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May 28, 2010

Dr Phil’s Private Eye Column Issue 1264, May 26, 2010

More Cornish Pastings….

Following the Eye’s coverage of the unfair dismissal of Cornish hospital boss John Watkinson (Eye last), health secretary Andrew Lansley has ordered NHS chief executive Sir David Nicholson to launch an inquiry.  Of particular interest is whether the South West strategic health authority, headed by Sir Ian Carruthers,  pressurised the Royal Cornwall Hospitals Trust (RCHT) into sacking Watkinson when he blew the whistle on their avoidance of proper public consultation  before moving a cancer service to Plymouth. Whether Sir David is the man to scrutinise Sir Ian is unclear. Sir Ian, himself a former acting NHS chief executive, has long been Sir David’s close friend and mentor.  And Sir Ian chaired the panel that recommended the knighthood for Sir David this year.

South West SHA has mounted a robust defence of Carruthers. In a letter to Health Policy Insight, regional director of public health Dr Gabriel Scally wrote: ‘ The claim for unfair dismissal was made not against Sir Ian Carruthers or the South West Strategic Health Authority but against RCHT, which made its own decisions acting on independent legal advice.‘ This is at odds with the recollection of John Mills, RCHT Chair at the time of Watkinson’s suspension:
‘The way they (the SHA) went about it was to put pressure on the board and I believe it is not unreasonable to view this pressure as tantamount to bullying. They said if you do not go along with the proposition that John Watkinson is suspended, then we, the non-executives, would be suspended under the powers to that end available to the Secretary of State. We were left in no doubt that it meant the removal of the non-execs and their replacement with a pliant group selected for the purpose by the SHA. By this time John Watkinson was seen as a trouble maker. They (the SHA) decided it was time to tackle him. The SHA had decided it wanted to get John out and I sensed didn’t much care how it was done. With the wisdom of hindsight I do regret not standing up to the pressure put on us by the SHA to do its bidding, and equally I regret not having voted against some of the conclusions, and perhaps therefore having resigned from the board there and then.’

RCHT may appeal against the findings of Watkinson’s tribunal, chaired by Judge John Hollow, but they were so unequivocally damning it’s hard to see how this would be anything more than a further waste of public funds:

“Our unanimous conclusion is that this appeal was a travesty of anything approaching basic fairness … the claimant’s dismissal flew in the face of any concept of fairness”.

“A fair-minded employer would have investigated the issues he (the claimant) raised and taken them into account, giving them careful consideration before reaching a decision. Patently that was not done … The speed and incompetent manner in which the claimant’s dismissal was handled sheds light in our judgment as to the respondent’s reason”.

“We have come to the unanimous conclusion that we can and do draw the inference that the reason for the claimant’s dismissal was due to pressure brought to bear on the RCHT by the SHA and the reason for that pressure was the claimant’s stance over the issue of consultation … the respondents had determined to dismiss the claimant as a result of pressure from the SHA”.

Lansley’s inquiry needs to broaden its remit beyond RCHT and consider other allegations across the region and the wider NHS where staff have been forced out or silenced for raising concerns or challenging the SHA, and where the public have not been properly consulted before changes have been forced through.  The NHS faces some tough spending decisions, and some services may need to be merged to make them safe and sustainable.  Labour’s preferred tactic was central control and bullying, and it filtered down into NHS management.  Lansley needs a more intelligent approach, based on public consultation, sound evidence and allowing anyone to speak up without fear of reprisal. After Watkinson’s ordeal (unemployed at 54 with house on the market), whistle-blowing seems as unattractive as ever.

 MD