The Negligent David Fillingham. History is how I write it.

Mr David Fillingham
Historical Summary

1. Mr David Fillingham currently holds the post of Chief Executive at Royal Bolton Foundation NHS Trust. He has held this position since September 2004. The Trust is currently in the top ten list of high HSMR [Mortality rates] according to Dr Foster. He also holds the post as Chair of the "Advancing Quality Alliance" (AQuA)

2. Before his current position, he was director of the NHS Modernisation Agency from 2001-04. Between 1997-2001 he held the post of chief executive of University Hospital of North Staffordshire trust, Stoke on Trent. Chris Sherlaw-Johnson who is the Surveillance Manager at the Care Quality Commission stated as follows [ Email from him to Sarah Seaholme dated 9th December 2009] at 13.15 “"Earlier data from Dr Foster does suggest that they did have more concerning mortality in years before 2003/4".

3. He joined the NHS in 1989 after previously holding senior managerial positions in personnel and marketing at glass manufacturer Pilkington. After a short period at Mersey Regional Health Authority, David has occupied a number of Chief Executive positions – in Primary Care at Wirral FHSA from 1991 until 1993; in commissioning at St Helens & Knowsley HA from 1993 until 1997. His past history is notable because there has been no investigation into patient safety issues at these places.

4. In the case of North Staffordshire NHS Trust, the litigation lag period and claims made in the years prior to 2005 resulted in payments made by the NHS Litigation Authority between 2004-2005. The table below shows the level of compensation paid out within claims filed during the reign of Mr David Fillingham between 1997-2004.

Clinical negligence payments made by the NHSLA in 2004–05 for all claims against trusts in Shropshire and Staffordshire SHA
£
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 [15 Mar 2006 : Column 2326W]

In summary, the compensation paid out by North Staffordshire NHS Trust was approximately 3-4 times that of Mid Staffordshire NHS Trust [currently scrutinised by the Mid Staffordshire Inquiry 2010]

3. A March 2002 report by the Commission of Health Improvement of a Clinical Governance Review at North Staffordshire NHS Trust found serious shortcomings in the supervision of junior doctors,

"CHI was informed that junior doctors working in medicine were often inadequately supervised and often left alone on wards, particularly on the medical assessment unit (MAU). During an evening visit we found only two junior doctors covering MAU, which was full to capacity, with a further junior doctor covering MAU and emergency admissions; one junior doctor covered the medical wards and one covered medical outliers but these patients could be on wards on either site. CHI felt this situation posed a potential clinical risk to patients.”

The 2002 report went on to say, in Paragraph 5.78:

"There were a number of concerns raised regarding support and supervision for junior doctors working in medicine. We were told of a number of occasions when it was felt there was a lack of support both during the day and when problems arise whilst oncall. The Trust has acknowledged that medical staffing at all levels is under resourced in medicine".
[ Full CHI Report available on request or from the CQC]

3. The above report found fault in the Trust’s supervision of junior doctors. This is despite concerns being raised in 1998 by Dr Rita Pal, a Pre Registration House Officer on Ward 87 North Staffordshire NHS Trust. Concerns were raised about patient safety being put at serious risk by the lack of equipment, lack of supervision, the lack of nursing staff etc. At the time, the Trust and its chief executive denied that there was a problem. Subsequent to this, internal documents were found stating as follows. A letter from Dr Colin Campbell to Dr John Green, Clinical Director at City General Hospital Stoke on Trent, read as follows: (CAC/ AR/LET 2nd December 1998) Point 2 (first page)

"To summarise other discussions that we have had on the medical PRHOs, I think that the following should be addressed within the directorate as a matter of urgency - (2) They should have proper clinical supervision at all times and help from a more experienced colleague... should always be available (The New Doctor GMC), On discussion with several of them they are still working without immediate supervision for significant periods.”

4.Despite reports verifying significant problems on Ward 87, David Fillingham and his team released a statement to Stoke Radio on Dr Rita Pal. It stated [ amongst other things] “"Where allegations were made about the treatment of specific patients, case-notes were reviewed and her claims could not be substantiated" [3rd April 2000].

In 1999, a internal memorandum noted as follows:-

Medical Division Memorandum
Ward 87
From Ms Teresa Fenech
Directorate Manager for Infectious Diseases City General Hospital Stoke on Trent.
Reference TF/CLS/005
18th May 1999

Point 3

“I informed you that I had undertaken an audit of every single patient on the ward the previous week. I identified a serious lack of baseline and routine observations. In the case of some patients there was also clearly a breach of policy and there was an apparent lack of misunderstanding from the staff of the importance of such issues. I informed you that in my opinion the level of care demonstrated for some patients on the ward at the time of my audit was nothing short of negligent"

[Documents available on request]

5.The Executive Summary of the Creamer Report in 2001 into minority data showed quite the opposite. This is what it stated :-

(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”.
[ Creamer Report 2001 and summary report 1999 available on request]

6.Mr Fillingham subsequently engaged in a series of events that were effectively designed to silence the whistleblower. He discussed a referral to the General Medical Council with the then Director of Public Health when the negligence on the ward was made public. He instigated and supported an investigation by the Health and Safety Executive into Dr Pal between 1998-1999. The Executive dropped the investigation and corrected their records some years later. This culminated into the above where the Chief Executive released a dishonest press statement to the local media [ and possibly the national media]. Fillingham’s intention demonstrated by the above has always been to undermine the whistleblower.

7.Mr David Fillingham’s negligent mismanagement has never been investigated nor has he been held accountable for his actions. The above are summaries of documents unearthed from North Staffordshire NHS Trust over the last decade or so. I have not investigated the other institutions he has managed. It should be noted that no wider data study was ever instigated on Ward 87 and David Fillingham did not wish to quantify the level of mismanagement that compromised patient care. No one [ medical staff or otherwise] was held accountable for the serious failures on the Ward. Mr Fillingham allowed the ward to remain open thereby seriously compromising patient safety. As detailed above, despite warnings on various issues that affected patient care, they were not corrected by him. To this day, because data was not kept, it is unknown how many patients’ lives were compromised by this negligent mismanagement of the ward and also the hospital.

In conclusion, Mr David Fillingham is not fit to manage any NHS organisation. The direct reason for the increasing mortality rate of the Royal Bolton NHS Foundation Trust is his severe lack of management skills and the failure to respect patient safety. Fillingham has a reckless attitude to patient safety. It is crystal clear that Mr Fillingham allowed patient care to be compromised at North Staffordshire NHS Trust for many years. It is imperative that he is not placed in a position of responsibility in the future.

