Author: minhalexander

Dr Minh Alexander retired consultant psychiatrist 22 July 2023

I am unable to do this serious matter justice and am posting in summary to share a recently published report on a surgical scandal at Salford Royal Hospital, which is now part of the Northern Care Alliance NHS Foundation Trust:

Salford Royal Spinal Patient Safety Look Back Review June 2023

The trust’s predecessor body the Salford Royal NHS Foundation Trust was for some years practically deified by regulators as an exemplar of unimpeachable safety practice. It was one of several trusts used by Jeremy Hunt as a rod with which to batter struggling, under resourced NHS trusts.

In 2015 Salford was the second trust to be rated “Outstanding” by the Care Quality Commission, after Frimley in 2014,  another Hunt favourite and PR tool.

However, alongside this loud celebration ran another story.

There were concerns about the practice of a spinal surgeon, Mr John Bradley Williamson.

The concerns related both to clinical safety and outcomes, and to his conduct.

There have been a number of press reports about the case in recent years.

This is the report that has just been published by the Northern Care Alliance NHS Foundation Trust into these matters:

Spinal Patient Safety Look Back Review led by Alistair Craig, published 20 July 2023 by Northern Care Alliance NHS Foundation Trust

In August 2014 an anonymous whistleblower raised concerns with:

– The trust (in predecessor form, as the then Salford Royal NHS Foundation Trust)

– The General Medical Council

– Robert Francis

– The Care Quality Commission.

The “look back review” stated:

“In August 2014, an anonymous whistleblower contacted Salford Royal NHS Foundation Trust (now known as the Northern Care Alliance NHS Foundation Trust), General Medical Council (“GMC”), Care Quality Commission (“CQC”) and Sir Robert Francis then QC, now KC, (a barrister who has chaired several high-profile medical inquiries) with concerns about Consultant Spinal Surgeon A. The letter from the anonymous whistleblower described a number of areas of concern relating to Consultant Spinal Surgeon A’s behaviour, conduct, probity and capability.

In August 2014, Robert Francis was at that point a non-executive member of the CQC board (appointed 4 June 2014). He had also been knighted in the Queen’s birthday honours that same summer.

And last but not least, Francis had been named on 24 June 2014 as Jeremy Hunt’s chosen Chair of the now notorious Freedom To Speak Up review:

“Finally, I am announcing an independent review into creating an open and honest reporting culture in the NHS chaired by Sir Robert Francis QC, who chaired the landmark inquiry into the poor standards of care in Mid Staffordshire NHS Foundation Trust. The review is being established to provide independent advice and recommendations on measures to ensure that NHS workers can raise concerns with confidence that they will be acted upon, that they will not suffer detriment as a result and to ensure that where NHS whistleblowers are mistreated there are appropriate remedies for staff and accountability for those mistreating them. The review will consider the merits and practicalities of independent mediation and appeal mechanisms to resolve disputes on whistleblowing fairly. It will do this by listening to and learning the lessons from historic cases where NHS whistleblowers say they have been mistreated after raising their concerns and by seeking out best practice.”

It is reasonable to surmise therefore that the anonymous whistleblower disclosed to Francis personally in expectation of a best practice system response to their concerns.

According to the just published report, what followed was that the surgeon was dismissed in January 2015.

It was not until September 2015 that the trust invited the Royal College of Surgeons to review possible harm to patients:

“In September 2015, the Trust contacted the Royal College of Surgeons to request an Invited Service Review of the Trust’s spinal surgery service and to undertake a clinical review of 10 clinical records relating to patients at the Trust who had been under the care of Consultant Spinal Surgeon A1.”

The RCS reportedly found no substantive concerns:

“…there were no overall concerns about the standard of care provided to the patients that formed part of the review, although a series of complications were acknowledged. From the information present in the clinical records, it appears that the way in which the complications were managed once identified was appropriate in each case.”

Crucially, it appears there was more whistleblowing at the trust in 2016, which was not acted upon:

“In 2016, an internal request was made to review 17 patients to determine if any required either a clinical follow up or an appointment to determine possible preventable harm. The SPSLBR has been unable to determine if this progressed as the review did not follow the usual governance processes and at the time of producing this report, it has not been possible to determine why this was the case.”

FIVE years later, processes were finally established to review patient harm:

“In 2021, a multi-professional staff support group was established under the Trust’s Freedom to Speak Up process which raised new questions and concerns around the conduct, probity and capability of Consultant Spinal Surgeon A whilst they were employed by the Trust. This group raised concerns directly with the Trust Chief Executive and following this, the concerns were triangulated, leading to the realisation that clinical notes cannot be taken as accurate and correct, and emerging themes were identified with specific concerns around Consultant Spinal Surgeon A’s conduct, probity and capability whilst they were employed by the Trust. As a result, in January 2022, the Trust commissioned the SPSLBR Investigation Group to investigate these concerns.”

Why had concerns not been “triangulated” before, to reveal that the patient records were not reliable?

Did CQC and Robert Francis diligently ensure that the original 2014 whistleblower’s concerns were properly addressed?

Did CQC and or Francis receive any further disclosures, and if so, what did they do about them?

In 2018 when CQC renewed Salford Royal Hospital’s rating of “Outstanding”, it nevertheless noted some warning signs about whistleblowing governance in surgical services:

“Not all staff were aware of the role or purpose of the Freedom to Speak up Guardians, there was some concerns about the culture in theatres.”

“Whilst most departments felt supported and valued by the executive team and senior managers, some departments did not feel recognised by their peers, for example, in oral surgery. The oral surgery department had recently accessed the Freedom to Speak Up service resulting in the division undertaking a full comprehensive review within oral surgery that was going to be presented nationally”.

The trust’s external “look back review” also identified what it considered to be culture of low reporting in the spinal surgery service:

“The SPSLBR identified that there was a culture of low reporting of spinal surgical incidents within the timeframe of cases considered.”

Is this something that the CQC should have identified and followed up?

The review also concluded that there was both moderate and serious patient harm over a ten year period:

Robert Francis recommended in his report of the Freedom To Speak Up review that patients harmed by failures to manage NHS whistleblowing properly should receive redress.

Yet his model neither worked efficiently nor quickly at Salford, despite the claims that the organisation had better than average culture.

Also, until 22 December 2022, the CQC continued to rate Salford Royal Hospital as “Outstanding”.

David Dalton the CEO of the Salford Royal NHS Foundation Trust, and then the Northern Care Alliance NHS Foundation Trust 2001 to 2019, was a powerful and much feted NHS CEO.

He authored the 2014 Dalton Review for Jeremy Hunt, advising on how NHS improvements could be made. It is full of “transformation”, “ambition”, “transaction” and suggestions for how successful organisations should be allowed to “expand their reach and have greater impact”.

He reportedly now operates his own company, Dalton Consulting, with this introduction on LinkedIn:

Importantly, Dalton was part of a group selected by Jeremy Hunt to work on the details of the Legal duty of Candour, which arose from Robert Francis’ Mid Staffs public inquiry recommendations. According to this briefing by AVMA Dalton advised as follows:

“Their report recommends that moderate as well as serious injury, or death, should be included in the new statutory duty of candour that the Government is about to introduce.”

Dalton’s joint report with Williams on Duty of Candour can be found here.

Status and hierarchy are often unhealthy in healthcare

Sirs and Dames, long letters after your name, friends rewarding friends and backscratching, beget incestuousness and circularity.

It can also impede accountability or give false assurance.

The look back review has noted:

“During the Trust’s Consultant Spinal Surgeons’ discussions with patients, a theme emerged that patients specifically sought out Consultant Spinal Surgeon A due to them holding senior roles in national professional bodies in the spinal surgical field. The patients’ interpretation of them holding such roles was that this demonstrated their clinical ability and that they were one of the leading surgeons in their field. These were non-elected roles. It is recommended that a copy of this SI report and action plan will be shared with those organisations where Consultant Spinal Surgeon A held senior roles and with their current Responsible Officer.”

RELATED ITEMS

Health Education England’s damning 2020 report on surgical training & safety at Sussex. Another embarrassment for the National Guardian’s Office

Dr Minh Alexander retired consultant psychiatrist 20 July 2023

Summary: A BBC Newsnight investigation into the Good Governance Institute a private company which employs a sacked former NHS director has resulted in Companies House writing to the company to ask it to stop using a name for which it apparently had no prior approval. The word in contention is “institute”, which may not be used without permission from the Secretary of State for Business. The use of this name is usually reserved for bodies which conduct high level research or are professional bodies of the “highest standing”. Companies House has advised the BBC that use of the name “institute” without prior permission is an offence. Other concerns were unearthed. I have asked NHS England to consider whether it wishes to review whether this is a company with which the NHS should have any links.

BBC Newsnight has taken a closer look at the private organisation, the Good Governance Institute (GGI), broadcast on 19 July 2023, starts at 20.45.

This arose from Newsnight’s investigation into the governance and patient safety failures at University Hospitals Birmingham NHS Foundation Trust (UHB), where the GGI has been involved.

Of concern, UHB was repeatedly and favourably assessed by external reviewers, including the GGI, despite significant issues.

In 2018, the GGI gave UHB’s then CEO Julie Moore, who was retiring, an award as part of its “festival of governance”.

Also in 2018, the GGI showcased UHB’s then Chair Jacqui Smith as its keynote speaker at the same festival of governance.

The following year, UHB commissioned the GGI to undertake a “developmental well led review” of the trust.

This was not published, but it has since been released under FOI.

Good Governance Institute: University Hospitals Birmingham NHS Foundation Trust Well-led Developmental Review

The review found no major concerns. The BBC concluded that there was no evidence that the GGI did anything wrong, but the remit of the review was too limited.

BBC Newsnight raised a question about the narrow scope of these types of well led reviews, which clearly do not always identify important problems, yet cost the public purse dear. In the case of the UHB, the GGI’s bill was reportedly £72,000 for the well led review and other services.

Newsnight reported that based on FOI requests, since 2015, the NHS has spent more than £9 million on the Good Governance Institute’s services. According to the BBC, the GGI’s website states it has reviewed over 600 NHS boards:

Of concern, Newsnight also reported that:

1. The GGI does NOT have permission from the Secretary of State for Business to use the word “Institute” in its name.

The word “institute” is designated a “sensitive” word for the purposes of naming companies and LLPs, and requires prior approval by the Secretary of State:

The BBC reported that the Good Governance Institute does not have permission from the Secretary of State, and that the GGI’s chief executive Andrew Corbett-Nolan instead registered a shell company in the Irish Republic under the name “Good Governance Institute”, where no special permission is needed to use the word “institute”. According to the BBC’s company research, this entity appears to have no assets, no staff and seems to conduct no business.

The Good Governance Institute UK’s website gives the company number as 06836117, which takes the public to a company with the registered name “GGI Ltd” on Companies House’s website,  which therefore of itself does not breach UK rules.

But is it within the rules for a UK company to use a trading name that includes the word “institute” if there is no permission from the Secretary of State?

It seems it is not: The government rules apply to any names under which someone carries on business:

“A ‘business name’ is any name under which someone carries on business. In the case of a company or limited liability partnership, it means a name that is not its registered name.”

Companies House told the BBC that it is an offence to use the term “institute” without prior approval, and they have written to the GGI to ask it to stop using the term.

