Monthly Archives: April 2015

Health secretary: ‘victimisation’ of Croydon NHS whistleblower not my problem

 Croydon Guardian23 April 2015  
Croydon Guardian: Photograph of the Authorby Chris Baynes, Senior Reporter – Croydon

 

Kevin Beatt was sacked by Croydon University Hospital for whisteblowing on patient safety

Kevin Beatt was sacked by Croydon University Hospital for whisteblowing on patient safety

 

Health secretary Jeremy Hunt has dismissed calls for him to intervene to halt the “horrific victimisation” of a whistleblower doctor at Croydon University Hospital.The Conservative MP said he would not act over the case of consultant cardiologist Kevin Beatt, wrongly sacked by Croydon’s NHS trust for raising concerns about patient safety, describing it as “a matter for the trust’s board”.Prime Minister David Cameron last month stepped in to prevent another whistleblower doctor being pursued for nearly £93,500 legal costs by an NHS Trust found to have bullied and sacked her for raising similar concerns. 

 But Mr Hunt, who had been repeatedly asked by a campaigner to intervene in Dr Beatt’s case, said concerns about Croydon Heath Services NHS Trust should be redirected to the trust board itself. 

David Drew, a doctor who has campaigned for better protection for NHS whistleblowers, wrote to the health secretary in January and again in February urging him to launch an inquiry into the trust’s treatment of Dr Beatt and its chief executive, John Goulston.

His second letter said: “Dr Beatt should be exonerated, reinstated and receive a full apology from the managers responsible for his mistreatment.

“Then, as I requested in my letter of January 15 I believe you should set up an inquiry into how the Trust board at Croydon conspired to destroy the career of a good doctor.”

Mr Hunt, who earlier this month told the Croydon Guardian he was unaware of the case, replied to the doctor this week.

He said: “[T]he employment of the chief executive of a trust is a matter for the trust’s board. It is for the trust concerned to decide whether a chief executive is fit for the job.

“If Dr Drew wishes to raise any concerns about the conduct of a chief executive of an NHS trust, he may wish to contact its board directly. Alternatively, he may wish to contact the NHS Trust Development Authority (TDA), which provides support, oversight and governance for all NHS trusts in delivering high quality services.”

But Dr Drew said: “Since my concerns involve the [Croydon NHS] board including the chairman I see little point in writing to them.”

He has reported the case to the TDA’s chairman. 

In February, Sir Robert Francis QC published an independent report on NHS whisteblowers, who he concluded were bullied and intimidated amid a “climate of fear”.

Following its publication, Mr Hunt, who commissioned the review, told Parliament: “The whole House will be profoundly shocked at the nature and extent of what has been revealed today.

“The message must go out today that we are calling time on bullying, intimidation and victimisation which has no place in our NHS.”

Dr Drew, in his strongly critical second letter to the health secretary, said: “Your own silence on this matter speaks volumes. And your inaction can only embolden bullying managers and make decent NHS staff even more reluctant to speak up for their patients. How can this help promote a safe reporting culture?

“It is clear that Dr Beatt’s situation is no better for having won at the tribunal nor for the work of Sir Robert Francis in exposing the scandalous treatment whistle-blowers are subjected to. No-one has called time on his oppressors.”

An employment tribunal ruled in October last year Dr Beatt had been unfairly dismissed for whistleblowing on patient safety and staff bullying. 

An appeals tribunal subsequently found Croydon Health Services had no grounds to appeal the judgment, but the trust still hopes to have that ruling overturned. 

 

 

Health secretary Jeremy Hunt criticised for inaction over ‘horrific victimisation’ of Croydon NHS whistleblower Kevin Beatt

Croydon Guardian 8 April 2015
Your Local Guardian: Photograph of the Authorby Chris Baynes, Reporter – Croydon

 

Jeremy Hunt, left, has been urged to end

Jeremy Hunt, left, has been urged to end “victimisation” of whistleblower Dr Beatt

Health Secretary Jeremy Hunt has been criticised for his inaction over the “horrific victimisation” of a whistleblower doctor at Croydon University Hospital.

The Conservative MP, who spoke to directors during a visit to the hospital yesterday, has remained silent over the case of consultant cardiologist Kevin Beatt, wrongly sacked for raising concerns about patient safety, despite being urged to intervene three months ago.

Dr Beatt led the hospital’s well-respected cardiac catheter laboratory until he was fired by Croydon Health Services NHS Trust in 2013 after criticising hospital management.

