Bully balls

Whatever happens to the NHS post-election, it desperately needs to be freed from its bullying culture. ‘New’ Labour talked a lot of tosh about devolution and empowerment  but controlled mercilessly from the centre and swept dissenters aside, as illustrated by the shockingly unfair dismissal of the chief executive of Royal Cornwall Hospitals Trust (RCHT) John Watkinson.

Watkinson took up his post in January 2007 and proved to be a popular and effective leader until he had the temerity to challenge Sir Ian Carruthers, the chief executive of the South West Strategic Health Authority (and a former acting Chief Executive of the NHS). In 2008,  Carruthers decided to centralise upper gastrointestinal’ cancer cervices to a single site in Plymouth rather than spread them out over the three existing sites in Plymouth, Exeter and Cornwall.

The need for reconfiguration was not disputed by Watkinson – complex treatment needs a concentration of expertise and resources – but he wanted more debate about whether Plymouth was the best choice and was wary of the fact that the then health minister Ben Bradshaw had lent support to his own unit in Exeter, which would have left Cornish patients with a two-hour trip to Plymouth without much benefit. But most importantly, he wanted to ensure that his hospital’s legal duty to proper public consultation was enforced.

Carruthers was less keen on public consultation. In a meeting in May 2008, he tetchily announced that the entire population of Cornwall could sign a petition opposing his plans and it wouldn’t matter, because this was government policy. Watkinson’s legal advice was that this hospital would be breaking the law if it avoided public consultation  and informed the RCHT board of this.

Watkinson and his chairman Peter Davies were then summoned to a deeply unpleasant meeting with Carruthers and told to toe the line. Instead Davies resigned his post and later, Watkinson was invited to take a ‘special leave of absence’ in September 2008 and subsequently sacked, and medical director Dominic Byrne resigned in protest at the treatment of Watkinson. So despite having the overwhelming support of the staff and patients, Watkinson found himself on the dole, and Carruther’s reconfiguration – without proper public consultation – came into force in January 2010. The local Overview and Scrutiny Committee referred the move to the Health Secretary and it s now the subject of an independent review due to report later this year.

However, the judgment from Watkinson’s employment tribunal appeared on May 6. The unanimous verdict of the panel was he was unfairly dismissed, that the dismissal was both procedurally and substantively unfair, and that he was dismissed simply for advising the hospital of its duty to undertake public consultation before reconfiguring services. The evidence put forward by RCHT was ‘in many respects unsatisfactory’ and Carruther’s behaviour ‘a matter for adverse comment’. He  refused to give evidence even though his office is was across the road from the tribunal in Taunton.

Carruther’s is unlikely to fall on his sword but his bullying has destroyed the career of a gifted and popular NHS chief executive, created a vast amount of resentment in Cornwall and left the NHS with a hefty bill for the cost of the tribunal and Watkinson’s likely compensation package. He has also threatened the viability of the reconfiguration he forced through, a tragedy given that it is probably best for the NHS, and most staff and patients could have been won over with proper consultation. This bullying bodes poorly for other reconfigurations in the south-west, particularly of pathology services in Bristol which are currently subject to an independent inquiry triggered by the Eye and provided by two hospitals neither of which has a permanent chief executive. I wonder why they left?

The Watkinson tribunal report is available in full here.