Compiled by Dr Rita Pal NHS Whistleblower Ward 87 North Staffordshire NHS Trust 1998. Contact dr.ritapal@gmail.com. All documents referenced can be supplied on request.

[Ward 87 Manager] David Fillingham's Trust has Second Highest Death Rate

David Fillingham's Flying Circus

David Fillingham was the Ex Chief Executive of North Staffordshire NHS Trust and the man responsible for Ward 87. I have to write these reminders because it becomes important to ensure some accountability netwise. NHS and Accountability - do they actually go together? Possibly not. That is why David Fillingham is yet to be fired from his comfy chair at the Royal Bolton NHS Trust.

Professor Jarman, the supergeek of Imperial College has accused the Royal Bolton NHS Trust of being one of the Trusts with the highest death rates [ still]. It has the second worst death rate in the country. If we translate this in lay man's terms, David Fillingham has been discharging dead patients. They have been dying due to the above draconian regime run by David himself. Patients are apparently waking up dead following the cashectomies performed by David's management team.

As usual the Trust is in denial. Of course, my solution is to ensure David Fillingham has resigned by next week. That will not happen of course because the Trust will never acknowledge that David is a failed manager with a dubious historical record - that includes the misdemeanors on Ward 87. Of course, if managers are not admonished for their misdemeanors, dead patients will continue to be discharged. Again, there is no feedback loop or corrective mechanism to ensure Fillingham is not allowed to discharge dead patients.

David Fillingham. Where is the corporate manslaughter prosecution then?

Smug Git in a Purple Tie

David Fillingham is a negligent Chief Executive. I know that because he dealt with Ward 87. He was never held accountable for his misdemeanors. The reason for this is this - as a doctor, if you kill a patient, the GMC normally comes after you. If you are a manager and you kill patients by breaching the NHS Management Code of Conduct, your salary just gets hiked. There is no regulatory body for managers. Lord Darzi, the man with a lot to say decreed that managers should not have a regulatory body. As such, there are limited ways with which to discipline managers. Most NHS Managers tend to have psychopathic tendencies, have special parking spaces while the doctors struggle to park in emergencies and are paid 10 times more than the average hard working junior doctor.

Essentially, patients died on Ward 87. They didn't just die in the two weeks I worked there, they died in the 20 years before me and the 7 years after me. Now that's a lot of patients. David Fillingham knows all about corporate manslaughter because in a fair world, he would have been found guilty.

After Ward 87, the National Health Service gave him a second position of responsibility. That position was at the Royal Bolton Hospital. The Royal Bolton Hospital is one of the deadliest hospitals in the UK. David being the biggest concealer of death rates in the history of medicine was trying to get himself out of a tight spot, he stated

"David Fillingham, chief executive of the Royal Bolton Hospital NHS Trust, said Bolton appeared to have performed poorly because of how the figures are worked out — for example, if other trusts make improvements, Bolton’s standing is affected"

He added: “The quality of care that patients receive is our priority. We’ve had some outstanding achievements in reducing death rates, for instance, for patients who have had a stroke.”

Dr Foster, a consultancy that analyses health information, said 128 more people died at the hospital last year than expected.

You just keep winding the newspapers up David. The evidence though shows that David is as negligent as they come. Having effected the end of numerous lives by neglecting Ward 87, he continued to do the same in Bolton.

There is a solution to this - David Fillingham should be prosecuted for corporate manslaughter, thrown in a high security prison and left there. The NHS should also strip him of his pension.

Silent Night

Too Difficult For Doctors

Apparently, North Staffordshire NHS Trust now has an orchestra. This is apparently to lift the gloom. The film extracts of the interview shown on the Sentinel.co.uk show an orchestra who has little in the way of smiles :). Perhaps things will change during their actual concerts.

"Musicians include a GP, radiologists, radiographers, speech therapists, a biochemist and a medical secretary. Violin and cello solos are in the caring hands of a junior doctor and medical student, and two Keele University music students have been drafted in to swell the ranks"

Interesting idea. Not sure if they are in tune on the video but there we go. 10/10 for trying and it will be alright on the night.

"This week's concert represents a 'follow-up appointment' for the University Hospital Orchestra, which enjoyed its first incarnation at a carol concert at the complex two years ago. Interest subsequently waned and it was trimmed down to a quintet called Take Five, which provided the accompaniment for this year's NHS 60th anniversary celebrations at Etruria's Best Western Stoke-on-Trent Moat House Hotel, the city's primary care trust's awards ceremony at Trentham Gardens and even at a 90th birthday party in the front room of a Clayton house"

It is good to see the doctors getting together, while the Coroner asks for more nursing cover. I don't expect any doctor at North Staffordshire NHS Trust to campaign for an improvement in the quality of service because doctors just don't do that there. They do though play in orchestras.

The hospital is pitching to be a Foundation Trust which means even more lack of accountability than it already has. The doctors are playing in the Orchestra.

The A and E Crisis continues . The doctors are playing fantasia

The parking is in crisis. The doctors are still coming to terms with the semi quavers.

They were blamed for the MRSA Crisis at the hospital but they remained silent and did not defend themselves. Of course, the MRSA Crisis wasn't the junior doctors fault, it was the fault of mismanagement of the Trust. The hospital has a track record of blaming junior doctors for the Trusts own inadequacies - easy target is it?!

There was of course once a Ward called Ward 87 during Christmas in 1998. The cover-up of the data on this ward, ensured the creation of Keele University Medical School. The person responsible for the death of patients there Dr Monica Spiteri, teaches at this University. Many people died, the death rate was never recorded.

The doctors kept silent.

Easier to Play

The art of playing Silent Night is well practised by many doctors at North Staffordshire NHS Trust. They have practised it for many years and can play it very well indeed.

Similarly, while the GMC enters the dark year of 2009 and as Revalidation looms, the Doctors will be playing Silent Night. This is because it is easier to play Silent Night rather than playing Rachmaninoff. Rachmaninoff is difficult, complex and risky but offers long term stability whereas Silent Night ensures short term safety but long term disaster.

No one plays Rachmaninoff ......

