Leading heart surgeon wins fight to work again saying she is victim of toxic hospital feud after headless doll and dead animal were sent to her home

  • Professor Marjan Jahangiri was suspended from St George’s Hospital in London
  • It was claimed she prioritised private patients and shouted at a nurse
  • The surgeon claimed she was sent a dead animal and decapitated doll in post
  • But today High Court judges lifted the suspension from hospital in Tooting

Professor Marjan Jahangiri outside the High Court                                   Professor Marjan Jahangiri outside the High Court

A failing NHS Trust that suspended one of the world’s top cardiologists has been ordered to reinstate her by a High Court judge.

Professor Marjan Jahangiri, 56, was excluded from St George’s hospital, Tooting, South London, after it was claimed she prioritised private patients over those from the NHS and had shouted at a nurse. 

The surgeon, the first female professor of cardiac surgery in Europe, claimed she was subjected to a ‘campaign of bullying and harassment’, and was sent a dead animal and a decapitated doll in the post.   

The St George’s Healthcare Trust was described as ‘toxic’ and in the grip of ‘dark forces’ in a report earlier this year. 

As a result of that report, the hospital commissioned a second review into the revelations surrounding the Trust.

Employees were warned not to speak to any witnesses involved in that investigation but the Trust claimed that Jahangiri indirectly contacted one of the witnesses through her secretary.

But today the surgeon was vindicated by Judge Matthew Nicklin, who said: ‘Overall, the decision to exclude was irrational, in the public law sense.’

He said of the surgeon: ‘She has been successful, she had been required to come to court to obtain the relief that she has obtained.

‘Whist the impact of exclusion on an individual doctor is always likely to be severe, when a skilled and respected surgeon, about whom there are no concerns as to her ability, is excluded the consequences reach far beyond the individual.’

Professor Jahangiri was excluded from St George's hospital after it was claimed she prioritised private patients over those from the NHS and had shouted at a nurse
Professor Jahangiri was excluded from St George’s hospital after it was claimed she prioritised private patients over those from the NHS and had shouted at a nurse

Speaking outside the High Court, Prof Jahangiri said: ‘I am delighted with today’s judgement and very much look forward to returning to my patients, their families, my colleagues and my trainees.

‘My priority, as it has always been, is combining excellent patient care with research and training.

‘I am devoted to the NHS.’

The professor’s barrister Iain Quirke said the decision to exclude the professor meant that patients were missing operations that could save their lives.

‘This present application is urgent because with each day that goes by, patients booked for heart surgery with the claimant are cancelled,’ he said.

Jahangiri operates around 250 cases a year at St George’s Hospital in Tooting, South London

He went on to say that Jahangiri’s skills were so specialised that she was sometimes the only surgeon able to carry out specific kinds of complex operations.

‘In some cases, the claimant is only person at the trust who is able to carry out those operations.’

Mr Quirke told the court how the average heart surgeon in the UK has a mortality rate of 7-15%. Professor Jahangiri’s rate is 1.2%.

‘Despite that, she has been treated in the most outrageous way,’ he added, ‘She is the envy of the unit.

Professor Marjan Jahangiri was the first female professor of cardiac surgery in Europe


‘I really do believe that this hospital is in deep trouble and that’s partly because the management want to get rid of the professor.’

Mr Quirke went on to say that 14 different complaints had been made against Jahangiri because she had acted as a whistleblower in the past.

‘The basis that the claimant has been excluded on is the thinnest of grounds. The defence case it totally, totally hopeless and outrageous.

‘The unit is dismantling her research by reallocating it to others in the department – that is a drastic measure.

‘The continued exclusion is in breach of the defendants own policy. There must be a reasonable and proper reason to exclude – my Lord, there is not.

‘The trust is in special measures. She is an exceptional surgeon and in internationally recognised.’

He told the court that Jahangiri is the only female professor in cardiac surgery in Europe.

Mr Quirke went on to claim that her students at the hospital have threatened to leave if she doesn’t return to work.

He said that of the accusations levied against his client, ‘they are outrageous, they are scurrilous and they are made for malicious reasons,’ calling them a, ‘character assassination.’

Mr Quirke said that the delicacy involved in heart surgery required constant use of her skills and that her exclusion meant that she would be unable to practice the extremely complex operations needed to save lives.

The trust’s lawyer, Simon Cheetham QC said: ‘There is no suggestion that anyone is saying she is the source of [the trust’s] problems.

‘These are decisions that, whether they are right or wrong, were made in good faith.

‘It was necessary to suspend her because if that was the claimant’s behaviour, then it would have been bound to have had an impact on the report.’

Professor Marjan Jahangiri denied that she prioritised a private client over NHS patients as well as shouting at a nurse.

She also denied that her indirect interaction with the report witness required her suspension.

Judge Nicklin ordered that the suspension of Professor Jahangiri by the St George’s NHS Trust be overturned.

Speaking outside the court Jahangiri’s solicitor Katy Colton said the professor’s legal fight would continue.

‘Ultimately we are looking for a statement from the court saying this was a breach of contract,’ she said

The professor now wants a full judgement from the court stating that the professor had been treated unfairly by the hospital trust. 

Jacqueline Totterdell, chief executive at St George’s University Hospitals NHS Foundation Trust, said she was disappointed by the outcome.

She added: ‘We are disappointed by the judgment issued today, but understand and respect it. We welcome that this ruling is not about guilt or exoneration, and the judge made no finding on the facts being investigated.

‘He has said that the exclusion process was not appropriate, but has allowed the trust to continue its investigation into very serious issues raised.’ 

Trailblazing heart surgeon was sent a DEAD ANIMAL and a headless doll in the post after she raised safety concerns during toxic feud at London hospital

  • Marjan Jahangiri was the first female professor of cardiac surgery in Europe 
  • Jahangiri was one of two surgeons excluded after a report found a ‘toxic feud’
  • In April a dead animal and a decapitated doll was sent anonymously to her home

A leading heart surgeon was sent a dead animal and a decapitated doll in the post as part of a ‘toxic feud’ after she blew the whistle over unsafe care.

Marjan Jahangiri, the first female professor of cardiac surgery in Europe, claimed she had been targeted because of ‘envy at her success’.

The surgeon, who operates on more than 250 cases a year at St George’s Hospital in Tooting, South London, said a ‘witch hunt’ had led to her suspension from her post.

Professor Marjan Jahangiri was the first female professor of cardiac surgery in EuropeProfessor Marjan Jahangiri was the first female professor of cardiac surgery in Europe

Professor Jahangiri was one of two surgeons excluded earlier this month after an internal report found a ‘toxic feud’ between two rival camps of surgeons had resulted in patient deaths.

The professor claimed the hospital was ‘an environment that appeared to be more interested in cover-ups and petty vendettas than patient welfare’.

Yesterday she asked the High Court for an order to lift her exclusion from St George’s University Hospitals NHS Foundation Trust with immediate effect.

Her counsel, Iain Quirk, said that despite being an extremely skilled surgeon, Professor Jahangiri had been treated in the ‘most outrageous’ way and targeted because of the ‘envy at her success’.

He told Mr Justice Nicklin she was excluded earlier this month on ‘the thinnest of grounds’ against the background of the Bewick report, an investigation into patient safety at the hospital.

There were claims of a ‘dark force’ in the troubled heart unit, the court heard. But Mr Quirk cited 14 complaints which had all been dismissed and alleged they were ‘motivated by those who are seeking to harm her reputation and standing, not least because she made whistleblowing disclosures’.

Jahangiri operates around 250 cases a year at St George’s Hospital in Tooting, South LondonJahangiri operates around 250 cases a year at St George’s Hospital in Tooting, South London

In April a package containing a dead animal and a decapitated doll was sent anonymously to Professor Jahangiri’s home address, The Times reported. ‘This was incredibly distressing for me and my family and I still feel traumatised whenever I receive a package,’ the professor said.

It came after she had expressed concern over the competence of her colleagues and added that the ‘vicious behaviour towards me was in retaliation for my actions’.

Mr Quirk said: ‘The inescapable conclusion is that this is a witch hunt – an attempt to pin the blame for the department on her.’

He added that Professor Jahangiri’s trainees – who said they would leave if she was not reinstated – were not being trained properly, the unit was dismantling her research and operations had been cancelled without patients being given a reason. Professor Jahangiri’s practice and reputation had been seriously harmed, the court was told.

‘Exclusion is the worst thing that can happen to a doctor, and for one of the country’s leading professors in cardiac surgery it is disastrous,’ added Mr Quirk.

Professor Marjan Jahangiri’s trainees said they would leave if she was not reinstatedProfessor Marjan Jahangiri’s trainees said they would leave if she was not reinstated

Just two weeks away is enough to allow those complex skills to lapse, which is why she has never had more than two weeks off. Her practice has been decimated.’

Simon Cheetham QC, for the NHS Trust, acknowledged Professor Jahangiri’s clinical skills and what she had contributed in the way of research and training, and said there was no ‘vendetta’ against her. The much bigger issue was the state of the cardiac unit which had a knock-on effect on the Trust’s future as a major trauma centre.

The Bewick report had identified a unit ‘in crisis’ at St George’s but no-one was saying Professor Jahangiri was the source of the problems, he told the judge.

Her exclusion arose from an allegation that she impeded the conduct of a Trust-commissioned review by contacting a witness. 

‘We say it was necessary because, if that was the claimant’s behaviour, it was bound to have an impact on the review being carried out,’ said Mr Cheetham. 

It was necessary, he added, that the review was completed quickly and efficiently and maintained its integrity. The judge is to give his decision on Tuesday.


After scandal of Gosport…time to act to protect whistleblowers

Express 24 June 2018


THE UK’S leading hospital safety expert has written to the head of NHS England demanding better protection for whistleblowers amid the Gosport scandal.

jane barton

Solent News & Photo Agency

Dr Jane Barton is believed to be on holiday in Mallorca

Professor Sir Brian Jarman, director of the Dr Foster Unit at Imperial College, London, which analyses excess patient deaths, said whistleblowers’ concerns must be overseen by an independent body as part of “radical changes” to improve patient safety.

