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May 20, 2017

Private Eye Medicine Balls 1441 March 30, 2017
Filed under: Private Eye — Dr. Phil @ 11:52 am

It’s still not safe to speak up in parts of the NHS – and the staff know it

The risks to the NHS of Brexit are well known. The promised extra £350 million a week to fund the service was never likely to materialise, but a staffing crisis may well do. There are currently 24000 unfilled nursing posts in England alone. The failure of government to guarantee a right of remain for the 140,000 EU nationals working in the NHS and social care system has bred further insecurity. In one survey, 42% of European health staff working here said they are now thinking of leaving the UK. Many have protested about being used as bargaining chips and almost 5,500 have left since the Brexit vote according to NHS Digital, a 25% increase on the 2015 figures. Coming in, only 96 European nurses registered to work in the UK in December, compared to 1,304 last July. Vital EU research funding streams could just disappear, as could EU collaboration on infectious disease control, licensing and regulation of medicines and public health initiatives. These risks are very real and present, yet the government’s latest mandate to NHS England made not a single mention of Brexit.

As usual, it will be left to whistle-blowers to tell the truth about the state of NHS and social care, and the effect of Brexit on it. The Care Quality Commission believes they are now well supported, publishing the following statement from Dr Henrietta Hughes, its National Freedom to Speak Up Guardian on its website on March 21. ‘Since the tragic events of Mid Staffs we have made considerable progress to making the NHS the safest healthcare system in the world including appointing a National Guardian and making sure every NHS Organisation has a Freedom to Speak Up Guardian.’ The NHS whistle-blower Minh Alexander spotted this statement was identical to a department of health press statement from the day before. It suggests that the far from being independent regulator, the CQC writes and regurgitates DH propaganda to give the impression that NHS whistle-blowers are well supported and the NHS is becoming the safest system in the world.

Many whistle-blowers want their ‘National Guardian’ to have statutory independence and powers, but Dr Hughes is housed within and beholden to the CQC, making it particularly difficult for whistle-blowers such as Dr David Zigmond who is campaigning for an investigation into how he was treated by the CQC. Last summer, the CQC and NHS England rapidly closed his highly regarded practice in Bermondsey despite a previous excellent CQC report, very high levels of staff and patient satisfaction and no serious complaints, GMC or coroner’s referrals in an otherwise unblemished career. Dr Zigmond sent detailed and thoughtful analyses of his situation and how he believes he was unfairly treated by the inspection team to the CQC, and has yet to receive a response (Eyes passim)

Henrietta Hughes is unlikely to be much help. She has arbitrarily capped her case load at 20 cases a year, thus shutting out the majority of whistle-blowers who will need help. She refuses to support law reform and claims that she is not in a position to seek statutory independence for her role, which contradicts her job description, and has been unable to help individual whistle-blowers such as Dr Chris Day (Eyes passim), although at least recognising he is ‘very brave.’ As for the Freedom to Speak Up guardians, one has been jailed for fraud. Jon Andrewes faked his CV to obtain employment as chair of Royal Cornwall Hospitals NHS Trust, Torbay Care NHS Trust, its successor Torbay and Southern Devon Health and Care NHS Trust and chief executive of St. Margaret’s Hospice in Taunton, Somerset. He obtained over £1 million in salary from his fraud.

Dr Day’s brave* attempt to ensure all 55,000 junior doctors have proper whistleblowing protection is the most important whistle-blowing case of recent times. He has the support of many grass roots doctors but, incredibly, not the British Medical Association. He is at least being supported by Public Concern at Work, who helped draft the original whistle-blower protection law (the Public Interest Disclosure Act), the stated intent of which was to support all whistle-blowers in the workplace ‘such as trainees, homeworkers and professionals in the NHS who are not normally protected by employment law.’ Dr Day has discovered to his detriment that he had no protection when he raised concerns, and it is shameful that the National Guardian and the BMA are not supporting his case. Who wants to encourage pesky junior doctors to speak up in the dangerous, post-Brexit NHS? The annual NHS staff survey shows 30% of NHS staff still do not feel safe to speak up. In some trusts, as 45% of staff do not feel safe to speak up. Hardly ‘on track’ to be the safest health service in the world.

*now successful – well done and thank you Dr Chris Day