Cure the NHS

Cure the NHS is a distinctly innocent group of campaigners. I spotted one of them today on the Politics Programme. Apparently, they were shocked and startled that the government had refused Mid Staffordshire NHS Trust. What Julie fails to understand is her hospital is not the only hospital with such poor care. It is simply a hospital that was noticed. Other hospitals simply go unnoticed due to the lack of community spirit etc.

Their campaign is laudable. After ten years they will find themselves in the same state. They will also find that there is no justice, or improvement of healthcare or anything of the sort. The only people that make money and fame out of the deaths of patients are the MPs and the lawyers. I suspect a lot of money will be spent on various clauses through litigation. These scandals simply follow a re-run much like ground hog day. We have to ask ourselves what happened to the Thameside Group who promised so much but delivered so little. After 18 months Julie Bailey is exasperated. It has only been 18 months. After a decade, no doubt the hospital will simply be as it used to be - because that is the culture of the NHS.

In the meantime just down the road in Stoke on Trent, Dr Ahmed has persuaded the Express to support him. He is featured in the papers again today. The CQC have apparently taken up his concerns which is a step in the right direction. Of course, the CQC are rather capricious.

Mr Shiban Ahmed, Circumcisions, Suspensions and Intrigue

Mr S Ahmed suspended by North Staffordshire NHS Trust was featured recently by the Express Newspapers. Hailed as the whistleblower and I suspect the media are hoping for another Bristol. Quite a different spin is given by This is Staffordshire. Moreover, there appears to be some litigation afoot.

In it the consultant, whom The Sentinel is not identifying, said: "As I think you are aware, Mr Ahmed is currently suspended, but the reason for this is not entirely clear."

He added: "There seems a perception that Mr Ahmed is causing the concerns to be raised and that this in some way serves his own interest.

"I believe that he is answering both his conscience and professional duty, possibly at some significant personal cost."

Richard Dawkins website has an interesting discussion.

North Staffs Management "fibbing" Again

So there is apparently another whistleblower at North Staffordshire NHS Trust. The Express lists a article.

"AN NHS trust has been accused of victimising an eminent paediatrician who claimed that a baby’s death and at least 28 botched operations on children were caused by unskilled doctors"

Apparently, North Staffs are saying "He has mental health problems". Fascinating. So, the fact that they grabbed my poetry and said the samething about me in 1998 when I raised concerns on Ward 87 is merely a coincidence. The fact that that rumour settled within the GMC is probably also a coincidence. Or we could say that North Staffordshire management just has a way with whistleblowers. That way is to say they are bonkers so no one believes them.

This is what North Staffs had to say

"A spokesman for the UHNS NHS Trust said: “No one has ever been, or would be, suspended for blowing the whistle at University Hospital of North Staffordshire. The trust cannot comment on issues relating to individual members of staff.”

ROFL. The Trust attempted to discipline me after I had raised concerns in 1998. They failed miserably of course. This case will be interesting to watch. The good thing is that consultants are normally considered right despite the fact there are no independent figures backing this doctor. Nevertheless, we need to give him the benefit of the doubt. It is all looking bleak from here because thats the way it goes at North Staffordshire. The management is a bit like a cesspit of poisonous snakes. If you don't get out, they devour you. It is a simple message for our whistleblower - time to extract himself from the Trust before the Trust extracts him from medicine.

No doubt the GMC will be sniffing around here wondering whether they should get their clawed hand into this fiasco just to ensure a fair mix. Mind you, he is a brave whistleblower for giving data to the media given the GMC's new guidance on confidentiality.

Dedicated to all my ex lawyers

"Queen's Counsel" by Stuart & Francis Staff :

"Who lost the case?" "Not I said the eminent silk, my junior let me down." "Not I said the Junior, my instructing solicitor was to blame" "Not I said the solicitor, my associate dropped the ball." Not I said the Associate. I was never supposed to work on this case. no one explained it to me, and anyway, I'm getting out of here in three weeks".

Public Interest Disclosure Act 1998

I recently wrote a piece called " After Bristol". During its research I discovered some interesting facts about PIDA [ Public Interest Disclosure Act]. The upshot of the research is this - the government says it is working but the research says it isn't. So is the government misleading us all?

In the media, the government's position is as follows

A spokesman for the Department of Health insisted that the law did not need to be changed and that anyone who raised concerns about patient care would be protected.

He said: "Whistleblowers already have full protection under the Public Interest Disclosure Act.

"We expect that any member of staff who reports concerns about the safety or quality of care to be listened to by their managers and action taken to address their concerns"

The main research has been done by Middlesex University

Professor Dave Lewis wrote the following some years ago.

"Although PIDA has been commended for skilfully balancing the interests of the public and of employers’, it could be argued that in reality employers' interests have been given prominence. Indeed, some would argue that internal whistleblowing/confidential reporting procedures can work against the public interest in that they facilitate cover–ups and deprive the public of information about wrongdoing.

In the light of our conclusion that PIDA 1998 has not adequately protected whistleblowers we make the following suggestions for reform. Firstly, in accordance with the basic approach to rights taken by HRA 1998, workers should be given a positive right to report concerns. This should be afforded to all those who work for and receive remuneration from another person or the State. Instead of excluding the security services altogether, it would be preferable to devise special rules for the protection of information about international relations and intelligence."

Then a review was done for 10 years of PIDA, the conclusions were as follows

"Purpose The purpose of this article is to assess the operation of the UK’s Public Interest Disclosure Act 1998 (PIDA 1998) during its first 10 years and to consider its implications for the whistleblowing process. Method The article sets the legislation into context by discussing the common law background. It then gives detailed consideration to the statutory provisions and how they have been interpreted by the courts and tribunals. Results In assessing the impact of the legislation’s approach to whistleblowing both in the UK and elsewhere, the author draws upon empirical research. Conclusion The author concludes that PIDA 1998 has not adequately protected whistleblowers and makes 12 recommendations for change. Despite the European Commission’s acknowledgement that whistleblowers can play a part in the fight against corruption, the author notes that common standards for their protection still seem a long way off"

Anonymous Medical Blogging

An interesting case in the Register for all those who wish to remain anonymous is this one.

A large number of medical bloggers are anonymous. Those bloggers are Dr Crippen, Jobbing Doctor, Witchdoctor et al. All of whom provide a good service for the rebel blogsphere.