Companies House also indicated that the registration under the name “institute” in another jurisdiction had no bearing on the matter.

The GGI responded:

2. The GGI’s chief executive used a title of “professor” based on a visiting rather than a substantive professorial post, and that he continued to use the title “professor” after the end of his time-limited, visiting position at the University of Chester.

Following Newsnight’s enquiries, Mr Corbett-Nolan stated that he had not been informed that his visiting professorship had ended, and he removed the title of professor from his website.

3. The GGI’s CEO had been previously repeatedly and publicly wrongly described as “Dr” in a number of GGI documents and other documents, when he did not hold a doctorate.

A colleague from the GGI had also previously been wrongly described as “Dr” when he only held a bachelor degree.

Andrew Corbett-Nolan explained this as error and confusion by others:

Of interest, Newsnight aired comments by the GGI regarding its employment of Mason Fitzgerald, a former NHS trust director who was sacked after a false qualification claim reportedly appeared on several reports and his LinkedIn entry.

Andrew Corbett Nolan commented to Newsnight that Mr Fitzgerald was “talented and experienced”.

He also commented to Newsnight that most clients were happy to receive services from Mason Fitzgerald:

This appears to imply that Mason Fitzgerald may well be working for some NHS bodies, despite his previous dismissal by East London NHS Foundation Trust.

Mason Fitzgerald commented to the BBC:

NHS England has to date refused to confirm or deny that it hired Mason Fitzgerald to work on ICS governance AFTER his false qualification claim was discovered and he was sacked by East London NHS Foundation Trust.

NHS England refuses to confirm or deny whether it employed sacked former NHS director Mason Fitzgerald, but it did accept “pro bono” research by the Good Governance Institute

NHS England replied to Newsnight:

“An NHS England spokesperson said: “Any money spent by the NHS on third parties for their expertise is scrutinised in accordance with our Standard Financial Instructions and in line with public contracting regulations.

“The funding cited as spent by NHS England and Health Education England adhered to these standards, while procurements led by other NHS organisations would have been managed at local and regional levels.”

Although NHS England emphasised in its most recent correspondence that it had checked its contracts and could confirm that it had no current contracts with the GGI, it did not actually say it would not hire the GGI again in the future.

Will the further investigation findings by Newsnight make any difference, or will NHS England start hiring the GGI again when the fuss has died down?

I have asked Amanda Pritchard about her plans regarding NHS commissioning of services from the GGI.

“BY EMAIL

Amanda Pritchard

CEO NHS England

20 July 2023

Dear Amanda,

In the most recent exchange of correspondence, NHS England informed me that it had checked its current contracts and none involved the Good Governance Institute (GGI).

This followed NHSE’s hiring of the GGI last autumn via the Chief Nurse’s directorate, AFTER the GGI employed the sacked former NHS trust director Mason Fitzgerald.

Last night BBC Newsnight broadcast an investigation into this private company which raises serious questions (starts at 20.45).

Companies House advised the BBC that no company should include the sensitive word “institute” in its name without permission from the Secretary of State, and that to do so is an offence. According to the BBC, Companies House has written to the GGI to ask it to stop using its current name.

There were also other matters of concern.

Will NHS England take the additional step of reviewing whether this company should ever be used again by the NHS?

As a wider point, Rachael Maskell MP questioned the usefulness and value for money in outsourcing governance reviews in this manner. Prof Andrew Sturdy from Bristol University pointed to the “demand inflation” that is driven by the self-interest of private consultants looking for repeat business, when they transact with the NHS.

Many thanks and best wishes,

Minh

Dr Minh Alexander

Cc Health and Social Care Committee”

Newsnight sought expert advice from Prof Andrew Sturdy, School of Business, University of Bristol who advised that NHS bodies are spending on average £1.2 million annually, each, on external consultancy which is making them less efficient. External consultants in his view want repeat business, cultivate friendly relationships and are reluctant to tell Emperors that they are exposed.

Prof Sturdy and colleagues’ 2020 paper on the NHS’ wasteful use of external consultancy can be found below:

Summary

Full paper: “The management consultancy effect: Demand inflation and its consequences in the sourcing of external knowledge”

Rachel Maskell MP questioned the sense of outsourcing such high-priced consultancies. She submits that governance determinations should be formal, statutory and subject to proper review of improvement.

In other news, NHS England and the ICB have crowned a long-served Rosser/Smith lieutenant, Jonathan Brotherton, as the new Group CEO of UHB even before the Bewick reviews on UHB’s frailties have been completed.

Very disheartening for many staff, no doubt.

We have of course been assured by the relevant parties that it was a fair and competitive appointment. Perhaps in the same way that the UHB gave assurances that the FPPR investigation on David Rosser was sound, but have refused to publish it.

University Hospitals Birmingham NHS Foundation Trust announces Group Chief Executive

Published on 17/07/2023

Jonathan Brotherton, Group Chief Executive of University Hospitals Birmingham NHS Foundation Trust (UHB).

Statement from Dame Yve Buckland, Chair of University Hospitals Birmingham NHS Foundation Trust:

“I am very pleased to announce, that following a rigorous and competitive recruitment process, Jonathan Brotherton has been appointed as Group Chief Executive of University Hospitals Birmingham NHS Foundation Trust (UHB).

“Jonathan, UHB’s interim chief executive, was successful in securing the role after a multi-staged process, involving a wide range of external and internal stakeholders, including senior clinical and non-clinical staff, governors and regulators.

“On behalf of the Board, I would like to offer our sincere congratulations to Jonathan on his successful appointment.

“I very much look forward to continuing to work alongside him and the Board, to deliver our ambitious – but fundamental – priorities, which will make real and noticeable differences to our patients and colleagues.

“Jonathan takes up his role with immediate effect.”

Speaking on his appointment, Jonathan said: “I am absolutely delighted to be chief executive of such an amazing organisation. As someone who was born in Birmingham and has worked in the area for a number of years, both clinically and managerially, it is a real privilege and an honour.

“For the past seven months – as interim chief executive – I have sought out the thoughts, opinions and concerns of many people, during what has been a very challenging time for UHB, its people and its patients. There is clearly a lot which needs to happen; we are reliant on the amazing people who work here to deliver that.

“As chief executive, I will be working hard to make sure that we have the kind of culture that allows people to flourish and thrive, to enable us all to do our very best for our patients.

“I want UHB to be a place where everyone is proud to work, where our patients are proud to be treated, and where we deliver the best possible and equitable care to each and every patient.”

Lastly, I made a small cameo appearance on the Newsnight broadcast, questioning why a governance organisation would employ someone who had been dismissed after a false qualification claim.

I see that the GGI has responded.

RELATED ITEMS

Darren Grayson was a former NHS CEO at East Sussex who resigned after a very critical CQC report. He sold services to the NHS though the Good Governance Institute, including at Sussex. Most recently, he secured a job at Sussex Uiversity Hospitals NHS Foundation Trust, as Chief Governance Officer.

NHS musical chairs: Darren Grayson, the Good Governance Institute & University Hospitals Sussex NHS Foundation Trust

Dr Minh Alexander retired consultant psychiatrist 14 July 2023

I raised concerns in a post earlier this week about NHS England’s refusal to heed concerns from bereaved families and whistleblowers about the suitability of a Jeremy Hunt favourite, Marianne Griffiths former Sussex NHS trust CEO, to investigate the North East Ambulance Service (NEAS) deaths scandal.

Should NHS England have been “content” with Marianne Griffiths as investigator at North East Ambulance Service?

I also pointed out that she gave sketchy details about her investigation team, which seemed to lack clear credentials for handling complex legal issues thrown up by the matters at NEAS.

A concerned party has now contacted me to say that they believe that Griffiths’ investigation team at NEAS were in fact former trust colleagues from her days at Sussex.

I have written to Amanda Pritchard, CEO of NHS England, copied to parliament and others, seeking clarification.

The correspondence is shared below and is hopefully self-explanatory:

BY EMAIL

Amanda Pritchard 

CEO NHS England 

14 July 2023

Dear Amanda,

Concerns about the selection of Marianne Griffiths’ investigation team at North East Ambulance Service 

I write to enquire about the composition of the team which, led by Marianne Griffiths former CEO of Sussex University Hospitals NHS Foundation Trust, which conducted NHS England’s investigation into the deaths scandal at North East Ambulance Service (NEAS).

According to the just published NEAS investigation report, this was the investigation team:

As you can see, the credentials of the investigation team members were not clearly and fully provided. 

It did not seem clear to me that there was sufficient expertise within the team to determine complex issues of whistleblowing, employment, coronial and criminal law which arose from the matters at NEAS. 

It was not obvious that there were any practising lawyers on the team.

A concerned party has now contacted me to say that they believe all members of the Griffiths NEAS deaths investigation team were former colleagues of Marianne Griffiths at Sussex. 

The person believes these are the relevant employment details of the NEAS investigation team members:

“Marianne Griffiths – CEO, Western Sussex Hospitals/Brighton and Sussex Hospitals/University Hospitals Sussex – 2010 – 2022

Denise Farmer – Director of Organisational Development and Leadership, Western Sussex Hospitals/Brighton and Sussex Hospitals/University Hospitals Sussex – 2010 – 2022

Lynn Woolley – Head of Midwifery and Gynaecology, Brighton and Sussex Hospitals/Western Sussex Hospitals – 2012 – 2021, Director of Maternity Services, Portsmouth Hospitals – 2021 to current (also CQC adviser on maternity)

Sian Finlay – Executive assistant to the CEO (Marianne Griffiths) and the Chair (Alan McCarthy) at University Hospitals Sussex 2017-2022”

Could NHS England kindly confirm if the individuals in the Griffiths investigation team have been correctly identified.

Concerns arise if so.

The impression of a handpicked team of Marianne Griffiths’ former Sussex NHS trust colleagues is troubling, especially from a trust which is now under police investigation into whistleblowers’ disclosures about deaths, which may amount to allegations of gross negligence manslaughter.

This is a presentation by a Denise Farmer who was Director of Organisational Development and Leadership at Western Sussex Hospitals NHS Foundation Trust about service improvement at the trust, reportedly aligned to the US Virginia Mason programme that was praised by a former UK Health Secretary, but was questioned upon later appraisal and after regulatory action.

Many thanks,

With best wishes,

Minh

Dr Minh Alexander

Cc 

Health and Social Care Committee

Grahame Morris MP

BBC Newsnight

Dr Phil Banfield BMA Chair

Dr Chaand Nagpaul BMA

Dr Minh Alexander retired consultant psychiatrist 12 July 2023

Summary: NHS England resisted concerns from several parties about the fact that it had appointed Marianne Griffiths former CEO of Sussex University Hospitals NHS Foundation Trust to investigate the deaths scandal at North East Ambulance Service (NEAS). It officially stood by her AFTER the police investigation into deaths at her former trust in Sussex became public in early June, stating that it was “content” with her. Her report today has been understandably dismissed by bereaved families as a whitewash. There are other concerns about the report. The credentials and suitability of Griffiths’ investigating team are not clear, especially with regards to the complex legal matters involved at NEAS. There is also still no sign of a persistently withheld report on bullying and whistleblowing governance at NEAS, only scant summary of findings of opinion without facts. As bereaved families have commented, “This is the NHS investigating the NHS”.

