Purposeful Concealment . "Significantly High Mortality Rates" at North Staffordshire NHS Trust 2000-2003

A Spectacular Cover-Up.

Well, this is just another crappy day at Whistleblower Towers. Today is one of those pivotal days in evidence collection. It is the kind of day I have waited for since 1998.

There is one aspect that few people understand. The burden of evidence gathering falls on the whistleblower. For ten years, at midnight, I chip away digging through the paperwork unearthing evidence piece by piece. So why do I do it? Possibly because I am an unforgiving sort and I often aim to stand at the top of the mountain laughing outloud at those who once mocked me and told me I could never prove that North Staffordshire NHS Trust had a high mortality rate during the period when Ward 87 remained open. Such is the nature of human beings - a total lack of faith and a total lack of determination. Many in the medical profession love to stand then look down on us mere mortals just to judge. By doing this, they consider themselves better than the average mortal.

When you get to my stage, its easy to do that because I now have the evidence. It wasn't so easy many years ago when I had to face hit after hit from organisation after organisation who shut their doors in my face . Of course, as a junior doctor, I have faced the feeling of being invisible. People walk past you. Indeed, everyone walks past a junior doctor. You aren't taken seriously by medical publications because you have the label "junior doctor" tattooed on your head because that was the time period they pigeon hole you into for good.

You aren't taken seriously by the media because you haven't got the sassy title "Consultant". Well, it is 2010, I have grown up and I treat those who treated me with contempt with the same dose of high strength medicine. I have become intolerant of many doctors. I don't accept the kind of "Pity" lipservice that some provide at arms length.

I feel like going up to Richard Smith and numerous people and shoving the evidence in their faces and saying " I was right and you guys were f***ing wrong". Richard was the typical " Oh you can post in the comments section" but we can't have whistleblowing riff raffs writing for the main journal. Richard loved senior doctors of course. You could get into the BMJ with a fragment of the evidence if you were a consultant. Andrew Wakefield did afterall.

There are many people like Richard, all conceited establishment doctors who stand on their pedestal and tell the world that they are the brilliant ones and the ones who know it all. In reality they know nothing. I say that about a number of very senior doctors who neglected Ward 87. What do I say to these decrepit old doctors who have one foot in the grave - having spent their NHS Pensions and maintained their positions in high society.

Yes, sure I have a few choice words to say to Professor David Brenton and the rest of the clan of half baked incompetent senior doctors who were sent to manage "me" as a whistleblower. There is Professor Temple, Professor Paice, Professor Moss and the list goes on. They are all failures in many ways. There are of course lists and lists of doctors at the General Medical Council but it would take too long to name everyone who played their supporting role in this Ward 87 farce. Then there were the legions of MPs, Peers, condescending lawyers and ex colleagues who opted to look down on me shoving me to their "Never Mind Whistleblower" pile. In the end, there is nothing left to say to these people because nothing can change or make up for the past damage caused. That is a stark reality. It is a reality that every whistleblower has to live with and I am no different.

The search for evidence on Ward 87 has been long and hard. Everything has been concealed from me by the General Medical Council, the Department of Health and every other regulatory body and authority. Unearthing evidence has taken me hours of hard work with huge amounts of paper everywhere. The impression these authorities would like to give the public is that my concerns about Ward 87 were "minor" and that I am making a song a dance about it for no apparent reason. Of course, the truth is a much more bitter tablet to swallow.

My journey this year took me to the CQC. The CQC love to visit this website because they know what a lovely disaster they created. The disaster was created because their head honcho is Cynthia Bower. Cynthia has a problem, she had a lot to do with the Midlands. Ward 87 is of course in the Midlands. The reason Cyn tries to obstruct the Ward 87 /North Staffordshire NHS Trust issue is essentially because she doesn't really want all her friends at the Midlands SHA to face troubled times. This is the reason why the CQC bullshits to me each minute they get. Of course, they presume that I have an IQ of a large fat frog. In reality of course, my IQ is probably equal to theirs.

Sometime ago, Baroness Young considered the Ward 87 issues. This year I approached the CQC after unearthing their archive documentation. I found their internal documentation fascinating. According to Meeta Patel of the CQC, I have a past life :). Perhaps, the CQC is of the view that I have 9 lives. Anyhow, Meeta initially denied the time of day so this is an email I wrote to her. These days, writing these emails often provides me with some sense of entertainment.

From Rita Pal
To Complaints
cc Complaints
date Thu, May 13, 2010 at 10:35 AM
subject Re: Press Statement

Ms Patel

" As you can appreciate we had no knowledge or information about your concerns that you had raised with HCC or CHI in the past"

Don't you have a database?

"Dr Pal, in a past life shared information"

The facts are as follows, patient care was affected before 1998 [ the date of whistleblowing] until 2005 [ when the ward was shut]. That is hardly a "past life".

By the CQC's own admission

" Earlier data from Dr Foster does suggest that they did have more concerning mortality in years before 2003/2004" [9th December 2009 at 13.14 to Sarah Seaholme].

Yet, the CQC produced a bizarre letter relating to post 2005 mortality rates.

On the 19th November 1998, you wrote " Yes, this is a response to a letter drafted for Barbaras office. Happy to meet to discuss further"......

On the 23rd November 2009, you both decided to meet in a canteen [ a public place] to discuss sensitive data about patients and myself.

" Great, will try and find a spare office but may have to meet in the canteen".

Prior to that you wrote on the 10th November 2009

" I have discussed the contents with my line manager Suzannah Burden and we feel that the best way forward would be to respond to the various issues that Dr Pal raises but not as a corporate complaint". [?!]

