Pressure mounts on Great Ormond Street

Three new gaping holes in Great Ormond Street Hospital’s defense of their managerial operation have opened up in the last couple of days.

Andrew Gilligan writing in the Sunday Telegraph today uncovers more material and more witnesses that demonstrate GOSH’s failure to deal with patient safety issues when warned by top consultants with the management turning on those who dare raise such issues. You can read his article here. This follows exactly what happened to my constituent, Kim Holt, a consultant paediatrician working for GOSH at St Ann’s before Baby Peter’s death – who warned that the situation was dangerous and for her troubles was turned on by the hospital. Clearly there are many others in similar positions at GOSH.

Second – a group of consultants have called on the Secretary of State for Health to order an independent inquiry into all of this. They say that there is such a culture of fear that no one dares speak out. I know quite a few people who won’t speak to the media – but would give evidence to an inquiry. Only with the protection of an official inquiry will we get to the truth. 

Thirdly – and most relevant to my concern that GOSH withheld vital information from the 1st Serious Case Review (a statutory process) which documents the events leading up to Baby Peter’s death – is that a key part of GOSH’s defense is that they withheld the information on police advice. In a BBC London report on Friday night the BBC say that Scotland Yard refutes this absolutely and they would never give such advice and it would not be in their jurisdiction to do so.

0 thoughts on “Pressure mounts on Great Ormond Street

  1. I believe that the security checks have been tightened up in relation to employment connected with babies, children, pensioners, and the disabled.

    The problems still arise with employees having an off day or losing interest in their job, but force themselves to remain in that employment for the monthly salary.

    We also face the problem of overworking employees, but underworking the other employees; not all employees are treated equally. Employees on a low-salary may refuse to assist those on a high-salary and demand an immediate payrise to assist.

    It is most important to hire a good recruiter to employ the perfect employee, ie: proper and full vetting undertaken before commencement of employment.

    There will always be the skivers, ie: employees trying to do the minimum of tasks and skiving from as many tasks as they can. Disastrous events may happen through the skiver. Employees rushing to get away early without their boss noticing can cause major disruptions, whether or not permission has been given.

    The section of staff involved with Baby P at St Anne’s, Gt Ormond St, GP Surgeries, etc., should all be dismissed and only reappointed should their name be legally cleared.

    Enhanced CRBs should be undertaken on all the employees. I believe that proper vetting was not undertaken before offering employment to those involved.

  2. I find Lynne one of those rare parliamentarians who really care for their constituents and in particular for the public at large. Her persistent effort to highlight wrongdoing and the culture of secrecy and fear in the NHS is a step forward for a cultural change.

  3. Pity she couldnt be bothered to go to the public meeting in her constituency about the NHS, whose ruination by the Coalition she supports 100%. It was at Highgate Wood school,had well-respected consultants describing the damaging nature of the proposals and was attended by over 100 of her constituents. And the MP who was there? David Lammy MP for Tottenham.

    Some Lib-Dems, like Evan Harris, have had the courage to speak out against profit-led competition and wholesale privatisation in the NHS; against cutting all targets and hence making hospital waiting times already nearly twice as long as last year. Not Ms Featherstone.

  4. David Lammy would be going to meetings now- he is no longer in power or craving to be a Minister.

    Where was David Lammy when his constituents in Tottenham were suffering- here is his voting record-

    How David Lammy voted on key issues since 2001:

    Voted very strongly for allowing ministers to intervene in inquests.

    Voted moderately for equal gay rights.

    Voted very strongly for introducing ID cards.

    Voted very strongly for the Iraq war.

    Voted very strongly against an investigation into the Iraq war.

    Voted moderately for replacing Trident.

    Voted moderately for a stricter asylum system.

    Voted very strongly for Labour’s anti-terrorism laws.

    yes, he was a great MP wasn’t he. What a tosser.

  5. “the BBC say that Scotland Yard refutes this absolutely and they would never give such advice and it would not be in their jurisdiction to do so”.

    Read the non-Murdoch papers or watched the BBC on our revered force lately?