They are anonymous mostly because they do not want the General Medical Council to deeply breathe down their neck. It is an uncomfortable feeling and believe me - not a pleasant experience. The entire judgment can be read here.

"The Times has overturned a court order which sought to protect the anonymity of a police blogger known as NightJack.

The blog, which has now been deleted, detailed the life and views of a serving police detective. Earlier this year it won an Orwell prize for political writing"

The blogger is Richard Horton a 45-year old detective constable with Lancashire Constabulary. When contacted by Murdoch's organ he sought an injunction to protect his privacy. But Justice Eady ruled he had no right to anonymity"

Well, of course Richard Horton was going to be outed as the writer. Afterall he applied for the injunction! Well at least he got the Common Purpose prize for his blog.

Mid Staffordshire NHS Trust Whistleblower

Mid Staffordshire Lawyers

Lawyers in Stafford are being paid large amounts of money to prevent whistleblowers from talking to the media. Mid Staffordshire NHS Trust is insecure. We know why they are insecure. They know the death rate [ if monitored adequately] would have shown how thousands died in the last 27 years. Similar quality of care is seen in North Staffordshire NHS Trust, the Trust who sported a 3 million compensation bill in comparison to the £600,000 for Mid Staffordshire. We don't talk about things like that do we? Not in England we don't.

Anyway, here is Pradip Singh, an admirable man who is raising concerns after the concerns have been investigated :). No doubt the Telegraph does not think he had a axe to grind, a honour they bestowed upon me in the year 2000 when I attempted to tell them about North Staffordshire NHS Trust. We don't talk about that in England do we? I know the history of the Telegraph though. I also know that their journalist was so disappointed that it was not featured in the British paper, he wrote the article up in a piece called The Whistleblower, featured in the Calcutta Telegraph. So, as a British Citizen, I had to rely on India to feature an issue relevant to the UK. The Telegraph have nothing to say of course. Two years ago, they spent a great deal of time removing everything about Ward 87 from My Telegraph.

They currently run a Heal the NHS Campaign. Well, its too late for that now. Lots of people are dead. The Telegraph should ask themselves - had they featured the poor quality of care at the Health Authority covering Staffordshire in the year 2000, would these deaths be prevented? Now that is the million dollar question.

From the Telegraph

Senior consultant Pradip Singh has used the protection of the House of Commons all-party Health Committee to tell his story of what went wrong at Stafford Hospital.

In documents lodged with the select committee, Dr Singh, 48, reveals how he first warned managers and fellow consultants of dangers as long ago as 2005.

And he claims that problems persist three months after the publication of a damning report by the Healthcare Commission which described standards of care at the hospital as "appalling and chaotic".

Dr Singh, a gastroenterologist, says in his evidence to MPs: "Over the years, many clinicians had noticed deterioration in the standards of patient care which became particularly acute approximately three years ago when major cut backs were made in staffing numbers.

"This included a savage reduction in the number of nursing staff.

"Sadly, despite the recent talk of transformation, and the damning Healthcare Commission report, the ground realities have not changed much."

He claims that following budget cuts, his department experienced "dozens of serious adverse clinical incidents resulting from abysmal secretarial support".

In one case, he says, a patient who had a treatable tumour in his pancreas ended up developing inoperable cancer after a report into his condition got lost.

Mid Staffordshire NHS Foundation Trust, which runs the hospital, last night called the allegations of adverse incidents "unsubstantiated" and invited the consultant to provide evidence.

Internal email exchanges, submitted by Dr Singh to the Commons committee, show that his continuing concerns are still shared by fellow doctors.

One email sent by a consultant at the hospital to Dr Singh on March 23, days after the publication of the watchdog's report, described the pressure on doctors to discharge inpatients.

It said: "Despite the Healthcare Commission report, it is clear that the management is still chasing targets.

"The patients are clearly aware that our main intention is to get them out of hospital at the first opportunity.

"Over the last 27 years I have seen the care available in Stafford fall from pretty good to abysmal."

At least 400 more people died at Stafford Hospital than would have been expected in the course of three years, with seriously-ill patients neglected amid pressures to cut costs and hit Government waiting targets, the Healthcare Commission report found.

After its publication, Alan Johnson, then the health secretary, said he was "amazed" that no clinical staff had blown the whistle on the way patients were being treated.

Dr Singh said that he and other consultants had complained to senior medical managers and the trust's management, but the complaining doctors had been ignored and branded as troublemakers.

He said a "palpable culture of intimidation" in the Trust deterred others from speaking out publicly.

One concern raised repeatedly by Dr Singh was the absence of nurses from ward rounds.

Having nurses on ward rounds is seen as important to ensure that a doctor's instructions are being carried out, and the arrangement is normal in most hospitals.

However, Dr Singh, who has been a consultant at Stafford Hospital for 14 years, says that the situation has remained unchanged even after the publication of the Healthcare Commission report, which criticised the absence of nurses.

He told MPs: "It has now become the accepted practice not to expect nurse presence as a matter of course on the ward rounds.

"This situation puts the consultants in an unacceptable, invidious, and extremely frustrating position."

In March, two weeks after the watchdog's report was published, Dr Singh was suspended from work for allegedly verbally abusing a nurse. He was reinstated a week later.

He claims that his suspension was an attempt by the Trust to intimidate him. He and the British Medical Association are fighting to get the charges against him quashed.

At a meeting of the Commons committee this month, MPs questioned Eric Morton, the interim chief executive of Mid Staffordshire NHS Trust, who denied that Dr Singh's suspension had been an attempt to "suppress" his views.

Responding to the consultant's allegations, Mr Morton last night pointed to Professor Sir George Alberti's report in April which identified "major improvements" at the trust.

Mr Morton said that he had written to all staff reminding them of their responsibility to raise concerns.

He said that nursing numbers had increased, making it easier for nurses to accompany consultants on ward rounds. He said that clinical staff had shown their willingness to adapt to new ways of working.

He added: "We have already publicly apologised for the fact that the care provided did not meet the standards that our patients have a right to expect.

"Improvements have already been made and further improvements are continuing to be introduced."

More than 4,800 people have backed The Sunday Telegraph's Heal Our Hospitals campaign, which is calling for an independent inquiry into the regulation and supervision of NHS hospitals.

Elderly Helped to Die?

