Re: Whistleblower was unfairly dismissed in case lasting 12 years, tribunal rules
The case of Dr Raj Mattu raises disturbing issues at the highest levels of the NHS. He was suspended by University Hospitals Coventry and Warwickshire NHS Trust in February 2002 on allegations of bullying, 5 months after he spoke to the BBC about the death of a patient in an over-crowded bay at Walsgrave Hospital, Coventry1. I worked as a Neurology SpR at the Walsgrave between January-December 2000 and it was “the most stressful period of my career”2. I was appalled at the policy of putting a 5th bed into 4 bedded bay (so called ‘5 in 4’) in order that the hospital could never be deemed full. I wrote to the Chief Executive, David Loughton in May 2000 and described it to him as “an inherently dangerous system…(which) would certainly contravene Health and Safety Regulations”. A copy of my letter went to the Director of the Medical Division who confirmed (25/5/00) that “I do not believe there is anybody in the Trust that does not share your concerns…. (and) your very questions were put to Mr Loughton” (at the Division of Medicine meeting). After 6 months of multiple letters with no reasonable response, I (and 9 other junior doctors) wrote again to Mr Loughton to tell him that we were forwarding our concerns to the Royal College of Physicians and our medical defence organisations. As a consequence, we were told in January 2001 that the Department of Health (DH) had told them that ‘5 in 4 ‘ ‘must be phased out”.
Unlike Dr Mattu, I had no consequence for raising legitimate concerns - quite the opposite, I was congratulated by my external assessor for doing so at my annual trainees appraisal. I remain mystified as to why Dr Mattu has faced years of mistreatment and ‘detriment’, and the effective end of his career at a cost for legal expenses alone of around £6 million. His successful employment tribunal will likely turn out to be the most expensive in NHS history.
Although Walsgrave in 2000 for me was a baptism of fire, it made me as a physician. I now use my experience to assist in the training of junior doctors on how to raise concerns and keep your job. My advice could be summarised - keep good records if you know something is wrong(I still have all 21 pages of correspondence between myself, Loughton and senior members of the executive team and Royal College between May 2000 and February 2001 which were shared with Mattu’s legal team and the BBC in 20062 and were supplied to the BMJ for the purposes of this article), work in a team (I had no idea that writing a joint letter from 10 junior doctors would be so powerful), never ever give up and pray you don’t get treated like Mattu.
However the most disturbing aspect of the Mattu case is that those responsible for the ‘5 in 4’ policy have faced no serious public scrutiny. David Loughton was described by MPs in 2001 as “impossible to reason with the man, and that he was arrogant and dismissive”4. Yet what happened to him? He resigned and was then appointed as the Chief Executive of New Cross Hospital in Wolverhampton. Clearly Mr Loughton must have turned over a new leaf since moving to New Cross, as he was awarded a CBE for services to the NHS. The fact remains that neither Loughton, nor any civil servant or government minister, such as Alan Milburn, have faced any public questioning over why ‘5 in 4’ was allowed for so long. I suspect that David Loughton may well have suffered from what is known, in other contexts, as ‘dual loyalty’5- a conflict of interest between achieving a government target and ensuring safe patient care. Given the millions of pounds and thousands of words that have been spent over patient safety, medical leadership and whistleblowing over the years, we need to know if such time and money is well spent. How can we have any confidence that staff concerns such as Dr Mattu’s will be dealt with any differently the next time, unless the most senior people such as Loughton and Milburn are held to account for their actions? The BBC have been trying to get the answer to this since 2006, but Freedom of Information requests have been turned down on the grounds of “to protect the workings of government” 2. It appears that even the Department of Health suffers from ‘dual loyalty’- the department exists to serve patients and taxpayers first, ahead of “the workings of government”. The very fact that rather than settling Dr Mattu’s case, the Trust and the Department of Health are looking to appeal his tribunal judgement speaks volumes as to what their true interests are.