    Rt Hon Andrew Mitchell MP gets Parliamentary Health Select Committee inquiry on whistleblowers

    Posted by Doctors4Justice at 11:35
    We are very pleased that hard working Rt Hon Andrew Mitchell MP has been successful in obtaining agreement from Rt Hon Stephen Dorrell for an inquiry into NHS whistleblowers. Dr Rita Pal, veteran whistleblower (ward 87, North Staffordshire) alerted Rt Hon Andrew Mitchell of problems associated with doing the right thing for the patients in a dysfunctional system of medical regulation.

    Dr Rita Pal, North Staffordshire whistleblower (care of the elderly in Ward 87) with help of Rt Hon Andre Mitchell MP managed to get a committeemen from Rt Hon Stephen Dorrell:

    “The committee will look into whistleblowers. It is every professional’s business to ensure that clinical care where they work is of a certain standard. Like Sir Ian Kennedy said after the Bristol babies inquiry: ‘It wasn’t that nobody knew, it was that everybody knew.’ Every doctor and nurse has an obligation to act if they know there is a problem and those who do nothing should be questioned by their regulator; it would soon stop this kind of thing.”

    We agree.

    However, we do know that when we inform medical regulator, regulator can turn nasty towards whistleblower too, so some measures would have to be introduced to deal with regulators’ wrongdoing. The first such measure would be for regulators to agree to consent order for whistleblower’s rehabilitation where regulator wrongly persecuted whistleblower and introduced sanctions against their professional practice. This would allow High Court to quash GMC findings, for example.

    Another measure would be financial fines for regulator who treats whistleblowers badly. I learned, for example, from training unwilling men to do housework that it was easier to achieve my goal by asking them to contribute towards cleaners’ salary that to give them lectures on feminism or to manipulate them by cooking nice meals for them (I am a good cook).

    Doctors4Justice has campaigned for a couple of years now for improvements in regulation of medical profession. We have produced several papers on whistleblowing. Here is one:

    Read Sir Ian Kennedy’s Witness Statement to Staffordshire Public Inquiry HERE.


    Hung out to dry: scandal of the abandoned NHS whistleblowers

    By Nina Lakhani

    Monday, 4 July 2011
    A parliamentary inquiry is to be held into the treatment of NHS whistleblowers amid growing evidence of cover-ups which can destroy careers, waste millions of taxpayer pounds and endanger patients by creating a culture of fear among health workers.

    The Coalition Government faces a swell of anger among health professionals who are demanding better protection for staff who speak out about substandard patient care and malpractice. Some health services are being cut and tens of thousands of jobs lost as the NHS faces unprecedented financial pressure over the next four years.

    Stephen Dorrell, who was Health Secretary under John Major and is now the chairman of the Commons Health Select Committee, last night promised to hold an inquiry into the treatment of NHS whistleblowers after outrage over the latest case to emerge.

    Related articles
    •Peter Dawson: As cuts bite, we need to protect those who expose failures
    Search the news archive for more stories
    Sharmila Chowdhury, 52, a radiology manager at a London district general hospital, is likely to lose her home after an inquiry found she was unfairly sacked after alleging that doctor colleagues were wrongly claiming thousands of pounds of public money every month, which the doctors and trust deny.

    Ms Chowdhury, a radiographer with an unblemished 27-year NHS career, was marched off the premises following an unfounded counter-allegation of fraud made against her by a junior whom she had reported for breaching patient-safety procedures.

    Ms Chowdhury’s employer, Ealing Hospital NHS Trust, has spent hundreds of thousands of pounds getting rid of her, leaving her depressed, unemployed and broke. After an employment tribunal judge found in her favour, the trust has decided to make her redundant. Her “special severance” must be approved by the Health and Treasury departments at a time when the NHS is cutting thousands of jobs and slashing services in order to save £20bn. She is expected to lose her home because of her inability to meet mortgage payments.

    During the inquiry, MPs can expect to hear from an abundance of NHS whistleblowers – doctors, nurses and even chief executives – who have been punished over the past decade while trying to expose colleagues’ wrongdoing or incompetence.

    Mr Dorrell is likely to demand that professional regulators, such as the General Medical Council (GMC) and the Nursing and Midwifery Council, come down harder on clinicians and managers who are found to be complicit in wrongdoing through their silence.

