Persecution: SUI-Cide Trick or Treat?

This is the Eighth in the Persecution Series, after The Persecution of Heretics, The Persecution of Vulnerable Adults, Harassment from the BBC to GMC, Harassment from Rolf Harris to James Coyne to Doctor Who, Persecution: Black Riders in the Shire, Persecution: Rumbles from Mordor and SUI-Cide in Betsi as well as the second in the SUI-Cide series.

The SUI in this case was being conducted by an apparently self-declared expert in SUIs, Dr Robert Higgo.

While in the process of moving to Wrexham a short time before hand, Dr Higgo had been called in as an “external” investigator on a serious incident involving one of his colleagues-to-be in Wrexham. When confronted with the fact that he wasn’t so external, he accepted that most people would not accept he was external but he said that nevertheless he figured his judgement was independent.

Lucky me to have both an expert on SUIs and someone of solid independent judgement involved in this SUI.

The Roberts

Dr Higgo is a friend of Dr Robert Poole.

Robert Higgo and Robert Poole first worked together in Liverpool. From 1998, they co-authored a number of letters and other pieces. There are comparatively few publications that either has that do not feature the other with Dr Poole indicating how close the links are by referring to the Poole-Higgo authorship.

Since 2006, they have books on topics like how to do a psychiatric interview. For trainees on the Liverpool Psychiatry training course it was standard fare to get these books ‘pushed’ at them. It was also standard to be told that the two authors had spent weeks together in a house in Snowdonia or in Andalucia writing the material.

Following a Royal College visit looking at mental health services in Wrexham, Dr Poole who had been one of the visitors was invited to move to North Wales and did.

Prior to his move, I knew Dr Poole and superficially at least we got on reasonably so that for instance Dr Poole, when hoping to get a silver merit award and applying through the Welsh ACCEA process and needing someone to write the citation for him approached me to write the citation. I did so.

Sometime later, before the formation of BCUHB, there was a push to create a Chair of Psychiatry in Wrexham for Dr Poole. Quite exceptionally, the advert did not say that the candidate had to have a track record of research or research qualifications.

I was approached to be an extern but had to decline. I was trying at the time to secure senior lecturer status for Richard Tranter. Richard had a PhD, extensive research publications, external grant funding, and was running the most successful recruiting centre for a major multi-centre study on antidepressants. But it was proving difficult to elevate him even to senior lecturer status. The system seemed to want to push him out of N Wales – See Richards Story.

The powers-that-be approached Professor David Linden to be an extern. He declined on the basis that Dr Poole was the only candidate and did not meet the qualifications for a Chair.

Dr Poole’s appointment went ahead, as I understand it at the insistence of Mary Burrows, then the CEO of Betsi.

Despite these difficulties, after the appointment, I got in touch with Dr Poole to see if an academic forum could be set up. There was no response.

Dr Poole’s enmity

As the latent tensions between Wrexham and Bangor within Betsi grew more marked, Dr Poole became an ever more prominent ‘player’. He had a significant position within the Welsh Division of Psychiatry. Consultant staff in Bangor have been aware for years that in Welsh Division circles he briefed extensively against Bangor.

Dr Poole appears unable to resist making it clear that he thinks that everything in Bangor is wrong, that senior clinicians should not air their concerns about the way the services are going, and that he was going to do everything he could to stop that. He mentioned this to ex-colleagues from North Wales at several Royal College meetings.

Most recently at this year’s College meeting, where he was according to himself angling to become the vice president of the College, he said he would be having a word with the new president of the college about the issue. The vice presidency of the Royal College is a position that is obtained by glad-handling.

It turns out the Dr Poole also has an involvement in an Internal Review Service the Royal College of Psychiatrists offers. This is a service that a Health Board can appeal to if they are having difficulties with their local clinical service.

After several failed efforts to have management of the mental health services in Betsi reviewed, my colleagues and I accepted an olive branch offered by Betsi of having a review undertaken by the Royal College – believing it to be independent. A mistake.

To our surprise and dismay, the College reviewers appeared not to see it as part of their brief to meet with two of the senior nursing staff had been summarily marched out of the building a few weeks before. They didn’t know that there had been 35 whistle-blowers in Hergest and didn’t engage with them.

Even more dismaying, when the report from this strange review emerged, it became clear that the reviewers bizarrely spent at least as much time interviewing people like Dr Poole and a range of others associated with and supportive of management and the Wrexham approach to things.

This was a failed process. It is now clear that Dr Poole’s role in the College Invited Review service made it fatally flawed. Dr Poole has simply no knowledge of the situation in Bangor. He repeatedly expresses the view in all and any settings that people in Bangor are wrong on all scores in a manner that appears to be close to fixed and unshakeable belief with no basis in evidence.

Whenever it has been put to him that Mary Burrows management style was perhaps part of what has gone wrong in N Wales, he has been rabid in his rejections of any such idea. More recently he has indicated that he either is now or will be supervising Ms Burrows for a PhD. Technically, this is not possible.

