Presentation to BSI on behalf of PCAW


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Case study of Gary Walker a former NHS CEO and whistleblower. Contains extracts of documents that describe the the pursuit of targets that led to a cover up costing over £500k involving the most senior people in the NHS. Shared at a presentation for BSI on 2 July 2014

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Presentation to BSI on behalf of PCAW

  1. 1. Presentation by Gary Walker for A whistleblowing case study… Gary Walker MBA, DipM, GradDipLaw Former NHS Trust CEO & Whistleblower
  2. 2. Presentation by Gary Walker for Career summary • Member Board Of Trustees, Public Concern at Work • Director, Modern Leader Ltd • Chief Executive, United Lincolnshire Hospitals NHS Trust • Turnaround of finances. clinical safety and targets • Chief Executive Surrey and Sussex Healthcare NHS Trust • Turnaround of £36m overspend and failure on all targets • Chief Operating Officer, Quo Health Ltd • Director of Service Delivery, Brighton and Sussex University Hospital • Turnaround of biggest waiting list manipulation - 2000 patients • Deputy Director of Clinical Services, Norwich University Hospital NHS Trust • Head of Performance, Department of Health • Performance management of 21 NHS Trusts Gary Walker, MBA, DipM, GradDipLaw Former NHS Trust CEO & Whistleblower
  3. 3. Presentation by Gary Walker for 2000 to 2006 - 8 CEOs - £27million accumulated deficit - Failed most targets - Healthcare commission report on bullying culture - Waiting list manipulation - Clinical safety issues: Vascular, Maternity, A&E, and more… 2006 to 2009 Repaid historical debt Recurrent balance, Waiting times halved Targets such as HAIs amongst lowest in UK (yet still missing the “target”) Governance systems replaced Clinical Safety Issues: e.g. Vascular rota saving 50 lives pa Staffing increased by 400+ United Lincolnshire Hospitals NHS Trust (ULHT) £320m turnover, 8,000 staff, 3 DGH sites, 3rd worst funded under Payment by Results, 3rd most rural NHS Acute Trust in England 2009-2013 - Several adverse CQC reports - £15m Deficit returns in 2011 - Targets missed Reviewed by Sir Bruce Keogh as part of 14 Trust’s with High Mortality Rates - Staffing levels too low - Highest rate of never events - Special measures Arrive Forcedout
  4. 4. Presentation by Gary Walker for Dec 2006 Dec 2007 Dec 2008
  5. 5. Presentation by Gary Walker for ULHT A&E Attendances 1 February to 5 April 2009 2500 2700 2900 3100 3300 3500 3700 3900 4100 4300 01/ 02 /2009 08/ 02 /2009 15/ 02 / 2009 22/ 02 /2009 01/ 03 /2009 08/ 03 /2009 15/ 03 / 2009 22/ 03 /2009 29/ 03 /2009 05/ 04 /2009 Attendances
  6. 6. Presentation by Gary Walker for “…I tried to explain that we are still in escalation and the situation with A&E and that we had cancelled electives this week (32 patients) owing to increased emergency admissions and was told that if we can't manage A&E we can't run a hospital!...” From: Director of Operations (ULHT) Sent: 18 February 2009 18:43 To: David Bowles; Gary Walker Subject: Update for Chairman IN CONFIDENCE Telephone call with SHA CEO Hakin Importance: High
  7. 7. Presentation by Gary Walker for
  8. 8. Presentation by Gary Walker for
  9. 9. Presentation by Gary Walker for
  10. 10. Presentation by Gary Walker for David Bowles Chairman ULHT 2006-2009
  11. 11. Presentation by Gary Walker for Extract… “This type of behaviour threatens patient safety and must be stopped. “I make this protected disclosure in the hope that you will be able to address the issues I raise. “I assume this Department of Health has a policy on whistleblowing and would therefore like this letter to be considered in that context and not freely copied to the SHA or local PCT”.
  12. 12. Presentation by Gary Walker for
  13. 13. Presentation by Gary Walker for After 5 month investigation* costing £70,000, Gary Walker is sacked on what witnesses later describe as “fabricated” evidence. * Throughout this period I had no idea of the charges against me Transcripts are altered by the NHS to remove all reference to Protected Disclosures** **Ongoing police investigation into MIPO
  14. 14. Presentation by Gary Walker for
  15. 15. Presentation by Gary Walker for Feb 2010 to November 2011
  16. 16. Presentation by Gary Walker for “SUPERGAG” – Cannot disclose its existence and specifically cannot disclose the 21 protected disclosures
  17. 17. Presentation by Gary Walker for Feb 2013
  18. 18. Presentation by Gary Walker for DAC Beachcroft Solicitors 12 February 2013
  19. 19. Presentation by Gary Walker for
  20. 20. Presentation by Gary Walker for
  21. 21. Presentation by Gary Walker for
  22. 22. Presentation by Gary Walker for > select Publications > 2012/13 > Mid Staffordshire
  23. 23. Presentation by Gary Walker for
  24. 24. Presentation by Gary Walker for Culture of Cover-ups £28m and 1000 compromise deals “There is simply no way of knowing how many of these special severance payments have been made across the public sector – or whether the compromise agreements have been used to ‘gag’ employees. To date neither the Treasury nor individual departments have monitored this adequately.” The Public Accounts Committee