    Mr Dorrell told The Independent: “The committee will look into whistleblowers. It is every professional’s business to ensure that clinical care where they work is of a certain standard. Like Sir Ian Kennedy said after the Bristol babies inquiry: ‘It wasn’t that nobody knew, it was that everybody knew.’ Every doctor and nurse has an obligation to act if they know there is a problem and those who do nothing should be questioned by their regulator; it would soon stop this kind of thing.”

    On the subject of fraud, he added: “If doctors are dishonestly claiming public money then they, and their medical managers, should be in front of the GMC.”

    Labour introduced the Public Interest Disclosure Act in 1998 following a series of industrial accidents and health and financial scandals, introducing legal rights for employees who expose corruption, safety breaches and fraud.

    When in opposition, Andrew Lansley, now the Health Secretary, promised to beef up protection for NHS whistleblowers amid growing evidence that the Act was failing to protect employees. The Coalition agreement said: “We will introduce new protections for whistleblowers in the public sector.”

    The Department of Health insists that it has “acted swiftly to deliver on this commitment” by consulting on changes to the NHS constitution and by introducing a new contractual right for NHS employees to raise public-interest concerns. However, patients and staff are unconvinced. Examples continue to emerge from hospitals and care homes for vulnerable patients where whistleblowers have been ignored.

    Peter Walsh, the chief executive of patient-safety charity Action against Medical Accidents , said: “The Government’s approach to whistleblowers is totally inadequate. We have fine words and guidance in abundance but NHS organisations have shown a consistent ability to work outside the spirit of these well-intended measures, and regulators seem to stand by when organisations blatantly flout them.”

    Case study: Legal bills – and no hope of employment

    The radiology manager at Ealing Hospital NHS Trust reported in 2007 that two radiology consultants appeared to be taking turns to work at a nearby private hospital every Monday while they were being paid to see NHS patients. The NHS trust says it has found no wrongdoing.

    She reported others for making duplicate claims and for claiming hours they hadn’t worked. She also reported her discovery of discs containing reports and scans from about 100 patients with conditions including kidney cancer which a junior radiographer had failed to upload on to the imaging system for six months.

    In 2009 Ms Chowdhury was interviewed by the internal fraud officer; days later she was suspended and marched off the premises. She was sacked, but pending a full hearing an employment tribunal ordered the trust to reinstate her full pay after concluding that “she would probably win”.

    Following this, and an independent investigation which found no evidence to support her dismissal, the trust wants to make her redundant. She will be left with less than a year’s salary after paying her £100,000 legal bill. Like many whistleblowers, she cannot get another job.

    Medics who dared to speak out

    * Dr Steve Boslin, the anaesthetist who finally exposed paediatric heart surgeons in the Bristol babies scandal in 1995, moved to Australia after being ostracised by the NHS.

    * Margaret Haywood was struck off the nursing register after she went undercover for a BBC documentary, exposing poor standards of care for elderly patients at a Sussex hospital. Five years later she was reinstated by the Court of Appeal.

    * Dr Kim Holt repeatedly warned Great Ormond Street Hospital that its Haringey clinic was unsafe because of staff shortages and inadequate training. Baby Peter Connelly’s life-threatening injuries were missed at the same clinic, two days before he died. Dr Holt remains on “special leave”.

    * John Watkinson was sacked as chief executive of the Royal Cornwall Hospital NHS Trust in 2007 after he refused to remove cancer services without first consulting local people. An employment tribunal awarded him nearly £900,000 in compensation; he has been unable to find another job.

    * Dr Ramon Niekrash, a urological surgeon, was suspended after he refused to stop highlighting patient-safety problems caused by cost-cutting measures at Queen Elizabeth Hospital in south-east London. He was awarded £17,000 by an employment tribunal, but was left with a £180,000 legal bill.


