Sunday Telegraph 3 August 2014
As Sir Robert Francis urges whistleblowers who have tried to raise the alarm over NHS standards to come forward, The Telegraph looks at some of their damning stories
Sir Robert Francis, the chairman of the public inquiry into the Mid Staffs scandal, is launching the first independent review of whistleblowing in the NHS, and calls on those who have been mistreated to speak out.
The investigation is expected to begin on Wednesday, when he will ask those who have been affected to come forward.
Here are some of those whose experience has led to the review:
1. John Marchant
John Marchant, the former head of security at Dudley Group of Hospitals trust, claimed staff had routinely forced vulnerable patients to stay in their rooms – and even confined them to their beds – despite them posing no danger to anyone.
He said his security guards had become so concerned about the practice that in one instance they had refused to restrain a child and warned bosses the action was illegal. Mr Marchant also alleged that pensioners had been subject to restraints when all they wanted was to walk around a ward, or chat with fellow patients.
Mr Marchant said: “Detention is being used simply because the patient become so frustrated at not even being able to go out for a walk in the hospital grounds because there are no staff to accompany them.
“Some would go back to their rooms if you asked them, but others would have to be closed in and it would be very distressing for them.”
He repeatedly raised his concerns over the practice with senior managers, but was made redundant from the Dudley Group in December 2012.
The trust denied Mr Marchant’s claims and insisted it always acted in the best interest of patients. However, it admitted that security staff had raised concerns about the issue.
Following the revelations in The Sunday Telegraph, in January, the Department of Health has ordered the Care Quality Commission, the health regulator, to carry out an investigation into his claims.
2. Annabelle Blackburn
Annabelle Blackburn claimed says she felt effectively “blacklisted” and forced to work in a neighbouring county after warning about potentially dangerous problems at the Oxfordshire GP surgery where she was employed.
She said she had found blood test results ignored and emails going unanswered. She also claimed to have found evidence that a woman had not been told about a probable diagnosis of leukaemia, and a man who should have been told he had prostate cancer.
Mrs Blackburn said the delays in acting on test results or information in emails may have caused severe harm to several patients. In two cases she feared that patients could have died prematurely because the information had not been acted on.
But when the experienced nurse spoke out, other GPs in Oxfordshire were told she was “exaggerating her concerns” and should not be regarded as a genuine whistleblower.
When Mrs Blackburn took her case to a tribunal in 2012, a judge said that members of the local primary care trust, since disbanded, had thought that she was “making trouble”. Although Mrs Blackburn lost the case, the employment tribunal agreed that the trust had failed to deal with the complaints she had raised.
Mrs Blackburn said: “The way Oxfordshire PCT handled the situation was terrible. They failed to treat the crisis at the clinic with any urgency and then they tried to ignore and discredit me.”
3. The doctor “brushed under the carpet”
A doctor who worked at two hospitals at the centre of a scandal over patients dying after keyhole cancer surgery claimed managers ignored him when he tried to raise the alarm over poor standards and dangerous practices by surgeons.
The doctor, who wished to remain anonymous for fear of losing his job, said he and other members of staff were ignored when they tried to warn about the behaviour of surgeons at Maidstone and Tunbridge Wells hospitals. He said his colleagues’s fears were “brushed under the carpet” and that managers preferred to ignore their warnings rather than confront the way three surgeons responsible for the keyhole procedure, Professor Amir Nisar, Haythem Ali and Ahmed Hamouda, were working.
The doctor said: “I reported my concerns but I was just given the brush off. Several other junior doctors, and nursing staff, expressed their concerns, but they all had the same experience as me.”
He spoke out after a damning report found that managers at Maidstone and Tunbridge Wells ignored repeated staff warnings dating back several years about the behaviour of the surgeons.
This newspaper revealed in May how the hospitals were forced to stop carrying out keyhole surgery for upper gastrointestinal cancer (GI), on the instruction of The Royal College of Surgeons (RCS), following the unexpected death of five patients who had undergone the procedure in December 2012 and early 2013.
