Kark, Fit and Proper Persons, NHS England, Mason Fitzgerald and the Good Governance Institute

Dr Minh Alexander retired consultant psychiatrist 15 October 2022

In 2018 the government commissioned a review of Fit and Proper Persons in the NHS after a number of scandals and also concerns about the Care Quality Commission’s application of CQC Regulation 5 Fit and Proper Persons:

A review of the Fit and Proper Person Test Commissioned by the Minister of State for Health by Tom Kark QC and Jane Russell (Barrister)

NHS England, despite being one of the targets affected by Kark’s recommendations, was put in control of implementing the recommendations.

Unsurprisingly, NHSE has dragged its feet and been secretive about the work undertaken these past few years, albeit it has attributed some of the delay to lack of government permission. At the last update earlier this week, NHS England advised that the terms of reference for its NEW Kark Steering Group will be finalised at the start of next month.

In the meantime, NHS England itself has illustrated the weakness of current approaches to Fit and Proper Persons in the NHS. Ruth May the Chief Nursing Officer has commissioned work from a private organisation, the Good Governance Institute (GGI).

The GGI states on its website that it employs as a senior consultant, Mason Fitzgerald a director sacked last year by the NHS after a furore about CV inaccuracy.

GGI previously failed to answer a question about this.

Material by the GGI that is in the public domain raises questions about whether the GGI – and indeed possibly Mason Fitzgerald – may be undertaking other work with NHSE and Integrated Care Systems.

I have asked NHS England to review it systems, approach to contracts and its relationship with the GGI.

This is the relevant letter to Ruth May, with the details, and is copied to Amanda Pritchard NHSE CEO, the NHSE director responsible for the Kark report implementation and Tom Kark QC:


Ruth May 

Chief Nursing Officer

NHS England

15 October 2022

Dear Ruth,

NHSE, the Good Governance Institute’s governance and Mason Fitzgerald, sacked former NHS director

I write to follow up my response to your social media promotion of the GGI’s work on a staff survey conducted by the GGI, for your team:

I am really concerned that senior NHS managers appear either oblivious of, or unconcerned about, the GGI hiring Mason Fitzgerald, an NHS director sacked last year after false CV claims.

The current GGI  website profile for Mason Fitzgerald, described as a GGI ‘senior consultant’, omits to mention anything about his sacking. See attached screenshot and link:


As you may recall, Mason Fitzgerald’s false CV claim was missed by ELFT and the CQC, but emerged after he was almost appointed as CEO of NSFT. Had that appointment process been completed, he would have had power over thousands of extremely vulnerable mental health patients:


The GGI appears to be unaccountable regarding its hiring of Mason Fitzgerald. When I wrote to the Institute in April this year about it hiring him, it failed to respond.

According to the GGI’s material, a number of NHS organisations continue to use its services.

In particular, the GGI published a blog by Mason Fitzgerald on 10 October 2022, in which he stated:

“GGI is currently working with ICSs to review their governance arrangements, and, through our networks and events, we are developing thinking on how ICSs should approach their first end of year review.”


The GGI tweeted this blog on 11 October 2022, tagging in NHS England (see screenshot), raising a question of whether NHS England is a partner in this work and has commissioned the GGI to undertake this project:

According to a response to this tweet by the GGI Chief Executive, the GGI is working with 13 Integrated Care Systems:

Does the NHS therefore still employ Mason Fitzgerald, as a senior consultant, through the GGI?


If so, is it appropriate for an individual sacked by the NHS after false CV claims, to be vetting governance by NHS organisations?


I am especially concerned if NHS England promotes the GGI or contracts with the GGI in the light of its hiring of Mason Fitzgerald, because NHS England is supposed to be implementing the Kark recommendations on tracking impaired or unsuitable NHS managers.


If NHS England had implemented the Kark recommendations in a timely and effective way, Mason Fitzgerald’s subsequent role at the GGI would have been flagged up if he undertook any work for the NHS through the GGI.


I ask that:

a. NHS England and its officers stop all promotion of the GGI until the issue of the GGI’s employment of Mason Fitzgerald, and the questions arising from this about the GGI’s governance, are further clarified and addressed,

b. NHS England reviews any existing contracts with the GGI based on the evidence, through the GGI’s hiring of Mason Fitzgerald, that the GGI’s choice and deployment of consultants and its governance are in question. Please also review whether Mason Fitzgerald is currently working for NHS England, any ICS or any other NHS body under NHSE’s control, as a GGI senior consultant.

c. NHS England considers in its Kark implementation the specific issue of whether NHS managers sacked by the NHS may resume employment through the back door as consultants, and that NHSE designs Fit and Proper Person systems that are strong enough to detect such a situation.

d. NHS England considers generally in its Kark implementation how it will ensure that consistent Fit and Proper Persons standards apply to contractors and contracted services, in the same way that it currently makes other quality requirements of contractors, through the way NHSE’s contracts are drafted.

I copy this to Amanda Pritchard, Jacqueline Davies NHSE lead director for the Kark implementation and to Tom.

With best wishes,


Dr Minh Alexander


Cc Amanda Pritchard NHS England CEO, Jacqueline Davies NHSE Director of Leadership, Lifelong learning and talent , Tom Kark KC

UPDATE 15 March 2023

Unsurprisingly, Ruth May CNO NHS England ignored me entirely. I wrote to her boss Amanda Pritchard CEO NHSE England in December 2022, who also ignored me.

I reminded them both via social media, but they continued in their silence.

I have now filed a formal complaint with NHSE England’s National Head of Complaints, copied to the Secretary of State and House of Commons Health Committee.

The correspondence to Pritchard and the formal complaint can be found here.

In the meantime, the Good Governance has promoted Mason Fitzgerald from “senior consultant” to “Director of Consultancy and Principal Consultant”. How much of this rise has been based on NHS work?



NHS England and its predecessor bodies have plenty of form on erring senior NHS managers.

Postscripts on Paula. NHS England’s apologia & regulatory reticence

So does the CQC:

Sorry is the hardest word: CQC, Paula Vasco-Knight and Regulation 5 Fit and Proper Persons

CQC downgrades Well Led domain at North Tees and Hartlepool NHS Trust. But no one found lacking on FPPR

Mr Tristan Reuser’s whistleblowing case: Scandalous employer and regulatory
behaviour on FPPR

CQC’s Victimisation of Whistleblowers: Failure to Investigate Concerns

Breach of confidentiality by CQC and complicity in referring a whistleblower to the
Disclosure and Barring Service

Whistleblowers Unheard by CQC

One thought on “Kark, Fit and Proper Persons, NHS England, Mason Fitzgerald and the Good Governance Institute

  1. I realise the NHS has essential tasks to honour and fulfil – such as P.R., attractive photographs of important people and boxes to complete.

    But, I am left to ponder whether the NHS’s predilection for employing, or associating with, those with dubious records is merely an oversight, as per above, or a deliberate strategy to benefit from their experiences.

    A great pity about the non-implementation of the Kark Review. Perhaps Mr Kark, KC, could supply the NHS with a suitably attractive photograph.

    Thank you Dr A.


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