By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 11 March 2018
Steve Barclay the recently appointed Minister of State for Health and Social Care was, a leading light in the charge against David Nicholson post MidStaffs, and a fierce interrogator of the CQC’s former Labour-appointed chief officers when he was a member of the Public Accounts Committee.
Fair play to a job well done.
But equally, the political capital made out of Mid Staffs by Jeremy Hunt has been brazen and most distasteful, especially when he has refused to implement some of the most critical recommendations on safe staffing and firm deterrence of whistleblower reprisal.
Whistleblowers learn from experience that there are few lasting and dependable reference points in the complicated corridors of power.
An appeal was made to the Steve Barclay in his new capacity as Minister of State to remedy his Department’s blatant obfuscation on and negligent handling of coroners’ warnings.
After all he had, on the back benches, said many fine things about learning from disaster, and he had previously attacked failures to act upon data:
It is correct that improvements were made in the collation of data. In fact, the Dr Foster data were published in national newspapers from 2001, but what is remarkable is that they were not acted on. That is the central charge for Ministers. We were the world leader in the collation of mortality data. We had the data, but Ministers did nothing with them.”
Hansard: Parliamentary debate 14 March 2013 on transparency and accountability in the NHS
The appeal to Barclay was backed up with evidence from many months’ work, tracing coroners’ warnings about the NHS between July 2013 and July 2017 and the system response to these warnings.
But it was not to be. There was no personal reply. Just a curt note from an official, via the ‘Do not reply’ email account, denying any mishandling. This note ended on a typically defiant trumpet solo:
“a series of actions have been put in place to ensure that safe, high quality ambulance services continues to be provided.”
Continues? Continues?! On Planet Comms with humongous side order of assorted hallucinogenics perhaps.
The correspondence with Barclay is provided below, as are some examples of the ‘safe, high quality ambulance services’ that the government claims it is providing.
16900 people in a week kept in NHS ambulances waiting for hospital care
CORRESPONDENCE WITH STEVE BARCLAY MINISTER OF STATE FOR HEALTH AND SOCIAL CARE ABOUT CORONERS’ WARNINGS (PFDs):
From: Department of Health and Social Care <donotreply@dh.gsi.gov.uk>
Subject: From the Department of Health and Social Care
Date: 9 March 2018 at 12:29:08 GMT
To: “Alexander, Minh” <*************************>
Our ref: DE-1119800
Dear Dr Alexander,
Thank you for your correspondence of 13 February to Stephen Barclay about the Department’s handling of reports on action to prevent future deaths issued by coroners. I have been asked to reply.
The Department does not accept your assertion that the reports are mishandled and I was sorry to read that you feel the reports are not taken seriously. This is not the case. I am aware that the Department has corresponded with you on this matter previously and refer you to the response given on 10 October 2017 (our reference DE-1096208).
I can assure you that the Department takes very seriously its statutory duty to respond to reports on the prevention of future deaths. The reports play a valuable role in bringing serious matters of concern to the attention of the appropriate bodies that have the ability to take action to prevent avoidable harm. As explained previously, the Department ensures that the relevant regulators and other bodies are made aware of the matters of concern brought to its attention so that the system can respond as appropriate.
Patient safety is a priority for this Government and learning lessons where things have gone wrong is essential to ensuring the NHS provides safe, high quality care. Responding effectively to matters brought to its attention through the inquest process is a recognised and important part of this. I would point out that coroner’s reports and their responses are publicly available once published by the Chief Coroner, thus bringing transparency to the process.
With regard to your concerns about the East of England Ambulance Service NHS Trust, the Department is aware that concerns have been raised about the trust, including questions about whether delays to ambulance responses have caused additional harm to patients during significant demand pressures experienced over the Christmas period. We take seriously any claims that there was detriment to patients, and have ensured that quick action has been taken to examine these. The trust has identified any potential cases where there were serious delays, and following an initial investigation the trust is examining 22 cases through the ‘serious incident’ procedure. This process is being independently assured.
Additionally a risk summit has been held with the input of NHS Improvement, NHS England and the Care Quality Commission, and a series of actions have been put in place to ensure that safe, high quality ambulance services continues to be provided.
