Intended for healthcare professionals

Rapid response to:

Views & Reviews Personal View

An unusual visit to court

BMJ 2010; 340 doi: (Published 10 March 2010) Cite this as: BMJ 2010;340:c1377

Rapid Response:

Well done for standing-up against a non-sensical and unprofessional hospital trust.

It is a real shame that such ill-considered and petty actions by
hospital trusts result in the wastage of time and money, and more
importantly the deflated morale of its employees. However, that is the
reality of the N.H.S. in the 21st century. I was shocked, but not
entirely surprised, that a hospital trust would drag one of its senior and
highly-valued employees through the legal system over an incredibly minor
misdemeanour (which is not even such in my eyes), but all kudos to the
author in question for standing his ground and for sticking by what is
logical and correct.

Hospital Trusts in the U.K. function as businesses and decreasingly
value their staff. I cannot fathom the mentality of the managers in this
trust and how the author’s attempts to resolve the situation at earlier
stages were rejected. Everything is protocol based, and heaven forbid
those who try to think outside of the box or those who try to work
efficiently in a manner that is not in keeping with the ‘set in stone’
protocol that has been devised. People like the author should be
applauded for believing in logic and for being able to make a point.
Almost everybody that I can think of would have ultimately given-in and
paid the £10 and perhaps also paid another penalty that would have
doubtless been slapped-on by the hospital for an initial late payment.
This consultant has endured the stresses, inconvenience, and loss of his
personal time due to this trust’s ‘leaders’.

The fact of the matter is that hospital managers, by and large, see
hospital employees, be it nurses or doctors, as commodities. Who can
blame this consultant for feeling bitter. In addition to the erosion of
medical autonomy, increased bureaucracy and paperwork, an over-
administered system (all too often by people who have little or no
clinical background or appreciation of how humans behave in the ‘real
world’), one now has to contend with employers who turn on their own. The
trust in question has acted appallingly by failing to consider the needs
of patients admitted as emergencies and by presenting ‘evidence’ that may
not have been in existence at the time of the alleged contravention of
hospital policy (i.e. parking signs).

Had this consultant or indeed any member of staff parked a car there
in order to go for a mid-morning coffee and a chat, then the fine would be
reasonable. Instead, this consultant was being persecuted for performing
his duties on an emergency basis. This leaves me pondering the following:
if a healthcare professional were to engage in a thoroughly trivial
pursuit and waste a trust’s (and hence taxpayers’) finances, then there
would no doubt be some form of disciplinary action; should the same
practice therefore be bestowed upon the manager(s)/ chief executive for
wasting public funds in such an appalling matter?

I thoroughly agree with the words of Dr. James Cave (in the first
rapid response), and I would be interested in reading what the input of
the Clinical Director was. Also, as alluded to by Dr. Dearlove (in the
third rapid response), I sincerely hope that this trust can let matters
settle and not make the life of this consultant difficult. I am left
feeling that managers have truly lost understanding and common ground with
doctors and the goals of good, rational and non-financially-prioritized
healthcare. Sadly, I cannot see things improving with the way the system
has evolved.

Competing interests:
None declared

Competing interests: No competing interests

20 March 2010
Niroshan Sivathasan
Registrar (Surgery)
Leicester Royal Infirmary, LE1 5WW.