From L to R: Alex Whitfield, Hampshire Ben Travis, Lewisham Daniel Elkeles London Ambulance
Three of the top 50 NHS chief executives chosen by a panel set up by the Health Services Journal in 2024 as the best people to run the NHS have been involved in attempting to cover up patient deaths and persecuting doctors and nurses who raised the issues.
One of the top three NHS awards went to Daniel Elkeles, as chief executive of London Ambulance Service Trust and is now chief executive of NHS Providers. He was chief executive of the Epsom and St Helier Trust when Usha Prasad, a cardiologist, reported the ” avoidable death ” of a heart patient. He told her to drop her case at an employment tribunal or face an internal disciplinary hearing which led to her being sacked.
I have since been told that Mr Elkeles was involved in an alleged cover up at the London Ambulance Service when a paramedic was suspended during the stressful period of the pandemic. He had alleged bullying, Elkeles said he would investigate but got the person to sign a non disclosure agreement. When it was signed it is said any investigation was dropped.
The second chief executive is Alex Whitfield who heads Hampshire Hospitals Foundation Trust, was involved in the sacking of Dr Martyn Pitman, a well respected obstetrician and gynaecologist, who raised patient safety issues in the already nationally stressed maternity services. The former oil executive is rated the 15th best chief executive.
The lack of care at the hospital in Winchester led to one mother and a baby dying, but Alex Whitfield used the tribunal to claim that Dr Pitman was ” putting patients at risk” rather than supporting the doctor and midwives who were helping patients. Lawyers for the trust monstered Dr Pitman claiming he was a bully for raising these issues.
Julie Dawes, the chief nursing officer at the trust, who also pursued Dr Pitman ,has just been awarded an MBE for services to nursing in the King’s Birthday Honours List.
The third award winner is Ben Travis, chief executive of Lewisham and Greenwich NHS Trust, which the Care Quality Commission, say ” requires improvement.”
Ben Travis was heavily involved in the 2022 tribunal hearings brought by Dr Chris Day, who has fought the trust for 10 years after he raised important patient safety concerns that became associated with two avoidable deaths in the intensive care unit of Woolwich Hospital, run by the trust. The 2022 tribunal ruled against him despite evidence given by Ben Travis which shown to be untrue, the destruction of 90,000 emails during the hearing and the discovery of fresh documents .which should have been released by the trust to him to help his case.
The results of the last hearing is up for appeal on six grounds next week. He won the right to appeal that some of the findings of the judgment were perverse, that the judgment failed to draw any inferences from the destruction of 90,000 emails and the failure to provide documents that would have helped Dr Day’s case. This in particular followed the disclosure in documents that under oath the chief executive, Ben Travis gave an untrue account about a board meeting and had hidden he had contacted other trust chief executives about Dr Day.
Chris DayUsha PrasadMartyn Pitman
Yet Mr Travis won the award on his personal performance over the last year; the performance of the organisation he led, given the circumstances it is in; and the contribution made to the wider health and social care system.
Award for Diversity
At the same time the trust has won a second award for its equality, diversity and inclusiveness despite its NHS staff report showing that it has a below average rating for the fair promotion of ethnic minority staff and for racial discrimination inside the trust and from members of the public.
The panel who decided the awards for the best chief executives included Dr Rosie Benneyworth, chief executive, Health Service Safety Investigations Body:Steve Brine, former Tory MP for Winchester and former chair, Commons Health and Social Care Committee,; Matthew Taylor, head of the NHS Confederation;Sir Julian Hartley, former chief executive of NHS Providers; Patricia Marquis, executive director for England, Royal College of Nursing and Dr Vish Sharma, chair, BMA’s consultant committee.
It is inconceivable that many of them did not know about the whistleblower cases. Dr Chris Day’s case is high profile; Dr Martyn Pitman’s case was in the national press and Steve Brine was his local MP. Usha Prasad’s case was a long running one.