In April 2000, I told the Sunday Times the following

"THE callous treatment of the elderly in NHS hospitals has been exposed by a doctor who claims patients are denied life-saving treatment, are grossly neglected and are given drugs which hasten death." 2nd April 2000. Sunday Times.

Of course, no one believed me. At the time, the General Medical Council wrote :-

" Our client was asked by the General Medical Council as to why the Complainant might have made these allegations and whether our client thought that the General Medical Council should proceed against the complainant for making what appeared to be accusations in an unprofessional manner"

Then Gosport Hospital happened.

"In April, a jury inquest at Portsmouth Coroner's Court decided that in the cases of GWMH patients Robert Wilson, 74, Geoffrey Packman, 66, and Elsie Devine, 88, the use of painkillers had been inappropriate for their condition.Arthur Cunningham, 79, and Elsie Lavender, 83, were prescribed medication appropriate for their condition but in doses which contributed to their deaths, jurors found"

Brunel University found some startling figures

"A third of the 584,791 people who died in 2004 - 192,000 patients - had their deaths "accelerated" by doctors using pain relief"

So I was right? Now what GMC? No one has anything left to say.

While I managed to get the DNR policy changed via the Department of Health in the year 2000, I didn't manage to get Diamorphine regulated post Shipman. This is because doctors, and other health professionals are broadly in denial about the reckless prescribing of diamorphine by those who view the elderly and disabled with a narrow spectrum subjective view. No doctor kills. They justify the value of a person's life.

Knee Jerk Reactions

Automatic Reflex

"Jobbing Doctor for instance keeps his emails down to one line in fear of what could happen, may happen and might happen. Of course, nothing will happen but their paranoia isn't my problem"

Jobbing Doctor has now written a long email.

He is also convinced the Department of Health has pinned him up on the trouble maker list. I doubt it.

Jobbing Doctor and Pulse are reeling around flapping away after they both conducted a spectacular male f*** up by failing to check my GMC status and history! The tale and rumours of an accidental mention of a suspension continues :). Yes, now much of the internet are of the view I was suspended - and this is rather a fascinating phenomena. It shows us how one inaccurate comment on a sheet of paper can spread. This is much like one inaccurate comment written by the GMC. Suddenly, fiction becomes fact due to the wildfires of gossip and few people actually take the time to read or check the facts.

I had to laugh about the fact that one lovely GP and one superbly straight editor [who keeps avoiding the story of Ward 87 like the plague] could get such a basic thing wrong. At present, both John Robinson and JD are running around like headless chickens in an attempt to placate me. They do remind me of Laurel and Hardy. Of course, I have no intention on pouncing on any of them. It is simply fascinating to observe what one misunderstanding turns into.

All they technically had to do was look on the GMC Register - they would have found out that I wasn't suspended but administratively erased :). That would mean, I didn't pay my GMC fees. Actually, this is all anyone has to do.

I don't hold it against JD because he is lovely and as he points out, has been amazingly supportive of me. Then while Boardman has had to do little to garner the support, I have had to work pretty damned hard. That is because consultants are believed by default and it takes a bit of time for juniors to be believable. I do though get the mention on the back of Shrine Boardman. Much like I get the mention on the back of Margaret Haywood.

Despite being the longest running whistleblower, the tale has to be run on the back of others stories. I often find this a tad insulting actually. That is probably why I hardly do media appearances. Seriously, who wants to play second fiddle after working so hard and surviving such a hard road? Certainly not me. This is by no means a dig at JD, just an observation of the status quo. Dr Pal is the afterthought - a kind of " Isn't it awful it happened to Madge, it also happened to Rita". And after a decade, Ward 87 becomes a secondary afterthought and I have never understood why the reports do not stand on their own.

John Robinson is being a typical man who hasn't a clue what to do in this situation apart from try and sooth my perceived ruffled feathers. Sure John, how about naming me in Pulse and covering the Ward 87 story? Pulse is for doctors right? Ward 87 is a medical whistleblowing tale right? Pulse could cover the fact I was shovelled off into General Practise in 1998-1999 because Ward 87 was too dangerous?!

You can see them going OMG OMG, we can't do that because the only whistleblower in the NHS is Madge Haywood. Pulse has never mentioned Ward 87 in the many years they have known about it. This was the same pattern followed by their sister publication, Hospital Doctor who opted not to feature it. Then the BMJ opted not to feature it. Of course, we have to ask whether systems would have improved had they featured it. It must give them a headache to even accept that huge levels of evidence exist about Ward 87. So John Robinson, how about actually featuring a medical whistleblowing tale as opposed to tagging me at the bottom of Margaret Haywood.

How about telling doctors what the GMC have done not only to Peter Wilmshurst but to me? I know Pulse will flap about the potential of libel - and in reverse I shall say that all the material has been online for a decade or more and no one has sued.

So thats the behaviour of boys who fear something that never happens. Fears of close associations with whistleblowers, fear for themselves, fear for everything that just doesn't exist in reality. It does though exist in their minds as a second thought. For Pulse, it has existed for years. For JD, it has existed for one year.

JD admits that he has been warned about me and despite that he has featured the odd link here and there. Well, if we all listened to empty threats and warnings, nothing would get done in the world.

Pulse may well be a little miffed at this blunt narrative. Then, I am of the view that publications should tell their doctors what the actual risk of medical whistleblowing is. The actual risk is the reversal of a GMC investigation on the whistleblower.

By comparison, Liz Miller has written as follows - as everyone will note, Miller is still functional and happy and the Department of Health have not strapped her up to their railings and forced her not to associate with me :). The material below is not about her compliments but about how she does not fear all the things feared by the boys above.

And that is the difference between faith and illogical manifestations of the pariah effect. There are perceptions of whistleblowers that are stuck within the medical profession. These perceptions have no origins in logic. It is a mentality that casts the whistleblower out to sea while the rest of the audience watch him or her sail the stormy seas. It becomes much like a spectacle. Everyone knows about them but will consistently deny their existence. My existence is denied by the vast majority of medical publications. We ask ourselves why?

The above men don't have faith, they certainly do not have faith in the evidence in front of them - preferring to believe the cosmetically created whistleblower over me because the media eg Panorama tells them to. So for Pulse, it is more "acceptable" to write about Margaret Haywood and tag me as an afterthought without a name. Ward 87 deserved better really. The issues deserved to stand on their own to be counted and to serve to improve the NHS.

