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April 20, 2014

Medicine Balls, Private Eye Issue 1364
Filed under: Private Eye — Dr. Phil @ 12:13 pm

NHS cover-ups go right to the top

‘Patients’ lives are saved when courageous people speak up – openly and honestly – and when each of us takes personal accountability for putting things right.’ So said incoming chief of NHS England Simon Stevens on April 1st. But the joke is that no one helps put things right for whistleblowers themselves, nor holds those to account who smear, ignore or black-ball them.

It is scandalous that whistleblowing Alder Hey surgeons Professor Ed Jesudason and Shiban Ahmed cannot operate in the NHS (Eyes passim) after making protected disclosures about patient safety. Ahmed also worked for the University Hospital of North Staffordshire (UHNS) and was suspended by them in 2009 on the grounds that he is as a mental health risk after a hotly disputed allegation by two Alder Hey surgeons – Matthew Jones and Colin Baillie – that he was suicidal, an allegation of which Ahmed was cleared by a subsequent investigation. Although Baillie and Jones accepted they were behind the suicide claim, this crucial evidence was withheld from Ahmed’s Employment Tribunal, and Alder Hey denied the claim had any role in his suspension. Ahmed’s insurers withdrew funding for his tribunal challenge due to the lack of evidence to support his case.

Jesudason discovered what Baillie and Jones had done to Ahmed, led the petition against Ahmed’s mistreatment and  unearthed material evidence of the unproven allegation and that Alder Hey withheld vital evidence from Ahmed’s ET. Alder Hey then wrote offering Jesudason a six figure pay off part of the deal being that he had to destroy this evidence.  He refused and was forced out after his High Court hearing collapsed (Eyes passim). During the hearing, the Eye was at one stage asked to destroy its damning evidence against Alder Hey because it was ‘the property of the court’, but this request was then rescinded. No attempt was made to examine the evidence, call witnesses or expose the mistreatment of Ahmed and the attempted silencing of Jesudason. MD has referred Simon Gorton QC – a barrister employed by Alder Hey and copiously funded by the public purse – to the Bar Standards Board, to investigate whether or not he played a role in misleading Ahmed’s ET, which  Gorton adamantly denies.. Ahmed and Jesudason’s patient safety concerns have never been properly investigated, but Alder Hey was recently classified as “potentially unsafe” after failing to meet four in five standards of quality and safety in an unannounced inspection by the Care Quality Commission (Eyes passim)

Equally shocking is the smearing of CQC board member Kay Sheldon. In 2012, Sheldon gave evidence to the Health Select Committee about her treatment after making very well founded and politically devastating accusations about incompetence and cover ups at the Care Quality Commission (Eyes passim). On November 28, 2011, Sheldon gave oral evidence to the Francis Inquiry which was publicly refuted through a message on the CQC website. Jo Williams, then CQC chair, wrote to Health Secretary Andrew Lansley the same day asking for her immediate suspension and replacement. Messages were also sent to CQC staff from chief executive Cynthia Bower and Williams undermining the evidence that whistle blowers gave to Francis.

Sheldon continued to attend board meetings but the atmosphere was so unpleasant it was hard for her to do her job properly and she experienced significant stress. She asked for an assessment with someone who understood her situation but was instead referred by Williams, without her knowledge or consent, to Medigold, a private occupational health company. On January 30, 2012, she spoke to the executive chair of Medigold, Dr. Mike Goldsmith, on the telephone for around 10 minutes saying there had been some crossed wires and that she didn’t need to see a doctor. They did not discuss any details about her health.  Following this conversation, and on the same day, Dr. Goldsmith wrote a three page letter to Williams. “My clinical view, based on a 20 minute telephone call, is that this lady is suffering from a mental health problem, which is likely to be one of the conditions that involve paranoia. The most common of which is paranoid schizophrenia and certainly some of the things that were said to me in a completely normal voice and without any emotion would fit with paranoid thinking” and “She may well be in denial, but I suspect she is actually suffering from significant paranoia at present”. He also suggested that her past history be obtained “in confidence” and that “if necessary, obtained a psychiatric opinion on her”. He said he would be happy to speak to the Chief Medical Officer about her. He also stated “I think it is really important that she is assessed or else removed from her position, because I think there are some serious issues here that need to be dealt with and not swept under the carpet”. Goldsmith also wrote a disturbing email stating he would be involved in her case “behind the scenes”.

Sheldon remains a vital member of the CQC board and has shown no signs of paranoid schizophrenia. Williams and Bowyer both resigned from the CQC when all of Sheldon’s allegations were proved correct. Dr Goldsmith was reported to the GMC and no action was taken, despite the inadvisability of suggesting a diagnosis of paranoid schizophrenia when you are not a psychiatrist, based on a short phone call that did not discuss health matters and did not gain patient consent.

The business of covert assessments, and other occupational health work, appears to very profitable.  Dr Goldsmith’s company – Medigold – paid him £256,676 in 2012 with much of the money paid as fees for the Medigold trademark meaning it may well be very tax efficient.  When asked about the tax efficiency, Dr Goldsmith’s son, a former City banker and now finance director of the company replied, “So what?”

But why did the CQC engage a private family occupational health company to do a secret psychiatric assessment? The answer was revealed as Sheldon gave evidence to the Public Accounts Committee last month. Medigold was recommended to the CQC by the Permanent Secretary of the Department of Health, Una O’Brien. So the DH was instrumental in organising the inappropriate, secret and erroneous psychiatric assessment of hugely embarrassing whistleblower by a private occupational health doctor based on a short phone call where health was not discussed.

Una O’Brien remains the most senior civil servant at the Department of Health and one wonders how many other secret mental health assessments have been conducted under her leadership. O’Brien refused to comment personally, but claimed, “The Department suggested Medigold, with which the Department holds a contract for the provision of occupational health services.” If Stevens really wants to support whistleblowers, and reverse the culture of his predecessor David Nicholson, he needs to shine the light at the top of the NHS