UK FAILS TO RECORD DEATH RATES

No Way of Detecting Poor Care

Coma is a cult movie written by the late Michael Crichton. It is also one of my favourite films. For a few years now, I have been hunting down the laws of the land that govern the death rate on wards. During the whistleblowing at Ward 87, I discovered there was a problem. That problem was a lack of recording of death rates. On the eve of Re validation and Re licencing, I wanted to discover what the real problem with the NHS is. We know it isn't the doctors because like all countries there are good doctors and bad doctors. We also know that Dame Janet Smith was completely wrong in her assessment of doctors. She missed out a very important issue within the system. She did not recommend that death rates on wards were compulsory. So this is what the Department of Health told me

DE00000364718

Dear Dr Pal,

Thank you for your further email of 6 November to the Department of Health about mortality rates. I have been asked to reply on this occasion. I can confirm that there is no regulation or law requiring individual hospital wards to calculate patient death rates. I hope this reply clarifies the Department’s position.

Yours sincerely,
James Butler
Customer Service Centre Department of Health

Is it only me that thinks the above admission is worrying?! So if there a hypothetical situation like COMA, no one would be able to detect it because it isn't compulsory to check the death rates. So if there is a next Dr Shipman as all professions have bad apples and psychopaths, there is no way of detecting high death rates because it isn't compulsory to record it.

Isn't this interesting!? So the UK health service quite happily goes through life without being held accountable. Essentially, there are pockets of mortality recording such as cardiac operations etc which was why Steve Bolsin managed to whistleblow adequately. For other specialities, there is simply no recording of death rate per ward.

So we have to go right back to the US media to find out the overall mortality rate in the UK. This is what a newspaper had to say

Discharging Patients For Life

Source Times Daily

"While those four countries averaged a 106.6 amenable mortality rate, Britain was almost 29 percent deadlier, with its rate of 135.3. The TPA thus calculates that the NHS took the lives of 17,157 Britons who otherwise would have survived were they treated by doctors across the English Channel. This figure is more than two-and-a-half times Britain's yearly alcohol-related deaths, and is quintuple its annual highway fatalities. Comparing 60 million Brits to 300 million Yanks, this is like a federally operated health agency eliminating 85,785 Americans in 2004."Anyone looking to reform the American health-care system should learn lessons from the European experience," says Matthew Sinclair, the TPA policy analyst who authored this study. "Britain's NHS has produced dismally poor results. Thousands die every year, thanks to its poor performance and its failure to make good use of new resources. Other European health-care systems deliver greater competition, decentralization and independence from political meddling."

Essentially, if there are no death rates recorded per ward, substandard care cannot be fully detected or improved. This is why Ward 87 and North Staffordshire NHS Trust practically got away with corporate manslaughter. Patients died but they themselves admit that they were not obliged to record death rate. Without a record of death rate, they were not obliged to improve healthcare.

Ward 87 is illustrative of just one ward. There are many other wards in the NHS.

In summary, the UK requires a law to make it compulsory to record death rates. This is actually the only way to detect the next Dr Shipman. The harassment of doctors within revalidation plus re licensing is a waste of time and ineffective in the absence of more monitoring in the NHS. None of the changes implemented by the GMC will ensure the next Dr Shipman is caught. The status quo and failure of the government to recognise their failings in monitoring death rate will mean that poor care is not detected or corrected.

There may be many reasons for poor care. Dr Shipman is simply one extreme. Nursing staff deficiencies, management failings etc will not be detected in the NHS. Perhaps this is convenient for the Labour Government - because if there are no statistics then there is no requirement to correct the system. Why correct the system when it requires more money?! This mode of behaviour reflects on the overall UK statistics as seen above. While healthcare is criticised in general, no one can specifically tell us where in the health care system, the problem lies. This is of course due to a failure to record statistics.

Professor Rod Griffiths CBE. You are a LIAR

I must thank Penny Mellor for reading the BMJ for me. She may be many things but she does spot media articles. When spotting said media articles she becomes much like a wolf hound sniffing out the articles and producing them on her website.

I find the BMJ rather boring to say the least. Someone has to read it, it might as well be an ex prisoner like Penny Mellor.

I see Fiona Godlee [Editor of the BMJ] has given Rod Griffiths further oxygen of publicity. Not only is he a negligent researcher but he lies at the drop of a hat. Prof Rod Griffiths can sue me if he wishes, I shall be ready for it anytime or anyday. To summarise this, Professor Rod Griffiths used to be Director of Public Health in the West Midlands. He was investigator in the Southall case eg the now discredited Griffiths Inquiry. The findings in the Nottingham Study and the Henshall case are opposite to the Griffiths Inquiry.

Griffiths was also the GMC investigator for Ward 87 North Staffordshire NHS Trust. During the investigation, David Fillingham the Chief Executive attempted to get Griffiths to refer me to the GMC in the year 2000. Griffiths did not do this but did do Fillingham a favour. According to Sarah Bedwell of the GMC, Griffiths had raised concerns about my alleged mental health problems. Griffiths denies this. Then he denies the time of day. The audit into Ward 87 were diametically opposite to the findings in the 2001 Report by John Creamer. Essentially, Rod Griffiths had lied. He told the GMC that " there was no evidence to substantiate my concerns". This is what prompted the GMC to commence a covert investigation into my so called mental health issues. Of course, there were never any mental health issues. The GMC later apologised to me via Blake Dobson and that incident resolved through the GMC's most embarassing litigation to date.

Edmund Hey et al may be all polite about Rod Griffiths but we have to remember that none of the members of PACA had the guts to refer Professor Rod Griffiths to the GMC. They did though spend extensive amounts of time debating the issue politely while David Southall was getting deeper and deeper into hot water.

I have published the recent two articles from the BMJ [ courtesy of resident BMJ sniffer hound Penny Mellor] .

Rod Griffiths slithers away because he has now been shown up to be an incompetent researcher. I know this because I made a GMC complaint about Professor Griffiths. The antics can be read here. The allegations listed by the General Medical Council summarises these issues I raised. The GMC though did their best to prevent the matter from reaching court or any hearing. The GMC threw it out the first time. I beat the Department of Health Lawyers at Rule 12 Presidential Review. The matter was taken through the procedures yet again.

During that period the GMC wrote the following allegations

Professor Griffiths - Annex A
Case reference: HH/FPD/2004/1056

That being registered under the Medical Act 1983 (as amended),

1. In April 2000, you were a Regional Director of Public Health for the West Midlands;

2. You were asked by the GMC to lead an investigation into allegations made to it earlier that month by Dr Pal of malpractice and sub-standard facilities and care at the City General Hospital in Stoke-on-Trent (“the hospital”), especially on ward 87, part of the University Hospital of North Staffordshire NHS Trust (“the Trust”), where she had worked as a doctor;

3. In January 2001 your report concluded, broadly, that Dr Pal’s allegations were misplaced;

4. a. On 27 April 2000, in the context of your investigation, you met Sarah Bedwell of the GMC and made the following, or similar, statements:

“[Dr Pal] should possibly have been more competent and knowledgeable than she appears to have been.”

