For those of you who like Breaking Bad, this the third in the Persecution Murder Mystery series. Without giving away the plot, it jumps right to last week. It has been adapted from a letter to members of the House of Commons committee on harassment in the NHS. The second part of the letter will feature later in the week – Harassment: From Rolf Harris to James Coyne and Doctor Who. Click on the image to read the text.
The many ways in which NHS staff can be harassed if they express concerns about patient safety have only recently begun to be recognized. The GMC however do not appear to have mechanisms in place to manage their potential role in this.
The GMC initial assessment process has a prejudicial default. It is calibrated on a scale from neutral to significant complaint, when the scale should run from harassment through neutral to complaint. The fact that GMC’s procedures self-evidently do not do this makes them wonderfully fit for the purpose of harassment.
In any reasonable universe, faced with such a blatant case of harassment in the materials they received from me four weeks ago, which will be posted over the next few weeks, the GMC should consider taking an action against someone in BCUHB.
If this is not what happens and GMC indicate they plan to investigate me, the question as to what is going on, a question that currently applies to BCUHB, will apply to GMC also, and will scream that larger forces are at work.
In such circumstances, do nothing and my fate lies in the hands of people who have proven themselves capable of considerable malice.
I cannot ask GMC’s advice on how I might “constructively” not participate as GMC do not seem to have a policy on or procedure on how to do what I am proposing.
Some might say wait till the current GMC process runs its course and concludes in my favour but if the GMC process goes on to the next step this will have been a mistake. It seems better to act now in mid-stage rather than wait on GMC.
Anyone contemplating how GMC might come up with a procedure to manage situations like this are going to be better placed to come up with the right answers if faced with the issues more clearly in real time than if contemplated in retrospect when the urgency is removed from the situation, damage has already been done, and goodness only knows what other forces have muddied the waters with what other material.
In cases like this, GMC are always going to have to make a judgement under uncertainty or else concede it is impossible to have a procedure that enables them to avoid being used as an unwitting accomplice to a harasser’s agenda.
The situation parallels the sexual harassment and abuse cases from Rolf Harris to Max Clifford that we have seen linked to the BBC in particular over the last year. GMC like BBC have hitherto been relaxed about the problems.
If they are going to have a procedure they need to forge it now in the white heat of a moment like this.
Meanwhile in another part of town
Meanwhile ‘forgeries’ on the BCUHB side appear to be coming thick and fast. Staff in the mental health team where both Tony Roberts and I work have been told to notify management about everything that might form the basis of a possible complaint against Dr Roberts or myself.
Some weeks ago, a letter to me addressed private and confidential was opened and almost immediately put into the hands of an individual previously involved in marching staff out of jobs here on spurious grounds, and other egregious breaches of natural justice – see POVA.
This commandeering of private correspondence has led to an investigation about the inquiry the letter contained that I only found out about by accident. The private correspondence was about a misunderstanding. I may well put the entire correspondence up on this post, but for the moment the key point here is the pressure that I, and other colleagues, are operating under.
A recent death kick-started an SUI – serious untoward incident – investigation, even before the person was buried. The problem with SUIs in BCUHB is that investigation panels selected by management regularly come to conclusions without bothering to interview the clinician or others involved in the care. They send all kinds of conclusions to coroners or the GMC, KGB or FBI without the person at the center of the case being aware of anything – even that there has been an SUI.
In this case, the person who died hadn’t been seen by me for almost two years – but that’s no guarantee the panel in their wisdom won’t forward a complaint to the GMC.
Weirdly beyond SUIs, it seems that BCUHB managers have access to material from confidential discussions – for instance with ACAS – that they should not be privy to.
There is no way I can be certain that GMC processes are immune to the reach of BCUHB, until the basis of that reach is established. This is something GMC will likely shrug off but should not.
Whatever uncertainty GMC think they are facing on these issues, and stress it might cause them, this is minor compared to the uncertainty that Anne Ward and Shyam Kishto and Tony Roberts and pretty well everyone in Hergest are operating under.
Despite two years of trying to sort the problems out, the malignancy at the heart of what’s going on here – which will be laid out in full details over the next few weeks – is alive and dangerous.
Betsi Cadwaladr: A health board scared of its patients and staff?
I am asking GMC to break new ground, but there is another novelty worth putting on the map. It would not surprise anyone here if some of the managers were to plead that they are being bullied. Indeed they might use posts like this as the basis for their complaint. Being in the light is “traumatic”. This case is so full of novelty it’s almost to be expected.
Staff here have all had fliers through during the last year for courses educating managers on how to avoid being bullied or intimidated by staff refusing to do as ordered.
There is other correspondence that fit this template.
Most interestingly in December 2013, there was a strange HIW (Health Inspectorate Wales) review of the Hergest Unit. Against a background in which the review team failed to note that there were thirty-five whistle-blowing nursing staff and failed to spot the use of POVA in an egregious breach of employment law, the final report states that:
Management do not feel empowered to initiate change and bring leadership to the unit – the reasons for this must be fully explored and strategies to resolve it must be implemented.
When the notes behind these reviews become available, under Freedom of Information requests, it appears that comments like this in HIW reports are close to simple transcriptions of what management says to HIW without any critical assessment as to whether management are the problem.
The report is consistent with a de facto HIW view that whistle-blowers need to be silenced. This may be a Welsh Government view.
This December 2013 HIW report was followed by what to most staff seemed an inexplicable directive from somewhere in Welsh Government to close the Hergest Unit down.
To the last syllable of recorded meaninglessness
It is essential to underline the motivation that staff such as Anne Ward, Shyam Kishto and the rest of my nursing and medical colleagues have had that has led us to stick our necks out and put our jobs and reputations on the line by raising concerns over an extended period. We have been trying to put right system problems that have serious safety and quality of care implications for patients. Our collective activity should be a clear safety signal.
We have been distressed at management responses that do little but tick a box again and again and again to the last syllable of recorded meaninglessness.
It’s hard to believe but the fundamental problem seems to be that BCUHB management is scared of its staff and patients:
- The one group of people who could tell Betsi where services have slipped up – families – have no input to SUIs.
- Only staff selected by management have input in HIW reviews – and HIW is not independent of Government.
- The Betsi Board believe everything they are told by CPG management – they have no interest to hear from the rest of us.
- The Betsi Board was dissolved recently, the CEO and Chair let go, with one of the criticisms being that the Independent Members of the Board were non-functional – they still seem to be non-functional.
There is no possibility of real feedback, of engagement, and the sense of common purpose that might come from that.
This disconnect from reality must be what gives rise to a palpable sense from the Board down through CPG management of semi-psychosis. There are many other elements that maintain the paranoia, such as diktats from Welsh Government, the fact the Health Board is all but bankrupt, the fact that management comes with salary perks, but it is difficult to weight these from outside the bunker.
Seems like they find their staff and patients revolting.