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September 20, 2010

Dr Phil’s Private Eye Column, Issue 1271 September 15

PFI at all costs….

In 2003 Dr Peter Brambleby, then director of public health for Norwich Primary Care Trust (PCT), received requests from senior clinicians at the PFI flagship Norfolk and Norwich Hospital hospital (Eyes passim) to look into their concerns about changes to the design and build that they believed put patients at risk. The ventilation system and isolation facilities were top of their list, but so were a lack of management response and a culture of secrecy.

When his preliminary inquiries confirmed cause for concern, evidence of covering up and a lack of proper supervision by Norfolk, Suffolk and Cambridgeshire Strategic Health Authority (SHA), Brambleby put the matter in the hands of the National Audit Office (NAO) on 31 March 2004. The NAO, led by Sir John Bourn [Eyes passim], referred it straight back to the SHA and hospital to investigate.

External scrutiny did at least prompt some remedial building work (at the NHS’s expense), a belated clinical risk assessment (from which Dr Brambleby was barred), an internal inquiry (which omitted key witness testimony and declined to track down critical records on changes to design specification), and a flurry of press interest. Much was at stake. Not just safety of patients and staff using the hospital, but the reputation and value of this scheme to its financial backers and the credibility of the whole multi-billion pound NHS PFI programme to follow.

On 4 May 2004, the PCT asked Dr Brambleby to give a statement to the media but to check with the SHA press officer, who was briefed and ready for the call. He said he had read all the “libellous” correspondence, had briefed the Secretary of State (John Reid), and warned Dr Brambleby that unless he dropped the whole matter he would end up “like Dr David Kelly who was found dead in the woods with his wrist slashed.” Complaints about that threat to NAO and SHA fell on deaf ears.

Documents recently released on the instruction of the Information Commissioner’s Office show that Norwich PCT chief executive Dr Chris Price took up the complaint in a letter to SHA chief executive Peter Houghton on 11 June 2004: “… the unacceptable behaviour of Mr Davies … was an orchestrated and deliberate attempt to bring pressure to bear … to intimidate me into making public statements which would discredit Dr Brambleby … (the press officer) made wholly inappropriate referral to the death of the late David Kelly as an illustration of what happens to whistleblowers … I know he said these things because he had a very similar conversation with me … I would hate to think that he might subject some other less robust individual to the same sort of treatment in the future and I guess that is the real reason I feel compelled to make this complaint.”

And the response? Nothing. It was months before the SHA looked into it, and years before the findings were released, albeit in redacted form, and through the intervention of North Norfolk MP Norman Lamb. In it, the press officer claimed his advice was: “… wholly appropriate given the circumstances … talked through the advice with colleagues … the recent case of David Kelly was a perfect illustration of someone who ended up caught in the crossfire between politics and the media … Peter Brambleby, as a public servant, had no democratic legitimacy … it was advice I would give to others in similar situations.”

This latest example of top-down bullying of those who raise legitimate concerns in the NHS reveals Labour’s desperation to make PFI work at all costs. While safety concerns were suppressed, former health secretary Alan Milburn was paid handsomely to speak at a ‘strategy seminar’ in the south of France, as guest of Financial Securities Assurance, the bankers who remortgaged the Norfolk and Norwich PFI.