“It may be that some of the problems arose because her own performance was sub-standard.”

b. You made these statements even though you had not investigated Dr Pal’s performance as a doctor;

c. At the same or another meeting with Sarah Bedwell and/or other GMC staff you raised concerns about Dr Pal’s physical and/or mental health, although you had not investigated this;

d. All/any of those three statements were dishonest and/or reckless and/or careless because you had not taken reasonable steps to verify them or put yourself in a position properly to assess Dr Pal’s competence or knowledge as a doctor or her physical and/or mental health,

e. By making these statements, you purposely sought to undermine and/or discredit Dr Pal,

f. Accordingly, you acted contrary to paragraphs 34, 35 and 51 of Good Medical Practice;

5. a. Your report’s conclusions about the practices and the standards of facilities and care of patients at the hospital were wrong and you dishonestly and/or recklessly and/or carelessly misled the GMC in this regard,

b. In particular, no reasonable doctor could have concluded that EP had not been neglected while a patient (especially from reading merely her medical records): see, especially, page 18, paragraph 33b of New Doctor,

c. Your intention was to undermine and/or discredit Dr Pal rather than to consider the evidence and report objectively,

d. Accordingly, you acted contrary to paragraph 34, 35 and 51 of Good Medical Practice.

6. a. In a letter dated 17 January 2005, submitted to the GMC on your behalf by Zahida Ramzan-Asghar, it was stated in relation to the missing drip set needed by Dr Pal to treat Evelyn Price that:

“An alternative available to the Complainant (i.e. Dr Pal) was to call a crash team herself and not leave the patient. The crash team would have had a drip set and would have provided more experience.”

b. This statement was misleading as you knew, or should have known, that crash teams do not routinely carry drip sets and it is contrary to accepted protocol to summon a crash team when the patient is not suffering from actual cardiac or respiratory arrest;

7. a. Your report was flawed by an undisclosed conflict of interest as it was in your interests and/or the interests of bodies for which you worked for your report to conclude, broadly, that Dr Pal’s allegations were misplaced. The more your report was critical of NHS practices or personnel, the more likely it was that NHS funds would be withheld or limited;

b. In particular, the conflict of interest arose through, and/or was accentuated by, your close association with Professor John Temple (the then Postgraduate Dean of the West Midlands Deanery), your involvement with the Service Increment for Teaching (“SIFT”) Joint Planning Committee and the threat posed by Dr Pal’s allegations to the hospital’s planned application for Pre Registration House Officer (PRHO) rotation,

c. Accordingly, you acted contrary to paragraphs 54 and 55 of Good Medical Practice;
8. a. You and the Trust accepted that there had been some deficiencies in practices, facilities and care of patients at the hospital, especially on ward 87, although you considered that efforts had been made to address them,
b. Nonetheless you dishonestly and/or recklessly and/or carelessly failed to mention and/or stress those acknowledged deficiencies in your report,
c. Your report ignored and/or minimised these deficiencies,
d. Accordingly, you acted contrary to paragraphs 26-27 of Good Medical Practice.

This finally went to case examiners who promptly threw it out but agreed with a number of points I had alleged. The audience can read the findings here. In a nutshell, Professor Rod Griffiths had compromised patient care, had misled the GMC and had shut down any further investigation. During the GMC investigation into his conduct his fibs began to escalate considerably. He then started to flount his CBE as evidence of his so called honesty. I have no doubts that the GMC was under pressure to throw the complaint out and they did. The decision was a "appease Rita" decision. A kind of " We agree with you but you will never prove it".

I threatened to judicially review this case but during this threat, the GMC conveniently instigated a complaint against me and lost me my job.

During this complaint

1. I was not allowed access to the full 2001 Dr Creamer Document. The playground farce detailing Toni Smerdon [ GMC Lawyers] game of pass the parcel is detailed here.
2. The GMC Refused to obtain documents from North Staffordshire NHS Trust. This is contrary to the ruling in Henshall.
3. The GMC overlooked the blatant dishonesties during Griffith's submissions. This included outright lies propagated by his legal representatives from the Department of Health.
4. The GMC refused to consider the matters listed below despite the fact I had raised them as evidence of repeated and similar conduct. His research misconduct was overlooked by the GMC.

Anyhow, as I am not one to give up, the matter has gone to Rule 12 Presidential Review again following disclosure of reports and various other findings. Let us see whether the GMC puts its money where its mouth is.

Joan Trowell Chair of Fitness to Practice

"The GMC’s key priority is to make its procedures fair and free from discrimination. Its reforms also emphasise prompt and effective investigation into serious concerns.” (October 04)

So while Edmund Hey is playing with his words on the BMJ and wafting it around the posher sectors of PACA, some of us do the real work that is required to get Professor Griffiths off the shop floor.

There is a certain irony of Rod Griffiths having an email address containing the word " demon". Yes, we know he flies on the dark side. We know that he and his mate Professor Temple concealed the truth from the GMC and every other authority. Of course, after all these years, it's the dirty little secrets that float out online that are troublesome for him to defend.


Latest from the BMJ.

Published 31 October 2008, doi:10.1136/bmj.a2347
Cite this as: BMJ 2008;337:a2347
Views & Reviews
Personal View
On drinking from a poisoned chalice
Rod Griffiths, president, Faculty of Public Health rod@stonebow.demon.co.uk

For a period in the late 1990s there were repeated headlines about research on children in North Staffordshire NHS Trust using continuous negative extrathoracic pressure (CNEP). They alleged that excessive deaths had occurred. As regional director of public health I had already commented to the media that premature babies of that age had a significant mortality and that the children in the trial had fared no worse that expected. Public health passed the story to the research and development directorate. The story did not go away and local MPs took it up. A meeting with the relevant minister and one of the MPs took place. The director of research and development should have gone, but he was in America. The minister wanted someone from the regional office to be present. I went.