Maidstone and Tunbridge Wells NHS Trust barred Prof Nisar, Mr Ali and Mr Hamouda from carrying out the procedure on the recommendation of the RCS, but they were allowed to continue general surgery at the hospitals.
4. Rebecca Prideaux
Rebecca Prideaux, a former inspector at Britain’s health and care watchdog, claimed that elderly people were being left to suffer in appalling conditions because regulators refused to act on warnings.
She said poor care routinely went unchecked because staff at the Care Quality Commission (CQC) were given inadequate training. Workers were discouraged from taking action when they uncovered risks to the most vulnerable, she added.
Mrs Prideaux resigned from CQC in May last year, saying she had repeatedly urged senior managers to improve the training given to hundreds of inspectors who visit care homes and hospitals.
The former policewoman said she was put in charge of an inspection of a 120-bed care home the day after her induction finished, after witnessing just two such inspections previously and receiving no advice on how to draw up a report.
She accused regulators of failing to take proper action even after she warned of appalling failings in care and claimed reports often omitted some of the most damning failings.
Mrs Prideaux said: “When I joined CQC I was over the moon. I had cared for my grandparents and I really believed in a job where you could make a difference. In the end I was left feeling that if I cared, that was the last place you should be working.”
The CQC said Mrs Prideaux’s views were not shared by the more experienced and specialist inspectors who worked with her. But it said it had changed the way it carried out inspections, in particular to ensure that all inspectors are specialists in the areas they inspect.
5. Raj Mattu
Dr Raj Mattu, a hospital consultant who was “hounded mercilessly” out of his job after raising concerns about patient safety, won a landmark legal victory for unfair dismissal in April, following the longest-running and most expensive whistle-blowing case in NHS history.
The cardiologist, was suspended for eight years, then sacked in 2010, after warning that patients were dying because of cost-cutting practices introduced by the then Walsgrave Hospital hospital, in Coventry.
NHS bosses hired private investigators in an apparent attempt to discredit him, spending an estimated £6 million in pursuit of the case against him.
MPs said the employment tribunal ruling, which found the whistleblower had been unfairly dismissed, shone a light on a “sinister and dystopian” culture of cover-up within the NHS, which destroyed the lives of those who tried to speak up for patients.
Dr Mattu said: “My treatment by the trust over the past 13 years has damaged my health, my professional reputation and my livelihood and its effects on my personal and private life have been devastating.”
University Hospital of Coventry and Warwickshire NHS trust said it was disappointed by the employment tribunal’s decision.
6. Roger Davidson
Roger Davidson lost his job as head of media and public affairs for the Care Quality Commission just before the 2010 general election, after telling how a quarter of NHS trusts had failed to meet basic hygiene standards.
He also warned that the CQC had stopped telling the public how to find reports on infections in their local hospitals in order to limit publicity damaging to the NHS.
Mr Davidson was forced to sign a gagging order when he left but his testimony emerged during the Francis inquiry into appaling failings at Mid-Staffs which led to hundreds of “excess deaths”.
It formed part of a tranche of documents which detailed how the regulator was apparently intent on suppressing negative publicity about the NHS, amid political pressure from then Labour ministers and their advisers before the election.
Mr Davidson, who went on to become head of media at NHS England, said: “The message that ‘we don’t want bad news’ infected the whole organisation. There was no compass.”
7. Professor Narinder Kapur
Professor Narinder Kapur was dismissed as a consultant neuropsychologist and head of neuropsychology at Addenbrooke’s hospital in Cambridge after voicing his concerns about patient safety and poor standards of care.
Cambridge University Hospitals trust (CUH) dismissed Prof Kapur in 2010, claiming there had been a breakdown in their relationship because of his management style and working methods.