NHS England’s investigation into North East Ambulance NHS trust has been published today:

The Report of the Independent Review in to alleged failures of patient safety and governance at the North East Ambulance Service (NEAS)

It was led by Marianne Griffiths former NHS CEO despite multiple objections from bereaved families and several whistleblowers, including those who reported she failed them. I objected over a year ago, based on concerns about governance at her former trust in Sussex where she was CEO, and received the usual stonewalling from NHS England.

After fits and starts of correspondence and long silences, NHS England eventually spat out its reluctant response on 20 June 2023:

“In brief, NHS England is content with Dame Marianne Griffiths’ suitability to lead this review and expect it to conclude soon.”

This was remarkable as it came AFTER revelations about the police investigation at Griffiths’ former trust in early June.

Sussex is the subject of a police investigation into concerns about deaths which occurred on her watch, 2015-2020, and which may amount to gross negligence manslaughter.

There was nothing in NHSE’s response to address the governance issues I raised about her former trust at Sussex. Or any sign that NHSE had investigated the ongoing issues at Sussex, some of which were seeded during Griffiths’ tenure.

Importantly, NHS England confirmed in its response to me that Griffiths had received a copy of a review about bullying and poor whistleblowing governance at North East Ambulance Service, as part of her investigation into the trust.

Email from NHS England 20 June 2023:

“Hi Minh

Apologies for the delay in responding to your email. NHS England take all whistleblowing-related issues seriously and as such I have taken the time to review your concerns.

In brief, NHS England is content with Dame Marianne Griffiths’ suitability to lead this review and expect it to conclude soon.

With regards to the Stanley/Boylin report, it was shared confidentially with Dame Marianne Griffiths. NHS England does not intend to request investigation documents, nor to commence a review of the investigation contents. We await the findings of Dame Marianne’s review, and will then consider whether any action needs to be taken in response to that review.

I note you have also emailed recently about the ‘implications of governance failings at Sussex’ and I hope this response addresses the point you raise there too.

I am sorry again for the delay in responding to you. I know there is another matter I have yet to respond to you on, and will aim to do so next week.

With best wishes

Tom”

[My emphasis]

The review about bullying and whistleblowing failures at NEAS took place in 2020, and it was carried out by Jennie Stanley (née Fecitt) and Tracy Boylin.

The report has been suppressed by NEAS ever since.

Affected trust staff were only given superficial feedback about the outcome of the investigation, that concerns were partly upheld.

The trust has refused to disclose it under FOI, whether in full or as summary findings and recommendations.

Via FOI Reference FOI.22.188 on 5 August 2022, NEAS revealed that it made a payment to Stanley’s company Primary Healthcare Training, company number 07942875, of £35,354.75.

Stanley’s HSIB profile currently states that this training company “is regularly utilised by NHS trusts”.

Griffiths’ report on NEAS, unveiled today, is a woeful affair. It refuses, on a test of the balance of probabilities, to find that repeatedly altering original documents and withholding documents from the coroner was deliberate concealment.

Bereaved families have criticised the report as a whitewash. The Health Service Journal reports:

“‘Whitewash’

Tracey Beadle, Quinn’s mother, told HSJ that the report was a “complete whitewash” due to issues including its limited scope and key details being omitted from previous investigations, and that the review failed to examine why the Care Quality Commission did not take action when concerns were raised with them. She also questioned the suitability of Dame Marianne to lead the review, given cultural problems previously highlighted at her former trusts.

“This is the NHS investigating the NHS,” she said. “Therefore no impartiality exists.”

She added NEAS “have [been] afforded protection from [CQC and NHSE], putting their reputations before the safety and wellbeing of patients”.

Griffiths’ conclusions reduce NEAS’ use of illegal and unenforceable clauses in settlement agreements, which prevented whistleblowers from pursuing public interest concerns further (applied in one case and rejected in another), to a matter of “misinterpretation” and “perception”:

“In those two cases, the circumstances were sufficiently sensitive and contentious as to make any form of proposed settlement open to potential misinterpretation. NEAS accept that there were perception issues with that, and its processes have been strengthened.”

It is unclear what specialist expertise informed Griffiths’ investigation. The full credentials of the investigation team are not supplied:

What credentials did the Griffiths investigation team have to make determinations on issues of whistleblowing, employment, coronial law and criminal law? It is not obvious that there were any practising lawyers on the team.

Griffiths’ analysis of NEAS’ general whistleblowing governance is staggeringly superficial and brief. The report’s section on Freedom To Speak Up was less than two pages long (see pages 62 and 63) and totalled 641 words. The specific section on the coronial whistleblowers tries to paint a “can of worms” type picture. This can be a technique that is sometimes used for misdirecting attention in whistleblowing matters.

I cannot find explicit mention of the Stanley/Boylin report’s outcome in Griffiths’ report.

I found this passage:

“6.34 Between 2019-20 there was a significant change in executive leadership; a new Chief Executive (CEO) (following a gap of 4 months), new Director of Quality and Safety, new Finance Director and new (and the organisation’s first substantive) Director of HR (HRD). The incoming CEO put the new executive team together including investing in Board development work. She also actioned the outcome of reports relating to behaviours and culture including meeting staff who had raised concerns.”

There were also these passages about an unspecified external Freedom To Speak Up commissioned by NEAS concluded in 2020, which would fit:

“7.38 The findings made clear that the functioning and leadership of HR, and relationships between senior staff, had been difficult for some time and had not been addressed effectively up to 2020.

7.39 Senior leaders had allowed dissent and factions to interfere with proper processes and therefore added to serious risk for HR and professional matters, and to the support given to the organisation, including to the staff raising concerns and grievances.

7.40 There was clear evidence of a lack of professional respect, and a lack of acknowledgement of professional duties and responsibilities and the consequent need to co-design processes.

7.41 There was a lack of transparency and consistency between the operational management of services and professional leadership.”

The facts supporting these opinions are not provided.

Opaquely, Griffiths gives no bibliography of the documents examined by her investigation.

A search of her report for the words “bully” and “bullying” yield zero hits, although she was tasked with examining culture.

Why has there been so much secrecy about the Stanley/Boylin report outcome?

Why has over £35K public money not been properly accounted for?

Why do private contractors undertake these types of reports without a clear condition that such reports will be openly published?

Is it because there would be no repeat customers if NHS organisations cannot cherry pick what is reputationally advantageous to publish?

Why are NHS bodies allowed to misuse public funds in the support of managerial self interest and against patients’, families’ and the workforce’s rights to transparency?

The bad, bad smell that still hangs over NEAS will likely intensify as the scandal at Sussex unfolds.

Perhaps NHS England will invite Helen Ray the NEAS CEO to review Sussex at some point. Only once CQC has confirmed improvement at NEAS and upgraded the trust to “Good” or “Outstanding”, of course.

But unaccountable senior NHS managers are bulletproof for now.

The Secretary of State has torpedoed the central Kark review recommendation of an ultimate sanction, of disbarment for serious misconduct such as whistleblower reprisal and cover ups.

But this serves to emphasise how perfectly unfit the NHS’ governance is when things go wrong, and how only hard law reform will suffice to protect whistleblowers.

RELATED ITEMS

I have written to the Secretary of State about the missing Stanley/Boylin report.

08.07

BY EMAIL

Steve Barclay

Secretary of State for Health and Social Care

12 July 2023

Dear Mr Barclay,

Suppressed report on bullying and poor whistleblowing governance at North East Ambulance Service

Marianne Griffiths’ investigation on North East Ambulance Service for NHS England was published today and references your predecessor’s announcement last year about this investigation.

One of the NEAS whistleblowers understandably declined to cooperate with this flawed exercise. The investigation was also criticised by the bereaved families.

I write to draw your attention to the fact that NEAS paid over £35K for a 2020 report on bullying and poor whistleblowing governance at the trust, which it has suppressed ever since. This was the so-called Stanley/ Boylin report. Its findings appear to be absent also from today’s Griffiths report.

NHS England confirmed in a note to me last month that Marianne Griffiths had been provided with a copy of this report.

However, I can find no clear mention of its findings in her report today. I could find only this paragraph:

“6.34 Between 2019-20 there was a significant change in executive leadership; a new Chief Executive (CEO) (following a gap of 4 months), new Director of Quality and Safety, new Finance Director and new (and the organisation’s first substantive) Director of HR (HRD). The incoming CEO put the new executive team together including investing in Board development work. She also actioned the outcome of reports relating to behaviours and culture including meeting staff who had raised concerns.”

Marianne Griffiths also provides no bibliography at the end of her report to transparently list the documents examined by her investigation. A search of her report for the words “bully” and “bullying” brings up zero hits.

The section of her report on Freedom To Speak Up is less than two pages long and comprises of 641 words.

The report claimed it could not say that the repeated alteration of original documents and withholding of documents from the coroner, which the trust had previously been warned were potential crimes, was a deliberate act of concealment.

I really do not think that the public interest has been served by this report. It is in my opinion a sample of what we should expect if the NHS is permitted to conduct its own “exit Fit and Proper Person tests”, as currently proposed by NHS England.

I forward below the correspondence from NHS England which informed me that Marianne Griffiths had been provided with the Stanley/Boylin report.

This brief response was the culmination of over a year of my raising concerns with NHS England about Marianne Griffiths’ suitability to lead the NEAS investigation given the previous concerns about whistleblowing governance at her former NHS trust in Sussex.

Additional concerns arose over the course of that year. You will see that none of this swayed NHS England.

With best wishes,

Minh

Dr Minh Alexander

NHS whistleblower and retired consultant psychiatrist

Cc Tom Kark KC

08.54

BY EMAIL

Steve Barclay

Secretary of State for Health and Social Care

12 July 2023

Dear Mr Barclay,

My apologies.

I need to correct my earlier letter today of 08.07.

I have found a further passage in Marianne Griffiths report which seems to give a brief outcome of the 2020 Stanley/Boylin report, although the report is not explicitly identified.

It is stated that an external report commissioned by NEAS concluded in 2020 with the following:

“7.38 The findings made clear that the functioning and leadership of HR, and relationships between senior staff, had been difficult for some time and had not been addressed effectively up to 2020.

7.39 Senior leaders had allowed dissent and factions to interfere with proper processes and therefore added to serious risk for HR and professional matters, and to the support given to the organisation, including to the staff raising concerns and grievances.

7.40 There was clear evidence of a lack of professional respect, and a lack of acknowledgement of professional duties and responsibilities and the consequent need to co-design processes.

7.41 There was a lack of transparency and consistency between the operational management of services and professional leadership.”

My understanding is that affected staff were advised that their concerns were partly upheld by the Stanley/Boylin investigation, but that they were given no other information. I have seen some of the feedback correspondence from the trust.

In Marianne Grittith’s above summary, opinions are given but the specific facts supporting them are not. 

She provides little comment on the issues of whistleblowing governance examined.

Information relevant to mounting an effective Fit and Proper Person challenge remains largely withheld from affected parties.

