
I remain unimpressed with the seniors in the medical establishment and the profession. I suspect I am probably a product of how ineffective the medical establishment really is in assisting people or decent doctors.
The Forgotten Grave of North Staffordshire NHS Trust
There is a lot of things most people can say about me but in reality I am NHS Whistleblower. In 1998, I followed the guidance set out in Good Medical Practice[GMC] and raised concerns about substandard care on Ward 87 North Staffordshire NHS Trust. I also raised concerns about the large number of Midlands Hospitals covered by West Midlands NHS Executive in 1999. Following the recordings of the HSMR scores, only Mid Staffordshire NHS Trust spiked their figures. This was due to the inordinately high death rates. These deaths could have been prevented had the government acted in 1999. There are many other hospitals with equally high death rates but 1000s have not raised the HSMR scores. The Mid Staffordshire Inquiry shows poor standards that are similar to many hospitals in the Midlands [particularly Distinct General Hospitals]. They were also the identical to the concerns raised by me in 1999, many years before.
In 2010 the CQC finally admitted that North Staffordshire had "significantly high mortality" in the years I raised concerns.
This blog follows my adventures as a whistleblower. It was written between 2008-2010. It seeks to present what the media have never done. I also aim to discuss a number of medical issues important in the NHS today. A short account of my experiences is presented here.
Essentially, I raised concerns in 1998, locally then to all the authorities, the GMC, Department of Health and Trust attempted to say there was no substance to my concerns. In 2005, I discovered that all authorities had concealed the 1998 and 2001 internal reports that verified my concerns. This is a brief step by step summary of the events related to Ward 87.
Between 2000-2002, the General Medical Council conducted a "discreet inquiry" into my Fitness to Practice. I was never told of this investigation until I discovered quite by accident following a subject access request under the Data Protection Act 1998. The GMC were subjected to litigation by me due to the illegal investigation and repeated leaks of prejudicial information to potential employers. They were beaten in court following the first litigation of its kind. The GMC settled the case in favour of me. During litigation, the GMC subjected me quite severe harassment by revolving door vexatious complaints - 2 in total. I was cleared of all of them. I was never subjected to any Fitness to Practise hearings. All complaints were thrown out at case examiner's stage despite the GMC's malevolent intentions.
The GMC subsequently erased me from the Register for non payment of subscription fees. It should be emphasized that I was never sanctioned or struck off has speculated by some bloggers. In total, I have been subjected to 4 years of complaints that had no relation to my clinical work. This has had catastrophic consequences to my work as a doctor and eventually caused the assassination of my references in 2007.
This led to the test case R v General Medical Council Ex Parte Pal with the intention of defining the definition of potential misconduct and preventing vexatious complaints against doctors. The complaints were made by Penny Mellor and her associate Fiona Wollard [ niece of Professor Sir Charles George].
While permission was granted by a judge with Employment Law experience, the final hearing was lost courtesy of Justice Sir Andrew Collins who made various statements. One was that the GMC was free to rule differently on two separate cases with exactly the same facts and the other was to widen the analysis of misconduct to include conduct outside the profession. Justice Sir Andrew Collins has sat on numerous cases related to the GMC. He has often failed to declare that his brother Dr Mark Collins was once prosecuted by the GMC for alliances in Clapham Common. Details of this can be read here.
The two diametrically opposite analysis of misconduct was also discovered following the GMC's submission to R v General Medical Council Ex Parte Remedy UK. Essentially, one analysis appears to be used for some foreign doctors and a different more lenient definition is used for establishment doctors such as Liam Donaldson. The GMC were essentially caught red handed touting two different analysis of misconduct in two cases. This discrepancy is currently being investigated by both the CHRE and the Equality and Human Rights Commission.
The defenses to all these cases have taken up 52 files. By comparison, the GMC refused to investigate the doctors on Ward 87 despite the fact that their conduct was directly related to clinical work. They continue to work in various positions in the UK. No one was held accountable despite 2 reports verifying my concerns. Moreover, the Health Commission refused to conduct a broader data study in relation to the Ward 87. The GMC and Ombudsman refused to inform the patients on the Ward of the 1998 and 2001 Reports. The Sentinel newspapers refused to feature a legitimate advert.
In 2009, after discussion with Dr Phil Hammond, he wrote an excellent piece in Private Eye. While the media have provided little or no support for these issues, I am indebted to my fellow bloggers - Dr Rant, The Jobbing Doctor, Dr John Crippen and Witchdoctor. This blog exists to protect other doctors who I hope will never tread the path of whistleblowing. It is a path paved with injustice. It also serves to show the public that they cannot legitimately expect doctors to raise concerns in such a dangerous terrain. This indeed places patient safety in great jeopardy.
This blog ended in February 2010 as it was unlikely that I would ever return to medicine. I have also decided to end this particular saga here. I hope this blog will educate, entertain and remind the public that whistleblowing is a dangerous escapade and no junior doctor has treaded the same path as I have for a reason. The terrain is unsafe and always has been. I would say that I have been relatively unsupported in my journey through whistleblowing but singlehandedly I have been able to undercover evidence and establish some very important issues regarding the dangers of whistleblowing. I have ceased to respond to the media but I am always very happy to discuss matters with the public.