He composed his letter in the wake of a government report into Gosport War Memorial Hospital, which found 456 elderly people died there in a 12-year period after being given lifeshortening opioid drugs.

The families of those who died campaigned for years to lift the lid on the scandal, for which both the Government and the NHS have apologised.

The report found GP Dr Jane Barton, who worked at the Hampshire hospital as a clinical assistant, routinely over-prescribed drugs during the 1990s, but nothing was done despite warnings by hospital staff.

And Prof Jarman’s call was echoed by a former head of the trust which investigated the Gosport deaths, who claimed parts of the NHS were operating as a “totalitarian state”.

Prof Jarman, a former president of the British Medical Association, said new powers were needed to “guarantee whistleblowers are not penalised for reporting problems or abuses” and “any NHS manager who disadvantaged a whistleblower’s career should be fired on the spot”.

He said all whistleblowers – currently overseen by the NHS-run Care Quality Commission – should instead report to a separate independent body, adding: “The NHS should not be in charge of investigating its own problems because of the risk of bias. It must be seen to be independent.”

Prof Jarman, whose group uses NHS data to make the health service safer, said the scandal surrounding Gosport could be mirrored elsewhere in the country because whistleblowers are still blacklisted for raising the alarm.

gosport hospitalPA

The families of those who died campaigned for years to lift the lid on the scandal

‘At the moment whistleblowers are fired, gagged and blacklisted’

Brian Jarman

He said: “At the moment whistleblowers are fired, gagged and blacklisted. I fear similar abuses could be going on elsewhere and at the moment we cannot be sure they are not.”

His letter, which has been passed to the Sunday Express, states: “In the light of the Gosport Memorial Hospital report, I am writing to you regarding the large numbers of deaths in that hospital and the need to exclude the possibility that a similar situation is not occurring in other English hospitals. Many patients, bereaved relatives and whistleblowers are deeply frustrated that disclosures to the CQC have not resulted in change.

“On the contrary, if NHS staff whistleblow they may still be fired, gagged and blacklisted. A truly independent of the NHS investigation facility for learning from serious failures is needed. Radical changes are needed if NHS safety is to improve.”

His comments have been echoed by a former governor of the trust which investigated the Gosport death scandal, who said last night the NHS was operating as a “totalitarian state”, with whistleblowers routinely suppressed amid a climate of fear.

John Green told the Sunday Express patients would continue to die needlessly under defective systems and a “form of anarchy” over consultants’ clinical practice and responsibility.

He said: “The NHS is like a Stalinist dictatorship where families, relatives and clinicians have no say in an institution motivated by a drive to save money under incompetent management.


Relatives of Gosport patients demonstrate outside the General Medical Council in London

“The system is seriously broken and people are dying like faulty products off a production line.”

Mr Green, an ex-public governor of Southern Health NHS Foundation Trust, which took over responsibility for Gosport War Memorial Hospital, added: “Most people who work in the NHS are dedicated and caring, but because they work in such a dysfunctional management system, it is a shambles.”

Mr Green, who joined the board of Southern Health in 2012, long after the deaths but before the inquiry, resigned “in disgust” in 2016, angry at how the NHS was being run.

He is now part of a new drive to improve the reconstituted Southern’s performance and has sent a list of 17 potential NHS reforms to Health Secretary Jeremy Hunt and all MPs.

“We have to get this right,” Mr Green said.

“But the only people who are going to be able to create change are the public by demanding better standards and breaking up this totalitarian state.

“Southern are now involving customers at board level and in the design of services and that is the only way unnecessary deaths can be eliminated.”

Mr Hunt says tougher checks mean a repeat of Gosport is unlikely and Dr Henrietta Hughes, the NHS national guardian – a post that promotes a more open culture – said more than 6,700 cases were raised to keep patients safe and support staff over the last year.

Disgraced former NHS boss Sir David Nicholson who retired on a £1.9million pension pot RETURNS to a health service job four years after quitting

Danyal Hussain For Mailonline   13 May 2018

  • Sir David Nicholson blamed for an NHS scandal which saw 1,400 patients die 
  • The scandal took place while he was head of West Midlands Health Authority
  • In his new role he is the part-time chair of the failing Worcestershire NHS Trust

A controversial former head of the NHS has returned to a health service job just four years after quitting in disgrace.

Sir David Nicholson, 63, was held responsible for not taking action over the Mid Staffordshire hospital scandal where 1,400 patients died – while he was head of the West Midlands Health Authority.

Sir Nicholson was dubbed the ‘man with no shame’ by protesters, over his refusal to take responsibility for various NHS scandals, especially the neglect of patients at Mid Staffordshire NHS trust.

Sir David Nicholson, pictured, was the head of the West Midlands Health Authority during the Mid Staffordshire hospital scandal


Sir David Nicholson, pictured, was the head of the West Midlands Health Authority during the Mid Staffordshire hospital scandal

He reportedly ignored warnings that patients were dying due to poor care at his former trust.

Nicholson, who earned £290,000 a year and left with a £2 million pension pot, has been advising private sector companies since retiring.

In his new role, he will get £40,000 a year as part-time chair of the failing Worcestershire NHS Trust, which has been placed in special measures by the Care Quality Commission. 

His second wife, 20 years his junior, was one of his former trainees and is now chief executive at Birmingham Children’s Hospital.

Before retiring, Nicholson was also criticised over a £50,000-a-year expenses bill that included first class travel and the use of luxury hotels. 

His new appointment has been slammed by those who called for him to quit as an NHS chief executive.

Julie Bailey, who lost her mum at Mid Staffs and exposed the scandal, said last night that she was ‘appalled’ by Nicholson’s appointment.

‘This man ignored the concerns that were raised about Mid Staffs and refused to meet the families of those who had died or been harmed by dreadful care. He will be good at balancing the books but will do nothing for patient safety.

The Mid Staffordshire hospital scandal saw 1,400 patients die with protesters blaming Nicholson for the disaster


The Mid Staffordshire hospital scandal saw 1,400 patients die with protesters blaming Nicholson for the disaster

Miss Bailey, who headed up the campaign Cure the NHS, added: ‘He left the NHS because of the shocking state it was in and now they are bringing him back

‘The chairman of NHS improvement recently talked about having a ‘morale compass’ over appointments and investigating managers who have done wrong. Now her organisation is bringing back the man who failed hundreds of patients.’

NHS safety campaigner Fiona Bell, who met Nicholson and challenged him over patient deaths at other trusts said: ‘Sir David was at the heart of the culture at Mid Staffs. As usual, the NHS recycle leaders that have failed patients and staff in hope that the public has forgotten past mistakes. 

‘It beggars belief that some with such a disastrous track record is brought in turn around a trust that faces so many challenges.’

Gary Walker, former chief executive of United Lincolnshire NHS Trust, warned Nicholson that lives had been put at risk by unreasonable demands to meet targets, and said his concerns had been ignored by Nicholson.

NHS Improvement chief executive Ian Dalton – who gave Nicholson the job- acknowledged the Worcester trust ‘still faces many challenges’.

Julie Bailey (pictured) lost her mother in the scandal and has slammed Nicholson's new appointment


Julie Bailey (pictured) lost her mother in the scandal and has slammed Nicholson’s new appointment

Defending the appointment he said: ‘David brings huge expertise at both national and regional level. I know he is absolutely focused on improving patient care, and looking forward to getting underneath some of the difficult issues to see what positive changes can be brought about.

‘Making sustainable quality improvements and getting the trust on to a stronger financial footing will be priorities, working closely with the chief executive and wider leadership team.’

While there were some signs of improvement in accident and emergency performance this winter, the trust was still among the worst performers for ambulance delays.

Trust chief executive Michelle McKay said Nicholson’s ‘knowledge and understanding of the challenges we face in this trust and across the wider health and care system will, I am sure, be enormously helpful to our efforts to secure safe, high quality hospital services for the people of Worcestershire, as well as the work we are doing to move to a position of sustainable financial balance’. 


Disgraced NHS boss who retired on £1.9million pension pot four years ago RE-HIRED

Sir David Nicholson left after being held responsible for failing to act over the Mid Staffs scandal

Mirror     Martyn Hall   12 MAY 2018

Chief Executive of the NHS Sir David Nicholson

Sir David Nicholson was in charge of West Midlands Health Authority

A disgraced NHS boss who retired on a £1.9million pension pot four years ago has been re-hired.

Sir David Nicholson left after being held responsible for failing to act over the Mid Staffs scandal where 1,400 lost their lives.

He was in charge of West Midlands Health Authority at the time of the deaths, before leading NHS England.

He will now trouser £40,000 a year as part-time chair of the ­failing Worcester NHS Trust.

NHS Improvement chief executive Ian Dalton said he “brings huge expertise” and is “focused on improving patient care”.

David Nicholson

Mr Nicholson will now trouser £40,000 a year 


But campaigner Julie Bailey, whose mum died at Mid Staffs, is “appalled”.

She said: “The chairman of NHS Improvement recently talked of having a ‘moral compass’ over appointments and investigating managers who have done wrong.


“Now the organisation is bringing back the man who failed hundreds.”

NHS surgeon accused of racism and ‘forced out of job’ after raising concerns about three Asian colleagues

The Telegraph 19 April 2018      

Dr Peter Duffy outside his industrial tribunal in Manchester  

Dr Peter Duffy outside his industrial tribunal in Manchester  CREDIT:  CAVENDISH PRESS/RICKY CHAMPAGNE


An NHS surgeon voted Doctor of the Year was forced to resign after being accused of racism for raising concerns about the abilities of three Asian colleagues, a tribunal has heard.

Peter Duffy, 56, reported one Indian doctor for missing “several” cancers, playing a round of golf when he had been called to treat a patient and being unable to use an ultra sound machine.

The married father-of-three also claimed that two other doctors, from India and Pakistan, had bungled operations, tried to “suppress discussion” over the avoidable death of a man who had had sepsis and were involved in possible overtime fraud.

But Mr Duffy, a consultant urologist, said he was subjected to “malicious, toxic and utterly false” allegations over a ten year period working at Royal Lancaster Infirmary (RLI) and was warned to “watch his back” over his whistleblowing.

