26 Oct 2013

How blowing the whistle cost two men their NHS careers

In the 1990s, a consultant anaesthetist at Bristol Royal Infirmary blew the whistle on the number of children dying from heart surgery. It was one of the biggest scandals to the hit the National Health Service.

It forced a public inquiry and led to two doctors being struck off the medical register and one being

As for Dr Steve Bolsin, that whistleblowing anaesthetist, he never worked in the UK again. Instead he and his family moved to Australia where he has made a successful career for himself at Geelong Hospital in Victoria.

But he is currently back in the country to receive an award from the Royal College of Anaesthetists.

Finally, perhaps, a recognition from the establishment of the central role he played all those years ago in highlighting the number of children and babies dying in the operating theatre at Bristol.

General Election - National Health Service

We spoke to him before the award ceremony and he told Channel 4 News that he would do it all again if he had to. “What happened in Bristol had to end. Someone had to step in,” he said.

But what has changed since then? The experiences of Mid Staffordshire would suggest not a lot. Whistleblowers are still finding it hard to have their voices heard.

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And this is backed up by the chairman of the Care Quality Commission (CQC), who this week told the health select committee that there was a ‘chilling’ culture in NHS hospitals that discourages potential whistleblowers from breaking ranks.

David Prior said he had spoken to a couple of surgeons whose careers have been severely limited because they expressed concerns about what was going on at their hospitals.

But it is not simply that careers are severely limited.

Careers are destroyed, marriages broken up, families split apart. Millions and millions of pounds are lost to the NHS because a doctor is no longer able to work. Their expensive training is lost, trusts spend unlimited funds on legal cases and payouts are made.

This is the point that Edwin Jesudason makes. His case his chillingly similar to that of Steve Bolsin’s. All that sets them apart is nearly two decades.

Mr Jesudason is a highly qualified award-winning paediatric surgeon and an associate professor in paediatric surgery. He specialises in surgery for birth defects and children’s tumours and has been widely-acclaimed for his research.

But he made the mistake of blowing the whistle and now he is unable to find work in this country and is, instead, carrying out research in Australia.

Mr Jesudason was a consultant in the paediatric surgery department at Alder Hey Children’s hospital in Liverpool when in 2009 he became concerned about patient safety and what he describes as a culture of fear and bullying.

He and a colleague called for a review of some of the fatalities following surgery. He says that nothing was done.

That colleague’s reputation was undermined, he was suspended and he is no longer working at Alder Hey.

Mr Jesudason went on sabbatical to America in 2010. When he returned briefly the following year he again complained that his concerns had not been investigated.

Alder Hey, at this point, called in the Royal College of Surgeons (RCS). They found that while the paediatric surgical department was no longer first class, it was providing a safe surgical service.

Thanks to a Freedom of Information request by Private Eye, it has now become apparent that the RCS was not in possession of all the facts.

Because in 2010, an internal report was commissioned to look at the psychological stress staff were under. It makes disturbing reading.

Produced by Alan Phillips, head of psychosocial services at the Alder Centre, it states that “many of the staff were in a high state of distress”, “concern for patient safety was a powerful theme” and “several incidences were recounted where staff had fainted or had been otherwise incapacitated whilst in theatres”.

“many of the staff were in a high state of distress” – an internal report at the Alder hopital

This was attributed to staff or colleagues being “required to attend operations when they are physically and mentally unable to perform their duties confidently or competently”.

Two paragraphs are headed self-harm and suicide and harm to others. Those paragraphs warns “the distress exhibited in the confidential sessions was accompanied by various degrees of anger and variations on the theme of ‘if something isn’t done soon someone will snap and attack someone’.”

All of this appears to substantiate what Mr Jesudason was saying all along. But the RCS was not given the report and the CQC said they had not seen it before or during an inspection of the hospital.

Mr Jesudason was back in America, but it had become apparent to him that he would not be welcomed back at the hospital, so in July 2012 he took the case to the high court, winning an injunction to stop him from being dismissed.

However, an attempt to have that injunction made permanent collapsed, and he was left to pay Alder Hey’s costs of £100,000.

Alder Hey has acknowledged that Mr Jesudason made protected disclosures, which is another way of saying he was a genuine whistleblower.

But in a statement Alder Hey said that as a result of Mr Jesudason’s concerns they had invited the RCS to investigate the concerns raised and that the RCS “concluded the department was safe”.

They said a subsequent review by the CQC in 2012 also “found that patients have safe and appropriate care, treatment and support”.

They also said that the trust believes that a culture of openness and honesty is vital for the maintenance of high standards.

That much is indisputable. But that is not always what happens in the NHS.

Next month, Mr Jesudason, who is now working in Australia, will have a meeting with the chairman of the CQC, and evidence he has gathered on the amount of money spent by the trust on his and his colleague’s case has now been sent to the comptroller and auditor general.

Of course, in the meantime, he will return to Melbourne and he will not be working in the NHS.

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