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NHS suspensions

Sheila Porter-Williams

Update August 2007:

Dr Raj Kumar Mattu, who has been suspended since February 2002, has now been reinstated by University Hospitals Coventry and Warwickshire NHS Trust, although he still faces a disciplinary enquiry and in view of the duration of his suspension will need extensive retraining.

See BBC report containing links to some earlier reports.  See below for the whistleblowing that preceded the suspension.

Media reports (not available on the Internet) suggest that the change is a result of changes in the management team.  While there has been a complete change since 2002, most of the board have now been in post for several years.  The most recent significant change is in the chair.  The previous chair moved over to Warwickshire primary care trust in October 2006.

See also Suspension of whistleblowers in West Midlands Ambulance Service, which virtually coincides with Dr Mattu's reinstatement.

Update April 2004:

From The Whistle No. 23 (Apr 2004)

By Sheila Porter-Williams

On 29th December 2003, in response to the scathing report on suspensions by the National Audit Office mentioned in Whistle 22, the Department of Health published a circular:

"Maintaining high professional standards in the modern NHS: a framework for the initial handling of concerns about doctors and dentists in the NHS"

(http://www.dh.gov.uk/PublicationsAndStatistics/LettersAndCirculars/HealthServiceCirculars/HealthServiceCircularsArticle/fs/en?CONTENT_ID=4065697&chk=1DZoY8).

We would be interested in knowing whether the new policy framework leads to any improvement.

Update November 2003:

From The Whistle No. 22 (Nov 2003)

By Sheila Porter-Williams

PREVIOUSLY:

Submitted to ‘The Whistle’, 3rd March 2002.

The Whistle No. 18 included a report on the suspension of two consultants at University Hospitals Coventry and Warwickshire NHS Trust, UK.

One of the two consultants suspended at that time was Alban Barros D’Sa who had raised concerns about a colleague’s high mortality rate among patients for colorectal surgery. The ostensible reason for the suspension was that he was alleged to have put improper pressure on a junior colleague to get information for his investigation, and an internal enquiry decided that a reprimand was sufficient sanction for that offence. The suspension continued for many months longer. Eventually the Court of Appeal upheld the High Court’s judgment that seeking the help of a Member of Parliament in trying to get reinstatement was not a valid reason for continuing the suspension, and Mr D’Sa was reinstated.

Shortly afterwards the Commission for Health Improvement (CHI) inspected the Trust and produced a comprehensive report of its failings, which led to the Secretary of State giving the Trust a “no stars” rating and put the management on six months’ notice to effect a significant improvement. Among the failings requiring action were the following:

1. High patient mortality rates (the problem Mr D’Sa had highlighted for one of his colleagues).
2. The need for a just management culture (while the report did not name names, it is likely that Mr D’Sa’s suspension was among the incidents prompting this recommendation).
3. The need to stop placing five beds in bays in high-dependency units designed and equipped for four.

The third point was highlighted during the inspection by another consultant, Raj Kumar Mattu. In February 2002 Dr Mattu was suspended on similar grounds to Mr D’Sa, for alleged bullying of junior staff. This is a remarkable coincidence.

My experience as a patient, and as the daughter of a patient, is that it is endemic in the culture of hospitals for consultants to use contemptuous or dismissive language to or about patients and subordinates. This is not acceptable, but, except for extreme examples (and there are horror stories of consultants with impunity ordering junior doctors and nurses to perform treatments expected to kill patients) or persistent offenders, the solution needs to be to change attitudes, not to use formal disciplinary processes. When I complained in 1997 about a consultant’s contemptuous refusal of surgery to my mother in one of the hospitals run by the same Trust, there was no question of disciplinary action against the consultant responsible.

Why suspensions?

The Trust does not explain its reasoning. It looks as though, whenever any employee highlights wrongdoing in the Trust’s hospitals, the Trust collects statements from anybody who has been involved in the investigation. Then if any statement reveals any evidence of any misconduct on the part of the whistleblower, even if the person making the statement has not made a complaint, this is used as ammunition to suspend the whistleblower.

In theory suspension of an employee suspected of wrongdoing is a neutral act to enable an orderly investigation. In fact it as used as an act of oppression and intimidation. There are so many examples of unnecessary and prolonged suspensions in the NHS that the powers of management to suspend staff must now be curtailed. There should be an absolute limit on a suspension of three months. But within a much shorter period (say two weeks) there should be a requirement to satisfy an independent body such as a Magistrates’ Court that continued suspension is appropriate. The employer would need to prove that the alleged offence if proved would reasonably justify dismissal and that there is sufficient evidence about the individual who is suspended to pursue further enquiries that could not satisfactorily be pursued with that person actively in post. [Submitted to ‘The Whistle’, 3rd March 2002]

Links to judgments

• Court of Appeal: D'Sa v University Hospital Coventry & Warwickshire NHS Trust [2001]
• High Court : Mattu v University Hospitals Coventry and Warwickshire NHS Trust [2006]