Written by Professor David A Brenton University College London to Dr Fiona Moss/ Elizabeth Paice Associate Dean plus postgraduate dean, Postgraduate Medicine North Thames 33 Millman St. London.In general, I have always felt that the basic problem with the genetic makeup of senior doctors is that they used to be recruited from well to do families. There is no problem with this but they all tend to be a little out of touch with real life. Dr David Brenton was a very nice man. Thats all anyone could say about him really. I know he was a brilliant teacher and taught me most of clinical medicine. Despite the criticisms of the Trust above, there was always a sense that Dr Brenton did not approve of me raising the appropriate concerns. To him, it was not the done thing and neither should I have done it. Retrospective analysis is a fine thing but the domino effect of circumstance is something that people cannot control. I often felt that these senior doctors were often at right angles to reality. It is as if the more research or books they read the more impractical they get. They aren't malicious people, just careless or short sighted.
I qualified from University College London so technically the above individuals were responsible for my training and also responsible for ensuring that all was well. As I said, the problem with senior doctors is that they are often completely out of touch. Their ability to problem solve practically tends to disappear the more they travel up the medical ladder. The problem here was Ward 87. They had the opportunity to instigate the appropriate procedures to solve Ward 87 but they opted not to. Throughout the postings on his blog, the reader will understand that the Trust and establishments always directs the problem to be the whistleblower. This has been found in various studies world wide. Due to this character questioning or assasination, it becomes incredibly difficult to prove yourself. I suspect for me, the constant questioning led me to go and obtain the evidence that I was effectively right. The above letter is from the Deanery's vaults obtained when Dr Brenton had retired. He had initially refused to disclose any material to me. His lawyers had advised him that " I would go away" if he denied this disclosure. There is though always a way to go fishing for documents.
This is what University of London did. I had gone there with essentially a whistleblowing case. Their reaction to this should have been to immediately inform the Department of Health and to remove me from the clutches of those who clearly did not have my best interests at heart. They should have also brought me back to London. What they actually did was something completely different. Dr Brenton wrote a letter to Fiona Moss. Thats as far as Dr Brenton's role went to. Fiona Moss than rang me up. I recall the conversation very well indeed. She was a upper class lady with a accent to match. She ruffled on the phone insisting she was a busy lady. Thats another thing that happens to senior doctors - they become to busy for anything. I was attempting to explain the problems to her and her solution to the entire thing was counselling.
" Ummm, I thought, how does counselling solve the problem on the Ward". Of course, it didn't solve anything. Infact, that is all the Deanery did, apart from inform the Midlands that I reported the problems to them causing the Midlands Deanery to froth. It is quite laughable now that they reported my concerns to my victimisers and then washed their hands of it. Infact, the trio left me in the clutches of my victimisers without so much as a solution.
This though is the senior medical profession for you. Inept at solving the problem, inept at looking at the wider picture and also inept at changing policy. UCL continued to send junior doctors there and had not listened despite being quite critical of what had happened. It also shows that no one actually acts to protect the junior doctor. The junior is pointed at with their pointy fingers and made the problem. Their internal musings and debates on their analysis of the junior then filters to all quarters.
Dr Brenton was sent the 2001 Report but he never responded. In his eyes he had done enough to support me [ whatever that support was]. I will always be of the view that he failed me or even more importantly, failed the patients. The Bristol Inquiry talked about the code of silence. Realistically, no one pays much heed to the Bristol or Shipman Inquiry. They are simply Inquiries to provide large levels of documentation that no one reads or considers.
Throughout this posting it is vital to note how the three senior doctors did not seek to ensure patient safety on the ward. They demanded no answers nor did they question issues nor did they refer the Trust to the GMC for non compliance of the regulations on junior doctor supervision. These issues were a clinical risk and despite talking amongst themselves, they all overlooked this one salient point. Action from them may have prevented numerous deaths.
So far there is a sequence of events from start to finish where the actual concerns were not reported properly to anyone by any senior doctor and primary responsibility left to the Trust - who took between 1998 to 2001 to conduct any meaningful investigation. This is of course the Trust who had concealed these issues for many years. The London Deanery did not follow up the concerns, did not follow up my progression, did not follow up what had happened at all. I was given the details of a counsellor, I threw it straight in the bin. It was simply that I didn't accept that I was the problem and no one was going to persuade me that I was infact the problem. To many people at the Trust, that is evidence of a " difficult personality" but just because you don't hide in a corner and accept that you have to be a victim does not mean you have a "difficult personality".
So overall, the local system failed, the system placed at my university failed -infact a lot failed. I show this because many potential whistleblowers think it is safe to raise concerns. The NHS is currently an unsafe organisation. No lessons were learned from the above. The trio at the University simply ignored all the reports and continues in their merry way while being convinced that they were right. Of course, they were far from right. Infact, their lack of action placed patient lives at risk.
The 2001 Report (click here to read) concluded, amongst other things, that:
a) “Patient care was clearly affected by the failures identified”;
b) “The Directorate failed to take appropriate action when the allegations were made in a statement by Dr Pal”;
c) “Although medical and nursing staff were concerned about the range of issues … no one voiced their concerns except Dr Pal which either demonstrated a general acceptance of the issues or staff felt unable to raise concerns”.
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