    By Nina Lakhani
    Tuesday, 5 July 2011
    Pressure is mounting on Government ministers to introduce tougher laws to protect whistleblowers
    as health professionals and MPs speak out against a “code of silence” in the NHS.
    A group of leading doctors are urging the government in this month’s Journal of the Royal Society
    of Medicine (JRSM) to consider US-style protection systems which have improved the plight of
    whistleblowers since the Enron financial scandal.
    American whistleblowers are entitled to a proportion of fines imposed on employers who punish or
    silence employees. In contrast, UK managers and bosses appear to operate with immunity while
    whistleblowers often face unemployment and financial hardship even when vindicated in court.
    Dr Peter Wilmshurst, co-author of the JRSM paper, says the huge financial cost of fighting an unfair
    dismissal in the UK acts as a powerful deterrent for colleagues left behind.
    “People know that whistleblowers do not do well in the NHS. This is a political problem that no
    minister is prepared to deal with but it is also a cultural problem within the profession. There is a
    code of silence and so those who do talk about problems are considered aberrant. There is no doubt
    there is a knock-on effect for all those left behind who get too frightened to stand up and speak out.”
    Last year, Ramon Niekrash, a surgeon from South London Healthcare NHS trust who was
    suspended after reporting patient safety breaches at Queen Elizabeth Hospital, before it merged to
    form a new supertrust, was left with a £180,000 legal bill despite winning his employment tribunal.
    A senior surgeon from the trust told The Independent that “things are out of control here, someone
    needs to do something”. Another surgeon said: “After Ramon, there has been a general feeling of
    fear and most people will not complain or take a stand… the doctors are totally de-motivated.”
    The trust said there was “no question” of any staff member facing any consequence as a result of
    raising concerns.
    Dr Stephen Bolsin, co-author of the JRSM paper, who exposed high death rates among babies with
    cardiac problems at Bristol Royal Infirmary in 1995, was forced to move to Australia after being
    ostracised by the NHS. His case triggered the 1998 Public Interest Disclosure Act, but doctors say it
    has “not been as effective as anticipated”.
    John Pugh, chair of the Lib Dem health policy group, welcomed the Health Select Committee
    inquiry, revealed in The Independent yesterday, and said he would ask the Health Secretary to
    consider the US model for protecting whistleblowers. “It’s time to blow the whistle on
    whistleblowers and provide them with protection that works,” he said.
    A Department of Health spokesperson said recent changes made to the NHS contract would help
    but “there is already strong legal protection for whistleblowers and it is clear that people who have
    been subject to detriment are able to seek redress”.

  9. NHS Whistleblowers are at the opposite end of the spectrum to NHS Complainants with significant cases.

    When a patient or relative dares to complain (about poor care/treatment), they may face an terrible up hill struggle and get treated very badly.

    My Father’s case was No. 6 in the 2009 Patients Association Report which dealt with poor nursing care (he was left laying in his own blood and urine for the last two days of life on a MacMillan Palliative Care Ward).

    However 4 years AFTER my Father’s death, I was still wanting answers as to why I had to call the Family GP 2 hours before death as Father laid ‘pulling at the sheets’ as is noted in the medical records.

    The Sheffield Teaching Hospital Trust released documents – 4 years on – that should have been disclosed to us within 40 days of his death when I applied for the medical notes.

    These charts showed an alteration in the Controlled Drug Chart.

    My MP David Willetts (Cabinet Minister) and my MEP Nigel Farage – UKIP, have written twice to the Hospital, Sheffield Teaching Hospital Trust (Andrew Cash) and they have been stonewalled.

    I have a copy of the controlled drug book with an altered entry that ‘implies’ that Dad had a morphine syringe driver refill at 20.20 of 10mgs. on his last night.

    I have a list supplied by the Sheffield Teaching Hospital Trust of when morphine and the syringe drivers were given which states it was 22.15.

    The Sheffield Teaching Hospital Trust informed the Nursing and Midwifery Council 7/7/10 (more than 4 years after Father’s death) that “on speaking to the nurse inquestion she says that it should read 08.20am instead of 20.20pm”.

    There are NO supporting documents for any of the 3 THREE times that I have been given.

    I have seen the original controlled drug book and the entry is actually 23.20pm 5mgs injection of morphine.

    The case is one of cover up – the 2 D grade nurses (juniors) left to man the MacMillan Palliative Care Ward, Sheffield ‘forgot’ to refill Dad’s morphine syringe driver – it was empty.

    My Dad went into Eternity in pain and in fear.

