By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 11 February 2020
In the fine tradition of NHS cover ups, NHS Improvement is in the frame for the grotesque whistleblower witch hunt at West Suffolk NHS Foundation Trust, but it has refused to answer questions about its role. This is despite being fingered by the panicky National Guardian’s Office.
The Guardian newspaper yesterday specifically reported that Tom Grimes the head of whistleblowing for NHS England and NHS Improvement has not clarified the issues about NHSI’s role.
Worse still, the Department of Health and Social Care has allowed NHSI to control the investigation into events at West Suffolk, despite acknowledging that independence is important. Unsurprising perhaps given that Matt Hancock Health Secretary stands to be embarrassed by further probing and more detailed revelations of why he failed to help whistleblowers at West Suffolk.
NHS Improvement has published terms of reference which do not explicitly include a clear examination of the role of oversight bodies and of the government, whether by action or omission.
Rather, there is merely a tangential reference to review of “any advice/interactions the Trust sought from other relevant bodies.”
This slippery wording potentially allows a complicit investigator to stop dead at the advice sought by the trust, and to avert eyes from the advice actually provided.
This is in contrast to NHSI’s previous terms of reference for the executive whistleblowing investigation at Wirral University Teaching Hospitals NHS Foundation Trust:
“The investigation will:
- investigate concerns raised by members of trust staff in late 2017 with NHS Improvement regarding cultural, behavioural and governance issues
- review the trust’s handling of a recent disciplinary case involving allegations of sexual misconduct; and
- consider NHS Improvements’ response to the concerns raised with it per above”
The lack of similar clear remit from the terms of reference for the West Suffolk rapid review point to a self serving NHSI cover up about the actions of its whistleblowing team.
This is extremely serious because NHSI’s whistleblowing team receives disclosures from desperate and vulnerable NHS whistleblowers who have exhausted internal whistleblowing routes with their employers. If they are jumping out of the frying pan into the malign fires of Hell, which whistleblowers already suspect from many bruising experiences with UK regulators, this should be clearly exposed.
And who has NHS Improvement chosen to undertake the investigation?
Christine Outram, an NHS insider and a peer of the directors of West Suffolk NHS Foundation.
Like Steve Dunn, West Suffolk CEO, Outram is a long served senior official with past tenure in central government as a DH Director General, now working at provider level as Chair of the Christie NHS Foundation Trust.
NHSI’s blurb emphasises that she is “respected”. And NHSI cites the fact that she got a gong recently:
“Christine was recognised for her service to the NHS last year in the Queen’s Birthday honours list.”
That’s alright then.
The register of interests at the Christie NHS Foundation Trust reveals that Outram has a pecuniary interest as a member of the advisory board of the controversial private e-GP provider, Push Doctor (Push Dr Ltd Company Number 08624572). She reportedly joined the advisory board in March 2018. An astonishing contrast of roles, but alas no longer unusual in our rapidly degrading NHS.
In April 2018 Push Doctor was criticised by the Advertising Standards Authority for misleading advertising material which failed to make clear that it was a private service which charged a fee.
Perhaps more a case of Pushy than Push.
The ASA additionally noted concerns that Push Doctor’s website featured five star Trustpilot graphics, but misleadingly omitted low star reviews. Push Doctor responded as follows:
“Push Doctor acknowledged that the box (provided through a Trustpilot widget) omitted reviews in which the customer had rated them with one, two or three stars, but said they were not aware of any requirements that they must feature negative reviews on their website. They said the Trustpilot widget included the feature and it therefore must be a widespread device on many websites.”
CQC inspection findings about Push Doctor in 2017 and 2018 were unfavourable, with findings of unsafe clinical practices.
However, after an advisory board of big names was established in 2018, “to support growth”, CQC upgraded Push Doctor last year to an overall ‘Good’ rating, and ‘Outstanding’ on the Well Led domain, with much gush.
Who else is on the advisory board of Push Doctor?
Why, the former Chair of NHS Improvement Ed Smith, a very busy person.
And who else was on the advisory board of Push Doctor, until it caused a scandal?
Nicola Blackwood, DHSC minister for innovation, with responsibility for data, digital and technology, including cyber security.
According to Outram’s LinkedIn details, she was at the time NHS England Director of Intelligence and Strategy.
Her social media activity shows her carrying the torch for tech, the controversial care data initiative and tele-health:
Outram’s declaration of interest at the Christie also reveals that she has a pecuniary interest in Yorkshire and Humber Academic Health Science Network:
“Yorkshire & Humber AHSN is one of 15 AHSNs set up by NHS England to operate as the key innovation arm of the NHS. Across the country AHSNs act as a bridge between health care providers, commissioners, academia and industry. By connecting these sectors, we help to build a pipeline of solutions for the NHS from research and product development through to implementation and commercialisation.”
Anti-NHS privatisation campaigners have been critical of AHSNs and of Outram for mixing public sector and corporate interests:
“Christine Audrey Outram is also Director of Foundation Trust Network , Manchester Academic Health Science Centre , Holgateside Consulting, St Annes Community Services Leeds, which rents and operates Housing Association real estate, provides Residential nursing care facilities, Residential care activities for learning difficulties, mental health and substance abuse and Other non-residential social work activities”
So, what’s the betting that Outram will feel a natural empathy for the little guy?
The National Guardian has demonstrated the usual lack of judgment in endorsing West Suffolk’s whistleblowing credentials without adequate evidence:
The public and whistleblowers will be cheated for as long as there is weak UK whistleblowing law and badly designed infrastructure. Things will be especially bad in the years ahead now that we have a authoritarian government which runs on cronyism, and which will abuse power to embed itself and cut down any opposition and threats. But when conditions are better, what is needed is radical reform of the law and the means to enforce it.
Reforming UK whistleblowing law and infrastructure also requires radical reform of corrupt bodies such as NHSI, which currently align with vested interests and which protect power against the public interest.