There is another issue which is worth pursuing in a later blog – how ethnic minorities are treated in the NHS and the level of racial discrimination and whether black and Asian people have fair promotion prospects. Lewisham and Greenwich NHS Trust is not alone
Thousands of followers of this website may remember last year’s nine blog coverage I gave to the employment tribunal over the sacking of whistleblower Mr Martyn Pitman at Hampshire Hospitals NHS Foundation Trust (HHFT). He lost the hearing. He was belittled and and repeatedly insulted by the former head of chambers, Mark Sutton of Old Square Chambers, including calling him a ‘freelance agitator,’ only to later be forced to retract that slur. Sutton, who picked up a big share of the £650,000 taxpayer funded legal fees pay out to represent the trust, approached the ET by portraying Mr Pitman as something of a tyrant, an assessment clearly not shared by his previous colleagues, who actually worked with him, attending in numbers at the hearing, or indeed by his thousands of social media supporters
Mr Pitman was sacked because it was said his employment there was ” a present danger to patient safety ” by the former chief medical officer of the trust, Lara Alloway. It was also claimed that his relationship with the Trust’s senior management had ‘irretrievably broken down”. Yet it was he who had raised patient safety issues which was stomped on by non-clinical senior midwifery managers, despite identical concerns also being raised a few months later by several senior clinical midwives.
Dr Lara Alloway now chief medical officer for Hampshire and the Isle of Wight Integrated Care Board
Well now a year on, following Mr Pitman’s dismissal, it is revealed that there is a ” present danger to patient safety ” in the maternity wards at the trust – a more than five fold increase in the number of babies delivered there with labour-related hypoxic brain injury (Hypoxic Ischaemic Encephalopathy: HIE) many of which may have been preventable. According to the Trust’s latest on-line patient information approximately 5,700 babies are delivered across its 3 sites.
The trust had an extremely low rate of HIE until now
In the final year of Mr Pitman’s Consultant tenure at HHFT, prior to his formal dismissal, the HIE rate across the Trust was reported as 0.5 per 1000 deliveries – equivalent to less than 3 babies per annum. In 2023, the year following his dismissal, the rate increased, in a previously unprecedented fashion, to 2.5 per 1000 deliveries, equivalent to 14 babies per annum.
Of course the trust dispute this – even though it was published in a very thorough article by Sirin Kale for Guardian Society. The full article is well worth a read and you can link to it here.
The trust communications department described the article as misleading. A statement said:
“There are instances in Ms Kale’s reporting where we believe her reflection of the facts is misleading. This interpretation of the data fails to provide the reader with the wider context required to understand it. It therefore runs the risk of unreasonably undermining public confidence in a service which is safe and performing well. To avoid misleading the public we would strongly suggest that your article must explain that the rate of HIE in live births with Hampshire Hospitals is well within the normal limits.”
I might have believed them but for an internal power point presentation at a clinician led Neonatal Morbidity and Mortality meeting held at the trust in February. Reproduced below it says precisely the opposite to what the communications department is claiming – that cases of HIE are ” significantly worse than the network average”. It also proposes tough action to combat it. If people are to believe there is no problem and everything is safe – such action speaks volumes.
This particular issue at the trust was one of the problems raised by Mr Pitman in 2019 when he made his whistleblowing complaint in early 2019.
He told me:” I had a specialist interest in fetal monitoring, CTG interpretation and labour management optimisation. Throughout my period of tenure I was responsible for cross-site staff teaching of fetal /CTG monitoring and had developed a regional reputation for my expertise in this area. For several consecutive years I had been praised for playing a significant role at RHCH in minimising the HIE rates down to commendably low levels well below the network and indeed national average for 2 consecutive years. For instance, we achieved the enviable statistic of not having a single poor maternity outcome attributed to CTG misinterpretation. This dramatic deterioration, in a critical maternity outcome metric, that I was passionate about and had successfully devoted my focus and clinical attention to, to have occurred within the 12 months since my dismissal will certainly not have escaped the attention of either the senior midwifery managers or the Trust’s senior management.”
Indeed significant events back in 2019, that led to Mr Pitman’s formal investigation and eventual dismissal included a a dispute between him and the midwifery managers about the dangers of sub-optimal fetal monitoring, including the potential pitfalls of assessing the baby’s heart rate using hand-held dopplers (intermittent auscultation) and confusing the baby’s heart rate with that of the mother.