It was claimed that one of the doctors vowed he would be “taught a lesson,” while another was said to be “spitting blood” after being suspended.

He claims he was “brutally driven out” by colleagues intent on revenge.

Peter Duffy claims he was forced to quit his job at the RLI 

Peter Duffy claims he was forced to quit his job at the RLI  CREDIT:  CAVENDISH PRESS/MIKE SWARBRICK


In 2015, Mr Duffy transferred to Furness General Hospital, Barrow, where he was voted “Doctor of the Year by patients and colleagues at Morecambe Bay Hospitals NHS Trust.


He was said to have streamlined the care of urology patients and reduced waiting lists to a level that had “not been seen for a considerable time prior to his arrival”.

He was also praised for treating all members of the team equally, “getting stuck in, even mopping the floor between theatre cases.”

But that year, consultant Saleem Nassem, one of the RLI doctors he had complained about, was appointed co-clinical lead for the trust’s urology department.

He claimed that one colleague told him: “You’ve made enemies here. They’ve got the means, the motive and now the opportunity to finally get shot of you.”

Mr Duffy resigned in 2016 complaining that his pay had been cut amid unproven allegations about his own overtime hours.

He is claiming constructive dismissal, alleging he was the victim of a “witch hunt.” He said on his last day senior managers “treated him like he’d got the Ebola virus.”

In a statement given to the Manchester industrial tribunal, Mr Duffy, from Lancaster, said he had been the victim of a “sustained campaign of victimisation, vilification and disinformation.”

“I firmly believe and was warned by colleagues that the campaign waged against me was one of retaliation for my protected disclosures,” he added.


“I was clearly threatened, abused, victimised and briefed against by those individuals who did not share my belief in a high quality clinical service in the best traditions of the NHS and who clearly felt threatened by my protected disclosures.”

Peter Duffy receives his Doctor of the Year' award

Peter Duffy receives his Doctor of the Year’ award CREDIT: CAVENDISH PRESS 


Mr Duffy said that since his “forced resignation” he had discovered that anonymous allegations were made to police suggesting he was a racist bully and that all ethnic minority doctors at the hospital were “in fear of him,” it was said.

A secret meeting was also allegedly held without Mr Duffy’s knowledge in which he was accused of racism by the three consultants, Kavinda Madhra, Ashutush Jain and Saleem Nassem. None of the claims were substantiated.

He added in his statement: “It is difficult to overstate the sheer toxicity of these utterly false allegations. I was warned in my first few months in the Trust that I must at all costs avoid an allegation of racism against me.

“I was told that such allegations, even if entirely unwarranted can destroy careers and that the NHS tended to regard racism allegations as “guilty until proven guilty”.

The urologist, who now works for a hospital on the Isle of Mann, said he had been left “extremely traumatised” by his treatment and felt unable to work for the NHS again.


The hearing continues.

‘Common people’ – play on whistleblowing


First time in history, a play was performed covering stories of whistleblowers with audience participation in order to educate and  raise awareness.

They were represented from UK, Italy and Romania

The play covered stories of 7 whistleblowers:

Ciro Rinaldi, Ornella Piredda – from Italy

Eileen Chubb, Sharmila Chowdhury and Ian Foxley – from England

Liviu Costache, Alin Goga and Glaudiu Tutulan – from Romania

The play was held at National Radu Stanca theatre in Sibiu,  titled, ‘Oameni Obisnuiti’, which translated means ‘common people’, because the play was about ordinary people who had decided to speak up and as a result faced detriment.

Sibiu is one of the most important cultural centres of Romania and was designated the European Capital of Culture for the year 2007, along with the city of Luxembourg. Formerly the centre of the Transylvanian Saxons, the old city of Sibiu was ranked as “Europe’s…

View original post 742 more words

Dentist May Hendry who sued NHS Ayrshire and won faces huge legal bill despite damning findings against executives

The Herald 24 March 2018

Exclusive by Helen McArdle Health Correspondent

May Hendry, a dentist based in Troon, won her employment tribunal against NHS Ayrshire and Arran (Pic: Colin Mearns)May Hendry, a dentist based in Troon, won her employment tribunal against NHS Ayrshire and Arran (Pic: Colin Mearns)

A RESPECTED dentist who successfully sued her health board after she was victimised for exposing misconduct has revealed that her legal costs outweigh her compensation despite a damning judgement against the NHS.

Dr May Hendry and her solicitor, Stephen Miller, said the case underlines how difficult it is for ordinary members of the public to pursue legal action against the “unlimited budgets” of the NHS.

Analysis: Case that exposed dysfunction riddling NHS management culture

Dr Hendry, 57, was vindicated at an employment tribunal against NHS Ayrshire and Arran in 2017 in a determination that condemned senior executives for trying to cover up wrongdoing.

Dr Hendry was awarded £80,000 damages for constructive dismissal but this will be slashed after tax, and she also incurred £85,000 in legal costs and expenses.

Whereas successful claimants in negligence cases are entitled to have their legal costs reimbursed this does not apply to employment tribunals, posing a major obstacle to staff who may wish to raise grievances for workplace bullying or harassment.

Although Dr Hendry, a part-time dentist in Troon, will have some her legal fees covered by insurance, she is still liable for much of it personally. Many NHS staff will have no insurance at all.

Read more: Dental firm suspected of misclaiming up to £300,000 avoided fraud probe on instructions of senior NHS executive

Mr Miller, a specialist employment lawyer at Clyde & Co, said NHS A&A had also wasted around £90,000 of taxpayers’ money on a case they were certain to lose.

He said: “The evidence against them was overwhelming, but the board were able to pursue a case knowing that the worst they could lose was £70-80,000 and even if the case took twice as long they wouldn’t have to pay May’s costs.

“So there is a definite point that goes well beyond May’s situation, which is that one of the dangers is that even if you win hands down you could end up having to nurse your own legal expenses.

Update on my case with HCA International

The HCA Hospitals lawyers have asked me to clarify certain matters.

This I am happy to do, just in case it was not obvious before.

The facts that I complain about occurred before I was made redundant and was frog marched out of the hospital.

For obvious reasons, because I am no longer working there, I cannot say whether or not those practices continue to this day.

Therefore when I say “serious ongoing patient safety concerns” I meant and mean ongoing up until the time that I left. I hope this clarifies matters.


Additionally the HCA lawyers have asked me to give reasons why I honestly believe what I said on  my Crowd Justice page.

I said:

‘My direct line manager being connected to my previous whistleblowing on fraud.’

The facts:

My line manager at Princess Grace was previously employed at Ealing Hospital where I had reported NHS fraud. My line manager at Princess Grace took over the post of my then line manager at Ealing to whom I had reported fraudulent concerns. In other words, they swapped places. I had been adviced by my line manager at Princess Grace, that they remain in regular contact.

I said:

‘During my work at Princess Grace I believe I was victimised for attending my ongoing life-saving treatment for cancer.’

The facts:

I have had breast cancer since 2013. I was advised by my Oncologist to attend for treatment every three weeks. As a result, I attended and still attend every three weeks.

At first, my line manager didn’t say anything to me about these treatments but simply sent me an email stating that the treatment days for cancer treatment, would need to be taken as ‘sick leave’ and that I would not be paid once the number of days reaches a maximum amount of sick leave, i.e. 10 days. I complained about this instruction to a Human Resources advisor. She agreed that this should not have happened.

However, my manager did not stop. Afterwards, I was advised by him  that my treatment days come round “too frequently”. I felt that he was suggesting that I somehow had control over my illness and the frequency of treatment. I am advised that he should have known better than to do this as it is an example of him directly victimising me for having cancer.

I said:

‘I also believe I was put through sham performance management’.

The facts:

Following upon my approach to HR for help with discrimination from my line manager, I was advised by my line manager (the same one who discriminated against me)  that I would face a performance review. This was despite having good appraisals and turning the radiology department from ‘red’ to ‘green’ following a Care Quality Commission inspection.

I honestly believe that the performance management was a sham for the following reasons. My manager listed a long list of performance criteria that he felt that I had failed. Unbeknown to him I had already completed all of them and advised him and HR. A few days later he produced a second set of performance criteria. Again, these too were virtually all completed. I had spoken to the President of Operations for HCA regarding these performances. He advised that he had good reports about me from the previous CEO and I had managed to turn the department around. Therefore I should not be going through a performance review. The performance review was eventually stopped by HCA’s own legal team.

I said:

‘CQC in their recent inspection of Princess Grace issued an improvement notice for safety and being well led.’

The facts:

This can be viewed on CQC’s website as it’s in public domain. CLICK HERE TO VIEW REPORT

It is for these reasons that I believe that the statements I have made on my Crowd Justice page would be the same opinions as an honest 3rd person.

NHS whistleblowers will get compensation if blacklisted by health service

The Telegraph 20 March 2017

A doctor holding a stethoscope 

Staff who blow the whistle will get more protection to ensure they are not victimised for disclosing bad practice  CREDIT: PA

NHS whistleblowers will be entitled to compensation if they are stopped from getting new jobs in the health service because of their disclosures, the government will announce today.

Last year a Telegraph investigation found that those who won tribunals after blowing the whistle were being effectively blacklisted from future jobs in the NHS because staff records wrongly said they had been dismissed.

Whistleblowers also claim they have been barred from positions, despite being fully qualified, because they are viewed as troublemakers.

But under new proposals announced on Monday jobseekers who believe they are suffering such discrimination can take NHS bodies to tribunal, even before they have worked for trusts. If upheld, they will be entitled to compensation.


Jeremy Hunt will announce that whistleblowers can take the NHS to tribunal if they are denied work

Jeremy Hunt will announce that whistleblowers can take the NHS to tribunal if they are denied workCREDIT: PA


Jeremy Hunt, the Health Secretary, said: “Today we move another step closer to creating a culture of openness in the NHS, where people who have the courage to speak up about patient safety concerns are listened to, not vilified.

“These welcome changes will prohibit whistleblowers being discriminated against when they seek re-employment in the NHS, ultimately ensuring staff feel they are protected with the law on their side.”.

Last year Sir Robert Francis published a review which found a number of people struggled to find employment in the NHS after making disclosures about patient safety.

