Dr Minh Alexander retired consultant psychiatrist 27 September 2023
This is a very brief post to note more NHS managerial recycling.
Dr Jasna Macanovic is a very experienced and highly regarded renal physician who whistleblew on an unsanctioned practice introduced at Portsmouth Hospitals University NHS Trust. It was the use of synthetic vascular graft material for dialysis access by “button hole” needling, creating risk of catastrophic bleeding and other complications. Such usage was contraindicated by the manufacturers of the material.
Her concerns were shared and also raised by other senior colleagues.
What followed was an ordeal of unlawful persecution and breach of policies and procedures by Portsmouth Hospitals University NHS Trust managers in their attempts to silence and then get rid of Dr Macanovic.
The Employment Tribunal found decisively in her favour, determining that she was a bona fide whistleblower who made valid protected disclosures, who was unfairly dismissed expressly for making protected disclosures (to the General Medical Council) based on a predetermined decision and on prior consultation between the medical director and nursing director. The purported and later discredited grounds for dismissal, was “misconduct”.
Importantly, the Tribunal determined that Dr Macanovic did not contribute in any way to her unfair dismissal.
She was blameless and terribly wronged.
Her health was affected, she suffered losses, financial and non financial. She did not even break even financially despite “winning” her claim and receiving compensation.
The January 2022 ET judgment and a summary of events can be found here:
The Portsmouth trust Director of Workforce during these events was Tim Powell.
The ET judgment notes that there was a failure by the trust to conduct a separate investigation into Dr Macanovic’s concerns of victimisation, and that Tim Powell was a significant figure in that decision:
“86. In August Dr Macanovic had a meeting with the Chief Executive, Mr Cubbon, and the Trust’s Chairman, Mr Nelthorpe. Also present was the ‘Freedom to Speak Up Guardian’ Mrs Booth. Dr Macanovic then wrote to Mr Cubbon on 26 August, summarising their discussions. She alleged, again, that she was being bullied by Dr Lewis, that the disciplinary investigation into her was an act of victimisation, and asked him to remove the restrictions to her practice. He replied on 21 September (p.760) stating that the allegations against Dr Lewis would be fully investigated by an independent investigating officer, that Dr Knighton [the trust medical director] would look into her restrictions, but refusing to intervene in the ongoing investigation. (This delay in responding is Detriment 11a.)
87. This represented a change from the position adopted by Dr Knighton, that the Wood investigation would look into all allegations. Afterwards, Mr Cubbon [the trust CEO] had discussions with Mr Tim Powell, Director of Workforce and Organisational Development, i.e. the overall head of HR at the Trust. After that, he too changed his mind, and decided not to have a separate investigation. This decision, however, was not communicated to Dr Macanovic; Mr Cubbon thought this had been done by Mr Powell or Dr Knighton. The result was that Dr Macanovic was left under the mistaken impression that there would be a separate investigation.” [My emphasis]
The ET was critical of this failure to conduct a separate investigation and noted that it contravened the trust’s whistleblowing (Freedom To Speak Up) policy:
“152. A number of procedural errors were identified on behalf of Dr Macanovic, all of which seem to us valid:
- The scope of the investigation was confined to her behaviour, and there was no separate investigation into her complaints of bullying, contrary to the policy on Freedom to Speak Up.”
It seems a weighty matter that a Director of Workforce failed to ensure adherence with the organisational whistleblowing policy, especially where victimisation is alleged.
According to his now deleted LinkedIn entry, Powell later left Portsmouth in August 2018 and became Director of People, London Fire Brigade.
He has this month returned to the NHS fold via Hampshire Hospitals NHS Foundation Trust.
And what a month to do so, as the Employment Tribunal hearing into NHS whistleblower Martyn Pitman Consultant Obstetrician’s ET case against Hampshire kicked off at the Southampton Office, with a demonstration outside the Tribunal yesterday.
If curious staff at Hampshire Hospitals NHS Foundation Trust staff want to know what Powell has reportedly been up to at London Fire Brigade, here he is being questioned by the London Assembly on 30 November 2021 on the big cultural push at LFB.
Apparently, it’s all about Togetherness and other worthy things:
“Tim Powell (Director of People, London Fire Brigade): What I would say is historically, they are right. That has been the process a little bit in terms of what you can remember and what you can write down. Going forward, it is fundamentally different. We have a behavioural framework that effectively sets out the expectations we place on all leaders. That is behaviours around leading with compassion, having accountability, and togetherness. All of our selection criteria are now based around that behavioural framework.”
This is Hampshire Hospitals biog on Powell:
And what does Powell’s appointment say about the Chief Executive and Chair of Hampshire Hospitals?
Dr Jasna Macanovic was interviewed by LBC about her experience in May this year. I invite Mr Erskine and Ms Whitfield to listen to this:
12 May 2023 LBC “Former NHS whistleblower Dr Jasna Macanovic on impact of sounding the alarm”
RELATED ITEMS
NHS England’s new Fit and Proper Person arrangements require
truthfulness by NHS directors:
Under an updated NHS Fit and Proper Person framework published by NHS England on 2 August 2023,
NHS directors are now required to “self attest” to their own fitness
annually. This requires truthfulness for the system to work.
This is a copy of the “self attestation” form.
The declaration that NHS directors must make annually is as follows:
“I declare that I am a fit and proper person to carry out my role.
I:
• am of good character
• have the qualifications, competence, skills and experience which are
necessary for me to carry out my duties
• where applicable, have not been erased, removed or struck-off a register
of professionals maintained by a regulator of healthcare or social work
professionals
• am capable by reason of health of properly performing tasks which are
intrinsic to the position
• am not prohibited from holding office (eg directors disqualification
order)
• within the last five years:
‒ I have not been convicted of a criminal offence and sentenced to
imprisonment of three months or more
‒ been un-discharged bankrupt nor have been subject to bankruptcy
restrictions, or have made arrangement/compositions with creditors and has not discharged
‒ nor is on any ‘barred’ list.
• have not been responsible for, contributed to or facilitated any serious
misconduct or mismanagement (whether unlawful or not) in the course of carrying on a regulated activity or providing a service elsewhere which, if provided in England, would be a regulated activity.“
I leave readers to consider the effectiveness of this arrangement.
In another employment dispute, Medway lost an ET case by default because the trust simply failed to respond to a claim:
Contempt and incompetence by Medway NHS Foundation Trust
I asked Jayne Black Medway’s CEO why the trust did not respond to the claim.
She has provided no explanation so far. Her office only responded to say that “To confirm, this decision has been revoked and the Trust has submitted a defend [sic] to the claim.”
Robert Francis appeared on BBC Newsnight on 11 September 2023 and supported NHS England’s claims that full regulation is not needed for NHS managers:
Francis suggested on Newsnight that NHS employers are unaware of errant
managers’ histories. By doing so, he drew a veil over what is an organised
system of mutual protection and recycling, which has NHS regulators at its
heart. The system even has a nickname, “The Donkey Sanctuary”.
The case of Paula Vasco-Knight exemplifies the collusion running throughout the system:
Postscripts on Paula. NHS England’s apologia & regulatory reticence
Historically, Medway NHS Foundation was one of fourteen “Keogh” trusts found to have high mortality:
2013 Report out today will highlight major failings across 14 NHS hospital trusts
Letby murders: McLellan’s arse, NHS Stalinism and reported NHS management recycling at Devon ICB
Lucy Letby murders: Former Countess of Chester Non Executive Director James Wilkie
Alexander's Excavations 