By the time of the meeting formal complaints had already been made both to the General Medical Council and to the trust. To my surprise the minister asked a new, though not unreasonable, question: could there be a problem with the governance system, at that trust or in general? I was the regional director of public health, and I came out of the meeting having agreed to do a low key review to look at the system. Lesson one: poisoned chalices are easy to pick up. After the review was announced new patient groups appeared, complaining about what was then known as Munchausen’s syndrome by proxy, nothing to do with our terms of reference, but they were persistent in lobbying the minister’s office. It would have been excessively complex to have commissioned yet another inquiry, so this was added to the task that we were asked to do. Lesson two: when drinking from poisoned chalices, try to avoid top-ups. We hired a team that interviewed everyone who wanted to give evidence and appointed a panel with relevant expertise. We reviewed all the statements and decided which individuals or groups we needed to interview in person. We set up dates to take oral evidence and spent several days doing that. A number of potential witnesses were prepared to give evidence only on condition that their statements would not be made public. Of course when we reported, it made it easy for others to say, "Where did they get that idea from?"

Some of the evidence that was given in confidence was important and without it we would have had a less complete picture, but it did make the review easier to criticise. Lesson three: if you have to drink from a poisoned chalice, better to do it in full public view if you can. We were told many diverse stories about some issues, both in relation to research and in relation to child abuse. They could not all be true but documentation did not exist to verify one consistent story. We had to conclude that the essential question raised by the minister had some validity—there did seem to be something the matter with the system. Accordingly we recommended that research governance needed a better system; that child protection needed clearer guidance about possible fabricated illness; that consent needed clearer guidance; and that there should be a way of reporting supposed adverse events from all treatments, not just drugs. We also concluded that parents really needed to know if CNEP in neonates did damage or not.

Short of a new randomised control trial it seemed that funding a longer term follow-up might give the answer. Marlow et al have now completed the review that we commissioned (Lancet 2006;367:1080, doi:10.1016/S0140-6736(06)68475-4); it shows that CNEP was associated with no more damage than control treatments. Several months after we reported and ministers accepted all our recommendations, we were roundly attacked in the BMJ (BMJ 2000;321:715-6, doi:10.1136/bmj.321.7263.715). I can’t think of anything I have found more uncomfortable than that weekend. Worse still was having to speak on the Monday at a conference on a different subject, wondering just how many in the audience had read that week’s BMJ. Lesson four: when drinking from poisoned chalices, don’t expect the effects to wear off quickly. It is easy with hindsight to think of ways in which we could have been given different terms of reference, spent more money, done things differently. Commenting on the detail at this distance seems pointless but I do agree with those who say that a body is needed that can either investigate complaints about research or advise on the subject. Had such a body existed at that time, however, I still think it would have come to similar conclusions. We do need governance systems that protect patients and provide safe circumstances for research to prosper. Both are essential, but neither was guaranteed by the systems in place before we reported. No doubt the current system could be improved, but we do need a system or there will be more inquiries.

Finally, does drinking from the poisoned chalice do any good—is it good for the soul, the personal development and all that? Do you develop a thicker skin, making you tougher and more able to take poison in the future? I think not. I feel more vulnerable and easier to hurt as a result of the experience, though that may be a good thing. People who are in senior positions need thin skins, not thick ones. So lesson five for poisoned chalices is simple: when handed one, drink up and smile—it goes with the job.

Cite this as: BMJ 2008;337:a2347

Rapid Responses published: An appreciation of Professor Griffiths' identification of a poisoned chalice Iain Chalmers, Edmund Hey (31 October 2008) --------------------------------------------------------------------------------

An appreciation of Professor Griffiths' identification of a poisoned chalice 31 October 2008 Iain Chalmers, Editor, James Lind Library James Lind Initiative, OX2 7LG, Edmund Hey Send response to journal: Re: An appreciation of Professor Griffiths' identification of a poisoned chalice

We write to express our appreciation of, and thanks to, Professor Rod Griffiths for publishing (1, 2) his perspectives on the events triggered by allegations that the trial of Continuous Negative Extrathoracic Pressure (CNEP) undertaken in neonates in Stoke on Trent was so flawed that it amounted to serious professional misconduct.

Everything we have come to know about this saga has made it clear that many of the allegations of misconduct had little to do with the CNEP trial and a lot to do with a determined campaign to destroy doctors who had been involved in child protection work, particularly David Southall and Martin Samuels.

As Professor Griffiths reports, once Ministers had agreed that an enquiry into the CNEP trial should take place, campaigners came out of the woodwork and demanded that the terms of reference of the enquiry be extended to investigate the child protection work done by these two paediatricians – in Professor Griffiths’ apt language, to top up the poisoned chalice that he had been handed. We agree wholeheartedly with Professor Griffiths’ conclusion that “if you have to drink from a poison chalice, better to do it in full public view.” We can also agree with him that, had a body capable of investigating complaints about research in public been in existence eight years ago, it might well “have come to similar conclusions” to his panel about the need for a more effective system of research governance.

Given Professor Griffiths’ views now on the CNEP trial (2), we are confident that he agrees with us that a thorough, public investigation would have been highly unlikely to have found fault with the way the CNEP trial was conducted. However, as we have made clear in our commentary in the Lancet (3), allegations of forged consent forms made behind closed doors continue to hang over the heads of 34 doctors who were providing neonatal care in Stoke on Trent during the early 1990s. No evidence to support these allegations has yet been made public. If consent forms were forged that is a scandal; if they were not then the allegations were false and highly derogatory and damaging (4). Although we believe that the Department of Health is largely to blame for the failure to ensure natural, transparent justice in this affair, matters would not have got so completely out of hand after the Department’s report appeared had some of the paediatricians most critical of the clinicians in Stoke been required to defend their opinions in public then and there. This observation applies particularly to Professor Terry Stacey, one of the three members of Professor Griffiths’ enquiry team (who was appointed to direct the Central Office for Research Ethics Committees soon after this report was completed), and to Richard Nicholson, Editor of the Bulletin of Medical Ethics, who has declared confidently that CNEP was used in research without parental consent (5). The clinicians in Stoke should be assumed to be innocent of this charge unless a proper investigation, conducted in public, reveals otherwise. Iain Chalmers and Edmund Hey References 1 Griffiths R. On drinking from a poisoned chalice. bmj.com, 1 April 2006. 2 Griffiths R. CNEP and research governance. Lancet 2006;367:1037–8. 3 Hey E, Chalmers I. Are any of the criticisms of the CNEP trial true? Lancet 2006;367:1032–3. 4 Hey E. The 1996 Continuous Negative Extrathoracic Pressure (CNEP) trial: were parents’ allegations of research fraud fraudulent? (in press) [Subsequently published in Pediatrics 2006;117;2244-2246] 5 Nicholson R. Editorial. Bulletin of Medical Ethics May 2003, p 1. Competing interests: None declared Editor’s note: This response was submitted in April 2006, but technical problems relating to the fact that the article which it was responding to had been posted as a webextra article meant that the response couldn't be displayed.