Miller as we all know is a different kettle of fish.

Thank you Rita, I am overwhelmed by your kind words. And I proud to call myself your friend

There are a few qualities that I believe are important if we are to be human beings rather than animals with snouts in the collective trough.

It is important to know what we believe, to speak up for those beliefs and to be willing to debate those beliefs.

It is important to support those beliefs with actions. There is nothing worse than saying one thing and doing the opposite. Any grasping loudmouthed politician can do that and there are plenty of those, in and out of medicine.

Most important is the qually of standing up for those people who have less rights, privileges and opportunities than you yourself have.

Rita, you have all of those qualities in abundance, and for those and other reasons I am proud to call you my friend.

And best of all, you make me laugh on a regular basis, which is great I love your artwork and your unique view on life.

Lizzie

Fairweather Friends

I had a phone call yesterday informing me that one of the people I worked with in my PRHO or F1 years has their first consultant post. Well, the Trust had to get someone cheap to do the clinically risky job. Apparently, this person decided to say " I knew Dr Pal in 1999" and then started to make all sorts of excuses about her behaviour 10 years ago.

Yes, we all knew Ms Fairweather Friend - once the phone was dropped on her by me, I never went back. The reason the phone was dropped on her was she never backed me up during the whistleblowing period. She spent the rest of the years plagued with guilt. Even to this day, she remembers what I don't even recall. As I reminded her in 1999, it would remain etched in her mind for good. I also reminded her that cowards aren't friends.

Quite frankly it takes me a lot to walk about on people - but I did walk out on her. Am I happy she is a consultant? Well, whatever social status means these days and I suppose she will be important in the circles she revolves in. What can I say about that? Did she develop as a person, probably not.

To be quite frank, I moved away from the medical fraternity of self perceived superiority many years ago and never returned back. It is a bit like those doctors who love writing their degrees and titles at the bottom of any documentation as if to " gloat" over it. As if it makes them any different than the rest of the world.

Apparently, the guilt has still festered around her for the last decade given her flustering effects yesterday. That isn't my problem. Her efforts to creep back by email a number of years ago failed. They are likely to fail in the future. She calls it a misunderstanding, they all do. I call it a betrayal. The other assumption of many people is that a whistleblower will settle for anything in terms of friendship. The perception is that they are somehow desperate in some way. Well, this whistleblower ain't desperate and unlike the rest of the population, I can exist independently without the need for company for quite sometime. Social dependance or acceptance is not my thing - then it never has been.

To top it all off, I note that this one wrote a paper with the very man who penned a hate missive with Professor John Temple to the Department of Health - regarding me. Seriously, for some reason these hateful people assume that they can pen any untruths and circulate it around the health service. And that is what happens when you are a whistleblower. Those in power derive great satisfaction in dissing you for no reason - then your ex friends go and write papers with them.

The circular effect of fate never ceases to amaze me. I wonder what this decade is going to bring - a gaggle of ex colleagues and friends all apologizing because they were yellow livered in 1998-9. I do recall, Dr Aloke Sen and his quipps during his marriage invites "Ah Rita, let bygones be bygones"? Really, so I am supposed to forgive the fact that he rang me up in 1999 and told me he didn't want to associate with a whistleblower because it wasn't good for his career. So how about saying " Sorry Rita, I was completely wrong and out of order". Of course, words like that are far too much for this GP. I suspect as they get older, they start to develop some kind of guilt for their conceited and selfish behavior. For some reason, the expectation is that I shall let bygones by bygones and forget. I believe the issue they forget is this - I have moved on, I no longer require idiots plaguing my life, I no longer have to listen to their superiority complex and I no longer have to put up with selfish people.

Elizabeth Miller hits the Telegraph

She is lookin good!

Here is the link

"Mind's chief executive, Paul Farmer, says that Miller is a "fantastic role model", working in a demanding profession yet finding time to be a passionate mental health campaigner."

Nice plug for forthcoming book :)

"In a new book called Mood Mapping, to be published later this year, Miller will demonstrate how people can manage their own mental wellbeing, based on her experiences of the past 10 years. She has not taken medication for six years now. "I used to go off sick because I was ill. Now, I go off sick to stop myself getting ill," she says. "My illness will not come back because I know what the triggers are and I have support networks. No one's going to ruin my day again"

Of course, Miller is more than the above. She is a great friend, a witty and brave person. She is also an extremely kind and generous lady. Apart from the cosmetics of the media, that is the most important aspect of her persona. That is what sets her apart from the rest of the selfish and conceited and sometimes arrogant world of medicine.

From my own side, she doesn't deal with whistleblowers like me as if they are a pariah or someone to be wary of. That is the impression given by the entire blogsphere of doctors or GPs. I cannot say I am ever impressed with this half paranoid effect of the blogsphere but there you go - it is simply another aspect of the cultural treatment of whistleblowers we all have to learn to accept.

Miller though has always been brave enough to associate with me and to be my friend. Indeed, it should be an example to other doctors - that she hasn't been "got at" or attacked and hasn't disappeared because of her association with me. People do associate with me - just that doctors have second, third and fourth thoughts about it. Jobbing Doctor for instance keeps his emails down to one line in fear of what could happen, may happen and might happen. Of course, nothing will happen but their paranoia isn't my problem.

By contrast, other medical bloggers have been wary, questioning and suspicious and today I came to the conclusion that I really cannot change anyone's perception or minds. They simply have to work it out for themselves as Miller did.

BMA Lipstick

BMA Cosmetics.
Snouts in the establishment trough

The British Medical Ass has shown itself to be doing much as they did in the year 2000. - Cosmetically restructuring the failing reputation of the medical profession.

They carried out a survey of various hospital consultants who obviously represent the entire medical profession [ NOT] and now present their study in the Independent.

This is supposed to give the appearance that our dear old trade union actually gives a damn about whistleblowers. We know the BMA actually doesn't give a damn about grass root doctors. They should also acutely remind themselves of their efforts to extract Harold Shipman from his trial. The BMA would call this an " accident" but I wouldn't. They knew exactly what they were doing and when caught with their pants down, attempted to slither away.

