Bewick, the ICB, misinformation by UHB about GMC referrals and a late correction

Dr Minh Alexander retired consultant psychiatrist 14 April 2023

On 14 April 2022 UHB answered an FOI enquiry incorrectly, claiming that of 26 GMC referrals in the ten previous years, none had resulted in any further action by the GMC.

But at the time, this data obviously raised questions of whether UHB was referring doctors appropriately.

It also equally raised questions of whether UHB was referring the right doctors.

BBC Newsnight later picked up on the FOI disclosure and reported it in a broadcast in December 2022.

Shortly after this I noticed GMC data that contradicted UHB’s FOI response.

I informed the BBC about this and wrote to UHB’s new interim Chair to question the accuracy of UHB’s FOI disclosure.

There was a delay in UHB responding, despite my chasing. This was later explained as a switch between email accounts by the interim Chair which led to some email being unnoticed.

In the meantime, David Melbourne the CEO of Birmingham and Solihull ICB emphasised to local councillors at the Joint Health Overview and Scrutiny Committee that the media had got their figures wrong.

This was very distasteful given that the false information had been supplied by UHB.

A similar message was transmitted by Mike Bewick’s rapid review report on UHB, published on 28 March.

Remarks on page 12 of Bewick’s report dovetail with the tone of Melbourne’s comments to JHOSC:

It is perplexing as to why Bewick focussed on the cases that DID result in GMC action, but omitted to discuss the cases which did NOT result in any GMC action.

One would have thought that all cases would have been counted in any check of accuracy.

And it is the cases that did not result in any GMC action that were of most concern in terms of UHB’s governance.

Yesterday, UHB finally responded through its Chief Legal Officer to my requests for the record to be corrected.

This is the response:

RESPONSE BY DAVID BURBRIDGE 13 APRIL 2023 Dear Dr Alexander Please find below a response to your email to Dame Yve Buckland, dated 29 March. For the period 1 April 2012 to 31 March 2022: – How many doctors the trust referred to the GMC ? At UHB (prior to and post the merger with Heart of England NHS Foundation Trust (“HEFT”)) there were 22 referrals At HEFT (prior to the merger with UHB) there were 16 (3 of these are dated just after the date of merger 1.4.2018, but are attributed to HEFT – we believe this may be because there was contact before the change of RO) – How many of these referrals were signed off by the medical director? At UHB 14/22, the remainder were signed off by Deputy Medical Director or acting Medical Director  At HEFT 6/16 were signed off by the Medical Director and the remainder were by Deputy or Associate Medical Directors.  – How many of these referrals resulted in no further action by the GMC? UHB – 4 were concluded at triage, 7 were investigated and concluded with no action, 11 were subject to advice, warning, undertakings, suspension or erasure HEFT – 3 were concluded at triage, 4 were investigated and concluded with no action,  9 were subject to advice, warning, undertakings, suspension or erasure – How many doctors died whilst under GMC investigation or monitoring? None – How many doctors died by suicide whilst under GMC investigation or monitoring? None Regards David Burbridge Chief Legal Officer

That is to say, there were a total of 38 GMC referrals in the ten year period, 18 of which were either dropped (or “concluded” as UHB put it) at triage or which resulted in no further action by the GMC.

For all the protestations and smoke and mirrors, we still have best part of a score of doctors who were possibly referred to the GMC when this was apparently not essential.

GMC referrals are a serious business. Could alternatives have sufficed? Were any of these doctors referred out of careless misuse of power, or as a punishment or intimidation, to silence them?

Any further reviews of UHB should look carefully at these eighteen GMC referrals.

In the meantime, I have asked UHB to disclose how many of these eighteen GMC referrals which were dropped at triage, or which resulted in no further action by the GMC, were signed off by either David Rosser or Clive Ryder.

This is because both of these senior doctors were criticised by the Employment Tribunal for their actions in the whistleblowing case of surgeon Tristan Reuser, for acts which included supplying inaccurate information to NCAS (now PPA), suspending Mr Reuser on a basis which they knew or ought to have known was unfounded, and misleading the GMC in the course of referring Mr Reuser.

It is also because David Rosser made a GMC referral on a whistleblower, Mr Reuser, which ended in no further action being taken by the GMC.

It is also because of a concern raised by the consultant body about cronyism at all levels of medical management at UHB, and because of a reported staff perception of arbitrary application of discipline.

The criticisms made by the Employment Tribunal of David Rosser and Clive Ryder were serious.

For example:

“It became clear that both Dr Ryder and Dr Rosser knew, or ought to have known, that it was unfounded before the exclusion was even put in place. That only came to light from documents which had not been disclosed but which were obtained by Mr Reuser through a subject access request (SAR).

No action was taken against Mr Negi in relation to what appeared to be a false allegation. This, coupled with my more detailed findings in relation to the exclusion earlier in this judgment, potentially suggests a level of bias and collusion at a senior management level against the claimant. Again, at the very least, it suggests a very serious lack of due care and attention to an important matter.”

“Dr Rosser was not sufficiently independent. There is a strong suspicion of bias given his approval of the exclusion on grounds he ought to have known were false. This appears further confirmed by the omissions and unjustifiably strong language of the GMC referral.”

UHB may object to my enquiry on grounds of personal data and confidentiality.

But the public interest and the seniority of the individuals in question are counter-arguments against such objection.

And for genuine culture change, as opposed to the PR and news management that NHS England and its hangers on will throw at this situation, truth and transparency are a pre-requisite.

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

NHSE, ICB and UHB’s three-ring circus and Rosser’s digital assignment

Can Healthwatch Birmingham please let us see its complaints & concerns data on UHB?

Bewick’s silence on patient complaints at University Hospitals Birmingham NHS Foundation Trust