Millions spent on doctor ‘gagging orders’ by NHS, investigation finds
A combination of pay-offs and fear is preventing whistleblowers going public with criticisms over care
Hospital doctors who quit their jobs are being routinely forced to sign “gagging orders” despite legislation designed to protect NHS whistleblowers, it is revealed today. Millions of pounds of taxpayers’ money are being spent on contracts that deter doctors from speaking out about incompetence and mistakes in patient care.
Nearly 90 per cent of severance agreements hammered out between NHS trusts and departing doctors contain confidentiality clauses.
A joint investigation by the Bureau of Investigative Journalism and Channel 4 News has discovered that at least 170 doctors in England and Wales agreed such a settlement with the trust employing them – backed up by pay-offs totalling more than £3m.
Fifty-five of the 64 contracts supplied by the trusts to the investigation team contained gagging clauses. The agreements have to be approved by the Treasury. The bureau discovered that a further 19 NHS staff who decided to go to employment tribunals after blowing the whistle on hospital standards eventually settled before their allegations were made public.
The widespread use of “gagging orders” against senior NHS staff who could raise patient safety concerns will intensify the doubts over the protection given to whistleblowers.
Campaign groups claim that NHS managers sometimes resort to intimidatory tactics to deter medics from coming forward, while others that break cover can face years of expense and uncertainty before their cases reach court. The result, they say, is that doctors accept the gagging clauses in order to protect their careers and avoid legal wrangling.
Mike Parker, of the Royal College of Surgeons, said: “The trusts find something upon which they can influence this individual and hold them virtually to ransom, and say: ‘You speak up and this will happen.’ It’s effectively a form of bullying, if you like, but we do hear about this sort of thing happening.”
Using Freedom of Information (FoI) requests, it emerged that 71 NHS trusts had entered into these agreements with a total of 170 doctors, although the true figure could be higher, as many failed to respond.
Twenty-two of the agreements were signed at the South London and Maudsley NHS Foundation Trust.
Forty spent a total of just over £3m on the agreements. However, a further 31 trusts simply refused to disclose the size of the payments. Further FoI requests discovered that another 19 health whistleblowers decided to take their cases to court, but abandoned them after signing so-called compromise agreements with employers.
David Bowles, the former chairman of an NHS Trust, told Channel 4 that he believed their use was “endemic”. “You shouldn’t be at a position of needing a compromise agreement with a whistleblower. You should never get to that point in the first place. You should have listened to the concerns and you should have managed them in accordance with legislation and indeed the NHS’s own published code.”
Worries over gagging orders in the NHS were underlined by the recent disclosure that Kim Holt, a pediatrician, repeatedly raised the alarm about children’s services at St Ann’s Hospital in Haringey, north London, more than year before the death of Baby Peter in 2007. Her employer, Great Ormond Street Hospital, reportedly offered her £120,000 to stay silent but she refused. The hospital denied it was an attempt to gag her.
Andrew Lansley, the Health Secretary, has acknowledged that a scandal of care at Mid-Staffordshire hospital went undetected because whistleblowers’ warnings went unheeded.
Whistleblowers gained full protection from dismissal or victimisation under the Public Interest Disclosure Act (PIDA) of 1999, which was supported by unions and all political parties. It covers employees in both the public and private sectors.
It followed a succession of cases where whistleblowers had been ignored, including the problems at Bristol Royal Infirmary, where 29 babies and children died after heart surgery. In opposition, the Conservatives said they would give NHS staff the contractual right to report errors and failings to the health regulator without fear of reprisal.
Shonali Routray, a lawyer at the charity Public Concern at Work, stressed last night that the law protected whistleblowers even if they had signed confidentiality clauses. But she added: “They have a real fear factor and discourage people from raising concerns. The worry is the person who has signed the agreement feels under pressure, or vulnerable, or do not understand their options.”
