A bizarre tribunal hearing on the treatment of Epsom’s health trust’s sole woman cardiologist

Dr Usha Prasad.

Dispute could last a decade

Last week by Zoom I attended a tribunal hearing – just one in a long running saga between the Epsom and St Helier University Trust and their former consultant, Dr Usha Prasad.

This dispute which is by no means over – she has already had one employment tribunal, one employment appeal tribunal, a reference back to the original employment tribunal – and has still to go to a General Medical Council hearing and an another tribunal over her unfair dismissal claim.

The hearing took I attended just one day but it felt to me that I had just stepped into an unreal world of interminable hospital politics. The issue goes back to 2012 and won’t be settled until 2022. And all this, by the way, is being funded by the taxpayer using NHS funds.

Dr Usha Prasad is a well qualified cardiologist who has been popular with patients but ran into difficulties with staff at the trust and complained she was subject to gender and racial discrimination, bullying and harassment. There are also whistleblower issues which are yet to come out at another hearing.

Three years ago she featured in the current trust’s chief executive’s report for receiving a Patient First Gold Badge award for giving ” a wonderful extra five years of life” to an 81 year old patient suffering heart disease. She is pictured here with chief executive Daniel Elkeles.

Dr Usha Prasad with the trust’s chief executive Daniel Elkeles at the award ceremony Pic credit: Epsom and St Helier University Trust

Behind these happy scenes however all was not well. Usha felt she was not being treated well by some of her fellow male colleagues and relations between her and her junior doctor Dr Aran Kumar Perikala were strained.

Anonymous letter sent to Jeremy Hunt

The centre of her complaint surrounded an anonymous letter which turned out to have been sent by him in 2015 to Daniel Elkeles, the chief executive, the Care Quality Commission, the General Medical Council, and to Jeremy Hunt, then health secretary and to one of her patients. It was signed as representing the entire cardiology team at St Helier Hospital and made very serious allegations that Dr Prasad was putting patient safely at risk.

Jeremy Hunt.

She saw this attack by a fellow Indian doctor as sex discrimination and also as racist. It went to an employment tribunal headed by employment judge Katherine Andrews (more about her later) and her complaint was rejected. She appealed to an Employment Appeal Tribunal who upheld three of the letters but said that sending an anonymous letter to a patient and to Jeremy Hunt was going too far. The EAT ordered it to be referred back to the employment tribunal which held a hearing last week.

The hearing was unbalanced from the start. The trust was represented both by a barrister and a solicitor at enormous public expense. She appeared as a litigant in person ( funding herself) but was helped by Philip Howard ,a part time consultant at St Helier, who acted as Mackenzie friend, a pro bono role.

The part time judge, Katherine Andrews -a solicitor – was appointed as an employment judge by Chris Grayling when he was Lord Chancellor in 2013. Coincidently Grayling is also the Tory MP for Epsom and Ewell and is familiar with the workings of his local health trust.

Judge rules clinical judgement is irrelevant

From the start the judge brusquely limited the hearing to the contents of the letter and nothing else. Two other consultants at St Helier, Dr Sola Odemuyiwa, and Dr Ranjit Shail, a consultant physician, who wished to testify about Dr Prasad’s abilities were ruled as ” irrelevant” by the judge as they had no detailed knowledge of the letter. She ruled as ” irrelevant” any discussion about the clinical judgement of Dr Prasad. An issue that her brother in law, Dr Anand Kamath, working as a NHS dentist had committed suicide after being bullied by a primary healthcare trust over a complaint about his record keeping ,when this started, was also deemed to be ” irrelevant ” by the judge.

This left Philip Howard a very limited role to help defend her. His description of the circumstances of Dr Perikala writing the letter were illuminating. He told the hearing that he wrote the letter while all the other consultants were on holiday, did not consult them about it and paid a ” rare” home visit to one of her patients without her knowledge. He was only unmasked when the chief executive thought the entire cardiology department were of that view and other consultants objected. He told the tribunal that the patient had received excellent treatment and had no objections.

You would have thought that he would be the key witness that should be cross examined about why he acted alone and what his motive was. But the hospital trust’s lawyers did not call him and the judge ruled that as it was his belief it didn’t matter whether he was right or wrong. In other words the man can say anything he liked to a lot of important people and as long as he believed it, it didn’t matter a jot.

Not a level playing field

The trust has taken the matter to the General Medical Council where his behaviour could be questioned and certainly the issue of clinical judgement will not be brushed aside there.

The judge ruled against her but she has asked for the whole matter to reconsidered because she has received new information. Some of the time was spent arguing that she had missed legal deadlines to present new information. Given one side is using full time professional lawyers – and she is having to bring a case while still working elsewhere for Mid Yorks Health Trust – on loan from Epsom and St Helier University Trust. – it is hardly a level legal playing field.

Since the first tribunal hearing in 2017 she has effectively been suspended by the trust on full pay and faced losing her job. There are still two hearings to go.

One has to ask why the Epsom and St Helier University Health Trust is spending so much time and taxpayers money on this protracted dispute rather than using the cash to treat patients. When I earlier raised this with the trust they said they didn’t discuss issues about individuals working for them. They have also refused to give me details of how much taxpayer’s money they are spending on disputes.

This story is not over and I shall return to it when there are more developments.