Whistleblowing policies fail to protect doctors who speak out about patient safety says the doctor who highlighted problems at the clinic which missed Baby P’s serious injuries.
A report published this week said Dr Kim Holt, who warned that a lack of resources was putting patients at risk at St Ann’s Hospital in Tottenham, north London, should have been protected by her employer’s whistleblowing policy.
But Holt was removed from her job after she and three other doctors wrote to their employers, Great Ormond Street Hospital Trust (GOSH), in April 2006 warning of a catalogue of problems. A year later a locum working in the clinic failed to diagnose that Baby Peter had a broken back.
The doctors’ concerns included staff shortages, an excessive workload, a chaotic appointments system, poor record keeping and poor communication.
Holt said trust bosses then tried to force her to quit and gag her with a £120,000 compromise agreement, which she refused to accept because she wanted her job back.
The report says the doctors’ concerns were “genuinely and reasonably held”. It agreed that problems with individual consultants’ workload were significant; relationships between management and clinicians were poor; there was a “hostile environment”; there were communication difficulties and evidence that training, supervision and support given to junior doctors was inadequate.
These issues “could have been managed more effectively in the interests of patient care”.
The report says that the issue of Holt’s return to work had not been managed effectively, given the provisions of the GOSH whistleblowing policy.
It adds: “She is entitled to feel aggrieved when, having raised patient safety and other concerns she later finds herself in the position where she is told she cannot return to her job.”
But the report also says the trust made genuine attempts to address the doctors’ allegations and concluded that there was no evidence that Holt was bullied or “targeted” for raising her concerns.
Dr Holt, who is currently working on secondment at GOSH, after being suspended for 18 months, said: “Protection for whistleblowers is not really there. There is a culture at the moment is that if a trust makes a mistake management think they can buy people off. That is against the sprit of the whistleblowing legislation.
“I believe I was bullied and witnesses who gave statements to the inquiry confirmed this. I have had two years of hell.”
A BMA survey earlier this year found that three quarters of hospital doctors have had concerns about issues relating to patient safety, malpractice or bullying over the course of their careers. Seven in ten had raised the issues at their trust, but their experiences had often been negative, with their concerns often being ignored or careers threatened.
Dr Mark Porter, chair of the BMA’s consultants committee, said Holt’s case showed how hard it could be for doctors to raise their concerns. “The NHS and all its constituent organisations must get better at recognising the invaluable service to patients performed by those who raise well-founded concerns about safety and quality.”
Stephen Campion, HCSA chief executive, warned that current cuts and staff shortages would result in more doctors expressing concerns about the safety of their services.
“What Dr Holt is saying mirrors what many consultants up and down the country are saying about their own trusts. She is not the only consultant to have reported concerns to their trusts only to find that those concerns have been not dealt with. She should be congratulated for doing her duty.”
A spokesman for Great Ormond Street Hospital said: “The compromise agreement was about employment and took place before any specific concerns were raised by her around child protection. As soon as such concerns were raised, the process was halted immediately, and an independent investigation commissioned by the trust to see that these were addressed.
“It is therefore absolutely clear from the sequence of events that the compromise agreement could not have been an attempt to gag her over those concerns.”
Read a guide to whistleblowing.
Tags: Baby P, Suspended, Whistleblowing
