Request for an Inquiry into how the NHS dealt with the whistleblowing concerns on Ward 87 North Staffordshire NHS Trust in 1998

Dr Rant has received a copy of the following letter from Rita Pal to the Health Secretary:

FAO Alan Johnson

Dear Sirs,

RE: Substandard Healthcare on Ward 87 City General Hospital (North Staffordshire NHS Trust ) Stoke on Trent.

I refer to the Inquiries Act 2005.

Brief Summary

1. As the Department of Health is fully aware, I raised serious concerns regarding the substandard treatment of elderly people on Ward 87 North Staffordshire NHS Trust in November 1998. My concerns were as listed below and are summarised by Professor Bolsin's report available here.

2. My concerns were as follows

a) Lack of basic equipment such as drip sets
b) Lack of adequate support for junior doctors
c) Lack of basic care for patients
d) Repeated DNR notices
e) Gross shortage in staffing levels

These concerns were raised internally with no result at the time then externally which instigated the 2001 Creamer Report.

3. Despite documentation being sent to the Prime Minister and the Department of Health between 1999-2000, no action was taken to rectify these issues.

4. In April 2000, I raised these concerns in the Sunday Times 2nd April 2000. The issues were also raised through other media outlets.

5. In April 2000, the issues were also raised to the GMC. Professor Griffiths Director of Public Health ( working for the goverment) for the West Midlands intentionally misled the GMC at the time. As a civil servant, his study conducted on the same data was diametrically opposite to that of the two internal Trust reports ( 1999 and 2001). The GMC then wrongly questioned my mental health resulting in legal action which I initially won and the GMC settled. The details of this case is available here. I have never had a mental illness. The GMC had not been informed of the two internal reports verifying my concerns. The existence of these reports were known to Professor Griffiths but he opted to conceal them. A complaint to the GMC resulted in a 2 year investigation where the complaint was initially thrown out then reinstated. The result is available here. Professor Griffiths is criticised but the GMC took no action against him.

6. The two internal reports were listed in 1999 and 2001. The 2001 is available here and concluded that my concerns were well founded. These were disclosed to me in 2005 after a great deal of effort from me. The 2001 Executive Summary stated the following Amongst other things, it concluded that:
(a) “Patient care was clearly affected by the failures identified”;
(b) “The Directorate failed to take appropriate action when the allegations were made in a statement by Dr Pal”;
(c) “Although medical and nursing staff were concerned about the range of issues...no one voiced their concerns except Dr Pal which either demonstrated a general acceptance of the issues or staff felt unable to raise concerns”.

7. The GMC has consistently victimised me and details of this is available on request. The GMC is currently subject to a Judicial Review - our main argument being one of malicious intent to silence a whistleblower by repeatedly instigating vexatious complaints thereby affecting my livelihood which they have now done. The highlight of the GMC defence and the nub of their case in R Pal v GMC was " a typographical error made by me" and the fact that I read Stephen King books. Following on from that the recent case taken up by the GMC was of a "link" on a blog of a public document. Once judicial review papers were instigated against the GMC, the case was dropped and I was cleared. This though resulted in the loss of my job. This behaviour has been detailed in the submission to court by my solicitors. On each occasion, there has never been any concerns raised regarding my clinical work.

8. The issue has been raised at all forums - the results are as follows

a. Consultants responsible for Ward 87 and neglect of patients. Screened out by the GMC at Registrar's stage.
b. Complaint made to the NMC - no response despite follow ups for 2 years.
c. Complaint made to the Health Commission. No investigation done for four years. Referral apparently made by Labour MP Mark Fisher. The Health Commission could find no record. Mark Fisher has refused to respond to my emails. I believe the referral was never made by this Labour MP.
d. Health Ombudsman. She failed to read any of the documentation provided. She also failed to address the important issues in medical regulation and the risks to patient care in relation to doctors raising concerns. She refused to investigate the issues because no MP referred this case to her on time. In my view, there is a lax attitude to doctors who are whistleblowers. Tony Wright though did kindly make a referral to the Ombudsman. This decision is undergoing an internal review.
e. Despite a-d - no authority can stipulate what the death rate was on Ward 87 North Staffordshire NHS Trust. Infact, accurate death rate data was never kept. No wider data study was ever done. The Ward was shut in 2005 to avoid an investigation and inquiry and to ensure that no one else questioned these issues. I note that it is not compulsory to record the death rate of a ward or hospital.
f. The Coroner has been informed. He has stated that a whistleblower cannot report a death because he/she is not an interested part under the Coroner's Act.
g. I have no MP representation in the Midlands. This has been a continued problem. In addition, I have obtained all the evidence enclosed and it has taken me more than 8 years to do so. The Information Commissioner has been dealing with my requests over these years and will confirm that the documentation flow has been very slow. In (d) despite my efforts, the Ombudsman has in effect laid the blame at the whistleblowers door while no valid independent investigation has ever taken place by the Health Commission and the Ombudsman to date. It is my contention that most of the documentation is extensive - so much so that the salient features are not grasped by them.
h. To date there has been no broader data study on the impact of an severely under-resourced hospital on patient care. Only a minor handful of patients (1 weeks worth) has been considered with damning results. It is almost impossible for any doctor to obtain wider data yet this is expected by the authorities. All authorities have left the accountability issues on the shoulder of the whistleblower while failing to take any responsibility for investigating the serious issues of patient neglect.
i. The GMC, Department of Health and the Trust have all denied me a full copy of the 2001 report. The Information Commissioner recently ruled against the Trust in question for non compliance under the Data Protection Act.

There is therefore a catastrophic failure in the current system that cannot address justified concerns raised by a whistleblower ( without in effect shooting the messenger) thereby placing patients at risk. The vendetta developed by the General Medical Council is an example of the overall culture described by Professor Steve Bolsin within his report. The lax attitude of the authorities has in effect resulted in a assassination of my medical career. This was described by a number of whistleblowers both in the Shipman and Bristol Inquiries. It is clear that nothing has changed. The above case is an example to show that the system cannot effectively address concerns at all. Moreover, the recommendations provided in the Bristol and Shipman inquiries are currently ineffective. This should be addressed urgently.

For the above reasons, I would like to request an public inquiry into how the NHS dealt with justified concerns raised by whistleblower to ensure lessons are learned for the future. Recommendations and changes should be implemented so that doctors feel it is safe to whistleblow. I have copied this to Mr Tony Wright who I hope will recommend a public inquiry into this issue that is in the public interest. If this is not done and the current situation not improved, no junior doctor can ever effectively raise concerns. This inevitably will place patients at considerable risk.

I hope to hear from you.

Regards

Dr Rita Pal

Dr Rant has seen how the NHS deals with whistleblowers over the years. It is cold, it is brutal, and it is almost always fatal to the whistlblower's career (and often their health).

Dr Rant recommends that everyone read the BMJ's Everything you always wanted to know about whistleblowing but were afraid to ask.