    The case is now with the Healthcare Ombudsman.

    I will keep you informed of the outcome.

    BTW. I published the contrary statement on my website and the NHS employed Lawyers to take my website down!

    Toms Anguish

  10. Have you seen the Press Release sent out by on behalf of 4 well known NHS Whistleblowers – Professor Steve Bolsin, Dr. Rita Pal, Dr. Peter Wilmhurst and Dr. Milton Pena?

    I am a member of the NHS Reform Group who on meeting with Jenny Jackson, Andrew Lansleys Chief of Staff last September, suggested a Health Select Committe to look into the NHS Complaints System and also the set up of a Health Select Committee to look into NHS Whistleblowing.

    Toms Anguish

  11. Dear Tom

    Thank you for reminding us that the real issue here is patient safety.

    It is a national disgrace that children’s lives were put at risk because of budget cuts, and targets, and then huge amounts of money have been wasted in keeping me on special leave. detail see this weeks Private Eye.

    For clarity the reason that I was kept on special leave was because occupational health wanted a meeting with HR in 2007 to discuss my workload in St Anns, and until they had the meeting they would not permit my return.

    I could have returned in 2007. There have been several official investigations into the service, by the serious case review, Sibert and Hodes and the CQC etc. Professor Sibert and Dr Hodes were told that I was on long term sick leave and unlikely to return which was not true and so they assume that I could not be interviewed. They were unaware of the warnings raised by the consultant team or that posts has been cut in 2006. This is all really important. This is the essence of whistleblowing. Hospitals nee to trust the frontline professionals, particularly if the entire team is united in raising concerns.
    The NHS is there to provide services for the public and most importantly for those such as children in need, mental health patients and the elderly who may not be able to access alternative care. We should be able to say if and when they fall to dangerous levels, without retribution.

    Sadly the Health select committee have changed their mind it seems to conduct a review into whistleblowing, saying that there has been a misunderstanding.?

  12. I am shocked and saddened at what our country has become in treating our loved ones in hospital. After publishing my diary “The Last Six Months” on my mothers care in the NHS from life to death, it has opened within me a volcano of ash and debris on the corruption that exits within the NHS.

    I am one of a tiny speckle of ash amongst a magnitude of people fighting for the right to be treated with respect, dignity and ultimate care within our NHS system.

    Good luck Ms Featherstone, keep up the fight and stay strong.

  13. Dear Kim Holt you say “huge amounts of money have been wasted in keeping me on special leave”.

    I dread to think of the amount of money that the NHS has wasted in trying to ‘bat off’ my complaint and others throughout the UK.

    Bottom line here: while the NHS and its regulatory bodies silence and discredit the NHS whistleblower and the NHS Complainant, standards will only decline.

    Dumbing down wins again. Welcome to 1984 – all power to the State.

    BTW did you know that the NHS wasted £3 BILLION in fraud p.a. – and all those kids denied treatment!
    Scandalous – and the CE at Sheffield Teaching Hospital Trust is one of the NHS top earners on £243.00pa.
    This CE has done nothing but mislead me, my supporters, my MP and my MEP – there is just NO accountability – Apparatchik or what!

  14. There is not enough transparency in the NHS and that leads to these problems it seems.

    How we respond to both concerns raised by staff and also to patient complaints is indicative of whether we can learn from mistakes which will always happen. Its how we learn from them that is important. In order to do that we need openness.

  15. Some are calling for a statutory Duty of Candour, including Tom Brake MP, John Pugh MP and Robert Syms MP.

    Please see:

    Until there is a legal obligation to tell the Truth everything will be covered up by the NHS Managers without Mandate, who by the way, total MORE than NHS Consultants. It will be NO good to write into contract’s a Duty of Candour, it just would not work. We have the ‘Being Open’ policy but that is constantly ignored.

    The law as it stands today
    William and Anita POWELL v. the United Kingdom
    Application no. 45305/99
    4th May 2000

    “Whilst it is arguable that doctors had a duty not to falsify medical records under the common law (Sir Donaldson MR’s “duty of candour”), before Powell v Boladz there was no binding decision of the courts as to the existence of such a duty. As the law stands now, however, doctors have no duty to give parents of a child who died as a result of their negligence a truthful account of the circumstances of the death, nor even to refrain from deliberately falsifying records.”