He told me:” I was concerned that deteriorations in the standard of fetal monitoring and, particularly midwifery complacency in this regard in what were thought to be low-risk mothers was a developing concern and that if it was not addressed would lead to worse outcomes and, potentially increased baby injury (HIE) and death rates. This warning was completely and utterly ignored by the senior midwifery management. ” Such concerns have been highlighted repeatedly in other units across the UK, including the recent reviews undertaken by Donna Ockenden”.
What he predicted and was striving to prevent, by making practice recommendations, in the April 2019 Fetal Monitoring Guideline meeting has now happened. Instead of supporting him moves were made to silence him and to get him out of the way.
He said: “The very evening after this, unusually confrontational and adversarial, guideline meeting was when I was first ‘invited’ to a meeting which eventually developed into my formal disciplinary investigation. The senior midwifery managers had decided that my attempts to prevent their dangerous normalisation agenda had to be stopped
Two terrible baby births at Winchester hospital
Worse then happened, within just a week of this fateful meeting. As well as the tragic case raised in Sirin Kale’s article distressing case, where a baby was deprived of oxygen throughout labour and delivery . This second baby was delivered within just hours of the case featured in Sirin Kale’s Guardian article. Mr Pitman was the Consultant on-call in the Winchester Maternity Unit when both these tragic cases were delivered but, as they were midwifery-led, as they were believed to be ‘low-risk,’ neither he nor the Obstetric team had been directly involved in their care, until the ‘crash-calls’ were put out.
He said: a ” supposedly entirely low-risk healthy baby, maintained under solely midwifery-led care, was born moribundly unwell from HIE and needed to be urgently transferred to Southampton Hospital for brain cooling. The Head of midwifery, my principal complainant, who had been in the guideline meeting would have come into work the following Monday, been informed of these 2 cases, that there were huge issue with the intrapartum monitoring of them both, realised that this put her in a challenged position and given my concerns and the practice changes that I had been recommending just the previous week. This appears to have prompted her to escalate her concerns about me into a formal complaint, rather than an issue that could and should have been addressed by mediation. The timeline of events, at this time, was very telling”
So where does leave the maternity services at Winchester and Basingstoke hospitals? The trust has been on a public relations drive inviting the local BBC TV station, BBC South, into the maternity wards BEFORE it published these worrying figures on babies delivered with HIE. This was arranged and was broadcast less than a month before the concerning increased HIE rates were presented.
Here’s a video of the report:
BBC South Today broadcast on maternity services at Hampshire Hospitals NHS trust on 4th January this year chief executive Alex Whitfield tells viewers it is safe
Since then the trust has promised an internal , rather than , perhaps far more appropriate, independent external inquiry – rather the same philosophy as the Post Office used to say their Horizon computer project was sound when sub postmasters were being jailed for false accounting.
The most tragic outcome is that there are potentially parents in Hampshire who face a lifetime of worry worry and expense caring for children, who may have suffered avoidable labour-related hypoxic brain injuries. One also has to wonder what the level of medical negligence claims associated with these cases could, potentially, extend to? This could have been prevented if the trust was doing its job. Given the state of social care in this country this is a very serious state of affairs. You cannot say the trust were not warned by Dr Pitman. The then interim chief medical officer was Dr Nick Ward, a consultant paediatrician whose expertise is in paediatric nephrology.
So does the top management carry some blame? I put it to the communications department that Alex Whitfield, Lara Alloway ( now CMO at Hampshire and Isle of Wight Integrated Care Board), the midwifery management team, and Steve Erskine, chair of the trust board did. I got no comment on this but given what appears to be their complacent attitude to what is happening there I really wonder whether they do care about anything except the trust’s reputation.
On May 2nd one of the foremost experts on inquiries into maternity care Mr Bill Kirkup, has been invited to give a lecture at the trust. He has investigated baby deaths in the Morecambe Bay Trust and in the East Kent Trust. I wonder what my former colleague on the Gosport War Memorial Hospital independent panel will have to say about the Hampshire Hospitals NHS Foundation Trust.
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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Dr Martyn Pitman Pic credit: Hampshire Chronicle Adele Bouchard
Jonathan Gray, the employment judge hearing the case brought by whistleblower obstetrician Martyn Pitman against Hampshire Hospitals NHS Foundation Trust used last Friday to issue his judgement dismissing all the doctor’s detriment claims against the trust. The judgement, despite widespread and national interest, has still at the time of writing, not been published by the HM Tribunals and Court Service.