See editor's footnote to that article for further explanation - http://www.bmj.com/cgi/content/full/337/oct31_2/a2347 This article has now been republished as a stand alone article, making it possible to post rapid responses to it.

North Staffordshire NHS Trust Lies to the Police About Ward 87 Death Rate.

Internal Discussions Regarding the Lack of Mortality Statistics

The important aspect about Ward 87 is the fact that its death rate was never recorded. The emails below stipulated that "The Information is not routinely recorded"

So, why am I talking about this issue 10 years down the line? Well, death rate is important. It tells us whether there are any particular problems in a ward. Death rate is also known as Mortality Rate. Anyone who has done statistics knows the calculation. That is everyone apart from the Trust minions at North Staffordshire NHS Trust who cleverly hoodwinked the police when they attended a few years ago. Ken Raper, a senior officer is of the view that he believes in justice. Ken Raper, a senior police officer cannot tell when a Trust is pulling the wool over his eyes. Perhaps Ken simply wants the wool pulled over his eyes. Afterall, he does not have to investigate what he ignores. It was similar to Staffordshire Police's contact with the Trust some years ago. They rang the Trust up and stated " Are there any problems with patient care". The Trust responded " No". The Police said " Ok, let us know if there are any problems". It is a bit like the police asking a criminal to report his crimes. The precedent here in any investigation of corporate manslaughter is this - the hospital can make up any statistics, the police will never check it and will believe it completely. In their view, Trusts never lie :). Of course, North Staffordshire NHS Trust didn't only harbour a terrorist in their heyday but continuously lie.

The first time I met Mr Raper was at a small town likened to Midsummer Murders. Raper never had any intention of investigating. He had every intention of charming his way out of a inconvenient situation and providing the cup of sympathy for the plight of whistleblower. Raper though is clever. He crowed away about how they were the best police force in town. Of course, this wonderful police force had no idea about death rate or how it was calculated. They neither checked the figures nor did they bother about whether it was accurate or not. So, while he was being clever, I faced him with the Statistics question. There was that blank look that the police give you until they shove you out of the room :).

Raper was told by Staffordshire Police to keep a lid on this issue. He did that almost charmingly. The death he refused to consider is currently being considered by other parties :). Anyway, I felt it was entertaining to feature the internal discussions at the Trust about their failure to keep death rates regarding the ward. Was it because people died like flies and no one kept a track?

Of course, death rates are important. Calculating the right death rates with the right formulae is also important. Neither the Police or the Trust did this. I say this of course because Ward 87 is just one ward. It is not compulsory to record the death rate of patients nationwide. So the broad spectrum outlook on this issue is this - if it is not recorded, there is no way of detecting poor levels of care for improvement, moreover there is no way of detecting the next Harold Shipman. So mortality statistics is another concept omitted by the Shipman Inquiry.

Essentially, in this case, Ken Raper never sought a medical opinion, he never sought a statistics opinion, he never sought to interview relevant people and he never sought to obtain the internal documents within the Trust. He based his decision on a half baked redacted copy :). I obtained most of it through the Information Commissioner after my meeting with Ken Raper. Ken Raper and Staffordshire Police failed to do so. That of course is the standard of the police today. To complete matters, I reported these issues to his Chief Constable. Of course, his Chief Constable was so embarassed that he hid under his table and still has not mustered up the courage to respond - probably because he cannot find his pen after 2 years. So, for all those who do visit Staffordshire Police, just remember, do be ready for the Keystone Cops.

As I explained to Raper before I left, this is on his conscience because I discharged my responsibility in 1998. The fact that thousands died unnecessarily due to corporate manslaughter is irrelevant to Mr Raper :). As I drove back from our last meeting, I had hoped that when he is an elderly man in his eighties, he is placed in a ward like Ward 87 and left to lie in his urine, left to be infected with MRSA and he may meet the same fate as many patients on Ward 87. And when he dies, no one will care just like the destinity of those on Ward 87. I am of course a great believer in karma and a good observer of human behaviour. I also know the difference between death rate and simply writing down "numbers". The detectives clearly failed to spot the difference :).

Concealment of Death Rates to Obtain University Status

Not long ago Professor Gillian Needham was visitor to Keele University Medical School.

Lets get a few matters straight here, in 1998 a number of senior consultants including Professor Temple [ ex Dean of West Midlands Deanery] were making an application to ensure that North Staffordshire NHS Trust succeeded in being accepted as "University status". In 1998, all the applications were going through RE University status. The question we ask here is this, how many of the patient deaths did they cover up to reach this status? Which hospital which has a poor record of junior doctor supervision, a poor record of patient observation, a lack of equipment manages to get University status?

I know Professor Rod Griffiths in collusion with Professor Temple and the clinicians at North Staffordshire NHS Trust to ensure that I was effectively " put away" so their plans could come into fruition. Their plan was important. Their plan was to side line and discredit a whistleblower so they were able to successfully reach University status. This was a known issue. This is also the reason why every independent inquiry was shut down around Ward 87. Ironically, the doctor responsible for the mismanagement of Ward 87 - Monica Spitieri is probably teaching at the University :). Such is the justice meted out by North Staffordshire NHS Trust on those who walk on blindly while patients die.

This was an email I wrote to Gillian Needham about her "blind eyed" view to Keele University Medical School. We need to understand one issue here, multiple clinicians lied to the General Medical Council about Ward 87. They withheld the Dr Creamer report from the GMC. They told the GMC that "all had been corrected" and that the "problems were minor". Having done so, Keele University Medical School continues to exist starry eyed. North Staffordshire NHS Trust would never have obtained university status. They know it, we all know it.

With the new University status comes multimillion funds :).

People Involved.

1. Dr Colin Campbell [ Department of Paediatrics]
2. Dr John Green [ Department of Medicine]
3. Professor Elder [ Department of Surgery]
4. Professor Monica Spitieri [ Respiratory Medicine]
5. Professor John Temple
6. David Fillingham Chief Executive
7. Mills and Reeve Law Firm [ because their advice is often so awful - we call them Mills and Boon]
8. Professor Rod Griffiths.