An employment tribunal ruled in October last year he had been unfairly dismissed for whistleblowing on patient safety and staff bullying.

An appeals tribunal subsequently found Croydon Health Services had no grounds to appeal the judgment, but the trust has refused to drop the legal fight and hopes to have that ruling overturned.

December 2014: ‘Landmark’ legal win for cardiologist sacked for whistleblowing on patient safety

January 2015: Health secretary urged to launch inquiry as tribunal rejects Croydon NHS trust’s appeal of whistleblower’s sacking

David Drew, a doctor who has campaigned for better protection for NHS whistleblowers, wrote to Mr Hunt in January urging him to launch an inquiry into the trust’s treatment of Dr Beatt.

But Mr Hunt, who in February pledged to end a culture of bullying and intimidation among NHS directors, has not responded and this week claimed he was not aware of the case. 

He told the Croydon Guardian: “I’m not [familiar with it], no. I may have had a letter but obviously I don’t have the paperwork in front of me now.”

In a strongly critical second letter to the health secretary, Dr Drew wrote: “Your own silence on this matter speaks volumes.

“And your inaction can only embolden bullying managers and make decent NHS staff even more reluctant to speak up for their patients. How can this help promote a safe reporting culture?”

In February, Sir Robert Francis QC published an independent report on NHS whisteblowers, who he concluded were bullied and intimidated amid a “climate of fear”.

Following its publication, Mr Hunt, who commissioned the review, told Parliament: “The whole House will be profoundly shocked at the nature and extent of what has been revealed today.

“The message must go out today that we are calling time on bullying, intimidation and victimisation which has no place in our NHS.”

But Dr Drew said: “It is clear that Dr Beatt’s situation is no better for having won at the tribunal nor for the work of Sir Robert Francis in exposing the scandalous treatment whistle-blowers are subjected to. No-one has called time on his oppressors.”

Your Local Guardian:

Mr Hunt, centre, with Conservative Party election candidates for Croydon Gavin Barwell, left, and Chris Philp at Croydon University Hospital yesterday

He added: “Dr Beatt should be exonerated, reinstated and receive a full apology from the managers responsible for his mistreatment.

“Then, as I requested in my letter of January 15 I believe you should set up an inquiry into how the Trust board at Croydon conspired to destroy the career of a good doctor.”

Mr Hunt, who met with Croydon Health Services chief executive John Goulston and chairman Mike Bell on Tuesday, declined to comment on the case.

Speaking after the announcement of £21m funding for the hospital’s new A&E department, he said: “It is difficult for me to comment on an individual case because I don’t have all the details in front of me.

“But certainly the conversation I have had with management today is very much about culture change and creating a culture where staff feel better supported to speak out about concerns. This is not something that matters just for Croydon University Hospital, it is a matter for all NHS trusts.

“Too many places have had a culture where front-line staff have not felt able to speak out and felt they would be victimised or bullied or harassed and the result is that patient safety concerns have not been addressed as quickly as they should, so I’ll certainly be doing everything I can to champion a change of culture in the NHS.”

Asked if he would consider intervening in Dr Beatt’s case, he said: “I can’t comment on this particular case but there are cases I have got involved in. 

“I met a whole group of whisteblowers before [Sir Francis’s] Freedom to Speak Up review and I hope whistleblowers have recognised that I’ve done more than any other health secretary in the past to try to improve the culture to make it easier to speak up. 

“But I’m also realistic enough to recognise that these things don’t change overnight.”

The General Medical Council last month dropped its investigation into Dr Beatt, who the employment tribunal ruled been “maliciously” referred to the regulator by Croydon Health Services.

Last month, Prime Minister David Cameron stepped in to prevent whistleblower Dr Hayley Dare being saddled with £100,000 costs after she lost her case against West London Mental Health Trust on a technicality. 

Protection of NHS whistleblowers and NHS quality improvement – two birds killed with one stone

 
A very disappointing and arguably flawed `Freedom to Speak Up Review Report’ by Sir Robert Francis published in February 2015. A flawed document because all the basic steps of problem solving are not evident in the report.  Also, properly to analyse the problem and establish a solution requires a good understanding of industrial psychology, organisational behaviour and the power of conformity, how world class quality standards are achieved and how to create the organisation culture needed to achieve it. 
 