  25. 25. Presentation by Gary Walker for Culture of Cover-ups £28m and 1000 compromise deals “We heard evidence of shocking examples of using taxpayers’ money to ‘pay-off’ individuals who have flagged up concerns about patient or child safety” The Public Accounts Committee
  26. 26. Presentation by Gary Walker for Ray Law, 60 Avoidable death 2010 Surgeon’s memo: “death of an otherwise healthy patient” 3rd prostatectomy on the operating list
  27. 27. Presentation by Gary Walker for …targets were exerting “enormous pressure”… ”…work with you to identify what additional resources we need to provide a safe service in the future” garywalkeruk One of six incidents including WL manipulation reported in 2010 Inspection didn’t review any incident Inquest 2014 - Expert said Mr Law “would have survived” Trust investigated. Did not die because of targets. Surgeon said: "It was not normal for me to perform three operations in a day. I haven't done it since.” Narrative verdict “Lessons learned”
  28. 28. Presentation by Gary Walker for “We still have too many patients dying in our hospitals when their relatives were expecting them to come home.” Sir Bruce Keogh NHS Medical Director Channel 4 News 11 September 2013
  29. 29. NHS Whistleblower (sample in public domain) Role Issues raised Employer Outcome Tracy Boylin Director (HR) Misconduct / Fraud The Christie Sacked David Drew Doctor Patient safety Walsall Healthcare Sacked Kim Holt Doctor Patient safety GOSH Kept job* Raj Mattu Doctor Patient safety Coventry and Warwickshire Sacked Edwin Jesudason Doctor Patient safety Alderhey Forced to resign John Watkinson Chief Executive Patient safety Royal Cornwall Sacked Jennie Fecitt Nurse Patient safety NHS Manchester Sacked Gary Walker Chief Executive Patient safety United Lincolnshire Hospitals Sacked Ramon Niekrash Doctor Patient safety South London Healthcare Kept job*** Helene Donnelly Nurse Patient safety Mid Staffordshire Forced to move job Narinder Kapur Doctor Patient safety Addenbrookes Sacked Margaret Haywood Nurse Patient safety Brighton and Sussex Struck Off Loo Blackburn Nurse Patient safety Oxford GP practice Forced to move Job Shiban Ahmed Doctor Patient safety Alderhey Kept job**** Steve Bolsin Doctor Patient safety Bristol Royal Infirmary Forced to leave UK Sharmila Chowdhury Manager Misconduct / Fraud Ealing Hospitals Sacked Mike Chester Doctor Patient safety Royal Liverpool Sacked Kate Clarke Administrator Patient safety Dudley Hospitals Sacked David Ore Security Patient safety Dudley Hospitals Sacked/Redund * Suspended 4yrs, reinstated, service transferred ** Ongoing – Jeremy Hunt intervened *** Left with £170,000 costs **** Left with £20,000 costs, suspended twice since, and still suspended on false allegations of mental illness.
  30. 30. 24. Refuse to disclose documents. No one cares about DPA and FOI 23. Accuse a whistleblower of not raising concerns early enough 22. Delay as much as possible to push up the legal costs for the whistleblower 21. Ignore PAC and other inquiries 20. Pretend that the Public Interest Disclosure Act offers adequate protection 19. If external investigation, the trust can still organise and pay for it, recruit the panel 18. Arrange an “in house” investigation. 17. Throw public money at an employment tribunal appeals (unlimited budget) 16. Throw public money at an employment tribunal (unlimited budget) 15. Make vexatious complaints to a professional regulatory body 14. Publicly humiliate the whistleblower 13. Rely on the cowardice and apathy of the Department of Health 12. Make friends with the coroner to avoid scrutiny 11. Appoint consultants to rubbish the whistleblower’s claims. 10. Threaten to sue the whistleblower 9. Apply to the Treasury for public money to pay off and gag the whistleblower 8.Misuse the code of conduct for managers 7. Claim it’s an employment conflict 6. Allege mental health issues (very popular) 5. Threaten whistleblowers and the media with libel suits 4. Threaten reprisals against colleagues who support a whistleblower 3. Repeatedly ignore, deny or pretend to address the concerns 2. Allege actual or invented misdemeanours 1. Inflict subtle sanctions beyond legal protection
  31. 31. Presentation by Gary Walker for Conclusion and what next? • For the NHS • Change the “culture of fear”* • For all organisations • Adopt the PCAW Commission Code of Practice (Private sector leading the way) • EVERYONE has a moral and ethical duty to raise concerns about wrongdoing and safety • Raise them anonymously if you fear consequences • Raise them with regulators • Learn from the employers that welcome concerns being raised • Whistleblowing is the final option – choose it understanding the consequences • For Regulators • Performance manage those you regulate using the Code of Practice • For the Government • Strengthen the law • Enforce the Code of Practice through Tribunals * DH commissioned in 2007 three American organisations – the Institute of Healthcare Improvement (IHI), the Joint Commission International (JCI) and Rand Corporation – which were only published in 2010. See also: Health Select Committee report on Patient Safety, 3 July 2009, and BMJ 2012;345:e8239, Lintern S. NHS chief executives Highlight “climate of fear.” Health Serv J 2012; Published online 22 November and many more…