Judge Jonathan Gray Pic credit: BDB Pitman
The judge, who previously worked for the law firm BDB Pitman in Southampton, managed both to accept virtually all his whistleblowing claims but throw out any claims that he had been persecuted by the trust for exposing them.
In short he believed every word given by Alex Whitfield, the former oil refinery executive turned trust chief executive; Lara Alloway, the former chief medical officer and Steve Erskine, the former businessman now chair of the trust and other leading figures who gave evidence for them. He didn’t believe a word of the case brought by Martyn Pitman of his bad treatment despite being ably defended by Jack Mitchell, funded by the BMA from Old Square Chambers.
What the judge did was turn Martyn Pitman against himself. His ruling at the end was :“Having considered each of the alleged detriments, there is in our view an overarching reason for what has happened to the Claimant that is not on the grounds of any of the alleged or proven protected qualifying disclosures. In short, it is the Claimant’s communication style and not the message he was trying to convey.”
To seal the deal the judge turned one of Martyn Pitman’s witnesses against him. He used the evidence of Dr Michael Heard, a fellow consultant, who backed up Dr Pitman’s whistleblowing claims to turn against Dr Pitman.
Dr Heard had made similar claims to Dr Pitman to the management at the trust and no action was taken against him. The judge used this to say it proved the trust management was keen to take whistleblowing seriously but not keen if it was presented in a forthright manner which affected the ” health and well being ” of the managers.
Alex Whitfield, chief executive, Hampshire Hospitals Trust
What was also strange in this hearing was that the person who made the most dramatic claims against Dr Pitman, Janice McKenzie, the divisional chief nurse and midwife, saying she had to leave the unminuted meeting dealing with patient safety with him, in tears to cry in the toilet, never gave evidence. But like ” Banqou’s Ghost” in Macbeth her claims hung over the hearing. I would have liked to see her testify given there is no written evidence of what happened there.
There was also a dispute – again unminuted – over the claim that towards the end of this long saga Dr Pitman was verbally told by Alex Whitfield, that he couldn’t continue working at the hospital because he was a risk to patient safety. She denied this and the judge believed her and not Dr Pitman.
Basingstoke Hospital Midwife team receiving an award in 2015 in better times. Pic credit: Basingstoke Gazette
Now there is a much wider issue in this judgement which goes well beyond this being a local hospital dispute. It arose because of a merger of two trusts which brought a clash of cultures between midwives who worked at the North Hampshire Hospital and those who worked at the Royal Hampshire Hospital in Winchester. Midwife managers from Basingstoke tried to impose their system on midwives in Winchester. This led to unrest and unhappiness in Winchester and Dr Pitman intervened because he was worried about patient safety and took it up with the midwifery managers who seemed unable to cope with criticism.
The management of this became a national issue when the Care Quality Commission inspected the maternity services at the trust and downgraded the trust (see here). Again I am surprised this was not mentioned in the tribunal.
But why I really think this ruling is bad is another event which coincidently emerged while this case was on. The Care Quality Commission published its annual report on maternity services and it makes grim reading. The number of inadequate trusts has doubled from 9 to 18, the number of trusts that require improvement has increased from 46 to 67 and only six are in the outstanding quality category. The CQC is obviously worried about this since they have only inspected 73 per cent of trusts and are planning to inspect the rest as a matter of urgency. The issues raised include poor management, lack of staffing, bad communication with patients, patient safety being inadequate and also racial inequalities.
Now judge Gray won’t know about this and probably say it was irrelevant to his hearing but his ruling will be a solace to managers worried about whistleblowers raising inconvenient claims of patient safety in maternity wards. By putting down such an eminent obstetrician ( even the judge and the health trust couldn’t find fault with his clinical judgement) he is potentially putting at risk the safety of millions of mothers giving birth in England. Who is going to raise their voice in the NHS about patient safety in the maternity ward if they see a doctor put down and not believed in a tribunal like that? Yes he may be forthright and strong minded but we need people to have high standards to improve the health service for everyone. Judge Gray has a lot to answer.