Step 1. What is the problem? The Report recognises that the protection of whistleblowers is a problem but fails to recognise the important problem of sacked whistleblowers, who are now unable to obtain redress for wrongful dismissal or redeployment in the NHS – the rectification of this essential if the Report recommendations are to have any credibility?  It also fails to recognise that the NHS is generally incapable of effectively rectifying failures in the quality of its services identified by whistleblowers/employees and for that matter its customers. Step 2. What is the cause of the problem?  The cause of whistleblowing is not effectively identified or analysed at all.   Step 3. What action should be taken to deal with the cause of the problem?  The Report provides a list of 20 `Principles and Actions’ as to how providers of NHS healthcare and regulators should behave and recommends yet another policing body to try to enforce it, which cannot be effective because it does not address the cause of the problem.   Step 2 ‘what is the cause of the problem’ is missing in the report i.e. what is causing people to bully others and repress free speech? As a result, Step 3 in the report does not address Step 2 and thereby resolve Step 1.
 
The main cause of the whistleblowing problem is reasonably clear.  The NHS is managed like a totalitarian state i.e. a very hierarchical command and control (C&C) dominated dictatorship using, target setting, regulation, inspection, intimidation (naming and blaming) at every level in an effort to improve productivity and quality to meet the needs and demands of customers.  It is a seriously outdated divide and rule, parent – child, them and us organisation and management system which creates fear in the workforce and is reminiscent of the UK car industry of the 1970s, which similarly failed competitively to improve its productivity and quality of products and services to meet customer need. Whistleblowing is only defined as such in centralised totalitarian/dictatorial command and control dominated management regimes. Free speech (and particularly the truth) is the biggest threat to dictatorship, which it has to suppress to survive.  Anyone who does not agree with its commands and practices is considered to be against the regime.  In such moribund cultures, which also breed informers, the vast majority of managers and staff do as they are told, avoid responsibility and keep their heads down for fear of losing their job or destroying their chance of promotion.  Indeed, the only way for people to gain promotion is to conform to meet the demands of their paymaster whoever they may be. All such regimes over a period of time fail to adapt to rapid change and inevitably corrupt and divide themselves into a protectionist profession silo mentality resulting in a pass the parcel service. 
 
Sir Robert recommends appointing yet another formal policing/inspection type system of an Independent National Officer and Freedom to Speak Up Guardians both of which are responsible to the totalitarian organisation and management system causing the present culture of fear and bullying. Behaviour change in the workplace cannot be achieved by regulation and inspection anymore than you can make people like each other.  Also, telling people how they should behave will not result in their behaviour changing. People’s overall behaviour in an organisation is substantially determined by four things:  1) its purpose; 2) its organisational paradigm i.e. the way it is organised and managed; 3) the knowledge and skills of its employees and 4) financial resources.  2) the NHS organisational paradigm is a key factor related to the problem, although the lack of a clearly defined purpose, financial resources to meet customer demand and the serious lack of knowledge of quality management methodology throughout the organisation is also contributing to the problem.
 
As a democracy, founded on the principle of no taxation without representation we, as owners of the NHS, should all be deeply concerned at the way the NHS is organised and managed.  Democratic, creative and progressive societies and organisations, where command and control management influence is minimal, are dependent for their existence upon everyone at every level being empowered to speak up to contribute to the process of continuous improvement of that society or organisation. A free press is essential and everyone is a whistleblower in an open democratic `stop the line’ (to use a process manufacturing analogy) continuous improvement organisational culture.  High quality services in complex industries like the NHS cannot be achieved in organisations operating a closed totalitarian C&C management dominated regime, which is designed to control social behaviour by subordinating and disempowering people – the exact opposite of what is required.  Thus the only protection a whistleblower in the NHS can be given is radically to dismantle and reform the present management regime of the NHS.  In turn this will radically improve productivity and the quality of services. Dismantling the regime will involve breaking it up into smaller autonomous units, creating an adult to adult management culture and training and involving everyone in the business planning and quality improvement and control process. There are only two ways to break the organisation into smaller units.   One is to privatise it, the other is to democratise it.  One of the problems with the privatisation of front line services is that it will fragment the services and thus militate against developing integrated services which is so desperately needed in the NHS, although the private sector may more effectively provide some supplier services.  Also, privatisation/marketisation and thereby competition does not ensure the development of high quality services. The car industry in the UK has always been highly competitive, but cost effective high quality car production was only achieved when total quality management methods, involving all staff, were introduced into the production process.  
 