----- Original Message -----
From: Rita Pal
To: Gillian Needham
Sent: Wednesday, September 03, 2008 2:19 PM
Subject: Re: xxxxxxxxxxxxx

Prof Needham

Many thanks for that. Of course, the status of xxxxx isn't going to remain a secret forever. I believe we both know that.

Anyhow, I was more interested in your views of Keele Medical School

What do you know about the involvement of North Staffordshire NHS Trust in the creation of this medical school. Moreover, during its creation there were substantial problems at the Trust in 1998 onwards.

A March 2002 report by the Commission of Health Improvement of a Clinical Governance Review at North Staffordshire NHS Trust found serious shortcomings in the supervision of junior doctors,

"CHI was informed that junior doctors working in medicine were often inadequately supervised and often left alone on wards, particularly on the medical assessment unit (MAU). During an evening visit we found only two junior doctors covering MAU, which was full to capacity, with a further junior doctor covering MAU and emergency admissions; one junior doctor covered the medical wards and one covered medical outliers but these patients could be on wards on either site. CHI felt this situation posed a potential clinical risk to patients.”

3. The 2002 report went on to say, in Paragraph 5.78:

"There were a number of concerns raised regarding support and supervision for junior doctors working in medicine. We were told of a number of occasions when it was felt there was a lack of support both during the day and when problems arise whilst oncall. The Trust has acknowledged that medical staffing at all levels is under resourced in medicine".

Were these problems addressed during the involvement of North Staffordshire NHS Trust in the creation of Keele University Medical School.

Perhaps you would also be kind enough to outline the process/procedure whereby a hospital is accepted and given University status. I am unclear of this procedure.

Many thanks

Dr Rita Pal

NB You should reinstate xxxxx so that NHS Highland can get back to normal business. I don't think a principle is really worth causing the entire Trust and its staff to be undermined via the internet [ of course, the internet does make a difference - you simply have to observe the case of Prof David Southall to understand how much difference it makes].

Power of the Dark Side :)

Dedicated to the Management of North Staffordshire NHS Trust

Despite being wrong, they have never admitted to it nor have they apologised to the relatives of the patients who died on Ward 87.

Dr J.R.B. Green - Head of Division. In Charge of All Junior Doctors

Dr J.R.B Green is available at the Nuffield Hospitals

He was Consultant at North Staffordshire NHS Trust, friend of Dr Tim Bowling and offered up the response above to the letter from Dr Colin Campbell.

There are a few things to say about Dr Green. He wasn't bad looking for a guy of his age but that is all he really had going for him apart from his clipped English accent of course. All his work was done by Associate Specialist Dr Saud Ishaq. Saud was a decent guy who tried to help but he had to leave me to sink because his own career would be on the line. He though told me that everyone knew about the Ward 87 problem but that no one admitted it.

Dr Green spent half his time playing golf as he always had too many clubs in his car and not enough books on clinical management. He turned up to approximately one ward round in a million weeks. Dr Green was my boss but he never knew me. He never knew me because he never took the time to know who I was. I never really knew him apart from the arrogance he floated around the ward with. Having been my boss for the first three months and he himself says " Dr Pal had successfully completed half of her PRHO post and contacted the Directorate as soon as she felt concerned in the new part of her rotation". If that was the case, then logic would lead us to believe that there must have been a problem with Ward 87.


As I have stated in all these narratives, Dr JRB Green like all of them knew about the problems on Ward 87. He also knew that his staff thought I was one of the most hard working doctors there. He goes to say " This should at least save her career". Why should my career have been at risk if he had managed the situation adequately and provided good supervision, adequate equipment etc. Dr Green though interesting attempts to shift the blame onto me and is not critical or does he admit to the problems on Ward 87 in his letter.


He goes onto say " I am aware of two recent problems within the Directorate". And we know what happened to the previous doctors don't we? The tale of one of them is on a doctors only web site.


Anyway, Dr Green was never a perfect man. He had many faults but his faults often exceeded his good points. It wasn't of course enough that he was cosmetically fairly interesting but the deeper you looked into him, the more darker his character got. There is no doubt that he must have been a good doctor sometime in his younger years but as a manager, his ego had began to control him and he was lost. Lost people of course have skeletons in the closets. Dr Green had many but we won't bore those who read this blog with the others. The most important was written by the Sunday Times. This is related to Dr Green of course.


"In her first month, a senior doctor ordered the medication to be withdrawn from an 89-year-old stroke victim who was critically ill and could not speak because he had a plastic tube down his throat.


"This man was actually conscious and could hear us," said Pal. "The doctor said, 'We need the bed - stop all his medication'. He obviously didn't think he was going to live. I thought: we are killing someone because we want the beds.


"They stopped the medication and at about 9.30pm he started getting short of breath. I held his hand and said, 'You will be all right'. I was sickened by the whole episode."


Pal disobeyed the doctor and gave the patient drugs to help him breathe. He was transferred to another unit, but later died. The doctor, whose name is known to The Sunday Times, declined to comment last night.

Last week one of the man's relatives said: "I think the NHS is atrocious. I don't think they care about old people."

Dr Green should also know that I restarted the medication on the PRN side of the chart so he would not notice. It was of course a lot for a Pre-Registration House Officer to disobey their consultant but I did because no one died on my shift that could be saved. He survived and we transferred quickly out of our ward quickly to a EMI home so Dr Green would not know. Dr Green always thought he died on the ward but he survived a year more. Just goes to show that if its not time to go, its not going to happen no matter how hard some doctors try and play God. Of course, the General Medical Council will not pay attention to this because in the end Dr Green is a consultant and I was a junior doctor. In the GMC's eyes, I would be wrong and the patient should have been allowed to die. In my eyes of course, no one died on my shift. That was my rule and it remained my rule no matter how difficult it was. I wasn't going to watch this patient die and live with it the next day knowing I could have saved him.

Anyway, the Locum Registrar and I got the EMI home for the above gentleman, did a high five and went off to have breakfast. The breakfast was great and we had a good snipe behind Dr Green's back as everyone did. In the end, no one really liked Dr Green. Too much golf, too much money, too much decadence and not enough humanity. Some people can be worshipped as consultants but some people are held with contempt. Dr Green felt that he could treat the juniors badly and they would obey and not bite back. Sometimes though even Dr Green can be wrong!

Dr Green was a good example of why doctors should not become managers.