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A highly critical report from NHS watchdog, the Care Quality Commission has confirmed fears from whistleblowers, including obstetrician Dr Martyn Pitman, that mothers were at risk using Hampshire Hospital NHS Foundation Trust’s maternity services in Winchester and Basingstoke.
The report was not raised during the two week employment tribunal hearing as I gather it came out too late to be included in the evidence. But it followed a visit by the CQC to the trust last year resulting in a report which highlighted a slew of concerns about the service.
The report has been taken up by Helen Hammond, a lawyer based in Basingstoke and Reading, who specialises in clinical negligence in maternity care, working for the international law firm, Pennington, Manches, Cooper. In a blog on its site she catalogues the damning findings of the report from staff shortages to injuries facing women giving birth. You can read her full blog here.
North Hampshire Hospital, Basingstoke Pic credit: Wikipedia
The health trust has spent hundreds of thousands of pounds of taxpayer’s money on expensive lawyers from Old Square Chambers to deny that Dr Pitman was a whistleblower concerned about patient care denigrating him at one stage -until subsequently withdrawn- as “a freelance agitator”. They produced evidence claiming he made a midwifery manager, who never gave any oral evidence to the tribunal herself, that he made her cry. Top officials of the trust including the former chief medical officer, Lara Alloway, chief executive, Alex Whitfield, and trust chairman, Steve Erskine, gave evidence against him.
Now the CQC report says that in 2022 there was a lack of midwifery staff to provide safe delivery of births; two day delays of inducing births, staff missing training because they had to fill in for staff shortages and senior midwifery staff not creating a culture that supported individuals. In Basingstoke there were cases of staff not spotting mothers deteriorating in the wards, and of a much higher level of serious maternity tears – caused by forceps delivery -than the national average. Staff at Basingstoke said they were asked to perform tasks they did not feel competent to do.
The service also delivered a much higher proportion of babies in poor health than the national average.
Helen Hammond, senior associate, Penningtons Manches Cooper
Helen Hammond says in her blog: “One frustrating aspect of the CQC report, which reflects our experience of representing local families whose babies have either died or developed brain injuries due to the management of their birth, is the failure to learn from previous incidents to prevent them reoccurring. Many families we have worked with have expressed a desire for the harm they or their child have suffered to lead to safer care for those who follow them. Acting on the findings of the report to make this the case would create a lasting legacy.”
The health trust said yesterday :
Our first priority is always our patients and it is vital we provide expectant parents with confidence in our care.
Following the 2022 CQC report, our maternity division is now fully staffed, and a number of policies and procedures are in place to remedy areas highlighted so that we address – among others – equipment concerns, communication issues, and training.
With that in mind, you have asked for a series of figures which we are concerned will be presented without appropriate clinical context, something that may cause undue alarm.
We ask that any expectant parents who may have concerns about the areas you have highlighted raise them directly with their midwives or obstetricians so that they can be given proper, medical advice and guidance. “
It is interesting that the trust would not provide me with current facts and figures on issues of maternity tears, babies born in poor health, or induction waiting times. I am sure that the CQC who normally revisit a trust to see if its services have improved, will look into this again and it will become public. It does rather fit in with the defensive attitude and lack of transparency from top officials at the trust during the tribunal.
Gary Hay former Capsticks lawyer and current member of the Portsmouth Hospitals NHS Trust board
An independent investigator appointed by the Hampshire Hospitals NHS Foundation Trust to review the treatment of whistleblower Dr Martyn Pitman, turned out be a former lawyer from Capsticks who specialised in exposing ” difficult doctors ” for NHS trusts, it was revealed at the employment tribunal hearing today.
The disclosure came during the questioning by Jack Mitchell, the junior barrister from Old Square Chambers, of the chairman of the trust, Steve Erskine, about how he and chief executive Alex Whitfield handled a request by Dr Pitman for an independent inquiry into the way the trust handled his grievances.
Dr Pitman, a well regarded consultant obstetrician and gynaecologist, was dismissed by the trust on the grounds that he couldn’t work with colleagues which could put patient safety at risk. This was the last day of evidence.
Capsticks are well known as the “go to ” lawyers for NHS trusts and have a big contract with the NHS which has just been renewed. They have a track record of denigrating and undermining whistleblowers in the NHS. The firm played a prominent role in the recent case against Dr Usha Prasad, the dismissed whistleblower cardiologist who revealed an ” avoidable death” of an elderly heart patient which the Epsom and St Helier University NHS trust never reported to the coroner.
