By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 16 April 2018
Whistleblowers are crucial to the public interest and the protection of people’s rights, but can be viewed as a vexation by those in power, who want to stay in power.
Whistleblower protection will always be very hard-won. Parliament called for better whistleblower protection with two major reports, published respectively by the Public Accounts and Health Committees in 2014 and 2015.
There has been plenty of government spin since, but no real progress has been made.
The controversial case of Dr Bawa-Garba has caused much alarm about the professional risks that healthcare staff may face if they are forced to work in unsafe conditions over which they have limited control and in which speaking up is still risky.
I asked the Chair of the Health Committee a year ago to review the continuing failures of whistleblowing governance, and I understand that others have also asked for review. I now ask again.
All recent correspondence is laid out below.
BY EMAIL
Dr Sarah Wollaston
Chair of Health and Social Care Committee
16 April 2018
Dear Dr Wollaston,
Implications of Dr Bawa-Garba’s case and whistleblower protection
Thank you for responding to my previous correspondence of 10 March and 23 March, which for convenience I copy below.
Therein, you advise that the Committee does not review legal decisions and point me to Sir Norman William’s review on Gross Negligence Manslaughter.
To clarify, I did not write in the expectation that the Committee would review matters that are decided by the Courts.
Rather, I wrote to you about the conduct of the General Medical Council (GMC), and in my letter of 10 March I shared data that raised questions about the consistency of the GMC’s decisions. These were similar questions to those raised by the Committee itself especially with regards to possible Race bias.
The Professional Standards Authority has also questioned why the GMC would deviate from case law established by the Supreme Court, in order to increase the severity of punishment against doctors:
PSA document disclosed via FOIA to the Health Service Journal (A)
PSA document disclosed via FOIA to the Health Service Journal (B)
I hope the Committee will help to ensure that there is fairness.
I am aware of the Gross Negligence Manslaughter review by Sir Norman, who also assisted Sir Robert Francis and the Department of Health with the Freedom To Speak Up Review. The recommendations from the Freedom To Speak Up Review were not strong. The relevant arms length bodies and the National Guardian’s office have over the last three years sought to further dilute even the modest help that Sir Robert proposed for whistleblowers.
In all, the Bawa-Garba case and other events leave doctors – and other Health and Social Care workers – in a cleft stick of being damned if they speak up, and damned if they do not.
The Secretary of State recently claimed misleadingly in a speech that 90% of staff who had raised 4600 concerns with Freedom To Speak Up Guardians would do so again. He also tweeted the misleading claim:
This figure of 90% was a flawed, unpublished statistic supplied by the National Guardian’s Office, the very body charged with upholding values of transparency and accountability.
The UK Statistics Authority has confirmed that the statistic was unpublished, and advised that it will write to the National Guardian’s Office to make suggestions for improvement. Discussion continues on the matter, and I will share further evidence with the Committee about these irregularities.
The truth is there is still no effective, reliable protection for Health and Care workers who speak out, at a time when service quality is deteriorating and there is a great deal of unsafe unmet need to report.
But whistleblowing to the Care Quality Commission is in fact decreasing, to the point that the Public Accounts Committee recently advised that the CQC should ensure that whistleblowers can be confident in contacting the Commission. (Page 7, Section 6)
And yet the conduct of the regulator itself is likely to be part of the problem, for example by admitting to breaches of whistleblower confidentiality but refusing to transparently audit its practice.
I wrote to you almost exactly a year ago to ask if the Committee might hold a follow up hearing on whistleblowing, particularly as its recommendations from January 2015 have not been implemented by the government to any real degree. I do not know of any whistleblower who has received genuine ‘apology and practical redress’ as set out by the Committee. (Page 36, para 115)
In fact, I know only of a single, seriously harmed whistleblower who has received an apology, which they consider is insincere because the DHSC has not helped to remove blacklisting.
I wonder if you would consider a follow up inquiry, as the failures of protection continue, at a serious cost to patients:
Of Arbitrarness and Arbiters: The Freedom To Speak Up Project Three Years On
There are concerns about whether the National Guardian’s Office is reviewing enough cases, selecting cases for review in a fair way and being open and accountable about its activities. The Office has disclosed via FOIA that it spent more on comms than on establishing the Speak Up Guardian network. It has also announced only three case reviews, which focus on systems and not on helping individual whistleblowers in difficulty. Further evidence will be shared with the Committee in due course.