It should be recognised that the Department of Health/NHS is by no means the only organisation involved in providing health and wellbeing services. The vast majority of existing local government services were created to prevent ill health through poor living conditions and to encourage individuals to maintain good health and wellbeing.  Public health, environmental health, refuse collection, leisure and recreation (re-creation), housing, social services and town planning services were all created for this purpose. In the case of mental health and the physical health of older people, which take up a sizeable part of the budget of the NHS, the importance of many of these services working together in harmony with health services to provide a whole person service cannot be underestimated.  Thus the democratisation of the NHS has to be the way forward and in doing so change the way it is organised and managed by creating district/neighbourhood multi disciplined and skilled health and care teams to work with clusters of GPs to provide an integrated service and empower staff by training everyone in quality improvement methodology. At present, circa £100bn is being spent by NHS civil servants, managers, clinicians and other professionals (represented by institutes/unions) with no accountability for their performance or the spending of public money to the local electorate. By devolving the commissioning and management of NHS services to the city/district level based upon the model used by local authorities, top health managers and clinicians would be directly appointed by elected representatives of the whole community to whom they would also be accountable for the design and delivery of services and the spending of public money.   It will also resolve the problem of whistleblowing. Whistleblowing is not a term that has been used in local government, where any attempt to suppress free speech of managers and staff (who are obliged to serve the whole council) by the political party in power would be seized upon by opposition political parties likely in the council chamber itself or through the free press.   
 
Arguably the Government/Department of Health/NHSE should concern itself only with developing overall NHS policy with regard to national health outcome standards, financial resource allocation and managing specialist services, which are not economically viable to be provided at the local level.  Otherwise, the local provision of NHS services should be delegated to the local community level, which arguably if placed under one health and care provider management umbrella would better enable the integrated management of all services related to the prevention of and recovery from ill health and the maintenance of good health and wellbeing.  It would also enable the creation of a more customer focussed service that can work in partnership with families and individuals at the district/ neighbourhood level better to identify customer need and encourage them to take more responsibility for managing their own health and wellbeing along with the development of the public services they own.   Increasingly the electorate are losing trust and confidence in the ability of national politicians and thereby national Government to manage public services to meet people’s needs. The time has now come to devolve much of the commissioning and management of the NHS to the local community level in the manner described above. In this process two birds will be killed by one stone – protection for whistleblowers and the creation of a high quality customer driven fully integrated health, wellbeing and social care service. 
 
John L Green MSc, NHS trust governor        Sir Brian Jarman, Emeritus Professor, Imperial College, London                                                                  johnlewis,green@virgin.net.                                                                                            \W&Q-4          Copyright © 2015
 

Statement – Barts and Charlotte Monroe

31 March 2015  A joint statement

Barts Health NHS Trust is pleased to confirm that it has invited Charlotte Monro to return to employment at Whipps Cross Hospital and that Charlotte has accepted the Trust’s invitation.

Charlotte will be returning in the very near future, working three days a week as a moving and handling co-ordinator, following a period of re-training.

The Trust and Charlotte have also reached confidential terms of agreement in respect of her Employment Tribunal claim. The Trust has valued the discussion of issues during the Employment Tribunal process. Charlotte deeply appreciates the thorough exploration of the issues in an objective light that the Tribunal has enabled. The Trust confirms that, as part of Charlotte’s return, it will for all purposes in the future, be removing reference from Charlotte’s employment record with the Trust, the disciplinary matters which were the subject of an internal process against Charlotte and which were then reviewed by the Employment Tribunal. This will allow Charlotte and the Trust to move forward fully, from what we acknowledge has been a difficult process for all concerned, above all for Charlotte herself.

Following the recent publication of the Care Quality Commission inspection report into Whipps Cross Hospital, an Improvement Board has been put in place to address all the concerns raised by the CQC. Charlotte Monro is an energetic and committed campaigner on patient care issues in the NHS, and the Trust welcomes the contribution which Charlotte will undoubtedly be able to make to the discussion about ensuring Whipps Cross’s future. Members of the Trust’s Executive will be meeting with Charlotte, Unison Regional Officer Derek Helyar, Chair of Staff Side at Whipps Cross, Valerie Phillips and Chair of the Staff Partnership Forum, Mireille Braid, in the near future, for an open and frank discussion about lessons to be learnt and Charlotte’s future contribution.

The Trust values Charlotte’s long professional contribution over many years to standards of patient care and to patient and staff safety.

Barts Health NHS Trust                                                            Charlotte Monro