Sir Robert warned of a culture of ‘fear, bullying and ostracisation’ within the NHS that punished doctors and nurses who exposed failings.

He said whistleblowers were derided as ‘snitches, troublemakers and backstabbers’.

 Jennie Fecitt at home in Cheshire,Jennie Fecitt at home in Cheshire CREDIT: JON SUPER, TELEGRAPH


Last year a former NHS human resources director told The Telegraph that staff records were being used to blacklist whistleblowers.

She said that anyone whose record states they have been dismissed from a previous role “would find it very hard to get work”.

Jennie Fecitt, who was dismissed from her post as a senior nurse at a walk-in centre in 2010, after raising concerns about a nurse who had lied about his qualifications.

Ms Fecitt went on to win an unfair dismissal case against NHS Manchester, which found she had been bullied and victimised by her colleagues.

But she later discovered that her employment record continued to state her reason for leaving as “Dismissal – Some Other Substantial Reason”.

Ms Fecitt, who went on to become the director of the whistleblowing organisation Patients First, said that many of her 200 members have reported problems with their staff records, and believe these are preventing them from finding work in the NHS.

The announcement comes ahead of a speech by Mr Hunt at the Learning from Deaths conference which is bringing together senior NHS leaders to find better ways to investigate complaints and learn from the death of patients.

A consultation on the new proposals is now open and will run for eight weeks, closing on 12th May 2017.


Ex-teacher sues for £700k after headmistress bullying ordeal

Evening Standard   9 March 2018      ANNA DAVIS 

Quit profession: Caroline Hadley told the court  that “teaching was my life”Quit profession: Caroline Hadley told the court that “teaching was my life” NEV AYLING

A former teacher who endured years of bullying by her headmistress is suing for £700,000 in damages

Caroline Hadley, 40, was the assistant headteacher of Gearies Primary School, Ilford, working under Anupe Hanch. 

Ms Hadley’s barrister Andrew Buchan said she was “exposed to a hostile working environment” over a four-year period and bullied between June 2010 and July 2012. She became “a direct target” after successfully steering the school through an Ofsted inspection, Central London county court heard. 


Mrs Hanch “undermined her career” by branding her a “rogue member of staff”, Mr Buchan claimed. She told the school finance officer that Ms Hadley “could not be trusted”, spread gossip about her and asked the caretaker to lie about her behaviour, the court heard. 

Mrs Hanch was eventually suspended and in May 2015 was found guilty of unacceptable professional conduct by the National College for Teaching and Leadership, said Mr Buchan. The panel found she said she would like to “chop off” a colleague’s head and once locked a teacher in an office for three hours. 

She was dismissed and, in June 2015, barred from teaching for life by the Government. Ms Hadley became head of a primary school in Camden but suffered depression and quit the profession, the court heard. 


She returned to her native Lancashire, where she cares for her mother. She is now suing the borough of Redbridge, which runs Gearies Primary School, over the bullying and harassment. The council has admitted breach of duty but is disputing the amount of compensation due to her.

Visibly upset in court, Ms Hadley said: “Teaching was my life… I tried going back several times and fought so hard for my career. But desire doesn’t have anything to do with it — there’s no way I could ever go back to teaching now.”

However after hearing all the evidence over two days, Judge Heather Baucher highlighted problems in the preparation of the case and directed a re-hearing of the claim.

She told Miss Hadley: “It’s not a decision which a trial judge takes lightly.  I know it’s very distressing for you, but it’s the right way forward.” 

The case is expected to return to court in September.

Mrs Hanch, 53, had no part in the case and was neither present nor legally represented in court.  

Healthcare company misled regulator about pensions

FT Aadvisor 8 March 2018

Healthcare company misled regulator about pensions

A healthcare company and its managing director have been found guilty of misleading The Pensions Regulator (TPR) about providing their staff with a workplace pension.

Birmingham-based Crest Healthcare and managing director Sheila Aluko admitted recklessly providing false or misleading information to the regulator and wilfully failing to comply with their automatic enrolment duties before Brighton Magistrates’ Court yesterday (7 March).

Ms Aluko had lied to The Pensions Regulator in March 2016 about informing and enrolling 25 staff into a workplace pension scheme.

But in reality, the court heard, the employer had not written to or enrolled any staff, it had not even fully set up a pension scheme and no pension contributions were paid.

What is more, Crest began deducting pension contributions from the wages of some workers but kept them in the company’s bank account and did not pay them into a pension scheme for more than eight months, the court heard.

It was only after a whistleblower raised the alarm that the pension scheme was set up and the contributions were paid in.

This was the first time the The Pensions Regulator has prosecuted an employer for knowingly providing false information in relation to auto-enrolment.

Darren Ryder, The Pensions Regulator’s director of automatic enrolment, said: “Sheila Aluko tried to conceal her company’s non-compliance by hiding behind false information and misleading her staff that their pensions were up and running.

“It was only after we intervened that the employer finally complied with its duties and provided its staff with the workplace pensions they were entitled to.”

He said the case should send a “clear message that it is unacceptable to dodge your pension responsibilities” and that further action would be taken against anyone failing in their duties.

Crest Healthcare and Aluko each pleaded guilty to one charge of knowingly or recklessly providing false or misleading information to the regulator and two charges of wilfully failing to comply with their automatic enrolment duties.

Both charges carry a maximum sentence in a magistrates’ court of an unlimited fine.

If tried in a Crown Court the maximum sentence for each offence would have been two years’ imprisonment.

The case was adjourned for sentencing until 15 May.



In her shoes – fighting cancer, fight for justice and fighting to keep a home

Please reblog #blogger


By Fiona Bell

I met Sharmila back in 2014, another campaigner. Sharmila emailed me. She was fighting for justice for herself and for other whistleblowers, desperate for a meeting with Jeremy Hunt. Many had been campaigning for such a meeting for a long time.  
It was a case of how do we get Mr. Hunt’s attention. I had an idea, so I advised, write him an email and copy in the press ( I forwarded her my treasured contact list of journalists ).
My advice was specific, email all copy in my journo’s contact list but do not blind copy.  I knew it would go one way or the other and it could cause a bit of a stir down at DH Press office.  Within 24 hours we had an offer of a meeting with Jeremy Hunt along with Simon Stevens CEO of NHS England. 
Here’s the link to the…

View original post 596 more words

In her shoes – fighting cancer, fight for justice and fighting to keep a home

By Fiona Bell

I met Sharmila back in 2014, another campaigner. Sharmila emailed me. She was fighting for justice for herself and for other whistleblowers, desperate for a meeting with Jeremy Hunt. Many had been campaigning for such a meeting for a long time.  
It was a case of how do we get Mr. Hunt’s attention. I had an idea, so I advised, write him an email and copy in the press ( I forwarded her my treasured contact list of journalists ).
My advice was specific, email all copy in my journo’s contact list but do not blind copy.  I knew it would go one way or the other and it could cause a bit of a stir down at DH Press office.  Within 24 hours we had an offer of a meeting with Jeremy Hunt along with Simon Stevens CEO of NHS England. 
Here’s the link to the TV coverage, the day I met Sharmila. A lovely warm person, struggling to survive, regular cancer treatment meant, she had to wear a wig. A person passing Sharmila in the street would never guess this is a lady fighting cancer
Along with 5 other whistleblowers, we entered Whitehall for our meeting with Jeremy Hunt.

He listened along with Simon Stevens. From that meeting we got Freedom to Speak up, FTSU.  Despite the publication of FTSU, there’s little that has changed. Our greatest fear was that after FTSU, NHS staff would think it safe to speak up and we would get a new batch of whistleblowers. That has happened, just take a look at Twitter – the Whistleblowing community has grown in both public & private sector.  Our job is not finished. 
So many whistleblowers are still gagged, still fighting and simply left on the bones of their backsides. 
Sharmila has never stopped fighting for others and for herself. Her NHS case was in my opinion unsatisfactory in regard to settlement, so much so the legal team that represented her are now finally being legally challenged. It’s our belief they did not settle in the best interests of their client. 
In addition to NHS whistleblowing a warning re the private sector. In April 2016 Sharmila was offered a post at HCA . It seemed like a blessing,  a chance to work again.  It’s believed HCA would have been aware of Sharmila’s NHS whistleblowing and her ongoing fight with cancer.  In 2017 that blessing turned into a nightmare. Sharmila once again found herself speaking up.
Speaking up in the private sector is just as tricky as speaking up in the NHS, Sharmila is facing a David and Goliath moment in whistleblowing, HCA has tooled themselves up with 3 legal firms for one whistleblower, Sharmila is fighting on all corners. From an outsider looking in, it looks like HCA have commissioned legalised bullying of a whistleblower. 
An organisation that claims “From the moment you choose one of our award-winning facilities, we’re here by your side. You can depend on us for round-the-clock care and the skills and compassion” 
From the outside, in my opinion, it doesn’t look like there is much compassion or support for a whistleblower with a life-threatening illness. 
The case overview can be found here  https://www.crowdjustice.com/case/nhs-whistleblower/  
So as a friend of many whistleblowers, bereaved families and fellow campaigners, I ask all of you to stop and think, your fighting for you’re life, you’re forced to fight for justice, to keep a roof over your head, what would you do in her shoes? 
All we have is a chance via Crowd Justice, HCA appears to be throwing the book at Sharmila. Unfortunately, the fight ahead will be costly. So if you have a spare pound please chip in. I look at things in a simplistic way – we need 40,000 one pound coins, so if you all share and tweet the crowdfunding page. Any journalists please share around your offices, publicity is welcome but more than anything we need donations.  £40,000 one pound coins …..
So many obstacles ahead, they can be overcome with help.  Sat in the Embankment cafe a few years ago, waiting for a quietly rushed meeting with one of Sir Robert Francis’s FTSU team, we were discussing, had the stress of whistleblowing contributed to the Cancer, Sharmila said to me, “I believe it has. Though treatments are tough, I’m not afraid of death. I can face that. I would just like to die in my own home “

Liverpool NHS scandal shows how culture of denial harms patients

The Guardian   

If staff do not feel able to speak out about their concerns, something is rotten at an organisation’s coreView more sharing options

 ‘Staff tried to keep services going but morale collapsed and sickness absence rose.’ Photograph: Christopher Furlong/Getty Images

The two most shocking revelations to emerge from the investigation into Liverpool community health NHS trust are that every part of the system failed, and it happened even as the trust was considering what it should learn from the Mid Staffordshire scandal.