Best wishes,

Minh

Dr Minh Alexander

Cc Tom Kark KC

Auditors concluded North East Ambulance Service failed to act on legal advice to ensure it complied with coronial legislation to disclose evidence, and vilified staff who followed the law

Health Education England’s damning 2020 report on surgical training & safety at Sussex. Another embarrassment for the National Guardian’s Office

NHS musical chairs: Darren Grayson, the Good Governance Institute & University Hospitals Sussex NHS Foundation Trust

Dr Minh Alexander retired consultant psychiatrist 11 July 2023

Steve Barclay Secretary of State waffled before Health and Social Care Committee on 20 June 2023, in response to questions about the failure of the government’s Freedom To Speak Up project to protect NHS whistleblowers, after eight long and miserable years.

In consequence, I asked him some questions under FOI:

Secretary of State who commissioned report on recycled NHS managers wonders if bad NHS managers are recycled

This is his Department’s response, in unusually quick time:

Department of Health and Social Care FOI response 10 July 2023 on implementation of the Kark Review on Fit and Proper Persons in the NHS

In brief, the Department says it has accepted the following four recommendations from the Kark review on Fit and Proper Persons in the NHS, but hasn’t a clue when they will be implemented, because it’s been palmed off onto NHS England:

“With regard to recommendations 1 to 4, DHSC does not hold the information you have requested. However, you may wish to contact NHS England, which may be able to provide an update on the timetable for recommendations 1 to 4.”

“Recommendation One

All directors (executive, non-executive and interim) should meet specified standards of competence to sit on the board of any health providing organisation. Where necessary, training should be available.

Recommendation Two

That a central database of directors should be created holding relevant information about qualifications and history.

Recommendation Three

The creation of a mandatory reference requirement for each Director

Recommendation Four

The FPPT [Fit and Proper Person Test] should be extended to all Commissioners and other appropriate Arms-Length Bodies (including NHSI and NHSE).“

Disbarment has been dumped

Importantly, it is also confirmed that Barclay has ditched Kark’s fifth recommendation, for a mechanism to disbar NHS managers for serious misconduct:

“The power to disbar directors for serious misconduct”

This is blamed on NHS England:

“The Government agrees with NHS England that effective safeguards are currently in place by ensuring an exit fit and proper person test is completed when directors leave employment and that any conduct issues which arise after their employment remain on the national register. These safeguards, together with a robust referencing process, will prevent unsuitable leaders being re-employed in the NHS and also act as a deterrent to misconduct itself.”

So, “an exit Fit and Proper test” has been secretly mooted but kept hidden even after publication of the NHS Workforce plan on 3 July 2023.

It sounds like a ludicrous fig leaf, that everyone knows is a ludicrous fig leaf.

Interestingly, NHS England previously blamed ministers for disbarment being dumped, telling me there was no “ministerial support” for this Kark recommendation.

How they all twist and turn.

It is worth remembering that Kark’s review reserved disbarment for matters such as criminal convictions leading to a custodial sentence, victimisation of whistleblowers or knowingly allowing the victimisation of whistleblowers, “Causing, facilitating, colluding in, or requiring any staff member to fail to comply with the duty of candour including by means of a settlement or confidentiality agreement” and “Falsification, concealment or suppression of records, data or other information which is required to be provided to any other person or organisation”.

And the disbarment mechanism also fell short of full regulation. The latter is rightly expected of hundreds of thousands of NHS staff who are responsible for patients’ lives. But so are NHS managers, who have been dodging regulation since it was recommended by the Bristol heart public inquiry over twenty years ago.

And what of the fact that Barclay told the Independent in the 2018 that he was determined to stamp out abuse of NHS staff by bullying managers when he launched the Kark review:

“Now Stephen Barclay, a health minister, has told The Independent he wants the “fit and proper” person test for NHS directors – introduced in 2014 – to be widened to require action on harassment and discrimination.

Mr Barclay said: “That one in four NHS staff have experienced bullying, harassment or abuse – and that more than twice as many BAME [black, Asian and minority ethnic] staff have suffered discrimination from their manager or colleagues than white staff – is deeply alarming and should be a call to arms for urgent action across the NHS.

“I am determined to put an end to this, which is why the NHS is already working to close the equality gaps and tackle bullying.”

It is also worth remembering that Barclay recently wondered out loud at Committee on 20 June 2023:

“What accountability is there for senior managers when wrong doing is established? Are they just rotated through the system? Or are people held to account?”

Really Mr B!!!!

UPDATE 23 AUGUST 2023

The Telegraph yesterday asserted that the ministerial fashion for dumping disbarrment originated with Matt Hancock:

RELATED ITEMS

NHS England’s “exit Fit and Proper Person test”

I have written to the Chief Workforce Officer at NHS England to ask for details of the “exit Fit and Proper Person test” mentioned in the Department’s FOI response:

BY EMAIL

Dr Navina Evans

Chief Workforce Officer

NHS England 

11 July 2023

Dear Dr Evans,

I have received information from the Secretary of State’s office  confirming previous reports that recommendation 5 of the Kark review for a disbarring mechanism has been dropped.

“The Government agrees with NHS England that effective safeguards are currently in place by ensuring an exit fit and proper person test is completed when directors leave employment and that any conduct issues which arise after their employment remain on the national register. These safeguards, together with a robust referencing process, will prevent unsuitable leaders being re-employed in the NHS and also act as a deterrent to misconduct itself.”

I would be grateful if in your reply to my enquiry of 4 July 2023 you could additionally include the details of the “exit Fit and Proper Person test” that is envisaged by NHS England, and by whom it will be applied. 

If no such exit test has yet been devised, please indicate the timescale within which the test will be developed and ready for use.

Would the exit test will be applied by a local employer with possible vested interest, as opposed to an independent central body, as disbarring mechanism would be?

I must say I cannot see how for example, University Hospitals Birmingham NHS Foundation Trust would have applied an exit test reliably to David Rosser, its former CEO who was criticised by the Employment Tribunal for his behaviour towards a whistleblower. He also received a warning from the General Medical Council. The trust board has still not published a flawed FPPR investigation review on David Rosser, conducted by a subordinate trust employee which it claimed cleared him. The trust board also misled the public in a bizarre fiction, claiming that Rosser stepped down as CEO and moved to a regional role, when he remained a trust employee as revealed by an FOI request. As the trust board continues to deny that its FPPR investigation found cause for concern, if left in control of an exit FPP test, I imagine it would allow him to recirculate in the NHS.

Many thanks and best wishes,

Minh 

Dr Minh Alexander

NHS whistleblower and retired consultant psychiatrist

Cc Tom Kark KC

     Health and Social Care Committee

     Secretary of State for Health and Social Care

Is the Patient Safety Commissioner a Prescribed Person under PIDA?

The UK whistleblowing law since 1998 is the not only useless but also harmful Public Interest Disclosure Act (PIDA).

Under this law, there are a number of designated bodies and individuals to whom whistleblowers may make so-called “protected disclosures”.

This too is a useless system as the Prescribed Persons sometimes are clueless about their responsibilities, and are legally obliged to do little more than to log the concerns received and to publish a superficial annual report about the numbers of concerns. No one is legally obliged to protect the whistleblower or act upon their concerns.

Barclay implied to Committee on 20 June 2023 that the Patient Safety Commissioner  (for Medicines and Devices only) might be a Prescribed Person for whistleblowers’ disclosures. She is not currently listed as one. I asked him if the Department intended to give her this legal status. It did not reply.

The Patient Safety Commissioner was of course the second and particularly objectionable NHS National Freedom To Speak Up Guardian who expended most of her and her Office’s energies on PR, self-promotion and supporting an establishment narrative. Not to mention instances of failure to apologise and learn when her Office actually harmed whistleblowers:

The National Guardian’s Office finally apologises for a breach of whistleblower confidentiality but fails to demonstrate sufficient learning

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

NHS musical chairs: Darren Grayson, the Good Governance Institute & University Hospitals Sussex NHS Foundation Trust

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

Dr Minh Alexander retired consultant psychiatrist 6 July 2023

Disappointing BBC News coverage featured Robert Francis and the latest NHS Freedom To Speak Up Guardian Jayne Chidgey Clark on 3 July 2023.

The piece helped to legitimise the National Guardian’s Office, when it is in fact a threat to NHS whistleblowers.

The BBC team who produced the material did not balance claims by the National Guardian with evidence of her Office’s failures or with criticisms of her Office by whistleblowers.

They also chose not to include whistleblowers with the strongest cases which exposed the serious failings of the National Guardian’s Office. Whistleblowers from whom they had  agreed to take this evidence were ignored.

Below is a letter to the relevant BBC team, placing my concerns about the coverage on record:

Letter to BBC News 3 July 2023

The thrust of the BBC reportage was on airing a defunct and empty argument that culture change alone is needed.

Robert Francis commented disingenuously that NHS boards need to “buy into” and “understand” about whistleblowing. He knows full well that many boards understand, but simply choose self interest and suppression. He used to advocate dismissal for abusive NHS CEOs.

Culture change is of course needed but it is not going to happen without enforcement. Road safety laws on safety belts and drink driving are an example of law changing behaviour and culture.

Power, however, naturally fears enforcement of whistleblowers’ rights to protection and action upon their disclosures.

The BBC News coverage appeared the day after The Guardian ran an item featuring the BMA’s call for reform of UK whistleblowing law:

NHS whistleblowers need to be better protected by the law, says BMA

Moreover, BBC News featured the National Guardian’s claims to purportedly support accountability for whistleblower reprisal:

“Dr Chidgey-Clark says the main healthcare regulator – the Care Quality Commission (CQC) – and NHS England itself could do more to protect individual whistleblowers and rein in rogue managers.

“I do call on them to do everything they can within their power to ensure there is accountability and these serious issues are looked into,” she says, “because without that, more high-profile cases will happen and, potentially, more patient harm and worker harm will happen. And in our society, in our healthcare system, we don’t want to see that.”

It is hypocritical of the National Guardian and her Office to call for others to ensure accountability for whistleblower reprisal and detriment, when they have done the opposite.

And why the distasteful focus on “high profile” cases? Every whistleblowing case matters, because every patient matters.

The National Guardian’s Office was primarily set up to provide independent reviews of poorly handled NHS whistleblowing cases, but has conducted a shockingly low number of case reviews since the Office was established in 2016.

Case reviews by the National Guardian since 2016:

Southport and Ormskirk NHS Trust 2017

Northern Lincolnshire and Goole NHS Foundation Trust 2017

Derbyshire Community Health Services Foundation Trust 2018

Nottinghamshire Healthcare NHS Foundation Trust 2018

Royal Cornwall Hospitals NHS Trust 2018

Brighton and Sussex University Hospitals NHS Trust 2019

Northwest Ambulance Service NHS Trust 2019

Whittington Health NHS Trust 2020

Blackpool Teaching Hospitals NHS Foundation Trust 2021

Thematic review of ambulance trusts 2023

The case reviews turned into toothless systems reviews and are now not even called case reviews anymore. They have been renamed “speak up reviews”, hiding their original purpose.

The NGO’s case reviews have avoided criticising any senior manager for harming whistleblowers.

Occasionally, ineffectual recommendations are made about detriment suffered by whistleblowers, such as the following recommendation at Blackpool Teaching Hospitals in 2021:

“Within three months the trust should:

… 1.12 Communicate that detriment for speaking up will not be tolerated, act to prevent detriment occurring, and put in place procedures that would enable cases of detriment to be looked into effectively when they are reported.”