We should also remember that the BMA/BMJ have been anti Remedy UK refusing an advert and going against them at the last judicial review against the Department of Health. You could say that Remedy UK were raising concerns about the MMC and were therefore whistleblowers of their time in a manner of speaking. As for myself, the BMJ has more or less banned me in the past from posting comments, the BMA were sent documentation concerning Ward 87 last year, they did not respond. As a trade union representing the medical profession, they really do stink to high heaven. We must not forget the admission of freemasonry within the organisation either.

"The register lists Sir Sandy Macara, the former British Medical Association (BMA) chair; Dr Simon Fradd, a negotiator for the BMA's GPs' committee; Dr Ronald Zeegen" BBC

In the year 2000, in response to the Bristol Inquiry findings, the BMA had a Whistleblower Conference. The BMA then moved on and nothing changed. I love this

"But, despite negative experiences, most doctors questioned said they were still determined to speak out".

Wow really?! When was that then?

Of course, no one has ever heard of these doctors. In any case, it is far easier for consultants to blow the whistle because unlike juniors, they have long term jobs, they have that stability and they don't have to depend on references. So BMA, just questioning your BMA members is not a reflection of the real world of medicine out there. It is simply a measurement of club culture.

This study does not appear to be a reflection of a cross sectional view of all medics. I certainly was never asked to complete the questionnaire. But then I am not a esteemed consultant who can sit in their office and look down on all of those who try and get on with life post whistleblowing. Consultants though have a strange definition of whistleblowing. Richard Smith Editor of the BMJ once called himself a whistleblower. Perhaps it is just a trendy name now. I broke out in laughter when he did so.

I love this amount of rubbish from the BMA Telegraph.

"The BMA's Dr Jonathan Fielden said: "No doctor, no nurse, no porter, anywhere in the NHS should be made to feel that speaking up for their patients is a bad career move. Their concerns must be taken seriously and acted upon, and ideas for improvements should always be encouraged. It is worrying that some trusts seem to be stifling professional voices. This culture of inactivity and despair is preventing issues from coming to light and putting patient care at risk."

Perhaps we should survey the effectiveness of the BMA in swiftly acting for junior doctors. The BMA were never active in representing doctors in the past. They never represented the doctors for the MMC. If they had been effective, Remedy UK would never have been born. I am of the view that everyone should resign their membership of the BMA. They have failed more doctors over the years than I care to remember. I have no idea why the new generation don't set up a new trade union - doctors would join in droves and the BMA would be left by the wayside as it should be.

I believe their treatment of me was beyond contempt. They are lazy, ineffective, incapable and judgmental. Any effort to tell the world that they support whistleblowers is a down and out lie. It is also done to fight off the criticisms against the seniors of the profession who DON'T support whistleblowers. The way the UK does it is to build this lovely image of how great the medical establishment is. The truth is that it isn't great, it bullies more junior doctors than any other country. It has a high rate of racism and lets face it, the wrong pigs are in charge.

Afterall, no one has ever heard of a PIDA case succeeding courtesy of the BMA have they?

Here is the Department of Health

"A Department of Health spokesperson said:

"All doctors have a professional duty to act... If they have used the reporting processes to no avail, they should blow the whistle with full protection under the law"

Is that Right Department of Health?. We won't mention the collusion between yourselves and the GMC to remove said whistleblower from the workplace then.

In my own case, the Department of Health acted in tandem with the General Medical Council in an attempt to character assassinate me. When they were faced with a complaint against Professor Griffiths, the GMC blamed the Department of Health who blamed the GMC.

The Department of Health wrote

" The HSE are actively seeking to prosecute a doctor as an example"

Here are the Department of Health lawyers sticking the knife in the GMC's back when pinned against the wall

" Our client was asked by the General Medical Council as to why the Complainant might have made these allegations and whether our client thought that the General Medical Council should proceed against the complainant for making what appeared to be accusations in an unprofessional manner"

It is therefore important to understand that the main problem with the system isn't the junior doctors, the problem lies directly with the conceited Department of Health and the General Medical Council. It also lies with the British Medical Association who remain unsupportive of many whistleblowers. They have certainly been unhelpful with regards to Ward 87.

At present, these problems are not recognised. Once the doctor has whistleblown, they then find out about the murky waters of the Department of Health and the GMC. It is not a pleasant sight. My view - never whistleblow - always walk away. No one is going to be there when you have to deal with the post whistleblowing crap. The path is long, it is also hard.

A better study with a cross section of doctors is the one done by Doctors.net.uk . It is probably the only good thing Neil Bacon ever did in his time with them.

Doctors.net.uk carried out a survey in which 2,500 doctors responded. The majority view, according to this survey, is that doctors would prefer to log an error in an independent internet site.

"81% said they did not report errors because they did not trust their NHS Trust. They said the Trust would not be impartial enough to manage a blame-free system (for reporting errors). They said the same of the UK Department of Health"

I think this would be a more accurate reflection of grass root doctors on the shop floor who are trying to do their job.

We should note that the BMA has not requested that the Health Select Committee take the time to investigate whistleblowing by actually interviewing real whistleblowers. That is because none of them wish to discover the truth about the silencing effect of senior doctors and management.

Shoot the Messenger

Of late, we have had a number of academics who have found themselves in hot water due to libel laws. One person is Dr Peter Wilmshurst and the other person is Dr Simon Singh. Bad Science's Ben Goldacre has also been subjected to the silencer. Those are the big names. Libel of course is one form of silencing, the GMC is another form. The combination provides an excellent silencing technique that may suppress scientific debate and whistleblowers for good.

I wanted to point out the smaller fry - ie me. The issue surrounded a link I had made to a public document hosted by Furious Seasons. The reason I raised this issue was because Dr Trevor Friedman had been making a "diagnosis" without examining the person. In this case it was Lisa Blakemore Brown. The complainant in the case related to Lisa Blakemore Brown was none other than Penny Mellor. Many other bloggers raised the issue and linked to the document in 2007. The only one who fell foul of the GMC's draconian processes was me. Facing GMC complaints is probably fairly traumatic only because the General Medical Council are quite bizarre.

Lisa Blakemore Brown was cleared on appeal at the British Psychological Society. That means we were all right about Dr Trevor Friedman. That didn't make an ounce of difference to the GMC. They didn't run after Trevor, they did though run after me. I watched them spent pots of money defending the case concerning a "link".

The complaint of a breach of confidentiality had been made by Penny Mellor who starred recently in Panorama. Mellor is a serial complainer, a lady who silences debate and one who uses all available resources to terminate criticism against her. On this occasion, it didn't quite work. Indeed, as Panorama clearly shows, this Scientology award winner is no longer the darling of the media.