The independent review by Dr Bill Kirkup into events at the trust between 2010 and 2014 shows the root cause of the trust’s problems was an inexperienced and bullying leadership obsessed with achieving foundation trust status, irrespective of the effect on patients. This toxic culture seeped into every part of the organisation, breaking the morale of frontline staff and inflicting serious clinical harm.

Those brave enough to raise concerns risked bullying, harassment and suspension.

It was a dysfunctional organisation from the moment it was created in 2010 with an inexperienced and inadequate management team. Two clinical commissioning groups and NHS England pushed it to achieve significant savings, which had a serious cumulative impact, but the trust made matters far worse with self-imposed cost cuts in pursuit of its managers’ dream of foundation status.

Kirkup points out that achieving annual cost improvements of 4% is the outer limit of what can reasonably be achieved; Liverpool tried to deliver a 15% cut in one year, apparently oblivious to the risks.

Governance was a mess. At times the finance director was responsible for clinical quality and the nurse director was the chief operating officer, so no one was championing patient care.

Staff tried to keep services going but morale collapsed and sickness absence rose. Pressure sores, falls and extractions of the wrong teeth were among the consequences. Reporting of serious incidents was discouraged. Middle managers under pressure to do the impossible lashed out at junior staff. There was a climate of fear, intolerance, disbelief and insecurity.

HR records reveal appalling treatment of staff, including arbitrary disciplinary processes and prolonged suspensions without reason. It was not uncommon to see staff crying in the car park.

Among the most egregious examples of abuse were the so-called scoping meetings, supposedly convened to investigate safety incidents. In practice they were “an interrogation and a frightening experience”. Staff reported feeling physically sick beforehand and approached them with trepidation. Across the organisation shouting and finger-pointing became the norm.

In what appears to have been an attempt at empire building, the trust took on responsibility for health services at Liverpool prison – which was recently condemned by inspectors as having the worst conditions they had ever seen. The trust’s failures in the prison harmed more patients.

Liverpool’s board discussed severe cuts to its workforce – notably nursing – at the same meeting it considered the findings of the Francis inquiry into Mid Staffordshire, the lessons from it apparently eluding them.

The strategic health authority failed to spot the problems. Subsequently the NHS Trust Development Authority identified concerns, then inexplicably reversed its assessment. The Care Quality Commission also failed to identify the problems until it was alerted by local Labour MP Rosie Cooper after staff spoke to her.

The trust has been broken up, but the lessons from its collapse need to live on. It shows again how, controlled by an oppressive culture pursuing unrealistic financial goals, an organisation can quickly mutate into one that harms the very people it is there to serve.

Senior clinicians need to keep a clear focus on their professional responsibilities and not be swayed by board denial or groupthink.

Non-executives need to get out from behind their board papers and keep in close touch with staff and patients. They are there to offer constructive challenge to the trust leadership, not to assist them in pursuing impossible goals.

But above all, the Liverpool scandal demonstrates yet again that an open culture which listens to staff needs to be at the core of every NHS institution. Instead, dissent was crushed and a culture of denial allowed patient harm to proliferate. A cursory glance at the annual staff survey would have been enough to reveal that something was badly wrong.

If staff do not feel able to speak up, something is rotten at an organisation’s heart.



Case going to tribunal

Firstly huge thank you to all of your support for this campaign.


I was employed at Princess Grace Hospital as an Imaging Services Manager. Princess Grace is part of HCA International. An American private health provider based in Texas, USA.

While in employment, I believe I have  faced victimisation as a person undergoing cancer treatment and  raising safety concerns, some serious.

Princess Grace decided to subsequently make my post ‘redundant’ which they advised was not personal but was purely a financial issue. I believe this was an excuse simply to get rid of me.

To help me with my legal costs, Crowd Justice was launched on 12 December 2017.

Many had contributed. Some were really generous. Within 2 weeks £10,000 was raised and I received lots of public support.

In the afternoon of 22 December 2017 – last working day before Christmas, I received the following letter from the legal team representing HCA healthcare:

letter 22 Dec - 1

letter 22 Dec - 2

I do not believe the timing of the letter was a coincidence. I believe it was designed to scare me, and perhaps it was hoped that everyone  who would be available to provide me with advisory support, would be away and I would crumble under stress and pull down my Crowd Justice page. They were wrong.

In my subsequent blog I advised about this letter, and that I would publish this. I then received the following letter:

letter 4 Jan - 1letter 4 Jan -2

Additionally, HCA international then reported me to the regulators informing that I am not fit to practice. As a result Crowd Justice funds needed to be raised from original £10,000 to £40,000 so as meet potential legal costs for defamation and to address any fitness to practice issue.


Unfortunately instead of  settling the dispute of a case which I believe is an unacceptable  victimisation of a staff with disability and a whistleblower who reported safety concerns while in post,  HCA international appears to me to have carried on like a ‘bulldozer.’ 

It is 3 years anniversary  of  Francis ‘Freedom to Speak up Review’.

It is now 3 months since I left Princess Grace. My case will now be going through an employment tribunal.  For which paperwork has now been submitted.

Please continue to help me with donations and sharing the crowd justice page. Thank you.


NHS bosses who cover up serious failings could be banned from taking another hospital job


  • Cuts at Liverpool Community Health NHS Trust caused ‘unnecessary harm’
  • But its former chief executive and chairman were allowed new NHS jobs after 
  • Health Minister Stephen Barclay has announced review in response to news  


Health chiefs who cover up serious failings could be banned from taking another NHS job.

The move to end the ‘revolving door’ scandal comes after it emerged that two bosses who ran a failed trust where patients suffered ‘significant unnecessary harm’ have found new health service roles.

A damning independent report has said that the board of Liverpool Community Health NHS Trust was ‘out of its depth’ when it launched a misguided cost-cutting drive.

The cuts left pensioners suffering crippling bed sores and fractured hips from needless falls, while others had the wrong teeth taken out.

Despite these failings, the former chief executive and chairman of the trust are still working directly or indirectly for the NHS.

And it was reported last night that regulators even helped the chief executive find another six-figure NHS job.

The move to end the 'revolving door' scandal comes after it emerged that two bosses who ran a failed Liverpool trust where patients suffered 'significant unnecessary harm' have found new health service roles


In response, Health and Social Care Minister Stephen Barclay will announce a review of the ‘fit and proper person’ test. 

It was brought in following the Mid Staffordshire scandal, in which hundreds of patients died needlessly amid appalling failings in care.

He wants to see it toughened up to end the ‘revolving door’ controversy – where failed executives are shifted into other parts of the NHS – once and for all. 

Liverpool Community Health (LCH) runs elderly care, walk-in centres and dentistry services for about 750,000 people on Merseyside.

The report by Dr Bill Kirkup, which was commissioned by the NHS Improvement quango, found the board attempted to ‘conceal’ the problems. 

And whistleblowers who attempted to expose the truth were bullied.

The report said standards at LCH deteriorated dramatically after managers attempted to cut costs by 15 per cent in a single year in an attempt to chase foundation trust status.

Chief helped into fresh post – by watchdog 

Bernie Cuthel (pictured) stepped down as chief executive of Liverpool Community Health NHS Trust in 2014 over her failings, but she walked into a new NHS job soon after

Bernie Cuthel (pictured) stepped down as chief executive of Liverpool Community Health NHS Trust in 2014 over her failings, but she walked into a new NHS job soon after

Bernie Cuthel, the £130,000-a-year chief executive of Liverpool Community Health NHS Trust, stepped down in disgrace in 2014 after her failings were exposed.

But she walked into a new NHS job soon afterwards and regulators helped her to get the position.

Emails seen by the BBC show that the Trust Development Authority, an NHS regulator, found her a position at Manchester Mental Health and Social Care Trust on a 12-month secondment.

The TDA also provided her with ‘coaching support’, and said ‘the secondment would provide her with a period of rehabilitation, enabling her to reflect on learning from her experiences in Liverpool’.

Her salary at Liverpool was reduced by 10 per cent in Manchester because she was no longer in an executive position.

Now she works at the Betsi Cadwaladr NHS board in North Wales. She is also on the governing body of Nugent, a charity in Liverpool that offers a range of services to children and adults.


This makes a trust semi-independent of Department of Health control and gives boards greater power over their finances and the setting of executive salaries.

The report found that LCH was a ‘dysfunctional’ organisation. 

In an echo of the Mid Staffs scandal, the report said LCH had acted ‘inappropriately’ in pursuit of foundation trust status – setting ‘infeasible financial targets that damaged patient services’.

Dentistry budgets were cut by 44 per cent and 50 district nurses were made redundant.

Dr Kirkup’s report said the senior leadership at the trust did not realise it was ‘out of its depth’. 

It added: ‘Staff were overstretched, demoralised and – in some instances – bullied. Significant unnecessary harm occurred to patients.’

Dr Kirkup said the chief executive and chairman of the LCH board were in ‘denial’ about their role in the affair between 2010 and 2014 – and had refused to co-operate with the review.

A damning independent report has said that the board of Liverpool Community Health NHS Trust (pictured) was 'out of its depth' when it launched a misguided cost-cutting drive

Bernie Cuthel, the chief executive, resigned after the failings were exposed. 

But emails seen by BBC News show that the Trust Delivery Authority, an NHS regulator, found her a position at Manchester Mental Health and Social Care Trust on a 12-month secondment.

Chairman Frances Molloy is now boss of the Liverpool-based Health and Work charity, which has contracts with the health service.

Every LCH board member bar one refused to co-operate with Dr Kirkup’s inquiry. Mr Barclay is set to refer all of them to the Care Quality Commission regulator to see whether they fill the ‘fit and proper person’ test.

Shamed exec got new health deal 

Frances Molloy was the trust's chairman, but had to step down after her failings were exposed. She now runs a Liverpool-based charity with NHS contracts 

Frances Molloy stepped down as chairman of Liverpool Community Health NHS Trust in 2015 – a year after failings at the trust were exposed.

