By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 19 October 2016
The Care Quality Commission, in association with other NHS regulators, has bent over backwards not to remove any NHS directors under Regulation 5, Fit and Proper Persons (FPPR).[1] Not a single director has been removed so far. CQC’s wilful blindness to cases of proven misconduct has been both condemned and ridiculed. The evidence of CQC’s failures keeps mounting as those whom it has protected inevitably get into more hot water.Legislative reform is needed for real accountability.
See here for a summary of CQC’s previous mishandling of FPPR and related obfuscations and distortions:
https://minhalexander.com/2016/09/24/cqcs-fit-and-proper-parade/
In December 2014 several whistleblowers, me included, took part in a telephone meeting with CQC’s Chief Inspector of Hospitals Professor Mike Richards and his entourage. This was to discuss how CQC would apply FPPR. During the meeting, Mike Richards claimed that removing too many NHS managers would not pass in the “Court of Public Opinion”. Discouragingly, he also said that reprisal against whistleblowers – which Robert Francis identified was a form of serious misconduct – would only be actionable under FPPR if it was of a sufficient degree.
Judging from CQC’s subsequent refusal to take action on several cases of proven managerial misconduct against whistleblowers, the acts of falsifying charges, bullying and harassment, unfair dismissals and cover ups cannot be sufficiently serious matters for the Professor.
CQC came a cropper after it surreptitiously shut down an FPPR referral on Paula Vasco-Knight, a former NHS chief executive about whom whistleblowers raised concerns of nepotism. Her conduct and that of her fellow managers in suppressing this matter was criticised by an Employment Tribunal. [2] Not long after CQC shut down the FPPR referral, “Fiasco-Knight” was dropped by her latest trust due to financial allegations. [3] A two week criminal trial is scheduled at Exeter Crown Court in January 2017. [4] After this latest scandal, CQC was forced to announce that it would review its handling of FPPR [5]. Five months on, there is still no evidence that it has done so. I am still waiting for CQC’s substantive responses to FPPR referrals, one of which is referral on Vasco-Knight, made a year ago.
In respect of David Loughton the NHS chief who was criticised over the case of NHS whistleblower Raj Mattu [6] and then again in the case of Sandra Haynes-Kirkbright [7], there is still no evidence that CQC has acted on FPPR referrals. Embarrassingly for CQC, David Loughton reported that Mike Richards had given permission for his trust to tell its staff to only “answer the question and then shut up, don’t elaborate” when dealing with inspectors.[8] CQC denied this, but doubts linger. This is partly because CQC has tolerated other questionable practices by trusts, such as allowing trust managers to instruct staff to report back on conversations with inspectors.
The latest in the long line of CQC FPPR scandals is that Phil Morley the controversial former Chief Executive at Hull, who moved to Princess Alexandra Hospital, is in the headlines again. This is due to findings of poor care and leadership at Princess Alexandra Hospital, now rated ‘Inadequate’. [9]
The local press in Hull reported extensively on Mr Morley’s tenure up north. For example:
“Hospital staff were called “incompetent, underperforming, useless and dopey”, pushed and prodded, had pens thrown at them, a damning report into bullying revealed”[10]
“SENIOR hospital staff were allowed to run riot with NHS credit cards without proper checks on their spending, a new report has revealed.Auditors KPMG were called in after managers spent £740,000 on their NHS credit cards in a single year.The Mail has already revealed former chief executive Phil Morley spent £50,000 on his NHS credit card, racking up bills at fine dining restaurants and luxury hotels during his time in charge of Hull and East Yorkshire Hospitals NHS Trust” [11]
Morley’s super powers of persuasion were not infinite. He made a complaint of harassment against the local press, but it was not upheld by IPSOS. [12]
Very seriously, a Hull whistleblower suffered significant detriment under Morley’s reign, and eventually received compensation from the trust. [13]
Local Hull MP Diana Johnson complained about the NHS’ ineffectual Fit and Proper Person governance, which allowed Morley to be recycled to Princess Alexandra. [14] She got short shrift. [15] Here is a photo of Jeremy Hunt literally standing by his man at Princess Alexandra hospital:
In its latest inspection report, the CQC admits that Princess Alexandra trust’s performance has deteriorated under Mr Morley’s stewardship, and that there is “apparent disconnect between the trust board leadership level and the ward level”. Well what do the CQC and Hunt expect if they recycle leaders with a reputation for poor behaviour against staff? [16]
