For the last day and a half Dr Lara Alloway, the case manager promoted to chief medical officer midway through his investigation, has been giving evidence for the Hampshire NHS Foundation Trust against whistleblower obstetrician Dr Martyn Pitman at his tribunal hearing.

She is a respondent in her own right alongside the trust and faced a forensic cross examination from Jack Mitchell, junior barrister from Old Square Chambers, paid by the British Medical Association which is backing Dr Martyn Pitman, who was dismissed from the trust for being” a danger to patient safety and the public” because of a breakdown in relations in his ward.

He traced the whole history of the case and challenged Dr Alloway over issues of conflicts of interest, failure to minute meetings, not following national NHS guidelines in investigating his case and sending a letter to Alex Whitfield, the trust’s chief executive, containing an untrue claim that he was involved in a clinical negligence case.

Dr Alloway presented herself to the tribunal as a person concerned with Dr Pitman’s welfare who wanted him to return to the trust and praising his clinical ability and reputation with some communication problems only to turn against him at the eleventh hour and secure his dismissal and the end of his career. The documents which sealed his fate were withheld from him, as earlier evidence has already been given, until he obtained them through Freedom of information and subject access requests.

Mr Mitchell cited a parallel with the Amin Abdullah case, the male nurse who burnt himself to death in 2016 outside Kensington Palace after being sacked and treated unfairly by Charing Cross Hospital An independent inquiry found the trust’s disciplinary procedures ” weak and unfair ” and the NHS sent new guidance for trusts in handling disciplinary procedures which have been sent to the Hampshire trust. The trust do not see a parallel.

Mr Mitchell also questioned whether she had followed the proper procedures for an investigation into him under the Maintaining High Professional Standards process since it was never referred to the national case review body.

He also asked her about the screening group of managers contained a conflict of interest since one of the participants Janice MacKenzie, a midwifery manager, took part the decision to go ahead with an investigation was one of the principal complainants against him. Dr Alloway replied it had been referred to her predecessor chief medical officer, Andrew Bishop. It turned out there were no minutes of the meeting and Dr Galloway admitted it was just “a conversation” not a meeting.

It was put to her that there had been a long standing concern by consultants at the Winchester hospital about lack of staffing and the failure of midwifery managers to help out when it was short staffed and the trust had a meeting with them to discuss their concerns. Mr Mitchell contrasted that with the attitude of the trust that when Dr Pitman raised the very same issue as a whistleblowing concern the trust said ” it was not in the public interest.”

It also emerged that about half a dozen consultants had sent evidence about having good relations with Dr Pitman in contrast to the four midwifery managers who had complained about their ” well being harmed” by his treatment of them. She admitted that she had received them but dismissed them because she thought Dr Pitman had encouraged them to write to her. Mr Mitchell described her attitude as ” perjorative” against him.

Today Mr Mitchell concentrated on the run up to his dismissal. Dr Pitman wanted to challenge the findings of the MHPS findings – and she suggested he should file a grievance procedure while taking part in mediation and psychological coaching so he could return to the wards.

Then there was a tragic incident which caused ructions in the maternity ward- a 32 year old mother, Lucy Howell, died giving childbirth to Pippa who survived . She previously had a Caesarian which has caused her damage but the hospital had lost the notes of the case which recommended another Caesarian. Instead she had an induced birth with hormones that were inappropriate and died from a rupture. All this added to Dr Pitman’s concerns about patient safety and it coincided with his grievance procedure. And it made relations worse.

Dr Alloway decided to call an extraordinary meeting of a trust advisory committee following this incident. But it turned out to be a meeting concentrating on bad relations in the ward putting safety at risk with Dr Pitman as the principal problem.

Mr Mitchell pointed out that his grievances about patient safety appeared to arrive on the same day – but Dr Alloway denied it had any impact on the meeting. Mr Mitchell raised the point as she had a ” conflict of interest” since she was both chairing the meeting and acting as his case manager.

The trust rushed in extra evidence to show revised NHS guidelines mean any top official can act as case manager and there is no conflict of interest and does not have to recuse him or herself.. It also emerged that two other managers did not declare they had dealings with Dr Pitman while coming to a decision on what to advise Dr Alloway. It was also confirmed by her that no documents or reports were given to the meeting, it was solely her verbal report.

She then wrote to the chief executive, Alex Whitfield, saying she needed to take action against him. It turned out she had consulted the human relations department and the trust’s legal counsel, but kept no minutes of the meetings. She admitted to the tribunal that was a mistake and she had learned from it. She also admitted she had wrongly included a reference to clinical negligence involving him.

Mark Sutton, the Old Square KC for the trust yesterday withdrew a statement calling Dr Pitman a ” freelance agitator” saying it was not the trust’s view of him. The case continues.

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