Presentation to BSI on behalf of PCAW

Presentation by Gary Walker for

A whistleblowing case study…

Gary WalkerMBA, DipM, GradDipLawFormer NHS Trust CEO &

Whistleblower


Career summary

• Member Board Of Trustees, Public Concern at Work• Director, Modern Leader Ltd• Chief Executive, United Lincolnshire Hospitals NHS Trust

• Turnaround of finances. clinical safety and targets• Chief Executive Surrey and Sussex Healthcare NHS Trust

• Turnaround of £36m overspend and failure on all targets• Chief Operating Officer, Quo Health Ltd• Director of Service Delivery, Brighton and Sussex University

Hospital• Turnaround of biggest waiting list manipulation - 2000

patients • Deputy Director of Clinical Services, Norwich University Hospital

NHS Trust• Head of Performance, Department of Health

• Performance management of 21 NHS Trusts

Gary Walker, MBA, DipM, GradDipLawFormer NHS Trust CEO & Whistleblower


2000 to 2006

- 8 CEOs- £27million accumulated deficit- Failed most targets- Healthcare commission report on bullying culture- Waiting list manipulation- Clinical safety issues: Vascular, Maternity, A&E, and more…

2006 to 2009

Repaid historical debtRecurrent balance, Waiting times halvedTargets such as HAIs amongst lowest in UK (yet still missing the “target”)Governance systems replacedClinical Safety Issues: e.g. Vascular rota saving 50 lives paStaffing increased by 400+

United Lincolnshire Hospitals NHS Trust (ULHT)£320m turnover, 8,000 staff, 3 DGH sites, 3rd worst funded under Payment by Results, 3rd most rural NHS Acute Trust in England

2009-2013

- Several adverse CQC reports- £15m Deficit returns in 2011- Targets missed Reviewed by Sir Bruce Keogh as part of 14 Trust’s with High Mortality Rates- Staffing levels too low- Highest rate of never events- Special measures

Arriv

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Forc

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ut


Dec 2006 Dec 2007 Dec 2008



“…I tried to explain that we are still in escalation and the situation with A&E and that we had cancelled electives this week (32 patients) owing to increased emergency admissions and was told that if we can't manage A&E we can't run a hospital!...”

From: Director of Operations (ULHT)Sent: 18 February 2009 18:43To: David Bowles; Gary WalkerSubject: Update for Chairman IN CONFIDENCE

Telephone call with SHA CEO HakinImportance: High





David BowlesChairman

ULHT 2006-2009


Extract…

“This type of behaviour threatens patient safety and must be stopped.

“I make this protected disclosure in the hope that you will be able to address the issues I raise.

“I assume this Department of Health has a policy on whistleblowing and would therefore like this letter to be considered in that context and not freely copied to the SHA or local PCT”.



After 5 month investigation* costing £70,000, Gary Walker is sacked on what witnesses later

describe as “fabricated” evidence.

* Throughout this period I had no idea of the charges against me

Transcripts are altered by the NHS to remove all reference to Protected Disclosures**

**Ongoing police investigation into MIPO



Feb 2010 to November 2011


“SUPERGAG” – Cannot disclose its existence and specifically cannot disclose the 21 protected disclosures


Feb 2013


DAC Beachcroft Solicitors12 February 2013





http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/publications/?type=&session=2&sort=false&inquiry=823

http://www.parliament.uk/healthcom > select Publications > 2012/13 > Mid Staffordshire

http://www.parliament.uk/healthcom

http://www.parliament.uk/healthcom



Culture of Cover-ups

£28m and 1000 compromise deals

“There is simply no way of knowing how many of these special severance payments have been made

across the public sector – or whether the compromise agreements have been used to ‘gag’

employees. To date neither the Treasury nor individual departments have monitored this

adequately.”

The Public Accounts Committee


Culture of Cover-ups

£28m and 1000 compromise deals

“We heard evidence of shocking examples of using taxpayers’ money to ‘pay-off’ individuals who have flagged up concerns about patient or child safety”

The Public Accounts Committee


Ray Law, 60Avoidable death 2010

Surgeon’s memo: “death of an otherwise healthy patient”

3rd prostatectomy on the operating list


…targets were exerting “enormous pressure”…

”…work with you to identify what additional resources we need to provide a safe service in the future”

garywalkeruk

One of six incidents including WL manipulation reported in 2010Inspection didn’t review any incident

Inquest 2014 - Expert said Mr Law “would have survived”Trust investigated. Did not die because of targets.Surgeon said: "It was not normal for me to perform three operations in a day. I haven't done it since.”Narrative verdict“Lessons learned”


“We still have too many patients dying in our hospitals when their relatives were expecting them to come home.”

