Raj Mattu and the death of whisteblowing

If ever a case demonstrated the futility and jeopardy of blowing the whistle in the NHS, it is that of Dr Raj Mattu. Eye readers will be well aware of the protracted and inhuman victimisation of Mattu (Eyes passim) which has destroyed his health and career, and robbed the NHS of a brilliant cardiologist who was brave enough to speak up about patient harm. University Hospitals of Coventry and Warwickshire (UHCW) has already wasted £6 million pursuing this vendetta, and may waste even more appealing against the employment tribunal judgement that he was unfairly dismissed and that his whistleblowing had been entirely justified. Mattu will never work as a consultant again, so the NHS has also wasted all the money it spent training him, patients have been deprived of his expertise and the compensation payment will be considerable. There has never been a proper inquiry into the alleged deaths and harm caused by the trust’s persistent cramming of five patients into four-bedded bays over a long period of time, relatives have been denied the truth and any chance of justice, and the NHS has not learned from its mistakes.

Perhaps most shocking about the treatment of Mattu, who had to endure absurd and invented allegations of sexual misconduct, fraud and over 200 spurious referrals to the GMC, is that it did not occur in secret. The serious problems in this hospital under the ‘leadership’ of chief executive David Loughton, who Labour handed a CBE to in 2010 for services to healthcare, were widely known to Parliament and at every level of the NHS. Mattu blew the whistle by the book. He filled in clinical incident forms from 1999, made protected disclosures and wrote meticulous, polite letters to Loughton in 2000 and 2001 about harm and possible deaths of patients. These were never answered. When it became clear that he had exhausted all the correct internal channels and the trust was not going to act appropriately to investigate or protect future patients from avoidable harm, he escalated his concerns in entirely the right manner to the media and local MPs, with the support of his consultant body. In the 15 years that he raised concerns about the appalling treatment of patients and then himself, he wrote to successive health secretaries, chief executives of the NHS and senior Department of Health officials. Nobody in authority in the NHS intervened on his or his patients’ behalf. For all the talk about the vital importance of whistleblowing and an end to cover-ups in the NHS, Mattu was simply hung out to dry in exactly the same manner as Steve Bolsin, the Bristol heart scandal whistleblower was 20 years ago, and Alder Hey whistleblowers Ed Jesudason and Shiban Ahmed are now (Eye last)

His local MPs at least took up the baton, and they had plenty to go on.  In 1999, the year Mattu started raising concerns, the trust suspended surgeon Alban Barros D’Sa after he blew the whistle on high deathrates after colorectal surgery.His suspension lasted 20 months and wasted around £500,000. A disciplinary panel said that dismissal would be “wholly unjustified” and recommended his reinstatement but when Loughton discovered Mr D’Sa had written to his MP, Jim Cunningham, about the “unacceptably high” death rates, he deemed this to be  a “breach of trust and confidence” and accused D’Sa of “serious professional misconduct”. After Mr Cunningham and his fellow Labour Coventry MP, Geoffrey Robinson, expressed outrage in the Commons that a constituent’s letter should be used against him, a High Court judge granted an injunction against the hospital. The Royal College of Surgeons recommended the cessation of colorectal surgery by a specific surgeon (a Clinical Director appointed by Loughton) but the Trust allowed him to continue performing these procedures for two and a half years after concerns were first raised.

In 2001, UHCW was found to have the highest death rates in the NHS for heart bypass surgery, more than double the national average. The consultants elected Mattu to lead them, but this was vetoed by the Loughton. Dr Mattu said that the hospital was obsessed with reaching targets rather than interested in quality care. ‘I believe there have been serious administrative deficiencies in supporting effective cardiac care. When these concerns were raised, management’s response was to victimise us.’ That year, the Commission for Health Improvement gave UHCW a damning ‘zero star’ inspection report, and was particularly critical of the practice of cramming 5 patients into four bedded bays, which had made it impossible for Mattu to resuscitate a patient. Six local MPs called for Loughton’s resignation and he went in 2002, only to re-emerge 2 years later as chief executive in Wolverhampton, supported by former NHS chief executive Sir David Nicholson. Nicholson also approved the appointment of Martin Yeates, the ill fated chief executive at Mid Staffordshire hospital, where hundreds of patients received degrading and substandard care. He and Loughton were Yeates ‘informal mentors’. Nicholson told the Francis Inquiry that Yeates never raised concerns about patient harm with his mentors (who would?), and neither did many clinical staff blow the whistle about the appalling care. Mattu tried his best at nearby UHCW – which had even higher death rates than Mid Staffs – and look what happened to him.