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.

Powerless Parliamentary Ombudsman lashes out at “command and control” NHS

Rob Behrens Parliamentary and Health Ombudsman

Last week was Whistleblower Awareness Week and Whistleblowers UK and the All Party Parliamentary Group on Whistleblowing organised a two day event in Parliament on issues affecting whistleblowing.

I attended the two hour session aptly entitled Whistleblowing in Health care – a Lesson in Futility? It drew a wide selection of people from the UK and the Isle of Man including doctors, lawyers, judges, nurses and speak up guardians

These included Dr Chris Day , who has been fighting Lewisham and Greenwich Health Trust for ten years after reporting two avoidable deaths in the intensive care unit at Woolwich Hospital and Martyn Pitman, a consultant obstetrician and gynaecologist, who recently lost a case against Hampshire Hospitals Trust, reporting patient safety issues after a mother died giving birth in one of their hospitals. Both cases can be found in a series of articles on my blog.

But one of the most striking contributions came from Rob Behrens, the Parliamentary Ombudsman – an Establishment figure – and the Health Service Commissioner more familiar to my readers over the debacle in getting compensation for 3.5 million 50swomen who faced a six year delay in getting their pension.

In a short powerful speech he rightly lambasted the culture inside the NHS which is leading to the failure, ,persecution and character assassination of whistleblowing doctors and nurses who report patient safety issues.

Describing the system in the NHS as “command and control”, he described the contrast between the management of trusts boasting to him how open their institutions were only to find the opposite when he talked to people lower down the food chain dealing with the complaints.

He pleaded for a more ” collegiate NHS” where managers and staff worked together rather than against each other. he wanted ” fundamental change” in the leadership of the NHS.

But his speech also revealed how impotent his role is in handling healthcare issues. He pointed out that the Ombudsman was handicapped by outdated legislation, couldn’t deal with staff issues unlike other Ombudsmen, was unable to take any initiatives himself, and couldn’t force the NHS to make changes even he wanted them to do so. None of this does his reputation with the public any good. I have only covered one of his cases. You can read about it here. Health warning it is a very grim story and the Ombudsman could only partially investigate it.

Northern Ireland Ombudsman has greater powers

How he must envy Margaret Kelly, the Northern Ireland Ombudsman, set up under more modern legislation, who has and uses her powers to initiate investigations. A report here on my blog shows how she took on private company Capita and its failure to treat disabled people properly applying for Personal Independence Payments.

At the moment plans to get a new law to protect whistleblowers ( they are also covered by outdated legislation which trusts can use lawyers to get round its provisions) is stalled. So is any legislation to give the Parliamentary Ombudsman fresh powers or rationalise the plethora of other ombudsmen in this country. I suggested one step that could be taken in election year would be for whistleblowers to press the major parties to include a pledge to legislate in their manifestos. There is an “oven ready” bill already by Whistleblowers UK to reform the system which could be the basis for fresh change. It is time we ended talking and took some action.

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