Sir Bruce KeoghNHS Medical Director

Channel 4 News11 September 2013

NHS Whistleblower (sample in public domain) Role Issues raised Employer Outcome

Tracy Boylin Director (HR) Misconduct / Fraud The Christie Sacked

David Drew Doctor Patient safety Walsall Healthcare Sacked

Kim Holt Doctor Patient safety GOSH Kept job*

Raj Mattu Doctor Patient safety Coventry and Warwickshire Sacked

Edwin Jesudason Doctor Patient safety Alderhey Forced to resign

John Watkinson Chief Executive Patient safety Royal Cornwall Sacked

Jennie Fecitt Nurse Patient safety NHS Manchester Sacked

Gary Walker Chief Executive Patient safety United Lincolnshire Hospitals Sacked

Ramon Niekrash Doctor Patient safety South London Healthcare Kept job***

Helene Donnelly Nurse Patient safety Mid Staffordshire Forced to move job

Narinder Kapur Doctor Patient safety Addenbrookes Sacked

Margaret Haywood Nurse Patient safety Brighton and Sussex Struck Off

Loo Blackburn Nurse Patient safety Oxford GP practice Forced to move Job

Shiban Ahmed Doctor Patient safety Alderhey Kept job****

Steve Bolsin Doctor Patient safety Bristol Royal Infirmary Forced to leave UK

Sharmila Chowdhury Manager Misconduct / Fraud Ealing Hospitals Sacked

Mike Chester Doctor Patient safety Royal Liverpool Sacked

Kate Clarke Administrator Patient safety Dudley Hospitals Sacked

David Ore Security Patient safety Dudley Hospitals Sacked/Redund

* Suspended 4yrs, reinstated, service transferred ** Ongoing – Jeremy Hunt intervened *** Left with £170,000 costs **** Left with £20,000 costs, suspended twice since, and still suspended on false allegations of mental illness.

24. Refuse to disclose documents. No one cares about DPA and FOI

23. Accuse a whistleblowerof not raising concerns earlyenough

22. Delay as much as possible to push up the legal costs for the whistleblower

21. Ignore PAC and other inquiries

20. Pretend that the Public Interest Disclosure Act offers adequate protection

19. If externalinvestigation, the trust can stillorganise and pay for it, recruitthe panel

18. Arrange an “in house”investigation.

17. Throw public money at anemployment tribunal appeals (unlimited budget)

16. Throw public money at anemployment tribunal (unlimited budget)

15. Make vexatious complaints toa professional regulatory body

14. Publicly humiliate the whistleblower

13. Rely on the cowardice and apathy of the Department ofHealth

12. Make friends with the coroner to avoid scrutiny

11. Appoint consultants to rubbish the whistleblower’s claims.

10. Threaten to sue the whistleblower

9. Apply to the Treasury forpublic money to pay off andgag the whistleblower

8.Misuse the code of conduct for managers

7. Claim it’s an employment conflict

6. Allege mental health issues (very popular)

5. Threaten whistleblowers and themedia with libel suits

4. Threaten reprisalsagainst colleagues whosupport a whistleblower

3. Repeatedly ignore, deny or pretend to address the concerns

2. Allege actual orinvented misdemeanours

1. Inflict subtle sanctions beyond legal protection

PETER GOODERHAM (1965-2011) Ways to skin a Whistleblower (not exhaustive) (adapted by Gary Walker)


Conclusion and what next?

• For the NHS• Change the “culture of fear”*

• For all organisations• Adopt the PCAW Commission Code of Practice (Private sector leading the way)• EVERYONE has a moral and ethical duty to raise concerns about wrongdoing and

safety• Raise them anonymously if you fear consequences• Raise them with regulators• Learn from the employers that welcome concerns being raised• Whistleblowing is the final option – choose it understanding the consequences

• For Regulators• Performance manage those you regulate using the Code of Practice

• For the Government• Strengthen the law• Enforce the Code of Practice through Tribunals

* DH commissioned in 2007 three American organisations – the Institute of Healthcare Improvement (IHI), the Joint Commission International (JCI) and Rand Corporation – which were only published in 2010. See also: Health Select Committee report on Patient Safety, 3 July 2009, and BMJ 2012;345:e8239, Lintern S. NHS chief executives Highlight “climate of fear.” Health Serv J 2012; Published online 22 November and many more…

Leadership & Management

Presentation to BSI on behalf of PCAW