The NHS has been told countless times that recycling managers who have failed is part of the problem. However, we hear excuses that a culture of fear would result if erring managers are sacked, and the shortage of managers is given as a reason for not sacking people. But does it ever occur to the NHS establishment that good managers are put off from working in the NHS because they don’t want to work with duffers? Julie Moore, a successful NHS Chief Executive in Birmingham spoke up about the fact that the NHS is damaged by managers who are “grossly incompetent” and who focus on self preservation:
“I have actually met one who said: ‘I have made a career out of never making a decision’… We’ve created a culture of people who are terrified of making decisions because you can’t be held to account for making no decision, but you can if you make a decision. We’ve got the leadership model wrong.” [17]
However, there is much resistance to removing erring managers. Robert Francis was at some point prevailed upon to change his position from ‘sack ‘em’ to ‘hug a hoodie’. See the history of his flip flops here:
https://minhalexander.com/2016/09/26/sir-roberts-flip-flops/
Earlier this month when speaking at the launch of a report by the National Confidential Inquiry into Suicide and Homicide, Francis was reported to have said “Retribution encourages concealment of mistakes in services, focus should be on learning and putting mistakes right”.
Last week, Jeremy Hunt made off-colour comments about a “witch hunt” at Southern Health, implying negative and improper motives by bereaved families seeking justice and a safer service. [18]
This week, John Manzoni the Chief Executive of the civil service and Cabinet Secretary ran an article for the civil service “Whistleblower Awareness Week”. [16] It was yet more waffle about culture change and of course, it emphasised that this will take more time. Never mind that government deliberately delays whenever it comes to whistleblowing. And never mind the fact that Manzoni had to admit to Public Accounts Committee in December 2015 that the government task and finish group on whistleblowing reform – set up in response to PAC’s recommendations of 1 August 2014 [19] – had only met once. [20]
When it comes to the most serious matters, societies do not generally say “let’s encourage everyone to do better”. No one argues that it is wrong to penalise murder, because it might drive it underground or create undue fear. And there are clear examples of law changing culture, such as the change in attitudes to drink driving after it was outlawed.
Genuine whistleblowing is a matter of public good and the victimisation of whistleblowers should be seen as an offence of serious dishonesty against the public good.
Public confidence in public sector accountability is low, and it is clear that reform is sorely needed. [21] [22]
Source: Committee on Standards in Public Life
The vindication of Hillsborough campaigners after many years of establishment mistreatment is a step in the right direction. The recently launched ‘Hillsborough Law’ – Public Authorities Accountability Bill – needs the public’s support. It is well worth keeping an eye on the campaign: http://www.thehillsboroughlaw.com/
Also see the campaigning charity Compassion In Care’s proposal, Edna’s Law on whistleblowing, which focuses on two essential issues – accountability and righting wrongs: http://www.compassionincare.com/
REFERENCES
[1] CQC Regulation 5, Fit and Proper Persons
http://www.cqc.org.uk/sites/default/files/20141120_doc_fppf_final_nhs_provider_guidance_v1-0.pdf
https://www.cqc.org.uk/content/regulation-5-fit-and-proper-persons-directors#full-regulation
[2] Devon health boss Dr Paula Vasco-Knight resigns. BBC 30 May 2014
http://www.bbc.co.uk/news/uk-england-devon-27636112
[3] Health boss Paula Vasco-Knight suspended over finance claims, 4 May 2016
http://www.bbc.co.uk/news/uk-england-devon-36204798
[4] NHS chief denies siphoning £20K of public money into her husband’s company, Ted Davenport, Liverpool Echo 26 June 2016
http://www.liverpoolecho.co.uk/news/liverpool-news/nhs-chief-denies-siphoning-20k-11527462
[5] CQC to review whether Fit and Proper Person rule ‘needs to change’, Will Hazel, Health Service Journal 24 May 2016
[6] Probe launched into NHS chief who blew £6m to get rid of whistleblowers as minister pledges to protect workers who speak out. Paul Bentley and Daniel Martin, Daily Mail 8 March 2014
[7] Verita investigation report January 2016 on David Loughton, Sandra Haynes –Kirkbright and the Royal Wolverhampton trust
verita-loughton-rwt-verita-report
Now sack £200,000 NHS boss who hounded whistleblower’. Paul Bentley, Daily Mail, 13 May 2016
[8] ‘Shut up and never explain’: What NHS boss told staff to do if inspectors called.