    The NHS, set up in the 40’s, has grown into an out of control business.

    The ‘Triangle’ is the wrong way up. Lots of Managers protecting unaccountable Chief Executives, then frontline staff numbers dwindle and that is why only 2 D grade, junior nurses were left to man an 18 bed specialist palliative care ward in Sheffield during January 2006.
    NB. MacMillan has said that is was MOST irregular.

    Men in suits rule!

  16. Babies and children are dying unneccessarily as are adults and the elderly and it is all down to the fact that honest Health workers are silenced and run out of town when they raise concerns. Just like the NHS Complainant with a ‘significant’ complaint.

    In the case of baby Joshua Titcombe, the Coroner ruled that ’11 nurses had colluded to cover up’:

    To date non of these 11 ‘nurses’ have been struck off.

    (Unlike the whistleblowing nurse on the NHS Reform Group who raised concerns that ‘agency staff’ were employed in the A & E of a Midlands NHS Hospital, who DIDN’T KNOW where the ‘crash trolley’ was or who to phone in an emergency!)

    We know of many Doctors who have also raised concerns about patient safety and found themselves either on ‘Gardening Leave’ or struck off.

    As the Doctors Bolsin, Pal, Wilmhirst and Pena who wrote a paper on NHS Whistleblowing:

    Scared? Well the NHS and Government think we can rest easy in our beds as they think that MONEY is the panacea to solve problems with poor health care:

    NHS pay 1.2 BILLION in damages and half were in connection with Maternity care (blunders)!!!—

    The World (or the UK) has gone mad!

  17. Hi Tom

    I certainly had no idea that gagging clauses were used in the NHS until I was shown the proposed compromise agreement and these are against Dept of Health guidance for obvious reasons. There have been requests to the Dept of Health as I understand it to send out reminders to CEOs and Chairs of Trusts that these shouldn’t be used. As more staff become aware of this hopefully they will have the courage to not sign them. The Minister for whistleblowing Anne Milton could helpfully make a useful statement about these gagging clauses to Trusts.PCts SHAs , CQC ensure that the guidance is followed?

  18. The guidelines all read terribly well.

    Anyone would think that you could and indeed would be welcomed to raise concerns about Patient Safety, but it is all a game you know.

    The NHS Complainant with a significant complaint is labelled ‘vexatious’ and Doctors and nurses who blow the whistle are damned if not cited as mad.

    Their is the ‘Being Open’ policy that is just a joke.

    Please see:!/nhsreformgroup

    Isn’t the NHS wonderful?

    Toms Anguish

  19. NHS system is not good enough to provide excellent patient care and protect excellent doctors.
    Management style that works in state run organizations tends to be”laisse faire” and one shoe fits all until some disaster when politicians get involved to design a better system. When they do, it is not easy for them either to persuade public unwilling to change from the passive position of dependency to something new.
    Out fear grows resistance in the form of hostility towards those who propose changes.
    Nonetheless, the only way forward is to accept where the root of the problem is.
    Money does matter but is not everything. However, managers do operate under financial and political constraints. Human Rights are not a priority and in fact, are a bit of nuisance to all. Freedom of Speech is guaranteed by law within its limitations.
    Gagging clauses do exist in NHS Consultants’ contracts. I have refused to apply for jobs where these clauses are in the job contract and when I questioned the legality I never got the reply from those trusts or interview.
    As English doctors leave medicine, more foreign doctors come and then they leave too. Consultants and particularly women and those of ethnic minorities are not supposed to have a voice and suffer more institutional reprisals. Yes, all of it is illegal.
    Years pass by and life opportunities are lost for whistleblowers while they wait for their profession to come to their senses and stand by whistleblowers. If all consultants stood by Dr Kim Holt she would be back in her job in no time.
    What happens if men take on the cause of children who suffer abuse. Well, they too can suffer rejection. If you watch Irish Prime Minister giving speech in Parliament you will see many empty seats. Yes, some subjects are unpleasant and there is little motivation to deal with them.
    Basic human motivators:
    less work