That is hardly accountability for serious wrongdoing. It glossed over serious harm already done to the trust whistleblowers.

At North Lincolnshire and Goole, where the trust Chair publicly and notoriously attacked a whistleblower, the National Guardian made no reference to this incident in its case review report other than to say that the Chair expressed “regret” and made no recommendation for regulatory action to be taken against the trust Chair.

The NGO case review report for North Lincolnshire and Goole merely stated that a review was carried out because:

“We carried out this review because we had received information that the trust’s support for its workers to speak up did not always meet with good practice.”

Whitewash Central in other words.

In the latest case review by the current National Guardian, which was a thematic review of ambulance trusts, the resultant review report listed grievous examples of detriment (pages 43 and 44).

But the National Guardian did not criticise any managers responsible and kicked the can down the road by only suggesting that the Kark review recommendations should be implemented:

“One of the Kark Review recommendations called for processes to ensure greater accountability for leaders, including a focus upon behaviour which suppresses the ability of people to speak up about serious issues in the health service. This recommendation must be implemented as a matter of urgency.”

It was in fact within the National Guardian’s gift, and indeed arguably one of her duties, to request that the CQC review trust directors under Fit and Proper Persons regulation, and that NHS England should take related action. But she did not report that she did so.

Compounding these failures to hold abusive managers to account and to set the right tone, successive National Guardians have also refused to facilitate access to redress for harmed whistleblowers. This is despite the fact that this was recommended in the 2015 Freedom To Speak Up Review:

The Greasy Freedom To Speak Up Review is Stuck. More Tales of Silence about Silence.

They have repeatedly taken the indefensible line that it is not part of their job.

Unsurprisingly, the National Guardian and her Office are not trusted by the NHS workforce and regularly receive only a tiny number of qualifying disclosures as a Prescribed Person under UK whistleblowing law, from an NHS workforce of 1.4 million.

BBC News reported quite wrongly that the National Guardian’s Office received over 25K contacts last year. This was actually the contacts received by local NHS trust Freedom to Speak Up Guardians and others.

In fact, in 2021/22 the National Guardian’s Office received only 30 qualifying disclosures from 1.4 million NHS staff.

Appallingly, the NGO sent 13 of these 30 staff back to their trusts:

“Signposted a worker to the Freedom to Speak Up Guardian at their organisation, so that the worker could contact them for support to raise matters relating to their disclosure”

When NHS staff contact the NGO (and some of them will be NHS trust Freedom To Speak Up Guardians who have been blocked or victimised for helping whistleblowers), they will have lost confidence in their employers.

It is unsafe and abusive to give such staff the runaround and make them go back to their employers.

Yet the NGO tried this approach in the whistleblowing case of Mr Shyam Kumar surgeon from University Hospitals Morecambe Bay NHS Foundation Trust (UHMBT), despite the fact that this trust was already notorious for several serious whistleblowing failures. This included a trust cover up of breast screening failures.

I am aware of at least seven whistleblowing cases from UHMBT, and yet the NGO has studiously avoided any case review of this organisation.

That must surely be a serious failure in the NGO’s duty of care to trust staff, and another example of the political nature of the NGO in how it sidesteps matters that are inconvenient to power.

Another well known example is Henrietta Hughes the former National Guardian’s favouritism towards the trust board at Sussex, when she arbitrarily allowed the trust time to “improve” before conducting a review. This had an impact on patient safety and likely helped to delay proper scrutiny of some very serious whistleblower allegations about deaths at the trust. The deaths are now under police investigation.

That is hardly holding erring senior trust managers to account.

I asked Ian Trenholm CQC CEO to investigate the failure of the NGO at Sussex since the police investigation became public knowledge. He passed it to the CQC complaints team, who replied on 5 July 2023:

“After considering your email, we will not be considering this as a corporate complaint, as it goes beyond the time limit of what we would consider under our policy.”

So no accountability.

In the case of whistleblower Dr Jasna Macanovic who asked for help, the National Guardian’s Office told her to come back after her Employment Tribunal had concluded. This meant there would be no help for her or for patients for years. This too has happened to other NHS whistleblowers.

It was left to the whistleblower community to refer Dr Macanovic’s dismissing Medical Director to the CQC (the National Guardian’s employer) under Regulation 5 Fit and Proper Persons, who as usual refused to find any breach of the regulation.

So no accountability.

NGO failure on Jane Chidgey Clark’s watch

And what of similar failings on Jayne Chidgey Clark’s watch, as the third National Guardian?

I have seen correspondence supplied by an NHS whistleblower with a very serious case who was dismissed despite seeking help from their local trust Freedom To Speak Up Guardian.

They contacted the National Guardian’s Office for help. They gave the NGO a detailed account of what had happened to them, including their attempts to seek help through the local trust Guardian.

The National Guardian’s Office, under Jayne Chidgey Clark, wrote back last year suggesting:

“We understand that you were a worker at REDACTED and have attempted to speak up about a number of issues, including those around patient safety. We understand that you do not feel able to speak to the Guardian at the Trust as they are employed by them. However, we would encourage you to contact them if you have not already done so.”

The NGO correspondence continued in this incompetent and insensitive vein, such that the whistleblower questioned whether the NGO had actually read their original request for help.

This is a typical example of how the NGO operates.

The Office resists requests for help, and its first response is to try to send NHS whistleblowers back to the organisations in which they have lost confidence. 

Sending victims back to abusers is not a recognised method of safeguarding.

I hope that BBC News will at some point acknowledge that the NGO’s actions smack more of collusion than accountability.

As does the disgracefully low number of case reviews conducted by the NGO.

The National Guardian’s Office simply does not protect whistleblowers.

RELATED ITEMS

The lack of evidence base for the Freedom To Speak Up project

The lack of evidence is examined here:

SSOTP: Robert Francis’ exemplar trust has feet of clay, and Jeremy Hunt’s safety claims are un-evidenced

Strikingly, in the same year that Robert Francis and the government launched the Freedom To Speak Up charade, the “exemplar” trust on which Francis purportedly based the model was criticised by the CQC.

It was reported that the prototype Cultural Ambassador role had disappointed some staff:

“The Staffordshire and Stoke on Trent Partnership NHS Trust created a role of ‘Ambassador for Cultural Change’. This innovative role was designed to allow the staff voice to be heard and concerns from staff to surface in a way that focused on the topic rather than the individual, protecting the identity of any staff member wanting to remain anonymous. This initiative received significant national attention. We saw that not all staff were happy with this role. They were often guarded and concerned they might not have the full protection promised. While some staff engaged with the Ambassador for Cultural Change many felt that the actions from this did not follow on as expected.”

And the trust was rated “Inadequate” on the Well Led domain partly because trust executives had not addressed staff concerns:

Francis et al did not put these salient facts in the glossy Freedom To Speak Up promotional material.

The truth, as ever, struggled to lace its boots whilst its counterpart had already been widely disseminated by government spin doctors.

The Low Fact National Guardian’s Office

The Disinterested National Guardian & Robert Francis’ Unworkable Freedom To Speak Up Project

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

NHS musical chairs: Darren Grayson, the Good Governance Institute & University Hospitals Sussex NHS Foundation Trust

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

Dr Minh Alexander NHS whistleblower and retired consultant psychiatrist 2 July 2023

Summary: This is a brief post to share documentation which shows that the private company WhistleblowersUK’s business model continues to be based partly on charging whistleblowers for help, and that it has linked with another company which sells services to barristers.

WhistleblowersUK also asks people for money if they wish to become “associate members”.

A statement of interests to Somerset Council by WhistleblowersUK’s Chair wrongly indicates that WhistleblowersUK is a public authority, and does not disclose that Whistleblowers seeks to influence public opinion and policy.

Background

WhistleblowersUK acts as the external secretariat of the Whistleblowing APPG. Leading members of the APPG and WhistleblowersUK seek to introduce a US model of bounty hunting.

WhistleblowersUK recently co-produced a lengthy document singing the praises of whistleblower rewards, with two major US bounty hunting law firms. However, the document omitted to mention serious drawbacks of the US bounty hunting model, such as its exploitative nature and the fact that the majority of whistleblowers are left with nothing, even if they suffer reprisal and loss. The model also siphons money into lawyers’ coffers. Bounty hunting is a billion dollar US industry led by lawyers. Lucrative cases from the financial sector generate huge bounties.

WhistleblowersUK’s document on rewards for informers also claimed that historically, the model worked well in England. Historical studies reveal that the model generated scams and corrupt practices, as has been the case with its modern successor.

I reported here about these issues:

Qui Tam. A tale of malicious informants and corruption in ye Olde England. And its evolution to the modern bounty hunting model

I have since been contacted by someone who approached WhistleblowersUK for help and who obtained the following documents, which they have shared with me:

1. A revised, updated version of WhistleblowersUK’s “Statement of cooperation”

I have previously published an earlier version of this document.

WhistleblowersUK’s statement of cooperation and agreement

This is the more recent version of the document, which was used as recently as 2022:

NEW WhistleblowersUK statement of cooperation and agreement 2021

Changes include the fact that this appears to be a joint document produced with another private company, the “Barrister Consultancy Services”.

The Barrister Consultancy Services’ logo also appears on this document, and the document reads:

“If appropriate we will introduce you to our trusted partner Barrister Consultancy Services (BCS), who will provide you with legal project management services enabling us to work together on your case from start to finish.” [my emphasis]

The document also indicates that WhistleblowersUK may arrange initial pro bono assistance by barristers that is not legal advice. It appears to imply that BCS may be involved in arranging access to barristers:

“We help you retain full control at all times because you know your case best.

Our specialist panel of barristers usually provide initial pro bono assistance (not legal advice) based on the chronology and supporting information that you supply. All barristers on our panel are regulated by the Bar Standards Board in England & Wales and/or Faculty of Advocates in Scotland, be assured that separate letters of agreement will be sent to you before any official legal advice is provided. You will not incur any legal costs without your agreement. WBUK & BCS does not accept responsibility or liability for any independent legal advice provided.”

The statement of cooperation links to the website of the BCS to a page about the BCS’ privacy policy.

The BCS website suggests that this company primarily provides specialist administrative support to barristers:

“Barristers in the UK often work independently in Chambers and are mostly self-employed. Therefore, they are responsible for managing their own practices and developing their business. However, managing a legal practice can be complex and time-consuming, which is why many barristers and their clerks turn to Barrister Consultancy Services for assistance.”

The “About” page of the BCS states:

“As former Barrister Clerks and Practice Managers, our primary objective is to enhance and refine internal practice management processes and procedures within barrister’s chambers.”

At the bottom of the pages of the BCS website, it is stated:

“Barrister Consultancy Services is the trading name of David Wright a self-employed consultant at DW Business Consultancy, a Company Registered at 23 Franmil Road, Hornchurch, Essex, RM12 4TR No: 10431011”

David Wright’s LinkedIn entry indicates that he has worked as a barrister’s clerk, legal practice manager and director of business at various Chambers.

The Companies House entry for DW Business Consultancy lists Linda Wright as company secretary and David Wright as director.  The nature of the business is stated to be: “70229 – Management consultancy activities other than financial management”.