She now runs a Liverpool-based charity that has contracts with the NHS.

Her Health at Work organisation provides experts in improving health in the workplace, reducing absence and staff turnover. 

The charity describes her as its ‘inspirational and influential’ chief executive. 

The organisation’s website says its delivers ‘public sector contracts for NHS commissioning groups and Public Health England’.

Mrs Molloy lost her son Michael, 18, in a coach crash in 2012. She campaigns for changes in the law to stop buses and coaches using old tyres.


Sources said he believes it is wrong that people who tried to cover up the scandal, continued to deny it was a problem and then refused to co-operate with the official review into the failings should be allowed to work in the NHS.

Mr Barclay will also ask Dr Kirkup to consider whether the test should be rewritten to make it clear that such people should not be able to work anywhere in NHS England – or for any companies which supply it.

Rosie Cooper, Labour MP for West Lancashire, was instrumental in forcing an investigation into the failing trust after nurses looking after her father complained about their managers.

Last night she agreed that ‘faceless NHS bureaucrats’ responsible for serious failings should not be allowed to walk straight into another NHS job.

‘It is time for the ‘fit and proper person’ test to be significantly strengthened to prevent this happening,’ she added.

LCH declined to comment. It is now in the process of being wound up, with most services passing to another NHS trust, MerseyCare, in April.

Read more: http://www.dailymail.co.uk/news/article-5365303/NHS-bosses-cover-failings-banned-new-jobs.html#ixzz56jxR34JF
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Independent Review of Liverpool Community Health NHS Trust


Parliament logo     www.parliament.uk   House of Commons Hansard

Acute and Community Health   8 Feb 2018


    • With permission, Mr Speaker, I wish to make a statement on the independent review of Liverpool Community Health NHS Trust, which was conducted for NHS Improvement by Dr Bill Kirkup and published today.

      What happened to patients of Liverpool Community Health NHS Trust is, before anything else, a terrible personal tragedy for all families involved, and the report also makes clear the devastating impact on many frontline staff. On behalf of the Government I apologise to them, and I know that the whole House will want to extend our sympathies to every one of them.

      As Mr Speaker correctly identified, I wish to pay tribute to the hon. Member for West Lancashire (Rosie Cooper). The people of Merseyside know only too well the cost of attempting to silence the victims and campaigners for those seeking justice. As the report makes clear, her personal commitment to get to the truth on behalf of the victims of Liverpool Community Health NHS Trust, her personal courage in asking difficult questions of those in senior positions within the NHS, and the persistence and precision of her search for accountability, are all vindicated today. We in this House, and across the wider health and social care services, owe her a debt. I also thank Dr Kirkup and his team for this excellent report. As with his report on Morecambe Bay NHS Foundation Trust, it is a clear, forensic, and at times devastating account of failures in the care of Liverpool Community Trust by its management, its board, and its regulators.

      The report covers the period from the trust’s formation in November 2010 to December 2014, and it describes an organisation that was, “dysfunctional from the outset”. The consequences of that for patient care were in some cases appalling, and the report details a number of incidents of patient harm including pressure sores, falls leading to fractured hips, and five “never events” in the dental service—an incredibly high number for one organisation.

      The failings of the organisation were perhaps most starkly apparent in the services provided at Liverpool Prison, where the trust failed to properly risk-assess patients, including for nutrition and hydration, and it did not effectively manage patients at high risk of suicide. The review also identified serious failings in medicine management at the prison. There are many more examples of poor care and its impact on both patients and staff in the report, but what compounds the shock is the lack of insight into those failings displayed by the organisation at the time. This was the very opposite of a culture of learning, with incidents under-reported or played down, warning signals ignored, and other priorities allowed to take the place of patient safety and care for the vulnerable.

      We have seen this sort of moral drift before, most obviously at Mid Staffordshire and Morecambe Bay. As with Mid Staffordshire, the management at Liverpool Community Health NHS Trust put far too much emphasis on achieving foundation trust status. The review states that,

      “the trust undertook an aggressive cost improvement plan, targeting a £30 million reduction over five years. This represented a cut in resources of approximately 22%. We were surprised that such an ambitious financial reduction was not scrutinised more closely—by both commissioners and regulators.”

      There is a direct line from the decision to pursue foundation trust status in that reckless manner to the harm experienced by patients. Indeed, an earlier report by solicitors Capsticks reported in March 2016 that the interim chief executive who took over from Bernie Cuthel found in her first week that

      “there was an underspending by £3 million on district nursing. These teams were devastated because they weren’t allowed to recruit, some of them down to 50%”.

      This is a district nursing service in which Dr Kirkup reports that patients were experiencing severe pressure sores, up to what is clinically called grade 3. That was accompanied by many of the hallmarks of an organisation that has lost sight of its purpose. As Dr Kirkup states,

      “the evidence that we heard and saw amply confirmed the existence of a bullying culture within the Trust, focused almost entirely on achieving Foundation Trust status. Inadequate staffing levels, poor staff morale and appalling HR practice went unheeded. This was the end result of inexperienced leadership that was not capable of rising to the challenges presented by the Trust.”

      Following the Mid Staffordshire report, Dr Kirkup recognises that steps have been taken to introduce independent, clinically-led inspection by the Care Quality Commission. The Government have also introduced the special measures regime within NHS Improvement. Alongside this, we have put in place a number of measures to create a wider culture of learning and improvement. The Secretary of State has offered a great deal of personal leadership in helping to create this culture, including the establishment of an independent chief inspector for hospitals, whom I met yesterday and spoke with again this morning, and the recent introduction of measures to support trusts to learn from deaths and to improve patient safety.

      I am sure I am not alone in finding it astonishing that Dr Kirkup found there was a

      “small minority of individuals who refused to co-operate”

      with the review. I wholeheartedly agree with his view that

      “it remains the duty of all NHS staff to assist as fully as they are able with investigations and reviews that are directed toward improving future services”.

      All but one of the board of the Liverpool trust shirked their legal and moral responsibility to be candid about the organisation they governed. In large, complex organisations, responsibility and accountability are always distributed to some degree. It is the case that the higher up in an organisation someone is, the greater their degree of responsibility. In this case those individuals were Bernie Cuthel as chief executive and Frances Molloy as chair. It is clear from reading the report that they each must take a significant share of the responsibility for these failures.

      Hon. Members will, I am sure, have noted the conclusion to the clinical governance section of the report, which highlights the responsibility of the former chief executive of the trust for the system of clinical governance and its failures. It would appear from the report that while the former chief executive, Ms Cuthel, is now able to see that there were failures in clinical governance, she does not have as strong a sense of her own responsibility as one might expect. I understand that she is no longer employed in the NHS in England, but she does continue to hold a role working with the NHS in Wales.

      In response to this report, the Government intend to take a number of actions. First, the Government accept the recommendations in full. While this was a report commissioned by NHS Improvement, I will write to all the organisations named in the recommendations set out at section six of the report, asking them to confirm what steps they will take to implement the recommendations, or to set out their reasons for not doing so. I will ensure copies of that response are shared with the Health Committee.

      Secondly, one recommendation is specifically for the Department of Health and Social Care, as set out in paragraph 6.5 on page 64. This relates to a review of CQC’s fit and proper person test. I intend to discuss the terms of that review with the hon. Member for West Lancashire and will appoint someone to undertake that review within the coming days. I believe that review will need to address the operation and purpose of the fit and proper test, including but not limited to: where an individual moves to the NHS in another part of the United Kingdom; where they leave but subsequently provide healthcare services to the NHS from another healthcare role, such as with a charity or a healthcare company; where differing levels of professional regulation apply, such as a chief executive who is a clinician compared to one who is a non-clinician; where there is a failure to co-operate with a review of this nature and what the consequences of that should be; and reviewing the effectiveness of such investigations themselves when they are conducted. I will be pleased to hear the views of the hon. Member for West Lancashire, and those of the Health Committee, on these issues.

      Thirdly, I have asked the Department to review the effectiveness of sanctions where records go missing in a trust, or where records appear to have been destroyed.

      Fourthly, I have asked the Department for advice on what disciplinary action could be taken against individuals in relation to the findings of this report. Clearly due process needs to be followed, but it is important that we address a revolving door culture that has existed in parts of the NHS, where individuals move to other NHS bodies, often facilitated by those who are tasked with regulating them.

      Fifthly, I will ask NHS Improvement and NHS England to clarify the circumstances under which roles were found or facilitated for individuals identified in the report as bearing some responsibility for the issues at the trust.

      Finally, I have spoken with colleagues at the Ministry of Justice and confirm to the House that they intend to investigate the issues arising from this report in respect of HMP Liverpool specifically and the prison estate more generally.

      All organisations and individuals make mistakes. Where this is used as an opportunity to learn and improve, we will do all we can to provide support. Where, however, there is any kind of cover-up or a blinkered denial of what has happened, Members of this House and the victims of that wrongdoing have a right to expect accountability. The hon. Member for West Lancashire has done the NHS a great service. I will place a copy of the Kirkup review in the House of Commons Library. The Government are acting in full on the findings of the report.


    • May I start by adding my appreciation for the tenacity my hon. Friend the Member for West Lancashire (Rosie Cooper) has shown in pursuing this matter over a number of years? She has led the way in tackling this injustice fearlessly and relentlessly. In that respect, she is an example to all right hon. and hon. Members in this place. I agree with the Minister that the report is a vindication of her courage, but is it not shameful that this scandal only came to light because a Member of Parliament was prepared to give a voice to those who were afraid to speak out?

      Today’s independent report on the Liverpool Community Health Trust lays bare a catalogue of failure that caused harm to patients across Merseyside between 2010 and 2014. It is a grim example of a repeat of the regulatory pressures and board management failures at Mid Staffs. What is of huge concern is that some of the failures came after the final publication of the Francis report. As we have heard, incidents identified in the report include the deaths of inmates at HMP Liverpool, patients having the wrong tooth extracted by trust dentists, and patients on intermediate care wards suffering repeated falls and broken bones or ending up with pressure ulcers. We have to make sure that the pain experienced by so many patients and their families is properly detailed and recognised. We must make sure the NHS is able to learn from these events and that systems are put in place to ensure they never happen again.