You go onto say

" I have in various colours below incorporated some notes/commentary which may assist but please ignore them if you feel they are not relevant" [ no doubt playing with your marker pens and I would like a copy of this document].

You therefore studied and had access to my original email. You know its contents already.

Before that on the 17th July 2009 you wrote

c) The advice given in the email below is incorrect......

If you are planning on pleading your naivety regarding the events of Ward 87, you should consider your position again. Firstly, it is wise of you to assume that as doctors we have a level of intellect equivalent to you. Secondly, it is probably wise that you understand that I am not willing to engage in this kind of obstructive behaviour from the CQC.

You state below "In a separate email to me on the 11th May 2010 you have indicated that you have already submitted a summary to Baroness Young in relation to your concerns"

Given you read, used your highlighter pens, had meetings about my concerns to Baroness Young, I am surprised at your position here. Perhaps a case of selective memory loss or is it one of convenience?

I requested a press release from yourselves. It is a simple affair. Please provide it.

Regards

Dr Rita Pal

The problem with playing with too many highlighter pens is that people often fail to read the contents of the email. I subsequently followed up the "more concerning" mortality rates disclosed in their internal emails. The CQC had cleverly failed to inform me of this. Of course, even Brian Jarman of Dr Foster failed to inform me of the statistics despite detailed conversations. So essentially, everyone opted to conceal this data from me. This includes the Kings of the General Medical Council. I sent the email below to the General Medical Council. I asked Neil Marshall to do some soul searching. I couldn't think of what else to say to the General Medical Council. Having needlessly "f***ked" up my life in many ways to DNR status, what else is there to say to them?

EMAIL FROM CQC INFORMATION TEAM DATED 10th June 2010.


Dear Dr Pal

Thank you for your email dated 12th May 2010 in which you made a request for information in accordance with the Freedom of Information Act 2000 (FOIA), which the Commission received on that day.

You requested:

* With regard to North Staffordshire NHS Trust - The data that Chris Sherlaw-Johnson referred to in an email to Sarah Seaholme as follows: "Earlier data from Dr Foster does suggest that they did have more concerning mortality in years before 2003/2004."

The Information Governance Team has now processed your request and I can now advise you of the following.

Mr Sherlaw-Johnson was using the HSMR's (Hospital Standardised Mortality Rates) published by Dr Foster.

Year HSMR 2000/01 115.9 2001/02 113.5 2002/03 113.1 Dr Foster classified each of these as 'significantly high'.

As a note of caution. CQC take the view that a high HSMR on its own cannot provide a judgement on the quality of care being provided by a service. It merely raises questions, some of which relate to how the patients are being coded across the trust. It is also very unfocussed and it is often more important to be able to look deeper into whether the high HSMR is unduly influenced by particular specialties.

I hope this explanation helps.

If you are not satisfied with this response you may request an internal review of the Commission’s decision. Please contact:

The Information Governance Team

Care Quality Commission

Finsbury Tower

103-105 Bunhill Row

London

EC1Y 8TG

Alternatively, you may complain via email to:

Information.access@cqc.org.uk.

Please clearly indicate that you wish for an internal review. There is no charge for making an appeal.

Further rights of appeal exist to the Information Commissioner’s Office (www.ico.gov.uk) once the internal appeals process has been exhausted.

The contact details are:

Information Commissioner's Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

Telephone: 01625 545 700



If you have any queries please do not hesitate to contact me.



Yours sincerely

Pamela Coxon
Information Governance Officer
Secretariat - Information Governance Team
Care Quality Commission
St Nicholas Building
St Nicholas Street
Newcastle upon Tyne
NE1 1NB


Tel: 0191 233 3552
Fax: 01484 770 014
E-mail: pamela.coxon@cqc.org.uk

The only person with any brain power at the CQC is Pamela Coxon who can actually do her job and do it well. The rest clearly spend too much time gassing in the canteen about confidential medical data.

As regular readers of the blog will remember, North Staffordshire NHS Trust had one of the highest compensation rates in the Midlands. Essentially, it was higher than that of Mid Staffordshire NHS Trust.

Member name	Total paid
Burton Hospitals National Health Service Trust	335,088
Mid Staffordshire General Hospitals NHS Trust	652,418
North Staffordshire Combined Healthcare NHS Trust	106,764
Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust	81,258
Shrewsbury and Telford Hospital NHS Trust	951,905
South Staffordshire Healthcare NHS Trust	33,420
Staffordshire Ambulance Service NHS Trust	0
University Hospital of North Staffordshire NHS Trust	3,515,590

Source - Hansard - NHSLA 2004-2005.

So yes, I can stand on the roof tops and scream that I was right. I can laugh at the General Medical Council, the CQC, The Health Commission, CHI, the NMC etc and say I was right and they were wrong. Where does that get me now? Where does that get the people who died? Who will be there to bring the consultants, doctors, managers who negligently and purposefully concealed this data so no reasonable investigation would see the light of day?

The answer is "No one". And that is the reality of whistleblowing as a junior doctor. In the end, few people give a damn whether you saved thousands of people or whether you were right or wrong. This is the reason why you just have to do your job as a doctor and quietly walk away. It is this indifference to evidence and accountability that should persuade each and every doctor to thick twice about whistleblowing. It takes 1 second to whistleblow and 12 years to establish that you were right all along. That is real life - not the cosmetics advertised by the BMA and other organisations who view whistleblowing as some starry eyed act of cosmetic heroism.