I hope this reply is helpful.
Yours sincerely,
Ellie Boyle
Ministerial Correspondence and Public Enquiries
Department of Health and Social Care
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From: Minh Alexander <minhalexander@aol.com>
Subject: Government mishandling of coroners’ warning reports on action to prevent future deaths
Date: 13 February 2018 at 06:23:18 GMT
To: Steve Barclay *************************
Cc: Brian Jarman <**************************>, julie bailey <*************************>, heather wood <*****************************>
BY EMAIL
Mr Steven Barclay
Minister of State
Department of Health and Social Care
13 February 2018
Dear Mr Barclay,
Government mishandling of coroners’ warning reports on action to prevent future deaths
I write to ask what action you think the Department of Health should take in respect of my findings on mishandling of coroners’ warnings by the Government and its arms length bodies.
The full report of my findings can be found here: Safe in their hands? Government’s response to coroners’ warnings about the NHS
The Centre for Health and the Public Interest ran a blog which summarised the findings: Lives at risk. The Government’s inadequate management of coroners’ warnings about the NHS
In short, it seems to me that the Government and its arms length bodies have not taken coroners’ warnings seriously enough and that this has had the effect of concealing serious unmet need and mounting NHS crisis. In particular, there is a trend of deteriorating ambulance safety, which triangulated with other parameters such as numbers of complaints, serious untoward incidents and other performance data, which all should have been acted upon a lot sooner to avert the shocking events that we have just seen with respect to the East of England Ambulance Service.*
I myself live in the same area with a very ill husband. Having spent hours last winter in A&E with my husband on a trolley, I have no confidence that struggling emergency services can reliably meet our needs. I hope you can understand how terrifying that is.
I understand that you were previously very critical of flawed and reckless NHS leadership which covered up safety problems and led to the Mid Staffs disaster **. I hope you will act to ensure that unmet need does not continue to be swept under the carpet by this Government.
With best wishes,
Dr Minh Alexander
cc Prof Sir Brian Jarman
Julie Bailey Cure the NHS
Dr Heather Wood
* East of England Ambulance delays linked to 81 deaths
**Police should investigate Labour ministers over Mid Staffs
Alexander's Excavations 
There is no denying there is a problem. It’s a pity the ‘powers that be’ continue to deny there is a problem. More budget cuts coming too – even though we are now supposed to be in a surplus budget!
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The line ‘we take very seriously’ trips off the tongue so easily for those with responsibility for delivering services to the public but the steady decline across the board, not just NHS tells a different story. Keep up the good work of putting this in the public domain. The very least we can do is leave a paper trail which will prevent any of them saying ‘I didn’t know’.
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Thank you for this report and update. I’m surprised we still have Coroner’s Courts – they could easily be replaced by P.R. Departments.
Very disappointing response to your impeccable and detailed work, but, unfortunately, not surprising.
Politics is about power – the gaining and retaining of it.
Whether the issue is of great consequence or is totally insignificant, the politician will seemingly only view it as of use to him and his ambition.
The issue, and its victims, are either used as a stepping stone to greater exposure for the politician or as a subject that can maintain their power base – the issue’s intrinsic merit being of little or no interest.
Many of those in the upper echelons of public life not only can’t tell the difference between a principle and a pineapple, but they also don’t see why they should – unless their P.R. Department advises them that they should, in which case they will claim such whilst continuing to demonstrate that they don’t.
Very sorry you experienced the dire consequences of a shambolically run NHS. Horrifying stories continue to ooze forth however much drivel from the P.R. Departments is used to try and staunch the flow.
I’d be most interested to hear of any response forthcoming from Mr. Barclay although I expect he is involved in far more important tasks. However, I shall resist detailing my guesses here because I would disgrace myself and I don’t wish to go down to their level.
Kindest regards, Zara.
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Hiya all. The difference between a principle and a pineapple made me laugh out loud. Thank you Zara.
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Deny delay and defend are the NHS (and regulators) default settings sadly! Honesty?……..what that then? “Can’t you see am looking for it” they say
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