      I put on record our thanks from the Labour Benches to Dr Bill Kirkup and his team for the work they have done in carrying out this investigation and helping us to understand what has gone wrong. Today’s report says that patients of community services suffered unnecessary harm because the senior leadership team was “out of its depth”. Let us be clear what lies at the heart of this: unrealistic cost-cutting by the trust without regard to the consequences that led directly to patients being harmed. The report exposes serious problems around the scale of cost-cutting being imposed on NHS trusts. In the case of Liverpool Community Health, the motivation was the drive to achieve foundation trust status. The trust disciplined and suspended staff who blew the whistle about poor care and its controversial plans to slash staff to save money. What guarantee can the Minister offer that trusts are no longer being allowed to prioritise financial savings over patient care? What protections have been put in place for staff who raise concerns about cost-cutting?

      Today’s report notes the irony of staff reductions being agreed at the same board meeting that had earlier considered the implications of the Francis report. That alone should have raised alarm bells about the capacity of board members to challenge the trust. The NHS still faces huge workforce shortages, so what update can the Minister give us on how the 10-year workforce strategy has been received? What additional measures will the strategy include to guarantee safe levels of staffing in all areas of the country, in community as well as acute services?

      I am pleased that the Minister recognises concerns that managers responsible for these extreme failures can often go into leadership roles in other parts of the health service, or indeed for private providers to the NHS in another capacity. Will he advise the House how many people who refused to co-operate with the investigation are still employed in some part of the NHS? Is there anything in the existing terms and conditions or structures that can be used to require future co-operation? Is there any redress in existing policies and procedures that we can use against these people?

      The report said that regulators were distracted by higher-profile services such as acute care. The Health Service Journal said today that oversight failures were partly attributable to organisational changes that were taking place under the Health and Social Care Act 2012, so what will the Government do to ensure that national priorities are not allowed to interfere with local oversight?

      Finally, the report raises serious concerns about the quality of healthcare in prisons. HMP Liverpool still has significant challenges, and the new provider of the prison’s health service—the Lancashire Care NHS Foundation Trust—has just said that it cannot continue with the contract on the level of funding currently available. The Ministry of Justice will investigate these matters more generally, but will the Minister assure us that prison healthcare is properly supported and resourced in Merseyside and elsewhere across the country?

      Paragraph 1 of the review’s findings sums up the devastating impact of these multiple failings:

      “Staff were overstretched, demoralised and—in some instances—bullied. Significant unnecessary harm occurred to patients.”

      In the unprecedented financial squeeze that the NHS currently faces, we need assurances from the Minister that patients and staff will come before finance and that today will be the last time we hear such a damning message about what is going on in our NHS.

    • I thank the shadow Minister for his questions and the manner in which he put them before the House. His first key question was to what extent measures are in place to address this sort of issue, should it arise again. Post Francis, and following Sir Bruce Keogh’s review of 14 trusts with high mortality rates, a new regime has been put in place. There is a new chief inspector of hospitals, Professor Ted Baker, and a specific regime involving NHS Improvement, which commissioned this report. NHS Improvement has a new chair, Dido Harding, a very senior figure from the business community.

      That regime has put 37 hospitals into special measures so far. The methodology that is used to alert regulators to areas of concern has also been revised. For example, far more importance is now placed on staff and patient surveys. However, it remains to be explained why a trust could pay so many compromise agreements, for example, in response to so many staff disciplinary issues. I assume that many concerns were raised by trade unions locally, as no doubt the hon. Gentleman is aware. We must also consider the extent to which earlier reports, such as the Capsticks report, raised concerns that should have been addressed. That is why, in my statement, I signalled my desire to look at those issues and ensure that they are addressed by the fit and proper person test in particular. As he will be aware, though, that test pertains only to board-level appointments in the NHS, not to all roles. We will need to look at that scope, at the effectiveness of the investigation and particularly at the revolving door element of the problem, which he recognised.

      Turning to the other issues that the shadow Minister raised, we clearly need to ensure that due process is followed. I do not need to remind the House of the difficulties of any enforcement against for instance, Fred Goodwin in financial services or Sharon Shoesmith in child services. People rightly expect due process, and all hon. Members would ask for that. The victims will rightly ask, “How can the chief executive, with this catalogue of issues, move within the NHS rather than be fired?” I know that the hon. Member for West Lancashire (Rosie Cooper) has many concerns about that, as do the Health Committee and many other Members.

      I look forward to working with the hon. Member for Ellesmere Port and Neston (Justin Madders) in the spirit in which he raised these issues. We share concerns, and I know the House as a whole wants us to get to the heart of them.

    • I pay tribute to my colleague on the Health Committee, the hon. Member for West Lancashire (Rosie Cooper). She is a remarkable parliamentarian and advocate for patient safety. All of us on the Committee look forward to working alongside her to examine in full the Kirkup report’s recommendations, and I welcome the Minister’s commitment to a review of the fit and proper person test.

      On the wider issues that the report raises, it is clear that when staff and funding continue to be cut from community services, there are terrible consequences for patient care. Will the Minister assure the House that he will work closely alongside the Care Quality Commission to identify other trusts in which issues such as this are likely to arise because of the workforce and funding pressures that are now being faced?

    • I am very happy to work with my hon. Friend on this. As she will be aware from reading the report, it is explicit that the finances were there for the existing service. That is stated at the outset of the report. What drove the problems was a wholly unrealistic attempt to seek foundation trust status, with a cost improvement plan that was simply undeliverable. There was a massive reduction, without any attempt to reconcile that with serious issues on staff levels and vacancies. As the report explicitly sets out, when staff raised those concerns, they were bullied, harassed and on occasion suspended without due cause. The culture has changed significantly, and measures have been put in place for how the regime involving NHS Improvement would address such issues and look at cost improvement plans.

      On the extent to which the culture was driving the problems, I refer to the remarks I made in my statement. According to the report, the interim chief executive went in and found a significant underspend—£3 million—in the district nursing budget, at the same time as there were significant vacancies and patient harm. That culture was driving the issue, and that culture is what we need to put an end to.


    • I thank the Minister for early sight of his statement. I certainly echo his comments about our sympathy for the families and staff members who have been involved over the years. I pay tribute to the hon. Member for West Lancashire (Rosie Cooper), although the tenacity required from her perhaps sums up what is wrong with the present system.

      On Dr Kirkup’s observations and recommendations, as the Minister has acknowledged, some individuals did not co-operate with the investigation. Is there therefore a case for a law change to prevent that from recurring in the future, or at the very least for employment and registration sanctions ultimately to be applied to such personnel?

      On the fit and proper person test that the Government have pledged to undertake, will any agreed new standards be applied retrospectively to board members who are currently in place? Again, the Government have acknowledged the revolving door culture, so it is important that the test is done properly. Will they review executive pay for chief executives and senior staff? After Mid Staffordshire and this, what will be done to properly protect whistleblowers in future to allow them to come forward?

      Funding and resources are clearly really important. Dr Kirkup’s report lays bare the fact that the defining strategic objectives were foundation status and a £30 million saving, or a 22% reduction in resources, rather than the true goal of clinical quality. What will be done to ensure that regulators pick up on such contrasts in future, and what responsibility do the Government take for funding and the drive for efficiency savings?

      Lastly, does the Minister agree that this situation confirms the failings of the trust system, and that any privatisation of the NHS and profit before care cannot be allowed under future free trade deals?

    • The hon. Gentleman raises a number of important points, but particularly regarding whistleblowers. That was one warning signal that clearly failed here. The regulations have been changed, as he will be aware. In the past, there was a culture in which compromise agreements were applied with gagging clauses attached. That prevented visibility of the compromise agreements. That is why I asked, on receipt of the report, why the compromise agreements that were paid were not escalated to the board, and indeed what sight, if any, regulators had of those compromise agreements. Clearly financial payments will have been made, so there should be an audit trail.

      The hon. Gentleman asked what changes had been made. An area on which my right hon. Friend the Secretary of State has placed a huge amount of importance, and in which he has given a huge amount of leadership, is patient safety guardians and ensuring that there are people in trusts tasked specifically with giving voice to patients. One of the many sensible pieces of advice that my predecessor, my hon. Friend the Member for Ludlow (Mr Dunne), gave me was that when visiting a trust, I should have a one-on-one meeting with that individual, not only because of their status within the trust but to gather information from them. He did so assiduously on all his visits.

      The wider point is how, from a regulatory structure point of view, we can ensure that there are safeguards when there are cost improvement programmes and ask what visibility there is of them. NHS Improvement has set out a series of measures to ensure that trusts learn the lessons of Francis. Obviously the period covered by the report goes back as far as 2010, but it is important that the NHS learns from the issues that Dr Kirkup sets out.

    • May I add my tribute to the hon. Member for West Lancashire (Rosie Cooper)? She is a formidable parliamentarian and has done some very good work on this. The report is shocking. Back in March 2015, following other incidents, the Public Administration Committee produced a report investigating clinical incidents in the NHS, in which it recommended the setting up of the health service’s safety investigation branch. The Government have now published the draft Bill for that. When will it enter pre-legislative scrutiny, so that we can change the culture and have the open learning culture that we should have in our NHS, very much as is seen in the airline industry?

    • My right hon. Friend raises an important point on the draft Bill and the consultation. I am not in a position to announce a date; that will be announced by business managers in the usual way.

      My right hon. Friend is right to allude to that Bill as one of a suite of measures following Sir Bruce Keogh’s review and the Francis report, which are all part of changing the culture. I acknowledge the importance of those measures, but I want to signal to the House today that Dr Kirkup’s report identifies remaining issues that need to be tackled. He has done us that service, and that is where I am keen that we focus as a Government.

    • Thank you for your indulgence, Mr Speaker. I do not intend to test your patience today by dealing with the details of these matters; I will do that through Adjournment debates, questions, the Health Committee and other mechanisms available to me.