But in July 2012 an employment tribunal ruled that he had been unfairly dismissed. It added: “The tribunal condemns unreservedly the way in which the NHS has conducted itself in respect of this allegation.”
However, because the tribunal found Prof Kapur had not been sacked because of his whistle-blowing, but because there had been “an irredeemable breakdown in trust, confidence and communication” between him and other managers, it did not order his reinstatement.
Prof Kapur, 64, who is now a consultant neuropsychologist at Imperial College Healthcare Trust and visiting professor of neuropsychology at University College London, said: “I raised my concerns about staff shortages and the impact on patient care several times to my line managers, I had a duty to do so on behalf of my patients, but I was repeatedly ignored by the hospital senior management. If that can happen to a professor like myself, with a worldwide reputation in his field, imagine what happens when more junior members of staff try to raise the alarm.”
8. Sharmila Chowdhury
Sharmila Chowdhury had enjoyed an unblemished 27-year career with the NHS until she was sacked after blowing the whistle on senior doctors who were moonlighting at a private hospital while being paid to treat NHS patients.
The radiology service manager at Ealing Hospital trust repeatedly warned the hospital’s senior managers that doctors were dishonestly claiming thousands of pounds every month and that the trust had lost £250,000 of public money through such arrangements.
Ealing hospital failed for two years to take any action against the two doctors later accused of fraud at a tribunal hearing. Instead, Ms Chowdhury was suspended after a counter-allegation of fraud made against her by a junior whom she had reported for breaching patient safety. The allegation was never proven and in July 2010 the employment tribunal judge took the unusual step of ordering the trust to reinstate Ms Chowdhury’s full salary. However the trust made her post redundant and the case was eventually settled out of court.
Ms Chowdhury, a widow with a teenage son, received two years pay, although £77,000 of that was paid out in legal fees. She found her whistle-blowing made it hard for her to find further employment in the health sector. She is also fighting cancer.
Ms Chowdhury, 54, who met Jeremy Hunt, the health secretary, in June, to discuss the plight of whistle-blowers, said: “The public has a right to know what is happening with public money. Despite winning a hearing in which I was proven to be a whistleblower, I’ve no job and no money.”
9. Helene Donnelly
Helene Donnelly raised more than 100 complaints about the way patients were being treated at Stafford Hospital while she was working there as a nurse in Accident and Emergency.
She became was a key witness during the Mid-Staffs public inquiry into reports of poor care, abuse and neglect of care at the hospital, where there were between 400 and 1,200 more deaths than would normally have been expected between 2005 and 2008.
In her evidence, Ms Donnelly said nurses in A&E were expected to break rules as a matter of course in order to meet targets, including falsifying records to pretend that patients had not been kept waiting for more than four hours.
When she raised her concerns she was met with threats and bullying by some of her more senior colleagues. At one stage she had to ask members of her family to come and pick her up when she finished a shift a night because she was afraid to walk back to the car on her own.
Ms Donnelly was appointed an OBE in May for her services to the NHS, in recognition of her work to support hospital staff to raise concerns and improve care for patients.
She is now an ambassador for cultural change at the Staffordshire and Stoke-on-Trent Partnership NHS Trust and works to relay staff concerns to the chief executive and is helping the Department of Health draw up whistle-blowing training for NHS staff.
Ms Donnelly said: “I am frequently being contacted by individuals from all over the UK who have tried to speak out at their own trusts, but find they are ignored. Far too many who hold positions of power – and who could affect change – are still dragging their feet while patients and staff continue to suffer.”
10. Kim Holt
Kim Holt, a consultant paediatrician, was suspended after she told managers about serious failings at the clinic where Baby P was later treated just days before his death at the hands of his mother and her boyfriend.
Ms Holt and three colleagues wrote to managers in 2006, warning that understaffing and poor record keeping posed a serious risk to patients’ safety at St Anne’s clinic in Haringey, north London, and that a child would die if action was not taken. But bosses ignored her warnings and removed her from the clinic.