A spokeswoman for the Department of Health said last night: “The Health Secretary has made it clear that patient safety should be at the heart of the NHS and that the improvement of whistleblowing policies is a key part of this … organisations across the NHS will also need to be clear that whistleblowing is not something that should be regarded as letting down your organisation.”
Dr Kim Holt: ‘Baby P hospital offered £120,000 for me to be quiet’
A consultant paediatrician who told the Baby P inquiry that her unit had inadequate staffing levels was offered £120,000 to keep quiet, she has revealed. Dr Kim Holt, left, repeatedly told her management she believed children’s services at St Ann’s Hospital in north London were unsafe and first approached them more than a year before Baby P’s death. Her employer, Great Ormond Street Hospital, was willing to give her £120,000 to stop her talking publicly about her concerns and to sign a document agreeing they had been addressed.
Baby P, whose real name was Peter Connelly, died in August 2007 two days after being taken to St Ann’s where a locum failed to spot his back was broken. Dr Holt and three other consultants had written a letter to management the previous year warning the clinic was “falling apart” and risking patients’ lives. She was offered the money after Baby P’s death.
“I was not going to be gagged,” she said. “I’ve done nothing wrong. I raised concerns: it was obvious the place was a mess. I refused to retract my concerns. They wanted me to stay quiet.
Gagging orders are wrong and shouldn’t happen. I don’t think they should be happening to anyone in the NHS. There should be much more transparency.
“It’s not the done thing to challenge management. That’s basically it,” she added. “The pattern seems to be you make a stand and life is made hell. Most people end up either becoming sick or they take money to end it all. The money is nearly always associated with a gag – what this is about is hiding their inefficiency.”
Dr Holt was put on special leave after complaining. Lynne Featherstone, the minister for Women, is among those who have backed her, saying: “I have wondered whether the management would ever be brought to account.”
A spokesman for the hospital denied there had been bullying or that Dr Holt had been targeted for whistleblowing. He said it was common practice for gagging clauses to be inserted into “compromise agreements”.
NHS doctor hounded out of her £90,000-a-year job because colleagues were bitter over maternity leave
A high-flying doctor was subjected to a catalogue of lies in a campaign to hound her out of her job after she took maternity leave, an employment tribunal heard. When Dr Eva Michalak left work to have a baby boy, she became the first consultant physician at Pontefract General Infirmary to take maternity leave.
But while she was away the 51-year-old was subjected to a bitter behind-the-scenes campaign by colleagues who created a list of spurious allegations against her, including claims she had bullied junior doctors.
A locum doctor was appointed to cover Polish Dr Michalak’s work and her nine colleagues were all given a pay rise to cover the extra responsibilities. But in reality the extra workload was low, the hearing in Leeds was told.
When Dr Michalak returned after having her son, now seven, she found out about the pay increase and asked if she could be paid more too. Her request was refused and she complained of sex discrimination. It was then that the ‘campaign to oust her intensified, culminating in her suspension and dismissal in 2008, the panel heard.
But her claims of sex and race discrimination were upheld today as senior staff from Mid Yorkshire Hospitals NHS Trust were blasted for inventing a string of lies.
Today Dr Michalak, who started work at the hospital in 2002, said: ‘I suffered years of psychological abuse. ‘They basically hounded me because I had a baby. They destroyed my life, my health and my career. ‘The last seven years have been a living hell. Their dishonesty was staggering. It was frightening and sinister how these people could abuse their positions and harass and bully me. ‘I was so stressed I was crying on my way to work. I have been profoundly traumatised by the conduct of fellow doctors.’
The consultant, who lives in Leeds, was represented during the hearing by her husband Julian, who quit his job as a scientific researcher in order to support his wife. He said: ‘Eva’s professional reputation has been destroyed.If this hadn’t happened we would have had more children but the stress, cost and time has cost us everything.’