Steve Erskine
Mr Erskine confirmed evidence by Alex Whitfield yesterday that his original decision to have an independent inquiry requested by Dr Pitman into his grievances was later change to include a much broader inquiry in which his grievances were subsumed. He insisted he did this on his own reflection.
Questioning by Mr Mitchell revealed that the trust knew it was not compliant with new guidance issued by Baroness Harding, on how NHS staff should be treated by trusts in the aftermath of the suicide of nurse Amin Abdullah who burnt himself to death outside Kensington Palace after being unfairly treated and dismissed by his trust. Baroness Harding was then chair of NHS Improvement before her more infamous role in charge of test and trace during the Covid pandemic.
The guidance that later became mandatory was not implemented by the trust until much later when it convened a sub committee, which meets in private, to draw up the changes. Mr Erskine argued that confidentiality was needed because of some of the information in the report. Initially he said the new rules had not been published by the board, but later when this was queried by the trust’s lawyer Mark Sutton and the judge because it breached a NHS directive, it was suggested there was some public reference which had not been given to the tribunal.
After the terms of the inquiry were changed, Dr Pitman wanted it dropped but was overruled by the chairman and chief executive. He then suggested that Verita, an independent investigation consultancy which found failings by Imperial College Healthcare NHS Trust in the way Amin Abdullah was treated, should be appointed to do the inquiry. Steve Erskine rejected this saying it would be ” a conflict of interest” if Dr Pitman suggested who should conduct the inquiry.
Instead the trust approached the law firm Bevan Brittan, who are representing the trust at the tribunal, to advise them.
The trust then settled on Gary Haye a lawyer and partner who had sat on the board of Capsticks and who Mr Mitchell said he had publicly said his specialism was ” dealing with difficult doctors” to be the independent investigator. He was also a member of Portsmouth Hospitals NHS Trust, the same board where Steve Erskine was a member. When challenged why he had not declared this, Mr Erskine said he did not need to, as they were members at different times.
Mr Mitchell disclosed that findings of Mr Hay’s report were part of Dr Pittman’s claim for detriment, as he found the report was “full of inaccuracies” and was “partial “. Mr Hay has no medical qualifications only degrees in law, English and business.
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Alex Whitfield, chief executive of Hampshire Hospitals NHS Foundation Trust
Alex Whitfield denies ever saying ” Martyn Pitman was a ” direct threat to patient safety”
Whistle blower consultant obstetrician Martyn Pitman made numerous attempts to get Hampshire Hospitals NHS Foundation Trust to independently investigate the allegations against him but was met with silence until he complained to the board , the tribunal was told yesterday.
The disclosures came out during the cross -examination of Alex Whitfield, the chief executive of the trust, by Jack Mitchell, the junior barrister from Old Square Chambers. Dr Pitman was dismissed by the trust for allegedly not being able to work with colleagues after he raised concerns about patient safety in the maternity wards at Royal Hampshire Hospital. The trust is arguing he is not a whistleblower in this case.
Alex Whitfield, a former oil refinery operating manager has been employed in managerial roles in the NHS since 2007. She was cross questioned in detail about how the terms of an independent inquiry were changed from one solely concentrating on his treatment by the trust after he had raised patient safety issues to much broader issues covering staff treatment.
Dr Pitman won the inquiry after complaining directly to a board member because no one else in management would take it up. It was passed to the chair of the board, Steve Erskine, a highly experienced Whitehall player and business development director who was keen for it to go ahead.
Steve Erskine, chair of Hampshire Hospitals NHS Trust on X as @ErskineSteve
At the same time the trust was grappling with new guidance later turned into a directive from Baroness Harding, on how NHS staff should be treated by trusts in the aftermath of the suicide of nurse Amin Abdullah who burnt himself to death outside Kensington Palace after being unfairly treated and dismissed by his trust. Baroness Harding was then chair of NHS Improvement before her more infamous role in charge of test and trace during the Covid pandemic.