With best wishes,
Dr Minh Alexander
Cc
Health and Social Care Committee
Harry Cayton CEO Professional Standards Authority
David Isaac Chair ECHR
Rob Behrens PHSO
Dr Philippa Whitford MP
Meg Hillier MP Chair of Public Accounts Committee
Secretary of State for Health and Social Care
Minister of State for Health and Social Care
Sir Terence Stephenson Chair GMC
CORRESPONDENCE FROM CHAIR OF HEALTH AND SOCIAL CARE COMMITTEE 16 ARPIL 2018
Dear Dr Minh Alexander,
Please find attached a letter from the Chair of the Health and Social Care Committee, Dr Sarah Wollaston MP.
Kind regards,
Health and Social Care Committee
House of Commons | London | SW1A 0AA
CORRESPONDENCE 23 MARCH 2018:
BY EMAIL
Health Committee
23 March 2018
Dear Dr Wollaston and colleagues,
Re Consistency of GMC decisions on erasure of doctors after convictions after conviction for criminal offences
I wrote to the Committee on 10 March to pass on disclosed GMC data, which showed that in the five years between 2013 and 2018, 50 out of 73 doctors subject to Fitness to Practice proceedings as a result of sexual offences were subsequently erased from the register.
The i newspaper published an article yesterday about the statistic of ‘1 in 3 doctors convicted of sex offences still able to practice medicine’, after it liaised with the GMC about these figures.
Today, the GMC has advised that it supplied incorrect data and that 60, and not 50 of the 73 doctors were struck off.
The relevant correspondence from the GMC is copied below
Yours sincerely,
Dr Minh Alexander
From: “Simon Willis (0161 923 6310)” <***********************>
Subject: RE: Your Information Access Request – F18/9323/SW
Date: 23 March 2018 at 13:32:15 GMT
To: Ian Alexander <************************>
Dear Mr Alexander,
I have noticed a typographical error in my email below and I am writing to provide you with the correct information.
In respect of your question 2, the number of doctors struck off was actually 60.
I apologise unreservedly for my mistake and for any inconvenience caused.
Yours sincerely
Simon Willis
Information Access Officer
Resources & Quality Assurance Directorate
LETTER 10 MARCH:
BY EMAIL
Health Committee
10 March 2018
Dear Dr Wollaston and colleagues,
Re consistency of GMC decisions on erasure of doctors after conviction for criminal offences
I write to submit evidence pertinent to the debate around the case of Dr Bawa-Garba.
- The GMC has admitted via FOIA that it has no policy on the automatic erasure of doctors convicted of gross negligence manslaughter.
This is despite its chief executive Charlie Massey asserting that the GMC had no choice but to seek erasure after Dr Bawa-Garba’s conviction for gross negligence manslaughter, implying automaticity.
The GMC is clearly more open to questions of arbitrariness and discrimination in the absence of a clear policy.
- The GMC has admitted via FOIA that in the last 5 years it has chosen not to seek erasure in one third of cases where doctors had been convicted of sex offences (23 out of 73).
It seems a peculiar and unjust state of affairs when the GMC overrides its own Tribunal to strike off a doctor who made errors that the Tribunal considered were not made recklessly,
|
Medical Practitioners Tribunal Service decision 13 June 2017: “There is no evidence to suggest that your actions on 18 February 2011 were deliberate or reckless.” https://minhalexander.files.wordpress.com/2018/03/mpts-dr-hadiza-bawa-garba_13_june_2017.pdf
|
but it applies lesser sanctions to doctors who have been convicted of wilful, often premeditated, criminal sexual offences.
This is the FOI correspondence with the GMC and the disclosed data which is summarised above:
Yours sincerely,
Dr Minh Alexander
Cc
Harry Cayton CEO Professional Standards Authority
David Isaac Chair ECHR
Rob Behrens PHSO
Dr Philippa Whitford MP
Secretary of State for Health and Social Care
Minister of State for Health and Social Care
Sir Terence Stephenson Chair GMC
RELATED ITEMS
Waste Industry: Abuses of the NHS Disciplinary Process & Dr John Bestley
Alexander's Excavations 
Thank you for this information.
As a patient, I do not feel safer and better protected from human and system failings within the NHS.
However, I am sure the mortgages and leisure activities of senior personnel within the NHS, GMC and Parliament and associated bodies are flourishing.
Kindest regards,
Zara.
LikeLiked by 1 person