A British health manager warned the boss of the NHS four years ago that his hospital was a threat to patients’ safety. A nationwide investigation into avoidable hospital deaths has found that such warnings from doctors were often silenced or ignored.
Gary Walker, the former chief of United Lincolnshire Hospitals Trust, was silenced in 2010 under a £500,000 ‘super gag’ agreement; he is now risking legal action by the NHS by speaking out. Walker reportedly received the payment last year; his former employer now faces a major investigation over its unusually high death rates, in the midst of the Stafford inquiry fallout. Walker said that the chief of the NHS chief was “not interested in patient safety,” and called on him to resign to end the “culture of fear” he had created in the NHS, Britain’s Daily Mail reported.Walker spoke to the BBC in an exclusive interview for its ‘Today’ show on Radio 4, in which he explained that his hands had been tied: “I was in danger of losing my house – I have children to support. And one thing you must remember that if you're attacking the very top of the NHS the sanctions are pretty dramatic.”On Tuesday, shortly after learning of his plans to appear on national radio, the NHS wrote a letter to Walker reminding that, “If you have provided an interview or should this interview proceed you will be in clear breach of the agreement and as a result the Trust would be entitled to recover from you the payments made under the agreement.” The letter reiterated that he was legally obliged not to inform anyone, besides family, of the terms of the gag agreement. The letter was released by the Lincolnshire Independents, a minor British political party, alongside other correspondences. The party said it was “shocked at the documents we have uncovered.”Walker was fired in 2010, allegedly for using profanity during meetings. He and his supporters claimed that he was forced out for whistleblowing.Leaked Letters reveal systemic neglectNew leaked letters have shown that doctor concerns over the Lincolnshire hospital were constantly ignored, despite that medical staff often challenged management about policies that threatened patient safety. The number of ‘excess’ deaths at Lincolnshire Hospital stood at 677 between 2009 and 2012, according to David Bowles, the former chair of United Lincolnshire Hospitals Trust. Bowles said he quit over such dangerous target-setting. In one letter, a doctor described a complex 10-hour medical procedure as a “major operation with major risks attached.” The patient’s operation was then postponed, because there were no Intensive Care Unit beds available at Lincolnshire Hospital in central England. Another letter outlined the serious threat to the public caused by excessive targets, as well as intimidation from above: “I must make you aware of my concerns about the balance between patient safety and targets and inform you that in my view the current bullish and sometimes ruthless pressure from above on the management team in my Directorate is unfair and unacceptable,” a clinical director told Paul Richardson, NHS Trust Chair of United Lincolnshire Hospitals.One more anonymous doctor begins, “I am writing in the immediate aftermath of today’s tragic death of an otherwise well patient,” adding that ward staffing levels were inadequate for postoperative care, and that the “enormous pressure” exerted by target requirements resulted in ad-hoc arrangements for short notice surgery. Lincolnshire Hospital is one of nine others that over the last week were slated to be investigated for unusually high death rates in the wake of the Stafford inquiry results. The Stafford inquiry was part of a long-term investigation into the hospital’s filthy wards, unnecessary deaths and understaffing.Stafford InquiryThe revelation comes shortly after inquiries into some 1,000 ‘avoidable’ UK hospital deaths in Stafford, central England, which concluded earlier this month that “corporate self-interest and cost-control” were to blame for the wider-scale NHS problems that allowed the deaths to happen.Inquiry head Robert Francis, QC, urged for greater protection for NHS whistleblowers, as it emerged that many who try to speak out against hospital management are silenced. Many complaints were voiced about standards of patient care at the central England hospital, but they either went ignored or were given no adequate response, despite approximately 1,000 deaths.Harrowing accounts of poor standards of care and hygiene and patients dying in undignified circumstances plagued the institution; further reports emerged of patient neglect and the failure to supply basic provisions. One patient’s relative reported that health and safety rules prevented drinks from being left out at night, leading thirsty patients to drink water out of a flower vase. Relatives of two other patients reported that their family members had been dropped. Others fell victim to deadly infections rampant in the filthy wards, such as the superbugs C. dificile and MRSA. One relative said that her mother was so badly infected with C. dificile that she had to be buried in a sealed body bag. Whistleblowers silencedThere have been serious attempts to discredit, bully, or fire NHS whistleblowers, which resulted in a media scandal last August. Kay Sheldon, a board member of a UK healthcare watchdog, raised concerns that poor leadership and performance were a threat to public safety. She was diagnosed as possibly suffering from schizophrenia by an external assessor in a clear attempt to discredit her. Many whistleblowers fear reprisal, as it there is a high possibility that they could be fired by those they raise concerns about. And in September, Labour MP Katy Clarke pointed out that lawyers representing the NHS were all too often silenced using gagging clauses when settling employment cases.“I warned [David Nicholson, NHS boss] that Lincolnshire was going to become the next Mid Staffordshire. He didn’t investigate those concerns, and now look what’s happened,” Walker said.“We cannot allow the disgraceful culture highlighted in the Mid-Staffordshire report to put Lincolnshire patients at risk,” said Chris Brewis, an independent politician on the Health Scrutiny Committee at Lincolnshire County Council.The NHS and the government do not seem able to “learn from the old inquires that have been from 30 years ago”, David Lawrence from the London National Health Action Party told RT. “The problem is that we don’t know yet how to avoid these [incidents] in the future and the government doesn’t know,” Lawrence added. “And that has got to be one of the main focuses of all our efforts – people who work in the NHS and all of us in the community to find out how to prevent the sorts of things going on. The pressures on the NHS have always been there. And I think over the last 20 years it got worse.”