Paul Bentley, Daily Mail, 14 May 2016
http://www.dailymail.co.uk/news/article-3590018/Shut-never-explain-NHS-boss-told-staff.html
[9] Trust in special measures after safety and leadership failings. James Illman, Health Service Journal 19 October 2016
[10] Hull NHS bosses threw pens at ‘incompetent, underperforming, useless’ hospital staff, Alexandra Wood, Yorkshire Post 7 October 2014
[11] Senior NHS staff in Hull ran up £740,000 in credit card bill ‘without proper checks’, Allison Coggan Hull Daily Mail, 18 December 2014
[12] IPSOS ruling 00180-15 Morley v Hull Daily Mail, issued 26 June 2015
https://www.ipso.co.uk/rulings-and-resolution-statements/ruling/?id=00180-15
[13] NHS whistleblower Pauline Lewin awarded £250K after accusing ex-Hull chief Phil Morley of bullying, Hull Daily Mail, 1 August 2016
https://www.ipso.co.uk/rulings-and-resolution-statements/ruling/?id=00180-15
[14] Letter by Diana Johnson to Jeremy Hunt about Phil Morley
diana-johnson-letter-to-hunt-morley-16-july-2015-1
[15] Health Secretary: NHS boss Phil Morley’s appointment ‘fit and proper’, Laura Hughes, Hull Daily Mail, 25 July 2015
[16] CQC inspection report on Princess Alexandra Hospital NHS Trust, 19 October 2016
https://www.cqc.org.uk/sites/default/files/new_reports/AAAF6797.pdf
[17] NHS troubleshooter calls for leaders to be sacked. Will Helpern. Politics Home. 9 April 2016
[18] Jeremy ‘witch Hunt’ and the mother blame. Sara Ryan 15 October 2016
https://mydaftlife.com/category/laughing-boy-tales/sloven-health/
[16] Be confident to speak up – encouraging a positive culture in the Civil Service. John Manzoni, 17 October 2016
[19] Public Accounts Committee inquiry report. 1 August 2014.
http://www.publications.parliament.uk/pa/cm201415/cmselect/cmpubacc/593/593.pdf
[20] John Manzoni. Oral evidence to Public Accounts Committee. 7 December 2015
[21] On the Politics of Lying. Nick Turnbull and Dave Richards, LSE 10 June 2016
[22] Survey of public attitudes towards conduct in public life, 2014. Prepared for the Committee on Standards in Public Life.
Alexander's Excavations 
I recognize the obnoxious quote from one of the article’s ghastly, chortling duffers. It says much about him that it appears he could barely contain his delight in sharing it with us: – the only way to get on in the Civil Service is not to make mistakes. The only way not to make mistakes is to do nothing.
This is the maxim that runs, like the Ebola virus, through all of our institutions (as I know to my personal cost).
However, it yet again indicates something more. Because an absence should be as detectable as a presence – one only has to look at the evidence that surrounds the blackhole.
However, the truly depressing aspect is that, so few people are willing to assume the responsibility of investigating anything to any worthwhile degree. May I thank you for being one of the few who does.
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Thank you zrprayder. Dare we whisper “PLUM duff”? 🙂
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