According to Companies House, BCS was incorporated on 17 October 2016, and it last filed accounts last year, with “Accounts for a dormant company made up to 31 December 2021”.

These accounts state that the company was dormant in the reporting period, received no income and incurred no expenditure.

BCS also has a post on Facebook as follows:

An examination of the metadata of the revised Statement of Cooperation by WhistleblowersUK reveals that it was last edited by David Wright:

In comparing the new “statement of cooperation” with the previous version that I published, the section “What we will do for you” has been expanded, with insertion of an additional service:

“We will help you identify and instruct specialist legal advisors.”

The latest statement of cooperation indicates that WhistleblowersUK still charges whistleblowers £100 per hour for its services, albeit it now states that it will provide initial assistance without charge for up to two hours.

The latest statement of cooperation indicates that WhistleblowersUK also asks for a “percentage” of any financial award that a whistleblower may receive. It differs from the previous version of the document in that where five percent was previously specified, there is now no numerical value given, and no clear limit on what share of financial awards WhistleblowersUK propose to take.

1. WhistleblowersUK’s application form for associate membership

This is the form: Associate Membership application form

This form states that membership advantages are:

WhistleblowersUK states in the application form that it does not charge fees for membership.

However, it asks any individuals wishing to join as an associate member for a minimum donation of £120 per annum.

There is a section at the end of the document which states:

“Financial hardship is not a barrier to becoming an Associate Member. The Directors will consider applications to waive the requirement for a regular donation. Please advise WBUK in Section 2, Question 3 if you wish to apply for a waiver.”

This is the clause in the application form which asks applicants to commit to the payment of £120 and to abide by the company’s by-laws:

I could find no company by-laws on the WhistleblowerUK’s website or recorded in documents filed at Companies House.

But the application form indicates in bold text that WhistleblowersUK’s directors can terminate membership at any time:

“Associate Memberships are approved by the directors and can be terminated without notice at any time.”

WhistleblowersUK states that its objectives include expanding its associate membership:

“We Grow our community through our associate membership promoting engagement, collaboration, and sharing of ideas and perspectives among our members.”

The company publicises dates for meetings of associate members, the most recent being 26 June 2023:

However, I could find no record of the current or past number of associate members, or of the level of income generated by associate members’ required donations of a minimum £120 per annum.

By the end of 2022, WhistleblowersUK’s accounts submitted to Companies House showed that the company had a total of £3,905 assets.

I asked WhistleblowersUK through its Chair Tessa Munt former Liberal Democrat MP, now local councillor, if the organisation wished to comment on matters arising from the above two WhistleblowersUK documents, but I have not yet received a reply.

“Tessa Munt

Chair of WhistleblowersUK

29 June 2023

Dear Ms Munt,

I write to ask if WhistleblowersUK would like to comment on and/or elaborate on reports that: 

i) WhistleblowersUK asks whistleblowers for £120 minimum donation per annum to be associate members

ii) WhistleblowersUK offers pro bono assistance from lawyers which is not legal advice, from a panel of specialist barristers

iii) WhistleblowersUK now works in partnership with Barrister Consultancy Services

Many thanks.

Dr Minh Alexander”

Munt is Liberal Democrat councillor for Wells, Somerset.

I note in Munt’s declaration of interests to Somerset Council that she is described as “interim” chair of WhistleblowersUK, and has declared that WhistleblowersUK is a public authority when it is a private company.

I have written today to the CEO of Somerset Council and the Leader of the Council about this factual inaccuracy, and also raised an issue of whether Munt should have declared the fact that Whistleblowers is an organisation which seeks to influence public opinion and policy.

BY EMAIL

Duncan Sharkey

CEO Somerset Council

2 July 2023

Dear Mr Sharkey,

Declaration of Interests by Councillor Tessa Munt: error and omission

I am sure it is a mistake but the council currently publishes inaccurate information about Councillor Munt’s interests.

Ms Munt’s declaration of interests states under Question 9 “Do you hold membership of other Public Authorities?” that she is “director and interim chair” of WhistleblowersUK.

WhistleblowersUK is not a public authority but a private company (09347927) which had £3,905 assets by end 2022, according to documents filed at Companies House. By the end of the previous year, WhistleblowersUK only reportedly had £736 assets.

 WhistleblowersUK is seeking to introduce a controversial and exploitative US model of bounty hunting, which if ever adopted as the UK national model would disadvantage the majority of UK whistleblowers and lead to only a tiny handful receiving vast rewards. The model primarily benefits bounty hunting law firms and is a billion dollar US industry, which has been trying to the break into the UK market for some years now. This model primarily targets the financial sector, where bounties from recovered monies can be huge.

Under question 11 of Ms Munt’s declaration of interests, “11. Do you hold membership of bodies influencing Public Opinion or Policy (including any political party)?”, Miss Munt has only declared membership of the Liberal Democrats. 

I believe she should also arguably declare her leadership position at WhistleblowersUK under this section because this company campaigns for whistleblower financial rewards and law changes which would open the door to such financial rewards.

WhistleblowersUK recently co-authored a document with two major US bounty hunting law firms,  which praised the benefits of financial rewards for whistleblowers.

The company states on its website that it explicitly seeks to influence public opinion and policy. It seeks to introduce an Office Of The Whistleblower, which mirrors the US Securities and Exchange Commission’s Office of the Whistleblower which handles a high profile whistleblower reward programme.

 For example, WhistleblowersUK state on their website:

“We Transform the way everyone thinks about whistleblowing, educate the public, and demonstrate the importance of whistleblowers in a fair and transparent society.

We Campaign for the Office of the Whistleblower now a Bill going through Parliament that will revolutionise the treatment of concerns and the people who raise them.”

Of note, WhistleblowersUK has since 2018 acted as the external secretariat to a Whistleblowing All Party Parliamentary Group, which explicitly campaigns for the law change which would open the door to the US style whistleblowing rewards. When the Whistleblowing APPG was first established in 2018, its declarations showed that it accepted money from Constantine Cannon, a major US bounty hunting law firm. This funding was badged as payment for WhistleblowersUK’s services as external secretariat.

Sir Norman Lamb former Liberal Democrat MP was a member of the Whistleblowing APPG but resigned after the CEO of WhistleblowersUK refused to answer questions about conflicts of interest and finances which I put to the APPG:

Norman Lamb MP has resigned from the Whistleblowing All Party Parliamentary Group

I copy below correspondence to Councillor Munt in her capacity as WhistleblowersUK Chair, seeking greater transparency about WhistleblowersUK’s financial arrangements and the handling of whistleblowers’ highly sensitive personal data. I have received no reply to my letter of 4 May 2023, and I await a reply to my letter of 29 June 2023.

Please confirm receipt of this letter and advise what action Somerset Council will take to ensure that Councillor Munt’s declaration of interests is accurate.

Many thanks.

Yours sincerely,

Dr Minh Alexander

NHS whistleblower and retired consultant psychiatrist

Cc Bill Revans Liberal Democrat councillor North Petherton, Leader of Somerset Council and Lead Member for Governance & Communications

 

RELATED ITEMS

The Whistleblowing Hunger Games: Why we should reject the Whistleblowing APPG

New research: US bounty hunting model, cronyism and the revolving door between
regulators and bounty hunting law firms

A Tory MP who is a pro bounty, former member of the Whistleblowing APPG
secured a junior ministerial post this year and launched a review of UK
whistleblowing law:

Tory MP Kevin Hollinrake who called for whistleblower “incentives” is now in a
ministerial role, launching a review of UK whistleblowing law

Qui Tam. A tale of malicious informants and corruption in ye Olde England. And its evolution to the modern bounty hunting model

Dr Minh Alexander retired consultant psychiatrist 29 June 2023

Summary: The Department of Health and Social Care has confirmed that its plans to set up a Special Health Authority to investigate maternity failures in the NHS are dead and buried, with no plans to resurrect. This is despite an abortive attempt to recruit a Chair for the Special Health Authority which concluded with fourteen applicants being turned away. It refuses to disclose its justification for transferring the maternity investigation programme to the Care Quality Commission or the legislation drafted for the now binned Maternity and Newborn Safety Investigation Authority.

Background

Jeremy Hunt former Health Secretary’s unwieldy vanity project the national maternity investigation programme was foisted on the Healthcare Safety Investigation Branch against advice.

It unravelled in secrecy as whistleblowers spoke out against poor management and inherent systemic problems, such as designed-in conflicts of interest from seconded staff feeling pressured to keep on good terms with the regional teams they investigated, for the sake of their long term career prospects.

NHS England and its predecessors tried to suppress the scandal but to no avail as an HSIB whistleblower’s Employment Tribunal hearing in April this year revealed crucial evidence and an investigation by Channel 4 (broadcast 15 and 16 May 2023) brought forth yet more whistleblower evidence of defective maternity investigations and cultural failings at HSIB. Importantly, HSIB staff claimed that they had been threatened with job losses if they did not churn out investigations reports quickly enough, which affected quality.

Related to these troubles, several investigations were conducted but suppressed by NHS England. Firstly the Newton report was conducted into a HSIB whistleblower’s concerns of detriment and concluded that there had been poor whistleblowing governance.

A review of culture and leadership was then conducted by the Kings Fund upon the recommendation of the Newton report, which was overseen by NHS England and the Department of Health and Social Care. The Kings Fund produced a curiously fact lite report which nevertheless found leadership failures. It also commented on the harmful effect of uncertainty about the future of the maternity division of HSIB and advised that this be resolved.

The King’s Fund review was informed by an internal review of the maternity division, the Benson report, which revealed serious dysfunction. Dawn Benson the HSIB lead author went on to give evidence at the above HSIB’s whistleblower’s ET hearing and also gave an interview to Channel 4.

Keith Conradi the head of HSIB’s retirement was announced after the King’s Fund’s conclusions were shared with HSIB staff.

On 21 January 2022 the Health Service Journal reported the findings of the leaked King’s Fund report, which was the first time the report’s existence was revealed:

Bullying, sexism and racism ‘prevalent and tolerated’ at national regulator

On 26 January 2022 Sajid Javid made a statement in parliament  announcing that the government would create a short life Special Health Authority to take over the maternity investigation function from HSIB. The idea was to eventually hand maternity investigations back to NHS trusts once an example of good practice had been purportedly modelled:

“Special Health Authority will be established for up to five years from 2022-23 to enable maximum learning to be achieved and to equip NHS Trusts with the expertise, resources, and capacity to take on maternity safety incident investigations in the future.”

The post of Chair for the special health authority was advertised in autumn 2022:

Advert for Chair of Maternity and Newborn Safety Investigation Authority 2 September 2022.

William Vineall and NHS regulators were represented on the advisory panel.

But on 30 March 2023, shortly before the HSIB whistleblower’s ET case was due to be heard, Maria Caulfield Parliamentary Under Secretary for Health and Social Care unexpectedly announced that the maternity investigation section of HSIB would be hosted by the Care Quality Commission:

“On 26 January 2022, Official Report, 25WS, by way of a written ministerial statement, the Department of Health and Social Care announced that a separate Special Health Authority would be established to continue the independent maternity investigation programme, which is currently overseen by the Healthcare Safety Investigation Branch.