2 comments:
Dear Dr Pal,
I have just found this site. Following your comments I took the trouble to read the Panel Judgement.It states:
"The patient confidentiality which she broke in so doing concerned the care (or lack of care) which (certain) patients on that ward experienced in that time frame and their suffering in consequence."
It seems extraordinary that exposing a patient's suffering due to a deliberate and negligent lack of care can be considered to be an action to be prevented by the relatively trivial issue of confidentiality. The legalistic navel-gazing is as nothing compared to the suffering, cruelty and degradation being meted out.
The Panel had regard to the protocol drawn up between Panorama and Mrs Haywood, prior to filming, which stated:
"PRIVACY There are going to be major problems with privacy. M will be recording patients at their most vulnerable and compromised. She will attempt
wherever possible not to record any highly personal or intrusive procedures, however if she feels she needs to record evidence of bad practice she will continue to record but will try to capture medical staff faces wherever practical.
TAPES We will inform patients and / or their families that we have been recording on the ward. Our aim will be to wipe tapes which do not need to be preserved for various reasons but not wiped until senior member prod team has agreed.
FAMILIES Unless families have explicitly alerted programme teams to bad practice, they will not be informed about filming until we have finished and reach the consent stage. Once filming is completed, we will seek the consent of every patient filmed or where they are too ill or incapable of giving informed consent, families or where appropriate, a close friend will be contacted and given time to come to a decision without pressure."
The protocol recognised the difficulties with regard to privacy and confidentiality and the intention was clear that consent was to be obtained prior to the programme going on air. Mrs Haywood was not reckless as to her responsibilities - she actually took steps to address the issue of confidentiality in a way she considered complied with her duty in this respect.
The Panel, however, took the view that in handing over the tapes to Panorama confidentiality had, at that point, been breached, regardless of any intention to subsequently seek consent.
They went on:
"But paragraph 5.3 of the Code sets out certain circumstances whereby information may be disclosed outside the team (of nurses and carers). If consent cannot be obtained for whatever reasons, disclosures may be made only where
they can be justified in the public interest (usually where disclosure is essential to protect the patient or client or someone else from the risk of significant harm).
The registrant relies on that sub - paragraph to justify her action in disclosing the confidential information to the Panorama team. Moreover, by reference to the paragraph in the protocol relating to FAMILIES she can say that no patients would be shown in the Panorama programme unless they or their families had given their consent. She says she was justified in carrying out the filming and breaching patient confidentiality because of the awful conditions on the ward.
It seems to the panel that the registrant’s stance must be tested by reference to the words in parentheses. Was disclosure of the confidential information essential to protect the patient from the risk of significant harm?
The panel is sensible to the fact that there may be instances where disclosure of confidential information may be essential to protect a patient from significant harm. But it addresses the issue of whether it was essential in this case. The panel has concluded that, for it to be “essential” for the registrant to breach confidential information, she must first have exhausted all other avenues of addressing the inadequacies on the ward; alternatively there must be an immediate need."
The panel decided that the pubic interest defence could not be relied upon since in their view Mrs Haywood had not exhausted all internal means of remedying the deficit in care. They go on to say:
"In the circumstances, the panel find the registrant is guilty of misconduct. She followed the behest of the film makers who were concerned “to portray the truly appalling care given to some elderly patients” to quote from the Record of Secret Filming and Recording application for permission to film, rather than her obligations as a nurse. There was a conflict of interests here and the registrant followed her role as a person engaged by the Panorama programme rather than her duties as nurse.
Further the panel finds that the registrant’s fitness to practice is impaired by reason of her misconduct. There has been no indication from her that the misconduct of which she is guilty has been remedied. Rather she relies on the justification of exposing the conditions on the ward to the public not the need to discharge her duties as a nurse."
One of her duties as a nurse was certainly to preserve confidentiality, and it seems to me that she both recognised that duty and took steps to properly and fully address it by the protocol she drew up. The distinction drawn on this by the panel seems to be one which it was not necessary to draw and they could easily have taken a different view without compromising their rules.
I would suggest that a greater duty, both as a nurse and a human being, was to take steps to bring to an end the cruel and degrading treatment being meted out to the helpless elderly patients.
Amazingly, the panel noted that the claims from hospital management that all issues were being addressed were untrue, and it was not until after the programme was aired that improvements were made.
There is such a thing as natural justice, and the fine print of the law or the rules should not act to prevent it. There was no mention whatever in this judgement of the benefit brought about by Mrs Haywood's action, no mention of the patients, and no mention of the nurses, doctors and NHS managers who conspired in silence.
Mrs Haywood deserves the thanks of every one of us, as do all those brave enough to whistleblow. I sincerely hope this is not the end of the matter for her.
http://www.wandsworthguardian.co.uk/news/4309459.Widower_appeals_medical_watchdog_s_decision_not_to_investigate_wife_s_death/
http://www.wandsworthguardian.co.uk/news/4309459.Widower_appeals_medical_watchdog_s_decision_not_to_investigate_wife_s_death/
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