Polish-trained Dr Michalak, who has worked at other hospitals in the UK, began work on the Medical Admissions Ward in 2002, earning £90,000 a year. She became pregnant the same year and the tribunal heard it was while she was still working that the campaign began.
At one secret meeting, the tribunal was told, head of department Dr Colin White and Val Baron, general manager in medicine at the hospital, agreed they would be seen to support her while actually trying to end her employment.
Dr Michalak, who was named best student at medical school in Lodz, left work in May 2003. When she returned in November, the row over her pay increase sparked spurious complaints about her bullying junior doctors. Eleven junior doctors were interviewed, with eight allegedly recording complaints.
Shortly after being appointed medical director of the trust, Dr David Dawson launched an investigation and suspended Dr Michalak in January 2006. Despite an independently appointed doctor finding that just one allegation of bullying had been lodged – and later revoked – further ‘evidence’ was gathered against the consultant and she was dismissed in July 2008.
In its judgement the tribunal panel said Dr Dawson had ‘manipulated and engineered’ the situation, describing him as a ‘self-acknowledged liar’.
Summarising how resentment started soon after Dr Michalak’s appointment the panel said: ‘We find that discontent was created amongst her colleagues by reason of the fact that, having just been appointed to this position, she became pregnant with the consequence that they were going to have to resume carrying out ward rounds on the MAU. ‘It is our finding that then sowed the seeds as to what thereafter was to happen.’
After the case Angie Watson, chief operating officer at the trust, said: ‘We have unreservedly apologised to Dr Michalak and I would like to take this opportunity to reiterate that apology in public. ‘We will ensure that mistakes of the past will not be repeated in the future. ‘
A decision on damages was not made today.
17,000 immigrants told to leave Britain won right to stay on appeal after government failed to attend court hearings
Thousands of rejected immigrants are being allowed to stay in the UK because the Home Office is not bothering to defend the decision in the appeal courts. Immigrants whose applications to stay in the UK have been rejected are routinely winning appeals against the decisions – simply because no Home Office official has turned up at court to defend the rejection.
The number of immigrants winning leave to remain in Britain at a hearing when no official was present jumped by almost 50 per cent last year. More than 17,000 won appeals in such cases – a figure which stood at less than 1,500 just five years ago. In some instances the Home Office has later decided to counter-appeal the decision – a procedure that comes at a significant cost to the taxpayer.
Keith Vaz, chairman of the Home Affairs Select Committee, told the Times: ‘This is a shocking state of affairs. ‘It represents a waste of money. ‘I think in some cases they cannot be bothered to turn up because they look at the papers and know they are not going to win. ‘In other cases it is sheer inefficiency. There seems to be an attitude that they do not even care what the result is going to be.’
In the absence of home office officials, migrants have won appeals against refused asylum applications, deportation orders and refusals of entry to the UK. Last year 17,473 migrants won their appeals at hearings at which the Home Office was not represented by an official. A further 23,997 won appeals when the Home Office was represented, a parliamentary written answer revealed.
A migrant is far more likely to win an appeal if there is no official present to defend decisions. But the UK Border agency is struggling to cope with a massive rise in the number of appeals to Asylum and Immigration Tribunals over the past five years and cannot spare the staff to attend all contentious hearings.
Richard Simcox, of the Public and Commercial Services Union, said the department did not have enough staff to cope with the number of appeals. ‘It will get worse if there are cuts in staff,’ he told the Times. ‘It is essential that officials are given the time to carry out their roles properly to ensure appeal cases are handled effectively and fairly.’
The Immigration Law Practitioners Association said that it was in the interests of justice that both sides be represented. It said that the Home Office frequently sought to appeal cases after failing to field a presenting officer, which it described as an extraordinarily inefficient use of time and resources.
Sophie Barrett-Brown, its chairwoman, told the Times: ‘It is difficult to know why presenting officers do not turn up. ‘I have had cases where the original decision was indefensible and there has been an official present. ‘There are other cases where there are quite complex arguments that should be argued in front of a judge and presenting officers are not there. ‘Often it is left to the judge to raise the issues.’