      I thank the Minister for his kind words and his comprehensive statement in response to the excellent work of Bill Kirkup and his team. I pay tribute to Dr Kirkup for his thoroughness and independence, and I thank him most sincerely, on behalf of the staff and patients in Liverpool who suffered really badly at the hands of what I want to call a dictatorship—the regime. Whatever it was, what was done was done in our name and the name of the NHS, and those people deserve justice.

      After the ACAS review, the CAP6 report and now the Kirkup report, with a National Audit Office report on the way and Nursing and Midwifery Council hearings due soon, it really is important that the NHS ensures that justice is not only done but seen to be done. Under Governments of all parties, the higher echelons of the NHS have closed ranks to protect themselves. That has got to stop. That senior people were able to inflict such harm on staff and patients and then just walk into other senior NHS jobs with six-figure salaries, and that in this case it could be arranged by the north regional managing director of NHSI, Lyn Simpson, is simply staggering.

      I still cannot answer the question that the Minister posed—why were the chief executive and the board not fired? Why were they not sacked? It is incomprehensible. Nothing has been learnt over the past four years. As of only a few weeks ago, NHSI is presiding over another potential LCH, over in the Wirral’s hospitals trust.

      I will obviously continue to pursue these matters with vigour on behalf of the staff and the patients, and I want to place it on the record for everyone who is affected that I do not see the Kirkup report as the end—far from it. The Minister has a legal and forensic background. How will he assure the House that these matters will be dealt with properly, and that cover-ups and backdoor deals have ended once and for all? The Secretary of State has said so many times, “This will stop. We are not going to keep moving failed executives around,” yet it continues to happen.

      I will say quite honestly that I asked a question of a Minister last year and he answered me in good faith. He said, “NHSI doesn’t participate in moving staff around.” Not only can we now prove that it is true that it does, but it nearly happened in the Wirral a few weeks ago. The message has got to go out: “If you do this kind of stuff, you are responsible. You will not escape.” The NHS must be accountable, and those in it held responsible.

    • I thank the hon. Lady for those comments. As I said, I have asked NHS Improvement and NHS England to clarify the circumstances under which roles were found or facilitated for individuals identified in the report as bearing some responsibility for the issues at the trust. I await the answer to that central question, which the hon. Lady posed.

      On the sense of cover-up, the Secretary of State has provided leadership in bringing about the culture change on patient safety. Following the awful situation in Mid-Staffordshire, it was recognised across the House that changes needed to be made on patient safety, and I think the NHS itself has recognised that. NHS Improvement has new leadership, who commissioned the Kirkup report themselves.

      On the changes that have been put in place, I alluded to the CQC regime and the chief inspector and the methodology. I spoke to the chief inspector yesterday. Every hospital has now been visited, using that new methodology, and obviously that programme will start to accelerate and target as further work visits are done. The methodology used for that has also evolved to include staff surveys, for example. So a number of measures have been taken, and the special measures regime is also very much at the heart of that.

      A number of steps are being taken, but the approach that underpins those is that although we must create a duty of candour, enabling people to learn from the mistakes that will happen in an organisation employing more than 5 million people, there should not be the sense that people can escape their responsibility by moving within the system. I have discussed that with people in the NHS, and I believe there is a wide recognition that the culture has changed significantly. But clearly, as we consider the issues that emerge from the Kirkup report, the House will need to see further reassurance.

      The hon. Lady asked how I and the Government will ensure that these issues are addressed, not covered up. First, no one doubts that the hon. Lady will use all the parliamentary tools to pursue this matter, including in her role as a senior member of the Health Committee. I am aware that other members of the Committee, such as the hon. Member for Liverpool, Wavertree (Luciana Berger), a former shadow Health Minister, will take a significant interest in this issue. I know that the Chair of the Health Committee will do so. I have regular discussions with her, and as we address the “fit and proper” test and other issues, I look forward to benefiting from the expertise on that Committee.

      It is clear that measures have been taken, and it is right that we recognise that much work has been done in the NHS to change the culture, to ensure that the warning signs are seen, and to ensure that something like this never happens again, but it is also clear that there are specific issues in the report to be responded to, and I very much share the desire of the hon. Member for West Lancashire that we do that.

    • Order. I remind the House that there is another ministerial statement to follow, and that although the debate on matters to be raised before the forthcoming Adjournment is not now intended to take place, no fewer than 19 Members wish to take part in the debate on community banking, so there is a premium on brevity. These important matters having been preliminarily aired, I now appeal to colleagues to ask single-sentence, pithy questions, without a great preamble, then we will progress towards other matters. I now call Sir Oliver Heald.

    • My hon. Friend will be aware, and indeed has said, how bad the situation was at Liverpool prison, where the trust had no understanding of what was required of it in its role as health provider. That put healthcare staff in a very difficult position. Does he feel that there is a need for better liaison between health and justice in relation to prison health facilities? Is the CQC really in a position to inspect them, or should there be joint inspections by Her Majesty’s inspectorate of prisons and the chief inspector of hospitals?

    • I spoke to colleagues in the MOJ yesterday about the issue that my right hon. and learned Friend raised in the first part of his question. I agree with him that the standards of care for those in prison should be the same as those in the NHS more widely. As he will know, NHS England took over commissioning for healthcare services in prisons in 2013; that is one of the changes that have been made. He will also know that the Dr Kirkup’s report drew attention to local factors, including a personal conflict of interests that goes to the heart of the relationship between the trust and the prison. However, he is absolutely right to allude to some wider issues from which we need to learn.

    • How many members of the board failed to co-operate with this scathing review, and can the Minister name them?

    • Only one member of the board co-operated with the review, from which we can deduce that all the rest did not. Given that I am relatively new to the Department, it would probably be wise for me to seek clarification on the extent to which individuals should be named, but I am happy to confirm that the chair of the board did not co-operate.

    • Does the Minister agree that the report shows that leadership really matters in our local NHS? What further steps can he take to ensure that hospital trusts fully understand the importance of transparency to clinical quality and patient safety?

    • My hon. Friend is absolutely right. That is why we are increasing the number of doctors in training by 25%. We are also looking into how we can increase the number of clinicians in leadership positions in trusts, and how we can reduce variance. That is one of the key issues. The NHS has some brilliant leaders, but the variance between trusts is far too wide.

    • Given that health is devolved to the Scottish Government, Mr Speaker, you may wonder why I am asking this question. Will the Minister reassure me first that the report will be shared with NHS Scotland and the Scottish Government, and secondly that, as and when senior appointments are made, there will be an ongoing, constructive and informed dialogue across the border? Now you will see why I asked the question, Mr Speaker.

    • I am happy to reassure the hon. Gentleman, but he has raised an important point. The question of people moving within the United Kingdom is not the only issue; another potential issue is the question of people moving to a charity or a private company that is providing services for the NHS, or taking up other roles in the healthcare landscape.

    • May I press the Minister a little further on his worrying suggestion that revolving doors are often facilitated by those who are tasked with regulating them? Will he also look at democratic accountability not just in the appointments of officials, but more widely in the NHS?

    • I referred earlier to my desire to work on these issues with members of the Health Committee, who include my hon. Friend, and I shall be happy to look into the points that he has raised. The previous statement was about the culture in the House of Commons. I think that what goes to the heart of my hon. Friend’s question and the matters that we are discussing is that issue of culture, and the need for the culture in pockets of the NHS to change. My right hon. Friend the Secretary of State has done a great deal to bring about such change, particularly in respect of patient safety, but I shall be happy to work with my hon. Friend to take that further.

    • What lessons can be learnt by Liverpool Community Trust—and, indeed, by other underperforming trusts—from the successful turnaround of some 20 trusts under the Government’s new special measures scheme?

    • My hon. Friend is right: although 37 trusts have gone into special measures, a significant number have not just moved out of special measures, but moved from “room for improvement” to “good”. That is relevant to a much wider challenge in the NHS, whether it involves procurement, workforce planning, or mentoring for junior doctors. I met the family of a junior doctor last week to discuss mentoring and support, particularly for those in their first year out of medical college. Trusts have shown leadership on a number of issues, and I think that the special measures regime has shown the scope to spread that best practice much more widely across the system.

    • I agree with the Minister that it is vital for us to expose and tackle failings in the NHS, especially when they put people at risk of harm. Does he agree with me that this case highlights the fact that money is not always the only answer? Effective leadership and responsible management are also important.

    • My hon. Friend is right. I think that at the heart of Dr Kirkup’s findings was the conclusion that what drove these events was not money—and he made that point specifically in relation to the finance for the initial services—but the desire to seek foundation trust status, which led to a wholly unrealistic cost improvement plan and an unwillingness to address the issues that arose as a consequence.

    • I thank my constituency neighbour, the hon. Member for West Lancashire (Rosie Cooper), for all the work that she has done on this issue.

      As has already been said, it is important for the right culture to exist in our NHS. However, it is also important for those who compromise patient safety to be brought to book and punished, and for us to know what action was taken, because otherwise the same thing will keep happening.


  • My hon. Friend is right. Professor Ted Baker, the chief inspector of hospitals, has drawn attention one of Dr Kirkup’s findings, which is that the CQC is now in a much better position to challenge and fine those responsible for unsafe care and poor standards. That also reflects the excellent work that Professor Baker and his team have been doing to ensure that inspections become much more rigorous in identifying issues such as those that we have been discussing today.

  • I am a member of the Justice Committee, which has taken a particular interest in Liverpool prison. Will my hon. Friend assure me that there will be a review of the suicidal potential of prisoners to ensure that the systems are right?

  • My hon. Friend is right to allude to the importance of learning lessons, especially given that there are many vulnerable people in prisons, and given the risks that accrue as a result. Yesterday I spoke to the Under-Secretary of State for Justice, my hon. Friend the Member for Bracknell (Dr Lee), who is responsible for offender management issues, and the Prisons Minister, my hon. Friend the Member for Penrith and The Border (Rory Stewart), visited Liverpool prison last week. I know that they have both taken a great interest in the report, and that they will take any further action that is needed.

  • Does my hon. Friend envisage an ongoing oversight role for Dr Kirkup that would enable him to help to put these failures right?

  • I should be happy to discuss any such future opportunities with Dr Kirkup. His excellent report builds on the work that he did at Morecambe, and I think there is a huge amount for us to take forward from its findings.


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