The Higgo – Poole authorship

Dr Poole persuaded Dr Higgo to join him in Wrexham. Even before coming to Wrexham, Dr Higgo had been appointed by Dr Poole to the Centre for Mental Health and Society (CMHS) now based in Bangor University. On its website, this centre has a one page CV from Dr Higgo outlining his research interests.

The first of these interests is research on SUIs and the implementation of recommendations that come out of them, raising the possibility that I and others involved in SUIs may have been research subjects, without being informed of this and without our consent being sought.

The CMHS was apparently set up under the patronage of Mary Burrows. As of 2012, it had been given close to £500,000 ($800,000) from Betsi, at a time when Betsi was all but bankrupt.

The Centre appears to have been given ’favored child’ status while Richard Tranter and I who were achieving the only grant capture and producing the only peer reviewed research in substantial journals that was coming out of North Wales psychiatry were finding ourselves shut out in the cold, audited within an inch of our lives, and stripped of funds rather than supported.

Richard finally decided to get as far from N Wales as he could. He described to colleagues how once he had handed in his notice Drs Harborne and Poole descended upon him. There were no expressions of regret that he was leaving – the concerns had to do with what was happening his research funding. My research funding in fact.

The Higgo-Poole bias in black and white

Drs Higgo and Poole published a book in 2014 on Mental Health and Poverty. In this they devote a substantial amount of space to antipsychiatry – not something that has an obvious link to the topic of poverty. They cover “contemporary challenges to organized psychiatry”. In this, to my astonishment they focus on me as an inheritor of the antipsychiatry mantle.

Despite being local colleagues at no point did they consult me to check if they were representing my views correctly.

Bizarrely they characterize me as a medical historian and a polemicist. The designation medical historian is wrong and seems denigrating. As regards the views they attribute to me, they concede are based on data. So the use of polemicist here is gratuitous and likely to be intentionally denigrating.

They discuss my views in the context of a claim that some people think depression is a modern invention, not so much a mental disorder as a marketing strategy. They concede that I have views that are based on empirical data, but views that they dismiss without offering any data, characterizing the issue in terms of “flaws in Healy’s rhetoric”.

This is bizarre. They don’t take into account that I have run the electroconvulsive therapy (ECT) service in N W Wales – something close to inconceivable for a person who thought depression was not a mental disorder and was only a marketing strategy.

The pharmaceutical industry would have been delighted if my views were remotely like the views Drs Higgo and Poole ascribe to me. It would have been possible to get me dismissed as an expert witness in the many criminal and civil cases I have been involved in.

This gratuitous animus was the position of the Higgo-Poole authorship, a year before the CASE A SUI-cide.

An independent expert?

This is a bias Dr Higgo should have declared to Dr Makin if not to me.

I had never heard of Dr Higgo before this SUI. I didn’t even know he was a Wrexham consultant.  I had no idea of his links to Dr Poole.

A few weeks later as I thought a viscerally hostile report on Dr A (me), landed on Dr Makin’s desk urging that my clinical practice needed to be investigated. It was this that led to the GMC referral. In fact it had been prepared before the interview.

As a self-declared expert on SUIs, Dr Higgo seems to have breached the basic rule of critical incident reviews, which are the cornerstone of patient safety within healthcare, a rule that was enshrined in the invitation to me to participate:

“I should point out that this meeting is not to investigate any allegations made against you personally and therefore you are not the subject of this investigation”.

Perhaps breaching the rules was part of Dr Higgo’s research on SUIs.

It seems extraordinary that someone who claims knowledge of SUIs would not have foreseen the train-wreck ahead. It seems more likely that there was an acceptance that due process would be violated.

For instance, Dr Higgo claims his report was based on what witnesses said – but because the interview process is confidential it is not clear that BCUHB can hand over the transcripts to me. Betsi can’t decide if they can even release a list of names of those interviewed.

Four months later Betsi haven’t worked out if they can hand over copies of the records of CASE A to me even though – these records as it turns out are missing key elements.

As things stand, no member of staff in North Wales would be prudent to attend any SUI being held under the auspices of Betsi – and some have already turned down invitations to be involved – until the wreckage of this crash is cleared.

Indeed, it would be difficult to blame staff who opted to go further and cover-up safety concerns – as one interpretation of what happened is that “Dr Healy at his interview raised questions about the legality of BCUHB procedures, and the response has been to shoot the messenger”. This confirms that shoot the messenger continues to be the standard BCUHB response, despite changes at Board level.

It gets better…

Betsi – BCUHB – Betsi Cadwaladr University Health Board
Formed in 2010 from an amalgamation of 3 Trusts across N Wales
Dr Matt Makin, Medical Director BCUHB
Dr Giles Harborne, Chief of Staff, Mental Health Clinical Programme Group (CPG)
Mary Burrows, Former CEO BCUHB
Dr Robert Poole – Consultant Psychiatrist Wrexham
Dr Robert Higgo – Consultant Psychiatrist Wrexham