At the time the trust was not fully compliant with the directive but the chief executive insisted at the tribunal that the trust was compliant with part of directive that covered Dr Pitman’s case. She also vehemently denied Mr Mitchell’s claim that she hid the non compliance ” to save her own skin” from questions by the chair.
The tribunal was told however that she was behind the change in terms of the inquiry to make it much broader than Mr Pitman’s case. If it had remained solely with him, it would have put her close colleague, Dr Lara Alloway, at the centre of the investigation, who, as reported yesterday as Dr Pitman’s case worker, faced questions of conflict of interest and not minuting meetings.
Dr Martyn Pitman Pic credit: Adele Bouchard, Hampshire Chronicle
The chief executive told the chairman that Dr Pitman would be able to appeal against any findings against him so would not lose out with a wider inquiry. But questioning from Jack Mitchell revealed this was not true. He would have been able to appeal if he had been found guilty of misconduct or lack of capability but because he went down the mediation route instead he had no right of appeal.
Mr Mitchell repeatedly argued that the trust had ” mapped out” a strategy to get rid of him at meetings – and also cited how the people director of the trust thought the best solution was to pay him off with a settlement. But Alex Whitfield insisted that they all wanted him to stay because he was such a good clinician and only wanted him to moderate his behaviour.
At the end of her cross examination she very strongly denied she had ever said that he had been sacked because he was a present danger to patients and the public. She insisted that she had never said that in discussions with Dr Lara Alloway.
Her denial sits oddly with Dr Lara Alloway’s evidence yesterday about the need for an extraordinary advisory meeting to discuss his future and complaints against him because they were worried about the risk to patient safety because of the toxic atmosphere with his relationship with some other staff.
And also the reason why Dr Pitman took ” special leave ” after he had a letter raising clinical issues does not fit with that. The hearing continues tomorrow.
Dr Lara Alloway: former chief medical officer. Pic credit: Hampshire NHS Trust
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.
Dr Martyn PitmanIack Mitchell
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.
The fourth day of the Dr Martyn Pitman tribunal provided extraordinary revelations of how top managers at the Hampshire Hospitals NHS Foundation Trust secretly got rid of the popular whistleblower obstetrician and gynaecologist who raised patient safety issues in the midwifery and maternity services.
Two very different witnesses, Daniel Pebody, a senior employment adviser to the British Medical Association, and Ben Cresswell, Divisional Medical Director for the Surgical Department at the trust, gave evidence on what happened to Dr Pitman from different sides of the managerial fence.
Mr Pebody was strongly questioned by the trust’s lawyer Mark Sutton, KC, the former head of chambers at Old Square Chambers. He had been called in by the BMA as a health employment expert, to examine the investigation report into Dr Pitman by the trust and the procedures used to dismiss him form his job.
He quietly clashed with Mr Sutton when the lawyer put to him that the “well being of midwifery managers” had been adversely affected by Dr Pitman ” bullying “attitude which Mr Sutton said led to one resignation. Mr Pebody said this was an issue of the “perception by the managers of their well being” and not an intentional attitude by the consultant “. Mr Sutton then brought up a guideline by ACAS ( the Advisory, Conciliation and Arbitration Service) that would allow a person to be sacked for ” unconsciously bullying people” to justify the trust’s decision.
Mr Pebody was also critical of the short time the investigator spent preparing her report – only one month – and pointed out it was one sided if not just short of biased, as nowhere in there were any views expressed from people supporting him. He hinted that perhaps the young person may have wanted to impress the trust as it was one of her first reports.
Biggest clash
The biggest clash came over when Dr Pitman learnt from the chief executive of the trust, Alex Whitfield, when he was about to be taken back by the trust that he couldn’t be because he could put patients ” at risk” and his clinical work would have to be monitored ( without any specification of what was wrong). The tribunal was told then he had no choice but to take “special leave”
Mr Pebody said this was ” appalling ” and ” this should never be allowed to happen again anywhere.”
The tribunal was then told by Mr Pebody of the battle Dr Pitman had to find out the reasons and get hold of the minutes of an advisory meeting of top managers who had met in private to advise Dr Lara Alloway, then chief medical officer of the trust, what action she could take against him.
He had to put in both a freedom of information request to his own employer and a subject access request before managers would part with the information. Mr Pebody was highly critical of the lack of transparency in the trust.