The allegation at the GMC was that I had "published the BPS minutes" on http://www.nhsexposed.com . Of course, I never had published it. When this was pointed out to the GMC, they moved the goal posts to cite " Dr Pal had published a link". The language here is interesting. Of course, those who are technical minded know that links aren't "published". They already exist.

So, the movement of this allegation is interesting. The lawyers for the GMC then amusing cited that I owed " Article 8 HRA rights" to the British Psychological Society. Of course, it was pointed out in no uncertain terms that I was an individual and not a statutory body or authority and did not owe any Article 8 HRA rights to anyone. It was clear that the GMC lawyers had not read their human rights law book.

At that point, the GMC fast tracked the complaint, and cleared me. The side effect of their negligence was the loss of my locum post and subsequent fibs by both parties to conceal what happened.

Anyway, the matter was challenged in court to examine the rights to free speech for doctors. We were in court recently after two years. I wasn't really impressed with my lawyers. Then those who never read or listen never win. And that is what happened to them both.

Mark Shaw WC was the better illusionist on the day. The GMC had funded the case with doctors's subscriptions millions in order to obtain a judgment that essentially silences all of them.

Permission had been granted for judicial review in 2008- to balance the interests of doctors and complainants. This was effectively a test case. Interestingly, the balance was never properly discussed at all in the main hearing. Perhaps it didn't concern Collins J. Or perhaps it was just a sunny day.

What interested me more was the interaction between the main players. I won some points and lost some but then the Royal Courts of Justice is much like a Casino.

Anyway, I wanted to present an extract from the courts :-

Apparently, I cannot claim Article 10 of the Human Rights Act 1998 according to Collins J. Despite not being a risk to the public [as specified by the GMC] - because the GMC commenced a silencer investigation on a article I wrote "linking" to a document, the Medical Act 1983 gives the GMC complete rights to violate the Human Rights Act.

This is what Collins J had to say in the judgment R v General Medical Council Ex Parte Pal. 2009 [Unfortunately, due to some serious factual errors made by Collins J where he failed to get the dates right, kept calling Lisa Blakemore Brown a "He" and far more, I am not about to publish the entire transcript just yet. There are no less than 25 or more factual errors within this judgment, that includes the wrong dates placed on the order of the court. It may have been good for the eminent judge to have read the documents. Then again, reading is something that is far too hard for any judge on a "sunny day".]

Anyway, this is an extract of the judgment related to Article 10 of the Human Rights Act 1998.

"Mr Garlick sought to raise an argument — one of the grounds upon which he was given permission — relating to Article 10 of the European Convention on Human Rights. Of course, freedom of speech is important, but the regulation of medical practitioners and professionals in general is something which is clearly in accordance with the law in this country and is necessary for the protection of the public. There can be no question that regulation by the GMC in circumstance such as this is proportionate and thus would mean that there was no breach of the Article 10 rights"

What does this mean? Well this means that the above academics [ not Dr Singh] can be referred to the General Medical Council. The General Medical Council is able to take up the complaints because these days "misconduct" means anything in a doctors life.

A "link" was capable of being misconduct by way of questioning a person's integrity. In Collins J's mind, disobedience of authority is essentially an integrity issue.

Dr Friedman's integrity in diagnosing a person and violating their human right's was not questioned or observed by Collins J. Again, here we observe the methodology used to effectively "shoot the messenger" on a minimal level of "linking" to a document.

It follows that if any authority objects to the "linking" of material, the scientist/doctor cannot claim the right to free speech if investigated by the GMC. So however bizarre the investigation, Article 10 of the Human Rights Act 1998 cannot ever be claimed to be a defence.

It should be noted that the GMC does not require a complainant to instigate a complaint.

That doctor will not have the opportunity for a civil rights defence. It should be noted that even those arrested by the police have a Human Rights defence. Doctors don't have that right.

This follows that even if they are not a risk to the public, simply by instigating an investigation, the GMC does not have to pay any heed to the European Convention of Human Rights ie Article 10 of the Human Rights Act 1998. That argument was put forward and won by Blackstone Chambers Mark Shaw WC. The chamber prides itself in Human Rights. Interesting, Lord Woolf is also at Blackstone Chambers. Lord Woolf being the grand father of British Justice and infamous for the Woolf Reforms.

The above by Collins J makes a mockery of the overriding objective set by Lord Woolf. Justice was not seen to be done. The judge simply provided the GMC with maximum immunity to sink any doctor in the name of an invisible " public interest".

Nevertheless, in Collins J's view, I was indeed small fry and small fry need to be silenced. Of course, practically nothing is ever completely silent forever.

Effectively, the judgment means that health professional linking to a potentially libellous document online eg Dr Singh's article could potentially be investigated by the GMC . All the organisation or regulatory body had to do is object to the link. The BCA has obviously objected to the piece. Therefore, by default that objection would be enough to question a doctor's integrity.

The link in Collins J's eyes is equivalent to a publication. At least that is what was argued in court. Collins J is essentially telling all of us " Link at your Peril".

This would also mean that any doctor linking to the McBride emails could theoretically fall foul of the GMC if 10 Downing Street complained. It follows that Parliament can complain to the GMC against any doctors linking to the public documents exposing the MP's expenses. Parliament had originally complained that the documents were"confidential".

So, Collins J's judgment has wider implications. The implications are so wide as to effective silence any doctor and prevent them from raising any concerns online or otherwise.

Collins J is affectionately dubbed "Injustice Collins" by many people. I didn't quite believe the rumours until I saw him at work myself. He speculated about Margaret Haywood in the case then proceeded to rule against raising concerns - in this case by way of a link - which is the minimalist way of raising such concerns.

During the case above he stated

"Yes, Sunny Friday Afternoon, its a bit late. I am sorry that I had to do it by extempore judgment. It could perhaps have been more polished if I had had the time to consider it more"

More polished? Bravo! I am small fry and my view doesn't really matter in the grand scale of the world but that of the Court of Appeal judges do :- [ From the recent cases at the Court of Appeal]

“Overturning two of Collins J’s rulings in cases against the General Medical Council (GMC), Lord Justice Chadwick said: “In my judgement the evaluation which [Collins] applied is, with deference, not serviceable or passable.”Chadwick concluded that “there was not in either of these cases any appropriate basis established for overturning the sanctions establish near the [GMC’s] adaptation to go over panel.” Lord Justice Laws and Sir Peter Gibson, besides get-together, concurre”

I nearly fell off my chair. I wondered what innocent men in prison do in circumstances where the judge is just too lazy to read what is in front of them. I understood on that day what Penny Mellor meant by the courts failing those who are indeed wrongly accused.

