Hospital trust branded the worst in Britain 'tried to gag whistleblowers'
A report into the management of hospitals in Mid Staffordshire will highlight a culture of secrecy about poor working conditions that may have contributed to more than 1,000 patients dying
Rajeev Syal, investigations editor The Observer, Sunday 31 January 2010
A hospital trust branded the worst in Britain by the NHS regulator actively discouraged staff from expressing fears about the safety of patients, an independent inquiry is expected to conclude.
Senior managers at Mid Staffordshire NHS Foundation Trust, where poor working conditions may have contributed to more than 1,000 deaths, will be accused of promoting a culture of secrecy, according to sources close to the inquiry.
The disclosure of a key finding of the report, expected to be released this week, comes as campaigners for patients who suffered neglect in Stafford and Cannock Chase hospitals call for a judicial review into the trust.
An official close to the inquiry told the Observer that it will conclude that staff were discouraged from bringing problems to the attention of managers and NHS authorities.
"Staff have known about the problems on the wards for many years, but there has been no means by which they can bring them up. Those who have tried to do so have been shot down. Some have been ordered to withdraw or hide their allegations," the official said.
The inquiry was launched in September by the health secretary, Andy Burnham, following a Healthcare Commission investigation that delivered the most savage indictment of any NHS organisation in the commission's five-year history. Its report condemned "appalling" standards of care at the trust's hospitals in Stafford and Cannock, particularly involving emergency admissions, which may have contributed to up to 1,000 deaths between 2005 and 2008.
The inquiry, chaired by Robert Francis QC, has heard evidence from a number of members of staff that they had been actively encouraged to ignore serious problems in frontline services.
One senior Stafford hospital official was suspended last week after documents from the inquiry allegedly showed that she tried to cover up damning comments about the care given to a 20-year-old who died just hours after being sent home from the accident and emergency department.
Kate Levy, board secretary and head of legal services at Mid Staffordshire NHS Foundation Trust, is being investigated over allegations that she encouraged a doctor to rewrite a report into the death of John Moore-Robinson.
Staff in accident and emergency failed to spot that the telecommunications worker had a ruptured spleen following a mountain bike accident on Cannock Chase in April 2006. He died at his home in Coalville, Leicestershire, less than 24 hours after being sent home with painkillers.
A report by Ivan Phair, an A&E consultant, into his treatment said: "The premature death of Mr Moore-Robinson in my opinion was an avoidable situation. I feel that an independent expert would criticise the management afforded to him by the staff. There is a high probability that the level of care delivered to Mr Moore-Robinson was negligent."
After reading the report, Levy wrote to Phair asking him to erase the comments. Her letter stated: "As reports are generally read out in full at the inquest, and press and family will be present, with a view to avoiding further distress to the family and adverse publicity I would wish to avoid stressing possible failures on the part of the trust."
The report was not presented to the inquest. Mr Moore-Robinson's parents only found out about Levy's letters when copies were given to them by a lawyer at the inquiry.
Frank Robinson, the dead man's father, told the Observer that there had been a "culture of cover-ups" at the hospital. "Nothing can distress us more than losing our son. So for this woman to claim that hearing the truth would distress us is a heartbreaking and cruel insult," he said.
"This is a hospital trust out of control. The place needs to be overhauled."
Staff have claimed that they have been intimidated into silence when they have raised concerns. Pradip Singh, a senior consultant who gave evidence to the inquiry, used the protection of the Commons all-party health committee last year to explain what went wrong at Stafford hospital after what he called a "savage reduction" in levels of nursing. "Over the years, many clinicians had noticed deterioration in the standards of patient care, which became particularly acute approximately three years ago when major cutbacks were made in staffing numbers. This included a savage reduction in the number of nursing staff," he wrote.
He means bedside Registered nurses. You can't throw untrained kids at the wards and then say that you have lots of nursing staff. But this is what management does because that is how badly they devalue bedside nursing........Anne
Singh, a gastroenterologist, said that he and other consultants had complained to senior medical managers and the trust's management, but those who complained had been ignored and branded as troublemakers. He said that a "palpable culture of intimidation" in the trust deterred others from speaking out publicly.
The culture of secrecy at the trust has been reinforced by a written "whistleblowers" policy that discouraged an open discussion of problems, according to one charity that made a submission to the inquiry.
Cathy James, deputy director of the charity Public Concern At Work, said she had found the written policy wanting. "In health, more than almost anywhere else, a closed culture will breed silence. Mid Staffs is a warning for all. I hope that this will push the other trusts to review their policies so that staff believe that it is safe and acceptable to speak up."
Whatever the final conclusions of the independent inquiry, campaigners whose family members have received poor treatment at the trust's hospitals believe that the parameters of the inquiry were too narrow.
Julie Bailey, founder of the patient group Cure the NHS, said that more than 100 families who support her organisation are now pinning their hopes on a judicial review.
"The inquiry was done in secret and seems to have gone through the same evidence as the Healthcare Commission report," she said.
"We need a judicial review to look at the failings of the regulatory bodies – where were the primary care trust, the strategic care authority, the Healthcare Commission, local MPs and the Department of Health while people were dying?"
Mid Staffordshire NHS Foundation Trust last night declined to comment until after the findings of the inquiry are officially released.
"We will be happy to comment on the conclusions, but wish to wait until it is out in the open," a Mid Staffordshire spokeswoman said.
A spokesman for the inquiry did not wish to comment.