The Department is committed to ensuring the continuation of independent, standardised maternity investigations that provide learning to the system and contribute to the Government’s ambition to halve the 2010 rates of stillbirths, neonatal and maternal deaths and brain injuries in babies occurring during or soon after birth by 2025.

Following careful consideration, the Department has determined that the most appropriate and streamlined mechanism for delivering the valued and independent maternity investigations is for the function to be hosted within the Care Quality Commission. The purposes of the maternity investigation programme remain as set out last January: to provide independent, standardised and family-focused investigations of maternity cases for families: to provide learning to the health system via reports at local, regional and national level; analyse data to identify key trends and provide system wide learning; be a system expert in standards for maternity investigations; and collaborate with system partners to escalate safety concerns.

We will now work with the CQC and the HSIB to complete the transition of the maternity investigation programme to the CQC by October 2023.

As announced in the written ministerial statement of 9 February 2023, Official Report, 40WS, the establishment of the new HSSIB will take place in October 2023, to enable all the necessary work to be completed to ensure a smooth transition of these investigation programmes.”

The Department of Health and Social Care’s termination of the Maternity and Newborn Safety Investigation Authority

To confirm whether this was a permanent arrangement and to find out more about the justification for locating maternity investigations within the notoriously politicised and none too competent CQC, I made an FOI request to the Department of Health and Social Care. This is the response:

DHSC FOI response 28 June 2023 Ref 1455271 plans for establishing Maternity and Newborn Safety Investigation Authority and Hosting by CQC

The Department confirmed that it went ahead with its appointment process for a chair to the Special Health Authority, for which it received fourteen applicants:

“DHSC received 14 applications for the post of Chair/Chair designate to the Maternity and Newborn Safety Investigation Special Health Authority (MNSI).”

The government claims no appointment was made because:

“An appointment was not made, as a final decision on the appointment had not been reached before the announcement on the future of the MNSI [Maternity and Newborn Safety Investigation Authority] via a Written Ministerial Statement (WMS) on 30 March 2023.”

Well that’s a good way to do business. Advertise a job and then tell everyone “Hard cheese chaps, the job’s gone”.

The government also confirms that the Special Health Authority was never legally established.

It stands by its claims that the best option is hosting by CQC rather than a standalone Special Health Authority reporting directly to the Department of Health and Social Care:

“….following careful consideration, DHSC has determined that the most appropriate and streamlined mechanism for delivering the valued and independent maternity investigations is for the function to sit within and be hosted by the CQC.”

However, the government refuses to disclose its justification for this opinion on grounds that it might be embarrassed. Sorry, I mean on grounds of Section 35 FOIA formulation of government policy, because the transition period is not yet complete and policy is still being formulated.

The government has no plans to revisit the idea of a Special Health Authority.

This implies that the maternity investigation division will likely be allowed to wither on the vine for some as yet undetermined period until it all reverts to NHS trusts. This will do nothing for the independence of maternity investigations.

The government also refuses to disclose legislation drafted for the Special Health Authority on purported grounds that this is legally privileged.

One is left wondering what sort of governmental hissy fit led to such a major change of direction, and the bizarre Heath Robinson arrangement of the Care Quality but We Don’t Investigate Complaints Commission hosting a specialised incident investigation function.

It is left only to commiserate with the unfortunate maternity investigation staff who have been so badly managed and supported from the outset of a political misadventure.

RELATED ITEMS

Hunt’s chutzpah

Hunt skilfully dined politically off the Midstaffs and Morecambe Bay disasters whilst simultaneously wrecking the NHS, fashioning a narrative of hero crusader against the wicked NHS and recruiting a number of families to insulate himself.

He dined off Midstaffs whilst reneging on core recommendations from the public inquiry such as mandatory safe staffing and real whistleblower protection, which would have helped to prevent further maternity tragedies and any need for his disastrous national maternity investigation gimmick.

Even in 2020, Hunt was still trying to politically capitalise from maternity tragedies:

Jeremy Hunt calls for national inquiry into NHS maternity safety after repeated scandals

His handiwork on the NHS is now all around us as emergency care has collapsed, regularly causing deaths, cancer care is teetering and 7.4 million people await treatment.

And at the UK COVID public inquiry it has just been revealed that Hunt wanted to cut Public Health England’s funding by half:

 Hunt wanted 50% cut to public health, says ex-PHE boss

Public health is one of the most crucial, effective and super-efficient medical specialties with profound effects on improving the health of the populace. Why would anyone except the utterly incompetent or those with malign intentions wish to cut it?

Slow and incomplete maternity investigations: Death of baby Theo Young and Coroner’s serious criticisms of HSIB

HSIB whistleblowers and the Secret King’s Fund Fact Lite report

More secret HSIB reports and failures of HSIB maternity investigations

Finally revealed: The suppressed Susan Newton report on whistleblowing governance at HSIB/ NHS England

HSIB has sent 152 letters of concern to NHS trusts about maternity safety, including 15 letters to one trust

Was the CQC wilfully blind to organisational failures by East Kent Hospitals NHS Foundation Trust on maternity safety?

Calling whistleblowers, patients and families: Language matters. CQC dismisses concerns as “complaints” to give you the bum’s rush, but it has to investigate “incidents” if CQC Regulation 12 is engaged

Why is CQC not investigating UHB under CQC Regulation 12?

NHS England appears to claim that tampering with medical records is not illegal. The legal minefield and what whistleblowing disclosures are legally “protected”?

NHS England appears to claim that tampering with medical records is not illegal (II). Or an apparent failure of organisational memory

I leave readers who are less familiar with CQC’s ways with this FOI revelation about how CQC senior managers huddled and deliberated on the best way to manipulate public into thinking that they had written a “hard hitting” inspection report, but with as few facts as possible:

Dr Minh Alexander retired consultant psychiatrist 24 June 2023

The private company WhistleblowersUK and its backers are pushing financial rewards for whistleblowing under the guise of ‘restitution’.

The US model of massive bounties for a tiny handful of whistleblowers (hundreds of millions for some individuals) is rapacious and wrong. It has spawned regulatory corruption. It feeds a billion dollar US legal industry that wants to open up the UK market.

The whistleblowing APPG and its external secretariat WhistleblowersUK are becoming more and more explicit in their pursuit of a model of financial rewards (bounties) for whistleblowing in the UK.

For a while, they toned down references to rewards in most of their written material. For example, WhistleblowersUK referred to “compensation” in contexts which made it clear that they were talking about rewards. Equally, although leading members of the APPG called for rewards and financial incentives, documents by the APPG coyly suggested that it was a matter for the government to decide if rewards were appropriate.

But last month, WhistleblowersUK produced this document with two major US bounty hunting law firms, Constantine Cannon and Kohn, Kohn, and Colapinto LLP, singing the praises of financial rewards:

International Whistleblower reward programmes. Is there a place for them in the UK?

Any wisps of veil are gone.This long report claimed to set out the strengths and weaknesses of whistleblowing rewards, but in reality it only knocked down straw men and it ignored elephants.

Importantly, as far as I can see the report does not explain how under the exploitative US bounty hunting model, only a tiny minority of claimants qualify for rewards. It is possible to be a genuine whistleblower and to suffer severe life changing reprisal and detriment but to receive no redress under this scheme.

The report also makes surprising claims, such as an assertion that “qui tam” prosecutions (legal claims in the name of the King, with a share of the proceeds going to the claimant as well as the crown) “worked well for many centuries” in England.

This claim by WhistleblowersUK et al appears to be unsupported. Qui tam suits were very rough justice introduced in the 13^th century only because of a lack of governance infrastructure and law enforcement resources. Citizens were effectively deputised.

Historical studies show that the qui tam system of governing was unsurprisingly beset with problems and that informants who personally benefited were despised:

“Early in Henry VII’s reign, it had become apparent that qui tam enforcement of penal statutes had created serious problems….”

False, malicious suits were sometimes pursued for personal gain. Corrupt officials “extorted” fines by imprisoning people until they “confessed” to wrongdoing. Trials without jury were held. Informers sometimes perjured themselves. Suits might be tactically and abusively filed hundreds of miles away from the accused’s home, making it nigh impossible to defend a suit.

A class of “professional informers” called “promoters” arose who made a living out of qui tam suits, and who were despised and distrusted:

“Informers were widely perceived as self-interested at best and malevolent at worst. The charge of self-interest was a natural inference from the bounty provision of a qui tam statute.”

“They were described variously as “varlets, “lewde” and “evil”…”viperous vermin”

“Indeed, informers harassed and impoverished citizens, particularly those in the lower classes, “for malice or private ends, [but] never for love of Justice.”

Some informers settled quietly and unofficially with their marks, in order to pocket more money and deprive the crown of its share, without bringing matters to the court’s attention:

“This collection of payments in return for a promise not to prosecute was, in essence, a form of blackmail or extortion.”

Informers were sometimes jailed for such scams. The worst offenders were occasionally executed.

Where justice is monetised, it is hardly surprising if the perverse incentives lead to corrupt practices. In the same way that the SEC Office of the Whistleblower became corrupted, its ancient predecessors were also sometimes corrupt.

Such was the level of abuse sometimes endured by the populace under qui tam law, that assaults and riots against informers were occasionally recorded in ye in Olde England.

Additional laws were repeatedly passed in attempts to manage the misconduct of informers.

So, hardly a picture of success as claimed by WhistleblowersUK et al.

And it is not reassuring that a claim of success was made.

Nevertheless, WhistleblowersUK, Constantine Cannon, and Kohn, Kohn and Colapinto LLP gamely argue in their report that publicity about large financial rewards increase public awareness of whistleblowers. They leap to a conclusion that this increased awareness must improve public opinion of whistleblowers, without providing the evidence to confirm this theory. (Page 20).

Notoriety for excessive whistleblower rewards, especially in scandals where victims are uncompensated, is of course an alternative explanation.

Yesterday, I observed most of a webinar by WhistleblowersUK and the Whistleblowing APPG  yesterday, bar the first twenty minutes which I had to miss due to a clashing commitment. The speakers were Rory Field barrister with a specialism in organised crime and who has spoken on organised economic crime, standing in for Iain Mitchell barrister, Richard Pike of Constantine Cannon, Susan Kramer former Whistleblowing APPG Chair but still active pro-bounty politician, Folashade Adeyemo Lecturer in Banking and Company Law Reading University and a specialist in Nigerian banking regulations, a whistleblower whose full name I did not catch and Georgina Halford Hall CEO WhistleblowersUK.

The theme of the event was “restitution”.

In reality, this proved to be about financial incentivisation.

Richard Pike of US bounty hunting law firm Constantine Cannon explained the US model of bounty hunting to the audience.

He took a similar approach to that of his colleague Mary Inman in 2018 at the Bylines festival, explaining that the concept came from the “mother country”, England, when ancient custom was to take action in the name of the King, qui tam.

Pike argued that a prime benefit of bounties was to ensure legal representation for whistleblowers, because if lawyers knew that they could get a large pay out, they would be more willing to work contingently (or in plain English, on a no win, no fee basis).

Importantly, Pike did not explain to the audience the vagaries of the bounty system and the minimum financial recovery thresholds that whistleblowers have to fulfil to qualify for a reward, which in reality means that only a tiny minority are rewarded.