Immigration minister Damian Green said that he had launched an initiative aimed at improving the system.
Two weeks ago the government announced that a permanent annual limit on immigration would be imposed from next April. Home Secretary Theresa May said an annual limit on non-EU economic migration was key to bringing net migration back into the tens of thousands instead of hundreds of thousands.
But critics claim the cap would not achieve this because the government has no control over how many migrants from Eastern European EU countries come to the UK.
Half of British men steer clear of helping children in trouble for fear of being branded paedophiles
Children have actually drowned because of such fears
Nearly half of men would be too scared to help a child in need because they fear being branded a paedophile, a survey has found. Forty-four per cent would be wary of coming to the aid of youngsters in their neighbourhood in case they were suspected of attempting to abduct them. And almost a third of both men and women would be reluctant to help because they fear the child would be abusive.
Such fears are behind a weakening of community spirit that has left children increasingly isolated, and more likely to stay indoors, according to the findings.
The children’s charity Play England, which commissioned the survey, warned that youngsters were missing out on opportunities to play outside their homes. Children typically have just six friends within walking distance of where they live – down from 14 a generation ago – the ICM survey of 2,000 adults and children found. As well as having fewer friends close by, nearly half of youngsters are not allowed to play outside unless supervised by an adult. And while 90 per cent of adults played regularly in the street as children, 30 per cent of today’s youngsters aged seven to 14 never get the chance.
Play England said youngsters grow up happier and healthier if they are able to play safely outside. But 21st century children tend to be cooped up indoors amid a lack of neighbourly concern, misplaced safety fears and, in some cases, poor traffic management.
‘Children are experiencing a very different childhood to previous generations, with freedom curtailed, and safety concerns exacerbated,’ the report said.
Some parents were worried their neighbours would ‘judge’ them if they left their children to play in the street unsupervised. Others felt their children might ‘annoy’ neighbours, for example by playing ball games or using chalk to draw on the pavement. However, these activities were considered acceptable a generation ago, according to the research.
Meanwhile, 38 per cent of parents with under-fives thought it was ‘common’ for children to be abducted by strangers while playing outside.
There was also evidence that adult worries were being picked up by children, with 17 per cent concerned about being followed or taken by strangers – a danger ranked above all others.
Adrian Voce, director of Play England, said: ‘More than half the parents we spoke to told us they only felt confident for their children to play outside if other children were playing out too. ‘The danger is that these anxieties are perpetuating a cycle of children being denied important opportunities to enjoy their childhood and develop healthy, active lifestyles.
‘This is storing up huge problems for the future.’
The survey was released ahead of tomorrow’s Playday 2010, which aims to get thousands of children across the country out to play through a series of locally-organised events.
Predictive accuracy: Proof that the Sun controls our weather and climate
Generating accurate predictions is the ultimate test of a scientific theory. British astrophysicist Piers Corbyn shows that solar-based theory does so. The Warmists have never predicted anything accurately yet. Britain’s Met office tried but failed so badly that they now make forecasts only a few days ahead
When I think of all the evidence I have been presented with over the past several years regarding the main driver of our climate, one man stands tall. That would be Piers Corbyn, founder of WeatherAction.com in the UK. He does long range weather and climate predictions and his accuracy is amazing, especially for the extreme events all based on the Sun.
I had seen his forecasts on the web but I had my first chance to talk with him in person at the 2008 International Conference on Climate Change in New York put on by the Heartland Institute. It was March and Piers had saved his first public trial forecast in the USA for the conference.
The prediction was for a record Midwest snowfall in the middle of March, then 2 or 3 weeks away. There was nothing about it from the national weather people. This forecast was way out there. What was more the data for the prediction was available more than a month, as much as 3 months in advance and it was based on the Sun! It was such an extreme prediction that it made eyeballs roll.
