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Archive - Tag: Whistleblowing

August 22, 2010

Dr Phil’s Private Eye Column Issue 1269 20.8.10
Filed under: Private Eye — Tags: , , — Dr. Phil @ 1:01 pm

Rewarding Whistleblowers

Well done Channel 4 News and the Bureau of Investigative Journalism for their exposure of the widespread use of taxpayers’ money to silence NHS whistleblowers (Ch 4 news, 2.8.10). Many employment contracts still have gagging clauses and most doctors who invoke the Public Interest Disclosure Act (PIDA) to raise concerns about unsafe or fraudulent practice reach a settlement with their employer to prevent concerns being made public. Superficially, this smells of whistleblowers bottling it and taking the money, but when you look at the experience of those who refuse to be silenced, there’s no great incentive to do the right thing.

The NHS’s most famous whistleblower, Dr (now Professor) Stephen Bolsin, was praised in Parliament for raising concerns about standards of child heart surgery in Bristol nearly 20 years ago, and his actions were fully vindicated by a Public Inquiry. Yet he became unemployable in the NHS and relocated to Australia, where he continued his excellent work in monitoring clinical outcomes. Had Bolsin remained in the NHS, it is inconceivable that small units would have been allowed to continue operating and the Oxford heart scandal would have been avoided (Eye last).

If Andrew Lansley is genuine in his desire to support whistleblowers, he should consider formal recognition of Bolsin’s bravery1. The Mid Staffs inquiry will doubtless show that staff were either too afraid to blow the whistle, or too easily silenced, despite the many avoidable deaths occurring around them. NHS whistleblowers are vulnerable and isolated, and have few role models. The public recognition of Bolsin’s legacy would go some way to making it acceptable to speak up.
For whistleblowers who want to go the distance, the best chance of being heard is to go to court. In the UK, any payouts tend to be swallowed up by legal expenses and loss of earnings. But in the US, whistleblowers are rewarded handsomely if they help the government bring a successful case. In May, the New England Journal of Medicine followed up 26 successful whistleblowers from the pharmaceutical industry 2. On average each received $3 million for speaking up, with the range going from $100,000 to $42 million. Last September, Pfizer paid $2.3 billion to settle allegations that they illegally marketed a painkiller, Bextra, which has now been withdrawn. A proportion of the settlement was divided between the 6 whistleblowers.

Whistleblowers are rarely motivated by money, and nearly all try to ‘go through the correct channels’ first before going public. And even a large payout is scant consolation for the emotional exhaustion and stress of speaking out. In May, an employment tribunal found that John Watkinson, a former chief executive of the Royal Cornwall NHS Trust, was sacked for blowing the whistle on the failure of the Trust and Strategic Health Authority to consult the public adequately before moving cancer services. An independent review has now agreed that public consultation was inadequate, but the Trust is appealing against the tribunal findings. They accept that Watkinson was unfairly dismissed but challenge that he was a whistleblower, wary off the unlimited damages that are supposed to be awarded to sacked whistleblowers under PIDA. In the meantime, Watkinson remains unemployed – and like Bolsin, probably unemployable in the NHS.

As well as publically recognizing whistleblowers, Lansley needs to place a statutory duty on all NHS employers to report all serious concerns about patient safety or fraud to the Care Quality Commission (CQC) and Monitor for investigation and publication. Gagging clauses, and attempts to buy the silence of public sector workers raising genuine concerns in the public interest, must be outlawed. Whether the CQC and Monitor have the independence, expertise and resources to deal with all the NHS’s dirty secrets remains to be seen, but the practice of damage limitation, either by paying off staff or ordering secret ‘independent’ inquiries that never see the light of day, must end.

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April 7, 2010

Dr Phil’s Private Eye Column, Issue 1259, March 31, 2010
Filed under: Private Eye — Tags: , , , — Dr. Phil @ 5:38 pm

Whistleblowing under Labour

It’s now over a decade since the Public Interest Disclosure Act was introduced to protect whistleblowers but the bullying of and discrimination against those who raise concerns in the NHS is still rife. Consultant paediatrician Dr Kim Holt used to work in the Haringey clinic, run by Great Ormond Street Hospital, where the imminent danger to Baby Peter was not spotted. In April 2006 – a year before Baby Peter was seen –Dr Holt was removed from her post after she and three other doctors wrote to management warning of tragedy due to failings including staff shortages, dangerous over-working and poor record-keeping. When Baby P was found dead, the hospital allegedly offered Dr Holt money to remain silent about her complaints.

Dr Holt claimed the hospital managers panicked after Baby Peter’s death: ‘They said I had to withdraw my allegation or the money was off the table. They were trying to buy my silence.’ Dr Holt refused to sign a statement saying all her concerns had been addressed. ‘I was not going to be gagged. I must speak about this because it is so wrong. If our concerns had been taken seriously at the time we raised them, then we could have prevented the death of Baby Peter. The children had no one else to speak up for them and we felt passionately that we were letting them down. The response of management was hostile and bullying.’
So what has happened to Dr Holt since she was sent on ‘special leave’ three years ago? Surprise! She’s still on special leave. In December 2009, Great Ormond Street promised to reach a ‘swift and amicable solution’ with Dr Holt after a damning NHS London report largely vindicated her criticisms of the Haringey clinic and recommended her reinstatement. However, Dr Holt has yet to be offerd her job back. NHS management remains notoriously intolerant of dissent, and yet Dr Holt is just the kind of brave clinician needed to speak up when patients are put at unacceptable risk. To support her reinstatement, sign here 1

Sir Ian Carruthers, the chief executive of the South West Regional Health Authority and a former acting Chief Executive of the NHS, is not a man to get on the wrong side of. Former Cornwall hospital boss John Watkinson quotes him as saying: ‘To teach chief executives to listen, I only have to put one head on a pole and put it outside the strategic health authority.’ Graham Rich, the chief exec of University Hospitals Bristol, offered his head on a pole in January, after the hospital failed to hit targets set for it by Monitor and became the subject of an inquiry into its pathology services. But – as with the heart scandal previously – the pathological allegations were long-standing and well-known not just to the hospital management but the PCT, local cancer networks and Royal College of Pathologists. Carruthers should have known about them too, but the culture in the South West is still to suppress bad news rather than encourage open debate.

The inquiry triggered by the Eye in June 2009 is being held in private and may not report until summer 2010. So is there a current threat to patients? UHB’s website would suggest not. The information for patients, last updated on 25/1/10, says: ‘University Hospitals Bristol NHS Foundation Trust and North Bristol Trust have been working jointly for some years to minimise any procedural obstacles to effective diagnosis. Both Trusts agree that no new concerns have been raised since 2008.’ 2 And yet MD has discovered that new concerns were made in November 2009, and that the Inquiry Panel, both hospitals, the GMC, the CQC and the NHS Medical Director are aware of them. Just don’t tell the patients….



Note: UHB have now updated their website in response to this article

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