Baby Peter Connelly was seen by an inexperienced locum doctor, Sabah Al-Zayyat, at St Anne’s in the summer of 2007, three days before he was killed and some time after Ms Holt and her fellow whistle-blowers had left. Zayyat failed to spot signs that the 17-month-old boy, who was on Haringey’s child protection register, had been physically abused.
Ms Holt later said: “I believe that if our concerns had been taken seriously at the time we raised them, then we could have prevented the death of Baby Peter. Several of the failings found by the inquiries into his death were 100 per cent the same as the failings we complained about the year before he died.”
She also said the hospital had offered her £120,000 to withdraw her complaints in the wake of Peter’s death – a claim the hospital denied.
In 2011 Great Ormond Street hospital and Haringey primary care trust, which co-managed the clinic, formally apologised to Ms Holt, who is currently advising the CQC on how the regulator can help support staff who raise concerns about standards of care.
11. David Drew
Dr David Drew, a consultant paediatrician at Walsall Manor Hospital claimed he was sacked after raising the alarm in the case of a toddler who died after being discharged from the hospital.
Kyle Keen had been admitted to Walsall Manor on June 21, 2006, where bruises were noted but no follow-up action was taken and he was discharged. The toddler was then admitted to the the paediatric intensive care unit at North Staffordshire Hospital, in Stoke-on-Trent, on June 29 with a brain injury and died a day later.
Kyle had been shaken by his stepfather Tyrone Matthews, then aged 25, who was sentenced to six-and-a-half years in prison for manslaughter.
Dr Drew said he had tried to raise concerns over his death and warned that his case should have been referred to social services.
The hospital was criticised in a serious case review in 2009 after it emerged nurses treating Kyle for a stomach upset had spotted suspicious bruises on his body a week before he was admitted with the brain injury.
Matters had came to a head after Dr Drew emailed a prayer around his department in April 2009, hoping it would help motivate his colleagues. The 65-year-old, who had an unblemished 37-year career in the NHS, was told to “keep his religious beliefs to himself” by a review panel called to investigate his conduct in March 2010.
He was sacked for gross misconduct and insubordination for failing to accept the panel’s instructions and for disclosing confidential information in relation to other matters.
Dr Drew said the email had been used as a smokescreen to push him out of his post. He said: ‘My case was never about the religion, it was about the fact the hospital wouldn’t listen to its most senior paediatrician telling them they were cutting costs to the bone and putting patient safety at risk. It’s all about whistle-blowing.”
In April 2012 an employment tribunal rejected his claims of unfair dismissal, religious discrimination and victimisation against Walsall Hospitals NHS Trust.
12. Kay Sheldon
Kay Sheldon, a non-executive director of the Care Quality Commission, feared patients’ lives were being put at risk because the NHS’s official regulator was not doing its job properly.
After she raised concerns at the Mid-Staffs public inquiry, the CQC’s then chairman called for her to be immediately suspended, then ordered an assessment of her which suggested she could be suffering from paranoid schizophrenia.
Ms Sheldon, who had been open about her history of depression, said: “They were trying to discredit me as either mad or bad, as mentally ill or a troublemaker – it’s shocking the lengths they were willing to go to in order to get me out.”
She refused to sign a gagging order and last June told The Sunday Telegraph: “I am worried that the regulator has been giving false assurances that hospitals are safe, when they are not, and that could mean patients are at risk, it could mean that they are harmed and it could mean that some die, when their deaths could have been prevented.”
The following month she was vindicated by an inquiry into the Morecambe Bay baby deaths scandal, which accused CQC of presiding over a “cover-up” of their failings.
While the former managers involved denied her accusations, the organisation’s new management is now radically overhauling its inspection methods.
Ms Sheldon said that the CQC had been under pressure to avoid “finding another Mid Staffs” in the wake of the 2009 scandal.