For those of you who recall that storm, you know it came true. Did it ever! Since then I have observed the outcomes of the predictions Piers has made and he has been amazing in his performance. There have been a few misses but his success is around 85% around the world and a bit higher in the USA. He regularly posts on You Tube, so you can see his predictions come true several times during the year. Let’s get to the discussion:
After 13 years of Labour Party rule, one in three primary pupils are still failing the 3Rs in Britain
More than a third of children left primary school this summer struggling to read, write and add up – despite Labour’s £2.5billion drive to raise standards in the three Rs.
The Government yesterday pledged a return to traditional lessons in English and maths after warning that achievement had ‘flatlined’ for much of Labour’s time in office. This will include a fresh focus on arithmetic and the ‘synthetic phonics’ reading scheme.
About 200,000 11-year-olds – 35 per cent – failed to reach the expected standard for their age in reading, writing and maths, national SATs tests results showed yesterday.
It means they start secondary school next month unable to grasp the point of a story, write extended sentences using commas or add, subtract, multiply and divide in their heads.
Reading standards slipped for the second year running, with 84 per cent making the grade this summer compared with 86 per cent last year and 87 per cent in 2008.
While results for writing improved, boys fell further behind girls, which will raise fears that many will fail to cope at secondary school.
Results for English overall – reading and writing combined – showed a slight improvement on last year, with 81 per cent of 11-year-olds reaching the required ‘level four’ grade against 80 per cent last year. Maths standards also rose, edging up from 80 per cent to 81 per cent.
But just 65 per cent of 11-year-olds reached ‘level four’ in each of reading,writing and maths, the results from the Department for Education showed.
Ofsted earlier this year estimated the cost of delivering Labour’s literacy and numeracy programmes since 1998 at £4.5billion across the education system – £2.5billion for primary schools and £2billion for secondary.
Despite former prime minister Tony Blair’s ‘education, education, education’ mantra, inspectors said progress had been ‘too slow’, particularly over the last four years.
Ministers are concerned that standards have barely risen in recent years. Schools Minister Nick Gibb said yesterday: ‘We need to ensure Government gives teachers the support they need to get the basics right.
‘Getting the fundamentals right – being able to read and write and having a solid foundation in maths – is crucial to a child’s success in secondary education and throughout their adult life. ‘This is why the coalition Government is committed to promoting the use of systematic synthetic phonics in primary schools and to ensuring that pupils are fluent in arithmetic and basic maths by the time they move to secondary school.’
Ministers will launch a review of the curriculum in the autumn and outline plans for boosting the status of traditional synthetic phonics, where pupils learn the 44 letter sounds of English and how they blend together. Other systems of phonics involve learning the sounds that make up whole words first, then splitting them up.
Plans for a new reading test for six-year-olds to ensure those who are struggling are identified early will also be unveiled.
Yesterday’s results came with controversy after 26 per cent of primary schools – 4,005 – refused to carry out the tests this spring as part of a campaign of industrial Government to scrap SATs. About 155,000 children were caught up in the boycott.
The Government was unable to publish authority-wide results for 20 local authorities because too few pupils took SATs for scores to be valid. Parents will be forced to rely on results in teachers’ own assessments when assessing schools’ performance.
Education secretary Michael Gove, who has pledged the tests will go ahead in 2011, is heading for a showdown with unions next summer if, as expected, the boycott gathers pace.
Results of teacher assessments of pupils aged 14, also published yesterday, showed 79 per cent achieving the expected standard in English – up two percentage points on 2009. Eighty per cent hit the target in maths – up one point – and 80 per cent in science, up from 78 per cent.
Shadow schools minister Vernon Coaker said English and maths results were ‘encouraging’ and ‘the culmination of a transformation in school standards thanks to Labour’s investment and reforms’. But he added: ‘There is obviously more to do, particularly in reading.’