1. Whistleblower was unfairly dismissed in case lasting 12 years, tribunal rules
BMJ 2014;348:g2881
Rapid Response:
Re: Whistleblower was unfairly dismissed in case lasting 12 years, tribunal rules
The case of Dr Raj Mattu raises disturbing issues at the highest levels of the NHS. He was suspended by University Hospitals Coventry and Warwickshire NHS Trust in February 2002 on allegations of bullying, 5 months after he spoke to the BBC about the death of a patient in an over-crowded bay at Walsgrave Hospital, Coventry1. I worked as a Neurology SpR at the Walsgrave between January-December 2000 and it was “the most stressful period of my career”2. I was appalled at the policy of putting a 5th bed into 4 bedded bay (so called ‘5 in 4’) in order that the hospital could never be deemed full. I wrote to the Chief Executive, David Loughton in May 2000 and described it to him as “an inherently dangerous system…(which) would certainly contravene Health and Safety Regulations”. A copy of my letter went to the Director of the Medical Division who confirmed (25/5/00) that “I do not believe there is anybody in the Trust that does not share your concerns…. (and) your very questions were put to Mr Loughton” (at the Division of Medicine meeting). After 6 months of multiple letters with no reasonable response, I (and 9 other junior doctors) wrote again to Mr Loughton to tell him that we were forwarding our concerns to the Royal College of Physicians and our medical defence organisations. As a consequence, we were told in January 2001 that the Department of Health (DH) had told them that ‘5 in 4 ‘ ‘must be phased out”.
Unlike Dr Mattu, I had no consequence for raising legitimate concerns - quite the opposite, I was congratulated by my external assessor for doing so at my annual trainees appraisal. I remain mystified as to why Dr Mattu has faced years of mistreatment and ‘detriment’, and the effective end of his career at a cost for legal expenses alone of around £6 million. His successful employment tribunal will likely turn out to be the most expensive in NHS history.
Although Walsgrave in 2000 for me was a baptism of fire, it made me as a physician. I now use my experience to assist in the training of junior doctors on how to raise concerns and keep your job. My advice could be summarised - keep good records if you know something is wrong(I still have all 21 pages of correspondence between myself, Loughton and senior members of the executive team and Royal College between May 2000 and February 2001 which were shared with Mattu’s legal team and the BBC in 20062 and were supplied to the BMJ for the purposes of this article), work in a team (I had no idea that writing a joint letter from 10 junior doctors would be so powerful), never ever give up and pray you don’t get treated like Mattu.
However the most disturbing aspect of the Mattu case is that those responsible for the ‘5 in 4’ policy have faced no serious public scrutiny. David Loughton was described by MPs in 2001 as “impossible to reason with the man, and that he was arrogant and dismissive”4. Yet what happened to him? He resigned and was then appointed as the Chief Executive of New Cross Hospital in Wolverhampton. Clearly Mr Loughton must have turned over a new leaf since moving to New Cross, as he was awarded a CBE for services to the NHS. The fact remains that neither Loughton, nor any civil servant or government minister, such as Alan Milburn, have faced any public questioning over why ‘5 in 4’ was allowed for so long. I suspect that David Loughton may well have suffered from what is known, in other contexts, as ‘dual loyalty’5- a conflict of interest between achieving a government target and ensuring safe patient care. Given the millions of pounds and thousands of words that have been spent over patient safety, medical leadership and whistleblowing over the years, we need to know if such time and money is well spent. How can we have any confidence that staff concerns such as Dr Mattu’s will be dealt with any differently the next time, unless the most senior people such as Loughton and Milburn are held to account for their actions? The BBC have been trying to get the answer to this since 2006, but Freedom of Information requests have been turned down on the grounds of “to protect the workings of government” 2. It appears that even the Department of Health suffers from ‘dual loyalty’- the department exists to serve patients and taxpayers first, ahead of “the workings of government”. The very fact that rather than settling Dr Mattu’s case, the Trust and the Department of Health are looking to appeal his tribunal judgement speaks volumes as to what their true interests are.
1. Whistleblower was unfairly dismissed in case lasting 12 years, tribunal rules
BMJ 2014;348:g2881
http://www.bmj.com/content/348/bmj.g2881
2. Crowded wards warnings ‘ignored’. BBC Midlands Today, 19th December 2006
http://news.bbc.co.uk/1/hi/england/coventry_warwickshire/6194283.stm
(accessed 27th April, 2014)
3. Raj Mattu audit trail
http://drphilhammond.com/blog/2014/04/25/private-eye/raj-mattu-audit-trail/ (accessed 27th April, 2014)
4. Hansard Debate 28th November 2001.
http://www.publications.parliament.uk/pa/cm200102/cmhansrd/vo011128/hall...
(accessed 27th April, 2014)
5. Physicians speak out about the treatment of hunger striking prisoners of war. 12th March, 2006
http://seedmagazine.com/content/article/going_after_gitmo/
(accessed 27th April, 2014)
Competing interests: No competing interests