By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 8 March 2019
The spectacle of the Health and Social Care Committee’s hearing on the Kark Fit and Proper Person Review approaches. It will be interesting, but surprising if it results in real change.
The reality is there is one rule for workers and another for the executive classes. NHS Providers is unsurprisingly, batting hard for the powerful and resisting the creation of a disbarring body along those lines:
NHS Providers’s evidence to Health and Social Care Committee “3 22. The cost of setting up a new body is likely to be significant and there is a danger of setting up a bureaucratic and cumbersome process. Evidence also shows there is a considerable financial and human cost of fitness to practice investigations. 3 23. In reality, it would be very difficult to ‘strike off’ a director. This would require proving criminal levels of behaviour and individuals would most likely appeal in the courts, as is often the case with General Medical Council (GMC) rulings. Given the profound impact on people’s livelihoods and futures, the evidence would have to meet a very high bar”
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Despite the faux lamentation by senior officials when cover ups and whistleblower reprisal are exposed. The truth is, many privately support such behaviour and or protect fellow club members.
Jo Williams controversial former CQC Chair was recycled to the NHS as a non executive director of Alder Hey Children’s NHS Foundation Trust, and was recently appointed as its Chair:
The Times 2 February 2019 Disgraced CQC chief Dame Jo Williams given top job at children’s hospital
She replaces David Henshaw, another controversial figure:
An FOI response by Alder Hey of 21 February 2019 about William’s recycling has disclosed that the great and the good provided her with references as follows:
• “Reference from past Department of Health official/current chair of a health Think Tank
• Letter from past Minister
• Reference from University Vice Chancellor
• Reference from current NHS Board chair”
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I do not know who these individuals are but have looked for possible candidates.
Who could be the “current chair of a health Think Tank”?
I asked three prominent health Think Tanks if their Chairs, all of whom are former Department of Health civil servants, had provided a reference for Jo Williams.
The Health Foundation did not think it came from them.
The Nuffield Trust has not yet replied.
The Kings Fund staff advised that they had forwarded my query to their Chair, Sir Christopher Kelly KCB former Permanent Secretary of the Department of Health, who has not yet replied.
However, according to a CQC announcement of 7 September 2012, Kelly said nice things about Williams upon her resignation from the CQC after scandal:
“Sir Christopher Kelly, former Permanent Secretary of the Department of Health, said: “Over a number of years of devoted public service, Jo Williams has shown tireless commitment to improving care for people, in particular people who rely on mental health and learning disabilities and their families and carers. ‘She has provided strong leadership to the CQC over the last three years, and leaves the organisation in an excellent position to deliver its crucial role as quality and safety regulator of the health and social care system.””
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I wonder if the victims of the Winterbourne View care scandal and their families would agree with Kelly.
The Serious Case Review on Winterbourne View gave a disturbing account of CQC’s failure to listen to whistleblowers who raised the alarm on gross abuse. It concluded bluntly: “…the apparatus of oversight across sectors was unequal to the task of uncovering the fact and extent of abuses and crimes at the hospital.”
Of note, Kelly was appointed by Gordon Brown in 2007 as the Chair of the Committee on Standards in Public Life (CSPL). In 2009, as CSPL Chair he gave evidence to the Public Administration Select Committee for its inquiry on leaks and whistleblowing in Whitehall:
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Kelly also produced this 2013 report on standards on public life, to which Williams was a contributor:
Standards matter A review of best practice in promoting good behaviour in public life
Who could be the past Department of Health Minister who gave Jo Williams a reference?
Could it be Lord Norman Warner?
Community Care 20 July 2010 Government launches adult care funding commission
According to FOI data, Norman Warner has provided a reference for another NHS trust director in recent years.
Who could be the university Vice Chancellor who provided a reference?
Could it be Professor Trevor McMillan, the Vice Chancellor of Keele University, where Jo Williams was appointed as Pro-chancellor last autumn?
Who was the current NHS trust chair who provided a reference?
Can anyone think of a current NHS chair who has worked closely enough with Williams to provide a reference?
Joint strategic agreement between CQC and NHS Commissioning Board (NHS England)
The Department of Health and Social Care’s masterly inertia
Whoever Williams’ referees were, it does not change the fact that under her leadership, the CQC was repeatedly and very seriously criticised by parliament for poor performance and ill-advised, unsafe management decisions:
Health Committee Annual accountability hearing with the Care Quality Commission 2011
Health Committee Annual accountability hearing with the Care Quality Commission 2012
Nor does it change the fact that this is what the Mid Staffordshire Public Inquiry concluded about the senior leadership of the CQC, when Williams was CQC chair:
“The CQC has an unhealthy culture, in which senior managers are more concerned about public image than delivery, which is hostile to internal and external criticism, and in which staff feel under pressure and unsupported.”
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Stephen Hammond Minister for Health, who inherited the Kark FPPR Review from his predecessor Steve Barclay, was asked if he would permit the conflict of interest arising from CQC’s handling FPPR referrals on Williams.
The DHSC naturally washes its hands:
DHSC response 7 March 2019 “As the CQC is an independent arm’s length body, the Department cannot and does not get involved in its investigations.”
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But do your best to keep a straight face when you tune into the Committee hearing next week on the Kark report.
RELATED ITEM
1)Evidence from myself and two other NHS whistleblowers to the Health and Social Care Committee for the Kark hearing, which includes a critique of the Kark FPPR Review report:
2) Kark got his sums very wrong on numbers of whistleblowing cases and what is much more important, the Department of Health and Social Care allowed it to be published:
Number of NHS whistleblowing cases: A disagreement with Tom Kark QC
3) An account of how NHS Improvement recently employed a trust director who had been found to have seriously harmed a whistleblower:
There has been no response on this matter so far from Dido Harding, NHS Improvement’s Chair, who will be giving evidence to the Committee on 12 March, and is in charge of deciding whether Kark’s recommendations will be accepted.
5) What could a new whistleblowing law look like? A discussion document
As long as we don’t allow ourselves to raise our expectations.
The model I now follow is what is known as the Mexican Model.
Like the Mexicans, we accept that the majority of the great and the good, i.e. those with influence and power but no accountability, operate largely for themselves. We are no longer shocked – sickened maybe – but, no longer shocked. We wait for Karma to manifest.
I assume that Mr Kark and those who will discuss his report are not unpaid volunteers.
I really don’t want to feel that the Fit and Proper Persons review will largely be used as a tool for transferring funds from here to there, and for diverting attention away from the daily operations and detrimental activities of unfit and improper persons who reign supreme.
I thank you for your report, Dr A, obviously a fit and proper person and therefore not party to this theatre.
Wishing you a fine weekend.
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Back of a fag packet refs?…….again!
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