals to regulators (GMC, CQC) and, astonishingly, an unfettered power to dismiss. These major life-changing decisions are arbitrary and undertaken, incredibly, without any independent or regulatory oversight. For dismissal, “get out” is apparently sufficient.

Allegations against the victimised doctor may be based on made-up and unsubstantiated claims. If major criteria for dismissal cannot be met there is always the “loophole” of “some other substantial reason” which conveniently does not exclude but also does not mandate any additional explanation.

Doctors who see poor practices, faulty equipment, processes (and the like) are obliged to speak-up by Duty of Candour (HSCA 2008 reg 20). But by speaking up but they may put their careers at risk as we have seen so many times recently.

The “The National Guardian” program introduced by Sir Robert Francis and intended to accommodate doctors who speak-up, evidently does not function as intended. It’s called “marking your own homework”.

Investigations into a whistleblower together with their concerns should be independent of the Trust in which they work and be seen to be so. But evidently, they are not. Furthermore, the Trust managements who make these decisions are themselves unregulated. That doesn’t seem right? Does the phrase “judge, jury and executioner” come to mind? Managers should also be regulated, shouldn’t they?

Arcane procedures such as MHPS appeal hearings can be overseen or conducted by “dodgy” external “agencies” some of which claim spurious credentials. These agencies are, in effect, “hired guns” available and willing – for a fee – to “confirm” the Trust’s unfounded allegations and to assist their aims – to dismiss the “troublemaking” doctor; not because of “incompetence” but because the doctor has “annoyed” Trust management by raising concerns about Patient Safety or something else. The reactions of management are often vengeful, as we have seen.

I know of at least one of these agencies which has appropriated and misunderstood (in a written formal report) the phrase not “fit-for-purpose” to describe a doctor in support a Trust’s decision to dismiss. The agency seemed totally unaware that this is not only fictitious nonsense but possibly libellous. No such phrase exists in English Employment Law. Unfortunately, NHS England has also been duped. I know because I’ve asked – in person.

The Judiciary, in the form of Employment Tribunals may be called into action if the dismissed doctor seeks to restore their career via this route. This is a bad choice by the victim as the evidence confirms. Only 3% of Claimants, “win” – not the most apt word – in this system. Put another way, 97% lose! Is that “open and fair justice”? I think not. Some of the judgments are beyond comprehension.

There are many practices which seem grossly unfair, perhaps deliberately. Some obvious ones stand out:

1. Inequality of arms; the law firms acting for the dismissing Trust are funded by each of us – the taxpayer. The Claimant, the doctor, healthcare worker will have no external source of funds except  perhaps by “crowdfunding”. Furthermore, if they lose their case, they may required to pay not only their own legal fees but the law firm’s fees too! That’s not fair. I can show you some law firm invoices which would shock you. The phrase “inequality of arms” doesn’t touch it.

2. “Cost threats” are a notorious device employed to, shall we say, “persuade” a claimant to withdraw their claims before, during or after a Tribunal. It’s another weapon deployed by the Respondent, the dismissing Trust, to force the claimant to surrender and withdraw their claims.

3. Non-disclosure agreements or NDAs, are devices designed to conceal the devious practices used to threaten the claimant (and, as it happens, to suppress evidence). They have no place in inquisitorial proceedings in this context. They should be banned.

4. The Public Interest Disclosure Act (PIDA) 1998; I quote: a worker has the right not to be subjected to any detriment by any act, or any deliberate failure to act, by his employer done on the ground that the worker has made a protected disclosure.

In other words, a doctor cannot be dismissed, for example, for raising patient safety concerns. So, any dismissal has to be attributed to another perceived misdemeanour.  Read any recent case and it is evident that the “whistleblowing” or “patient safety” concerns were discounted and irrelevant to the dismissal. It was about an “attitude”, a “manner of speaking” and similar unquantifiable and, in most cases, unverifiable attributions. Ask one of the presenters today.

5. At a time of great need for medical expertise, doctors are still being persecuted and dismissed having committed NO offence. The law firms which spend so much public money to pursue the claimants should have no place in any procedures which are primarily about patient safety. Furthermore, the concerns and the person who raised them should be formally registered and documented, including all steps taken towards a solution. This is not happening. Doctors who raise concerns about patient safety are treated like criminals! This must stop!

6. Last but not least the patient safety concerns, the very things that trigger most of these shenanigans. What happened to those? Well, they get buried and forgotten don’t they. What a wonderful system. All that waste of public funds to destroy a doctor’s career instead of correcting potentially dangerous practices. That is why a register is needed.

The problem is a nationwide one of the same gravity as the “Great Post Office Scandal”. Perhaps NHS whistleblowers need a TV drama-documentary because we have seen how that shifts public opinion and awakens the media with unprecedented force. I’ve already draw up a potential cast list!

Last, there should be a searching, durable, logical and legally sound review of the treatment of ALL whistleblowing related laws and processes. Whistleblowers are the canaries in the coalmine. They do society a favour. They should be praised – not persecuted.

This is the 21st century! What country do we live in?

Thank you all for attending. Thank you to all those who presented. And particular thanks to Dr Salam Al-Sam, Dr Azhar Ansari and the Justice for Doctors group.

UPDATE: Who came and Who didn’t send anyone

Newspapers who sent a reporter: Times, Guardian, Daily Mail, Standard,

Major media who sent a reporter: Sky News 

Major media one would have expect to send reporter:

BBC, ITV, GBNews, LBC

Major regulatory professional bodies who were notably unrepresented: (very bad show I think especially as some of their members Fellows were major subject dig the WB scandal). If they didn’t know or just couldn’t be bothered –  it’s shameful, either way!

BMA, CQC, GMC, Royal Colleges (all of them, Physicians, Surgeons, Obs and Gynae), National Guardians Office (FTSUG), HMCTS (at least they could have send a junior barrister), Law firms; all those with an obvious interest in oppressing Claimants

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