I wasn't in prison thankfully. But those who use the courts may well be in prison. What then? Do they have to tolerate errors after two years of waiting for a hearing?

Are we going to tolerate the fact it was a "Sunny Friday afternoon" and quite frankly Collins J had better things to do. No wonder there are so many innocent men trapped within the prisons. I wasn't concerned about the legal aspects of guffawing lawyers, I was concerned about the utter carelessness in the court room. It was rather like a circus of fools all making judgments as supposedly educated men on aspects of the internet that none of them had a clue about.

This is why we have the result that a link is equivalent to a publication and that Article 10 of the Human Rights Act can be run over for what the GMC deems is the " public interest".

The background on Collins J is the following - his brother Mark Collins is a rich Priory Group Consultant Psychiatrist who once had a run in with the General Medical Council. Well, Dr Mark Collin's past is rather interesting. Boy was that a run in!

Collins J faced a formal complaint at the Office of Judicial Complaints sometime ago but was cleared [related to the Private Eye piece below]. This was made by the group opposing Chai Patel. Despite his close medical connections, Collins J sits on numerous medical cases. Is this in line with Lord Woolf's overriding objective?

Scientific Challenge is dead. Those who have dared to challenge - brave men like Peter Wilmshurst or Ben Goldacre are seeing their days numbered. Because most doctors live with their heads in the sand, they will never realise what the current dangers really are. All you need is one enemy.

Of course, the usual attitude would be " Ah but this does not apply to me". Doesn't it?

Addendum - Private Eye - Collins J.

FROM PRIVATE EYE

31 March 2006

In The Courts

“WHY has Mr Justice Collins apparently been keeping the recent spate of of contentious appeals from the General Medical Council, including the cases of Labour good samaritan Dr Chai “Diddums” Patel and Professor Sir Roy Meadow, to himself?

The GMC no question thought it had the reaction when it came to extreme thirty days’s steep yard hall interview auditory rang into the GMC finding to strike off Sir Roy, over the deeplyflawed evidence he presented in the case of Sally dark, wrongly jailed in1999 over the deaths of her two sons, three-month-old Christopher andtwo-month-old Harry.Lawyers for the GMC asked the umpire appraiser provided he should excuse himself from hearingMeadows’ prayer because the GMC had sat in intelligence on the judge’s brother -”towering excessive society psychiatrist” Dr Mark Collins, ancient history allegations of sensual faux pas with a vulnerable female patient.

While the GMC cleared Dr Collins of humourless professional malversation and found the sexual allegations unproven, it did publicly criticise him for crossing patient-doctor boundaries prep along meeting the philosophical outside of job and “allowing his head to be turned” over a attractive patient. GMC lawyers further pointed out that the barrister representing his relative, Nicola Davies QC, was also representing Sir Roy. Mr Justice Collins could behold no potential collision resulting from his brother’s clearing prep along the GMC and said that he did not know Ms Davies.

He then went on to give up a judgment which not only circumscribed the powers of the GMC to regulate doctors who give inaccurate and deceitful declaration to courts, on the other hand also gave greater custody from approval from any old “buff”who gives evidence, no business how dodgy. The discernment has approach in for disparaging scrutiny and is being appealed by way of the GMC.

But should Mr Justice Collins hold removed himself from hearing the GMC casket against Labour benefactor Chai Patel, who continues to stamp his feet at not getting a titled classes? Eye readers are well clued-up that the box in defiance of Dr Patel accompanying to Lynde House in west London, then dart near his firm Westminster Care Homes, where there were popular allegations of leave alone. It was the first experiment of whether a cobble should inhabit disciplined accomplished the care of patients who he was not exactly treating. But it was thrown elsewhere over Mr Justice Collins in advance of it by any chance got underway on the grounds that the charges brought averse to Dr Patel by the GMC were a “corrupt prosecution” and looked like scapegoating. As the whole world knows, Dr Patel is the male later than at the botto the Priory group of haleness and rehabilitation clinics… and Mr Justice Collins’ brother, Dr Collins, was a clinical director at the Priory clinic in dominant London and now, according to its website, mill at the Priory Hospital in Roehampton” .

Miller Talks Back

Elizabeth Miller is cool. She also understands what other doctors don't. This is what she wrote to me this morning while munching on her cornflakes.

"Hi Rita,

I am beginning to seriously rethink my position as to whether doctors should bother to fight the GMC at all. It may be better to walk away as soon as the GMC announces that you will have a hearing

1 - Once a hearing has been arranged, sanctions are inevitable.
2 -Once sanctions are in place, if you do not have a job or have lost your job, you become unemployable for several reasons
3 - Modern HR forms include a question as to whether you have been ever had any investigation into your practice, warnings, conditions, sanctions, suspensions. Once you have reached such a situation - ie a hearing, HR will exclude your application at the screening stage. Your application will not even be presented to the doctors making the shortlist.
4 The MDU will not indemnify you. The MPS say it is negotiable. This may not be critical if you are working for the NHS, but it means you have no means of defending yourself against further attacks from the GMC
5 Without medical indemnity, you cannot work in the private sector, either independently, through a locum agency or in a private clinic
6 Finally and most importantly, you waste years of your life fighting for justice in a setting that has the skills of Stalinist Russia, Chinese communism and The Establishment at its disposal.

Surely it is better just to walk away? and look for an alternative career at the earliest stage before the damage has been done to your career. Let the GMC try you in your absence, but if no one turned up for a hearing, how long would the gravy train last?

The multitude of panelists, expert witnesses and lawyers would find themselves out of work, as doctors refused to be involved in this circus.

Just leave and with no one to crucify, the GMC would whither on the vine? The GMC only survives because we play its game. Perhaps we should stop playing?"

I should make one comment, once the Fitness to Practise procedures commence within conduct, voluntary erasure is impossible. In addition, non payment of fees does not result in an erasure once there is a conduct hearing due. It is true that doctors such as David Jarman have hopped off the GMC Register despite having a conduct hearing due but this isn't possible now. So walking away either has to happen before GMC proceedings or after GMC proceedings are complete.