This leaves many genuine whistleblowers with no redress. It is possible under the US bounty system to be a bona fide whistleblower who suffers severe reprisal, who loses their livelihood and suffers longterm economic insecurity, but be left with zero redress.

Despite this reality, Pike described the model as “phenomenally successful”. This is possibly more of a comment from the point of view of the bounty hunting industry, and to an extent, the State.

Pike stated that the model is designed to recover money for the State, and indicated that it is therefore a problem when whistleblowers raise concerns about the State itself. His commented that federal whistleblowers might find themselves in prison.

He did not inform the audience of the existence of the the US Office of Special Counsel which looks after federal whistleblowers, who whistleblow about the State. This agency would be of less interest to bounty hunting law firms because it does not financially incentivise whistleblowing and operates a lean public sector model of restitution. It restores whistleblowers to the position that they would have occupied but for the whistleblowing, and no more, and it can ensure non-financial redress.

The whistleblower on the WhistleblowersUK panel suggested that bounties could perhaps be capped.

This reminded me of a past quote from Mary Inman who upon discovering Brits’ “visceral” dislike of the idea of paying whistleblowers, suggested that the bounty model could be made more culturally acceptable by capping rewards:

“she thinks the UK could create a culturally appropriate scheme which caps any rewards.”

And will this proffer of capped rewards survive the implied intention to pursue large and eye-catching bounties, mentioned in the above joint document published only last month by WhistleblowersUK, Constantine Cannon, and Kohn, Kohn and Colapinto LLP?

Alongside Pike, Folashade Adeyemo also spoke about restitution and by this she appeared to mean financial reward. She also used the words “recognition” and “acknowledgment”.

Mostly, Adeyemo’s contribution consisted of different ways of talking about financial transaction. For example:

“Compensation, not payment for informing, but recognising the value of that information”.

There was no clear discussion of non-financial redress.

Susan Kramer former APPG chair, who employs WhistleblowersUK’s CEO as a researcher at the House of Lords spoke on how the APPG and she have garnered interest from members of parliament. She anticipated that the Bill would fall again but made it clear that the campaign would continue.

Of note, Kramer appeared not to be familiar with the details of her own Bill and initially stated that people could have their claims dealt with by either the proposed Office of the Whistleblower, or by the Employment Tribunal if they preferred.

This would actually not be possible under Kramer’s private member’s Bill, which repeals PIDA and provides no alternative path to litigate whistleblowing cases in the Employment Tribunal.

Georgina Halford Hall WhistleblowersUK CEO stepped in to state that the whistleblowing element would be dealt with by the proposed Office of the Whistleblower but other heads of claim such as discrimination would need to be presented to the Employment Tribunal.

An important question from the audience about public sector employees did not receive a satisfactory answer. The panel was asked how their Bill would benefit public sector whistleblowers and if public servants would effectively be paid for information.

Underlying this question is the issue of the Nolan principle of selflessness in UK public life, drawn up after repeated sleaze scandals during the Major premiership.

Either panel members did not appreciate that or did not wish to address it, because the response did not address this principle.

Folashade Adeyemo instead replied:

“Why do we need to incentivise? Valuable information that will save lives, by our very nature as humans, if there’s no incentive, people won’t come forward”

Georgina Halford Hall pushed the boundaries furthest by arguing for the legitimacy of rewarding information from wrongdoers, like convicted fraudster Bradley Birkenfeld who received $104 million in bounties for informing on his co-offenders.

All the talk I heard was about recovering money from frauds and SEC’s 10 to 30% bounties from recovered money.

I heard almost nothing about protecting the public from harmful health and social care, excepting a very few broad comments about saving lives, with no particularisation.

My impression was that the APPG and WhistleblowersUK wish to throw as many nice words as they can at the concept of monetising information and bounty hunting.

As in the words of WhistleblowersUK, Constantine Cannon, and Kohn, Kohn and Colapinto LLP :

“The real sticking point remains the idea of rewarding people for doing the right thing. The UK remains publicly queasy when it hears the word “reward” in the same sentence as “whistleblowing”. However, when we change “reward” to “compensate” or “restitution” attitudes change. No one can dispute the importance of fairness and that whistleblowers should not suffer for doing the right thing.”

So when you hear “restitution”, do not forget that the Whistleblowing APPG, WhistleblowersUK and the substantial corporate power behind them, are talking about financial rewards and the billion dollar bounty hunting industry led by lawyers.

Any financial reward that exceeds fair compensation for loss, and is calculated on a percentage is still bounty, capped or not.

RELATED ITEMS

The Whistleblowing Hunger Games: Why we should reject the Whistleblowing APPG

New research: US bounty hunting model, cronyism and the revolving door between regulators and bounty hunting law firms

Dr Minh Alexander retired consultant psychiatrist 22 June 2023

The letter below, sent today to the parliamentary Justice Committee, is hopefully self-explanatory.

BY EMAIL

Sir Robert Neill MP and colleagues

Justice Select Committee

22 June 2023

Dear Sir Robert and colleagues,

Processes for reviewing and assuring the fitness of senior officers of the Criminal Cases Review Commission

I write to raise a concern about procedures for reviewing the fitness of senior officers of the Criminal Cases Review Commission (CCRC).

I raised a concern with Helen Pitcher Chair of CCRC about the suitability of the CCRC CEO arising from actions and omissions in her ongoing capacity as a non executive board member of University Hospitals Birmingham NHS Foundation Trust (UHB).

The trust has been undergoing multiple investigations following concerns of poor governance, whistleblower victimisation, a “toxic” culture with reported “cronyism” and patient safety failings.

In particular, I was concerned about the UHB trust board’s actions in ratifying an internal Fit and Proper Person investigation of the former UHB trust Chief Executive. The investigation was launched after he was criticised by the Employment Tribunal for conduct towards a senior medical whistleblower, and related referrals were made to the Care Quality Commission by several external parties, myself included, under CQC Regulation 5 Fit and Proper Persons.

The Employment Tribunal’s criticism included the fact that the former UHB CEO made a misleading referral to the General Medical Council in which he omitted to declare as required, that the whistleblower was a whistleblower. For this he later received a  formal warning from the General Medical Council, as a registered medical practitioner himself.

The subsequent UHB trust internal Fit and Proper Person investigation which reportedly exonerated the trust CEO (it has never been published or even shared with the whistleblower) was undertaken by a subordinate trust manager who was not a board member, assisted by a lawyer from a firm retained by the trust, which had been  paid £497K for other services in the three previous years. It could not be described as an independent investigation and a probity issue arises from the fact that a subordinate employee was put in this position.

This was compounded by the fact that UHB misled the whistleblower and informed him wrongly in correspondence that the assisting law firm was independent and without current or previous links to the trust.

There were a number of procedural irregularities in the manner in which the whistleblower had been disciplined, suspended and dismissed by the trust, which were criticised by the Employment Tribunal. These breached a principle that NHS doctors should be disciplined with regards to Article 6 rights.

Documents were repeatedly withheld from the whistleblower and from the Employment Tribunal, which had the effect of concealing the fact that he was suspended on a false premise, which the Employment Tribunal determined the former UHB CEO should have known was false. The Employment Tribunal judge indicated in a costs judgment against the trust that he could not rule out “deliberate dishonesty” by the trust and key players, or that there would not be future serious governance failures of this sort.

The CRCC CEO had sight of the trust’s internal Fit and Proper Person Investigation report exonerating the former UHB CEO. She is on record as having reassured the trust governors that the investigation was sound. The minutes state at a UHB Council of Governors’ meeting on 29 July 2021:

“Karen Kneller also wished to provide reassurance to the Governors that the NEDs are particularly enquiring and have examined the situation thoroughly to their satisfaction and all are happy with the review.”

Although I am informed by an individual who actually witnessed the meeting that their recollection is that she stated there was “no smoking gun”.

The former CEO of UHB announced his retirement on the day that the first investigation report on the trust was published, on 28 March 2023.

Helen Pitcher also received information about the understandably serious impact of events on the whistleblower.

The issue I wish to raise with Justice Select Committee is this:

Helen Pitcher initially informed me via her Office on 14 April 2023 that she would consider my concerns and respond within twenty eight days.

On 18 May 2023 Ms Pitcher’s Office informed me that enquiries continued and that there was no date for completion.

On 2 June 2023, after an enquiry, the same message was given again.

There was no date set for review/ update.

I understand that serious matters take time to consider, but I am concerned by this open-ended approach to a serious matter, by an agency that is supposed to be all about fairness and accountability and should be above reproach.

It does not seem to me to be a sufficiently accountable approach.

I ask Justice Committee to note it for any future consideration of the effectiveness of the CCRC and CCRC’s governance.

I should note that parallel to this matter, NHS England’s “Well Led” investigation of UHB is expected to conclude early next month. There is reason to have modest expectations of this given that NHS regulators have repeatedly protected and helped to recycle erring NHS senior managers, which was a trigger for the NHS Kark review on the Fit and Proper Test in the NHS. The report of this review by Tom Kark KC was published over four years ago, but reflecting the recalcitrant nature of NHS senior management culture, its implementation was entrusted to NHS England and it has not yet been implemented.

I copy below the relevant correspondence from the CCRC showing its initial response and later responses with no identified timescale for completion or even review and update.

Yours sincerely,

Dr Minh Alexander

NHS whistleblower and retired consultant psychiatrist

Cc Health and Social Care Committee

From: REDACTED

Subject: FW: Concern about Karen Kneller’s role as Criminal Cases Review Commission CEO

Date: 14 April 2023 at 14:50:04 BST

To: REDACTED

Dear Dr Alexander 

I confirm that your correspondence of 13 April 2023 has been passed to Helen Pitcher.

Ms Pitcher will consider the contents and respond to you within 28 days.

Please could I also ask that you direct any further correspondence on this matter to this address rather than the Commission’s general mailbox.

Yours sincerely

Kind regards,

REDACTED

Executive Assistant to the Chairman  | CCRC

From: REDACTED

Subject: FW: Concern about Karen Kneller’s role as Criminal Cases Review Commission CEO

Date: 18 May 2023 at 15:51:04 BST

To: REDACTED

Dear Dr Alexander

Further to recent correspondence, Ms Pitcher has asked me to confirm that matters remain under consideration and inquiries are underway.

At this stage, we do not have a date for completion, but we will inform you of the outcome in due course.

Yours sincerely,

REDACTED

From: REDACTED

Subject: RE: Concern about Karen Kneller’s role as Criminal Cases Review Commission CEO

Date: 9 June 2023 at 10:49:39 BST

To: REDACTED

Dear Dr Alexander,

Thank you for your recent email.

Our inquiries remain underway. We do not have a specific completion date but will inform you of the outcome as soon as we can.

Yours sincerely,

REDACTED

Executive Assistant to the Chairman  | CCRC

RELATED ITEMS

There is a difference in Karen Kneller’s declaration of interests at UHB and her declaration of interests at CCRC, which are more extensive.

This is her declaration of interests at UHB taken from a published trust document of 2020 (the most recent I could find):

Kneller has since resigned as a director of BRAP as of 10 January 2023.

This is Kneller’s declaration of interests at the CCRC, disclosed via FOI on 20 April 2023:

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

Secretary of State who commissioned report on recycled NHS managers wonders if bad NHS managers are recycled