Later the trust’s Ben Cresswell gave evidence and was cross questioned by Martyn Pitman’s lawyer, Jack Mitchell, a junior barrister from Old Square Chambers. He had attended this key advisory meeting though he did not have any dealings with Dr Pitman.
Questioned by Mr Mitchell he had to admit that the extraordinary meeting- which was chaired by Dr Lara Alloway, who was handling Dr Pitman’s official grievance – received no written evidence, did not see the investigation report and were only told that there were multiple people who had complained about Dr Pitman.
Mr Mitchell described the sacking procedure as ” appalling”
Two issues were strongly contested by Mr Mitchell. First he pressed Mr Creswell on why Dr Alloway was chairing a meeting which would advise her on what to do when she was handling directly Dr Pitman’s grievances. He described this as ” a conflict of interest”. Mr Cresswell insisted that there was NHS guidance dating from the 1990s that limited what was a” conflict of interest” and senior staff were entitled to chair meetings when directly challenged by a doctor.
The second issue was over the wording of the final paragraph of the minutes which Mr Mitchell insisted showed that in fact a decision had been made by this advisory committee, which compromised all the senior managers, to sack Dr Pitman ” to protect patients and the public ” because patient safety was at risk if Dr Pitman could not get on with his colleagues. Mr Cresswell said this was advice and Dr Alloway would decide ” as the responsible officer” what view she was going to take. Dr Alloway, now the former chief medical officer of the trust, will be giving evidence on Monday as the tribunal continues.
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Trust lawyers try to turn his patient safety claims against them against him
Dr Martyn Pitman
Mark Sutton, the leading lawyer for Hampshire Hospitals NHS Foundation Trust, tried to turn Dr Pitman’s patient safety complaints against his employer in both the maternity wards and the midwifery service against him in the third day of the hearing.
The former Old Square head of chambers highlighted a letter from the trust’s chief executive when Dr Pitman was trying to rejoin the trust after being suspended for two years. This followed a meeting of senior managers that decided that he could not come back because he posed a ” risk to patient safety “. Dr Pitman again had not seen the full minutes of the meeting.
Previously the KC had highlighted a disputed serious treatment case in the maternity ward- where Dr Pitman challenged a colleague and blamed the person for not being competent to do the job which led to the death of a patient.
Mr Sutton claimed that this led to a row in a hospital corridor which Dr Pitman said did not happen and was sorted out at a meeting in his office.
The lawyer also said that patient safety was at risk in the ward he managed because his relationship with the consultant team was dysfunctional. This was categorically denied by Dr Pitman who said he had ” eight years of positive relationships with his colleagues”.
His lawyer, Jack Mitchell, a junior barrister from Old Square Chambers, then pointed out that Mark Sutton had missed out a passage in one of the documents that showed Dr Pitman, far from not being concerned about patient safety, had warned the then associate director of midwifery Ms Janice MacKenzie of changes needed in the maternity ward to avoid deaths. A week later one baby had died and another had serious problems and no action had been taken by her.
Dr Putman ended the cross examination feeling weepy . The Judge Jonathan Gray, asked him why he seemed to be blaming everyone in the health trust for his predicament. He said this because every time he took issues up with the hospital hoping it would be resolved at a higher level including at board level there had been no attempt to do so.
Later Dr Michael Heard a retired consultant who worked alongside Dr Pitman defended his stance at the hospital. He said Dr Pitman was ” direct not rude” and ” passionate about his job “. He said he had good relations with Janice Mackenzie – who has accused Dr Pitman of forcing her to leave a meeting to cry in the toilet – and could not comment on some of the accusations brought by her because he was not there.
He described him as ” direct to the point and put his main points in writing in bold ” but did not use expletives. He said his style was “challenging and well researched.”
He also confirmed Dr Pitman’s main point that the maternity and gynaecology wards had been short staffed and all the consultants had been frustrated about it for years because nothing was done about it by the trust.
The trust’s lawyer, Mark Sutton, also raised whether a letter he wrote to the trust about Dr Pitman had been prompted by him. Dr Heard said he had done without his knowledge in the hope that matters could be sorted out informally.
” By then matters had gone too far”, he said. The tribunal continues tomorrow.
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