The Times Law 17 March 2016
There needs to be an overhaul of procedures, with principles of independence, expertise and plurality enshrined in them
The heartbreaking story of Amin Abdullah, the award-winning nurse who committed suicide by setting himself on fire on February 9 this year outside Kensington Palace just days before an appeal hearing against his sacking, highlights the need for urgent reform of a flawed disciplinary system in the NHS.
Amin Abdullah was an outstanding nurse but was being disciplined for how he stood up for a colleague — he was one of 17 who signed a petition in support of the colleague when a patient complained. He also wrote a letter backing up the colleague and stating that the patient was “a professional complainer”, which was mistakenly attached to the petition.
A disciplinary process followed that proved too much for him and he developed depression and took his own life. His partner, Terry Skitmore, commented: “It’s a travesty. They are doing this to people all the time. It’s not just nurses but doctors and especially whistleblowers. I don’t want this brushed under the carpet.”
Sadly, Amin Abdullah’s case is far from an isolated incident. NHS employees are rightfully fearful of speaking out because the personal repercussions can be intense. And evidence shows that black and ethnic minority (BME) staff are more likely to report suffering detriment such as being victimised or ignored by management or colleagues , compared with their white colleagues — despite government rhetoric of a new legal regime and culture that supports openness and transparency.
Disciplinary procedures can also be used to undermine those who speak out. The February 2015 Francis Report into creating an open and honest reporting culture in the NHS, following the care scandal at Mid-Staffordshire NHS Trust, was highly critical of the “horrific” culture it found of workers’ lives being destroyed because they had spoken out for people in their care. It found even then that some were being driven to the brink of suicide. Sir Francis urged action at every level of the NHS to create a more open and honest culture.
Amin Abdullah’s tragic death a full year later shows how little things have changed. Secretary of state Jeremy Hunt’s statement in the House of Commons on March 9, 2016 — that a “culture change must also extend to trust disciplinary procedures” — in this case is sadly too little, too late.
Sir Francis heard that some disciplinary hearings are little more than one-sided kangaroo courts: “Repeatedly we hear of unaccountable managers protecting themselves and undertaking biased investigations, character assassination, lengthy suspensions, disciplinary hearings which resemble kangaroo courts, and ultimately dismissal of staff who previously had exemplary work records . . .”
Even if an employee has an exemplary record for performance or conduct, NHS employers can use the get-out clause of “some other substantial reason” if they wish to get rid of someone, claiming a breakdown in relations with other staff. Official records show that this was used more than 1,200 times by NHS employers in 2014-15.
Imperial College Healthcare, the trust that runs Charing Cross Hospital where Amin Abdullah worked, said: “We are saddened to hear of Mr Abdullah’s dealth and would like to offer our sincere condolences to his family and friends at this difficult time. The trust will engage fully with any investigations into Mr Abdullah’s death.”
There is no doubt, however, that there needs to be a major overhaul of NHS disciplinary procedures, with basic principles of independence, expertise and plurality enshrined in them. The current system results in harm to patient care, huge waste of public funds on legal and other costs; and causes suffering to dedicated NHS staff.
Dr Narinder Kapur is a visiting professor of neuropsychology at University College London. He is a past president of the British Neuropsychological Society and the former head of Neuropsychology at Addenbrooke’s Hospital, Cambridge. He has campaigned for a fairer and more open NHS and published articles on patient safety, including on lessons to be learnt from the Mid Staffs inquiry