July 2001 Edition of The Whistle

Suspensions at Coventry hospitals

The University Hospitals Coventry and Warwickshire NHS Trust has two consultant surgeons who have been suspended for over a year for inadequate reasons, to the loss of the local community.

Alban Barros D’Sa queried the number of a colleague’s patients who had died after colorectal surgery. He, as the person raising concerns and trying to ensure accountability for clinical incompetence, was suspended in September 1999. Subsequent enquiries confirmed his concerns. Mr Barros D’Sa sought the help of his Member of Parliament to lift his suspension. The NHS Trust justified the continuation of his suspension by claiming that speaking to his Member of Parliament was misconduct. On 27 March 2001 this case and consultants’ general lack of confidence in the Trust were debated in Parliament. In that debate Minister announced that the Trust had accepted a recommendation to appoint a qualified colorectal surgeon. That surgeon has since started work, but the surgeon whose performance prompted Mr Barros D’Sa and others to raise their concerns is still performing colorectal surgery. Two other staff of the Trust who shared Mr Barros D’Sa’s concerns have not been suspended but have been harassed in other ways.

Briony Ackroyd was suspended in February 2000 after performing an unsuccessful breast operation that led to a compensation payment by the Trust. It is estimated that her disciplinary hearing will not be held until nearly two years after the incident to which it relates. Meanwhile the cost of the suspension is likely to be of a similar order of magnitude to the cost of the compensation, and if she is reinstated she will not have been practising her skills for all that time.

Both surgeons have substantial support from former patients and from colleagues.

This NHS Trust (and its predecessor – Walsgrave Hospitals Trust) has for many years had a “no whistleblowing” policy and treated any contact by its staff with the media as misconduct. This continues, even though Ministers claim to have banned gagging clauses in NHS contracts. Relations with the Press have been broken off. The Trust pursues policies, like marginalising the local hospital in Rugby and pursuing a grandiose private finance partnership at Walsgrave Hospital, to which there is substantial local hostility. For further information on the Trust see the Rugby Advertiser and search with the keyword “Walsgrave”.

These suspensions pose several issues of concern.

Freedom to Care is aware that the NHS often misuses long suspensions, often of highly skilled and competent staff who ask awkward questions and identify abuses that could leave the NHS with compensation bills, as a way of gagging their staff and covering up abuses. If there is a valid disciplinary case against an employee who is suspended, there is no excuse for failure to bring the case to a conclusion (reinstatement or dismissal) within three months. When suspensions are lengthy, any disciplinary case is likely to be so weak that the suspension itself is unjustified and a waste of money and medical/surgical skill.

It is surprising that this NHS Trust used contact with a Member of Parliament as justification for continuing Mr Barros D’Sa’s suspension. The Speaker ruled that the Trust was not in breach of Parliamentary Privilege. But the Public Interest Disclosure Act 1998 was intended to protect employees who disclose matters of public concern. If there is any doubt that the Act protects from dismissal disclosures to Members of Parliament, or if suspensions are being wilfully used in circumstances where dismissal would be illegal under the Act, the Act needs to be strengthened, and harassment (such as by unjustified suspension) of employees who rely on the Act needs to be made a criminal offence.

There are also signs of factionalism among consultants. One of Miss Ackroyd’s vociferous opponents is a surgeon who sent me away after a test that has since been discredited as unreliable three years before I was found to have breast cancer that kept me off work for almost a year. This same surgeon, when suspended from one of the hospitals where he worked for twice neglecting to attend when called by a junior colleague shortly before patients died, avoided disciplinary action by resigning that post, while continuing to work elsewhere as an NHS consultant.

Suspension is most serious for doctors and surgeons who commit themselves full time to the NHS. Those with multiple employments or private patients, who show less commitment to the NHS, are also less affected by being suspended. Therefore the NHS management style that misuses suspensions also undermines the commitment to the NHS of experienced medical and surgical staff, and thereby undermines the NHS itself.

What should be done?