Overall, I am of the view that revalidation and appraisal is not something the GMC should be dealing with because they are malicious and incompetent. No one has to believe me on this, it is likely to happen to most people in about two years. The discovery of how incompetent the GMC is may be quite an eye opener. The ostritch effect is endemic in the medical profession with the attitude " It couldn't happen to me". This attitude has got them a regulatory body that is essentially unfit to practise but only exists due to a good public relations company and their peppered influence on leading medical journals.

Shortage of Shrinks

Mad about Foreign Trained Doctors

The Royal College of Psychiatrists are apparently in its pre whinge state and moaning that they have no UK Graduates applying for their jobs.

The Guardian asks

"So why is it that only one in eight trainee psychiatrists are of UK origin? What exactly is putting British medical students off if services have improved?"

So lets ask ourselves why the Royal College of Psychiatrists has encouraged a foreign graduate from Uganda with a criminal record while two British graduates are left out. Here is Dinesh encouraging him. We also have to ask ourselves the question - why two British Graduates were denied Section 12[2] Approval under the Mental Health Act 1983 in 2005 while the Ugandan graduate was approved by none other than Royal College of Psychiatrist rep. This is despite the two British graduates having considerably more post Registration experience than the Ugandan. Apparently, in the old days, the Royal College wanted to encourage foreign doctors and went out of their way to pamper them. The fact that few of them could speak to patients properly escaped them. Personally, I used to be sick to death of covering for doctors who had just landed in the UK.

So while we are asking these questions, we have to examine why I as ex Psychiatrist was firstly fired off my job courtesy of a GMC Investigation on the strength of a link. Having shattered my Fitness to Practise record into pieces by vexatious complaints, the GMC takes no responsibility and the Royal College of Psychiatrists simply look over and ponder. Because that is all they can do. Being supportive is not within their makeup.

We also have to ask ourselves why I have not worked as a Psychiatrist since 2007? Something to do with harassment by the GMC?! Has the Royal College of Psychiatrists done a thing? No of course not. Incidentally, they do provide GMC assessors who are paid handsomely to diagnose Aspergers in doctors without Asbergers :).

We then have to ask ourselves why Dr X a capable psychiatrist and British graduate is currently stuck within the Interim Order Panel despite everyone admitting he was never a risk to patients. We have to ask ourselves why he has been stuck there for about 3 years.

So we have to ask ourselves what role the General Medical Council plays in dissuading British graduates.

Essentially, we are both British graduates. What has the Royal College of Psychiatrists ever done to support/encourage us? Sweet FA.

So there is absolutely no point in the Royal College of Psychiatrists moaning that British Graduates are not coming into the shrink profession. Are they encouraged?

Well, here we are - 2 British graduates. What is the Royal College of Psychiatrists going to do to encourage us ? Sweet FA again then?

Doctor in Trouble

I was amused by the antics of the General Medical Council in the last week. One of their psychiatrists from Leeds rolled into GMC Towers last week and exclaimed that a doctor who had passed medical school exams and had been working in the NHS for years had Asbergers :). When I was told this on the phone I burst into laughter.

Only six months ago, the doctor was accused of having a personality disorder. When the GMC felt that could not be sustained, they moved to Asbergers syndrome. Of course, there is nothing wrong with this doctor apart from the fact he sent some emails to the GMC showing up how incompetent they are. The GMC are apparently plotting to send this doctor to a Fitness to Practise hearing on the strength of inappropriate emails and storming off out of a consultants room. Fascinating!

What was even more hilarious is that the General Medical Council sent Dr Findus a form requesting that he confirm that he "understands the conditions". So, lets see, the GMC moots Asbergers syndrome then progresses forward to request that this doctor complete a form and understand complex material!? They can't have it both ways - understanding documents and having a learning disability.

This is of course real a tale from GMC Towers.

Well, I suppose it is a better tale than the junior GP who got lost one day on her way to the patient, was subsequently referred to the GMC because she could not read an A to Z. She was subsequently given various cognitive assessments and reviews by neurologists etc. Following that, she was forced to take Haloperidol despite the GMC admitting she had no problems. The GMC stated that if she did not take the Haloperidol, she would be forwarded to a Fitness to Practise hearing. The lady still remains on conditions 10 years later.

Well, this is the kind of medical regulatory body the rest of the doctors ignore. The impression is that I must in someway be fibbing or exaggerating. There is no exaggeration at all. These are from transcripts and first hand knowledge.

At 5 doctors per day going down at the Interim Order Panel, I wonder if there will be any doctors left in the NHS soon :).

Pulse Rumours and Students

I was sent a discussion on Students Room. It quite rightly detailed the issues related to whistleblowing. What it didn't get right was the issues regarding me. This is what the post stated

"Actually, the Rita Pal case was about being suspended, sacked and hauled in front of the GMC if you speak out..."

The rumour about my so called suspension was first propagated by Jobbing Doctor. This was partially due to his misunderstanding of the situation and partially due to Pulse's failure to check their facts.

The fact remains I was never suspended.

I was though fired from my last post once a GMC investigation commenced in 2007 but was subsequently cleared. As for being hauled in front of the GMC, I have never been to Fitness to Practise hearing ie I was never hauled. The GMC though have instigated a number of vexatious non medical related complaints against me and have done so for about 9 years now. These vexatious complaints which they instigated with some glee terminated in 2008 when I was administratively erased from the GMC Register.

Contrary to popular belief, the GMC has never been able to suspend me, place sanctions on me, never taken me to an IOP hearing or any kind of hearing. Every investigation has been cleared and there is nothing outstanding.

What they have done is instigate a cloud of aspersions on the factual accuracy of what happened. Despite the cloud of confusion that exists, because no one bothers to read, I will have to tolerate this kind of defamation on my name. Thanks to Jobbing Doctor for misunderstanding the situation in the first place. It isn't his fault - it just shows you that no one reads - not Jobbing Doctor, not journalists, not lawyers and certainly not judges.

Indeed, it isn't the whistleblowing that is the problem but the entire system of accountability. Actually, there isn't any accountability at all even at judiciary level. We therefore conclude that, due to the UK's failing system, no doctor should ever raise concerns at any level.