As for anyone seeing Dr Green privately, I would spend the money on someone else. There are lots of doctors in the world to spend your money on. As the years have gone on, his looks have probably dwindled and after that has gone, there is really nothing left.

These last few posts have been placed to describe the matter in which senior doctors and management do develop a "pack" attack attitude towards the whistleblower. The situation often reminded me of the fox hunting season. I didn't like being a fox but then there was never a choice. Creating tiger like instincts took a long time but survival is important and everyone has to survive.

It is a great shame that Dr Green did not prevent the deaths on Ward 87 earlier.

David Fillingham. Chief Executive to Ward 87, North Staffordshire NHS Trust

Covering Up Your Mistakes and Moving On

The important issue to understand about managers in the NHS is that there is no accountability for them. It is also true that managers are the reason doctors end up at the GMC. This was certainly the case for Mr Robert Phipps a whistleblower in Bradford.

I have a theory about managers. The more patients they kill, the more likely it is for them to gain an CBE. Of course, its not the Queens fault but more the Labour Party. Ward 87 was of course the legacy of the Labour government. There are many wards like it and the Labour Party is the arch Spinmeister General. They certainly were when it came to the issues surrounding Ward 87. You just have to review their internal documentation on me to discover this. Ward 87 is a legacy our government and further evidence that they like to cover the dirt up, cover the graves up so the gloss is set and no one in the future will pay any attention to what happened. That is of course what happened to Ward 87. While the world has been distracted with the dysfunctional msbp mothers screaming their innocence, people died on this Ward. The Labour Party as a government has thrown so much discrediting material against my name that it has ensured that people shy away from the truth. Well, no one would like to investigate the truth because for every journalist these issues are far too complex. My reputation has been tainted with various issues that the Labour Party thought up through Professor Griffiths. This is the average tactic against whistleblowers. No accusation deters from the fact that patients died and suffered on this Ward. That fact remains still in time.

In those days, the top dog of North Staffordshire NHS Trust was David Fillingham. David Fillingham knew all there was to know about Ward 87. He of course had no intention of doing a thing about it apart from attempt a cover up until the foundations of the Trust was shaken by the media. Then he did a quick fix investigation on minority data consisting of a small sample and left the wider data in their graves. For David Fillingham, quick fixes were good. He could damage control the situation and move on.

The BMJ states the following "

Fillingham developed his interest in managing change outside the NHS. After graduating in history at Cambridge University, he worked for Pilkingtons, the glass manufacturer, for eight years, first in personnel then in marketing, where he realised that "glass was very boring." So he joined the NHS in 1989 as the regional personnel manager of Mersey Regional Health Authority.

He then became chief executive of one of the new family health services authorities, which he enjoyed. He said: "Because most people in the NHS were fairly ignorant about primary care we were allowed a lot of freedom." When family health services authorities merged with health authorities he became chief executive of St Helen's and Knowsley Health Authority. He then became chief executive of North Staffordshire Hospital, until he joined the Modernisation Agency this July. He applied for the job because it drew together his interests in change and change management "and the people aspects that are often overlooked."

David Fillingham as predicted as given a CBE much like his cohort in coverups Professor Rod Griffiths.

This is what a website says about him "David Fillingham has been Chief Executive at Bolton Hospitals NHS Trust since September 2004. He joined the NHS in 1989 having previously worked in Personnel Management and Marketing positions with Pilkington Plc. After a short period at Mersey Regional Health Authority, David has occupied a number of Chief Executive positions – in Primary Care at Wirral FHSA from 1991 until 1993; in commissioning at St Helens & Knowsley HA from 1993 until 1997 and in acute hospital services at North Staffordshire Hospitals Trust from 1997 to 2001.

From 2001 to 2004 David was Director of the NHS Modernisation Agency responsible for developing new ways of working and promoting leadership development across the NHS as a whole. David is now relishing the challenge of putting that national experience in to practice back on the frontline of the NHS at Bolton. In particular he is deeply involved in applying “lean” principles to healthcare. David lives in St Helens in Lancashire. Other than the NHS his passions are watching his local rugby league team and spending time with his wife and two daughters"

So having failed thousands of patients in Stoke on Trent, he was promoted by the Labour government to teach everyone else around the NHS. Fillingham though did a good job of covering up and putting a lid on the serious problems that compromised patient care.

Fillingham in his hay day also attempted to instigate Professor Rod Griffiths into getting me in trouble with the GMC over medical data that I had exposed in the public' interest. Rod Griffiths and Fillingham feared so much that this patient data would strike right back at them. They would never be able to answer why there was no equipment on the ward that they finally decided against it and dropped their idea of referring me to the GMC. Infact, no one has been able to answer the basic question - why was there never any basic equipment on the ward? Fillingham will gloss over it of course. Having attempted to discredit me repeatedly, in the very end it is Mr Fillingham whose conduct comes into the spotlight. Because in the end he was Chief Executive of a malfunctioning Ward as established by the 1999 and 2001 Reports. Of course, no one will question it because he knows how to sweep up inconvenient dirt when it counts.

Fillingham tried his best to silence me. Infact, North Staffordshire NHS Trust still attempts to zip my mouth up with their empty legal threats but quite frankly I don't give a damn anymore, not about them and not about what they wanted to do to silence. I believe it is important for the future to create a transparent environment for North Staffordshire NHS Trust so that they can be scrutinised by the public with respect to accountability. No one was held accountable for mistakes made on Ward 87 North Staffordshire NHS Trust. As we can see David Fillingham moved onto bigger and better things. He buys smarter suits these days but he has a past he would like the world to forget.

The only accountability that exists for managers is really by exposure publicly. I also stand by what I have said against Mr Fillingham. I also state that he was the worst chief executive to grace North Staffordshire NHS Trust. Each comment can be verified by the documentation I have.

Despite the substandard care on this Ward, Fillingham was never disciplined. He was though given a CBE for his efforts. This is what I mean by management in the NHS. The more negligent you are, the better the chances are of getting a CBE.

We still ask David Fillingham why no patient death rates were kept and why so many people's lives had to be compromised for so many years. There are still no answers to these questions are there? If there was a corporate manslaughter investigation into North Staffordshire NHS Trust Ward 87, the blame would fall squarely on Mr Fillingham. Of course, there will never be such an investigation, not with the Labour government tightening the lid on Ward 87. Nails will always be placed on the Ward 87 coffin for fear that the hauntings may arise again just like it always does.

David Fillingham has worked in Bolton Hospitals NHS Trust since September 2004. Do they know about Ward 87 - I suspect not.