Birmingham,The Stirrer, Black Country

news that matters, campaigns that count

for Birmingham, the Black Country and beyond

WHEN TO BLOW THE WHISTLE

11-11-2008

Birmingham Childrens Hospital has rejected claims that its standards of care are comparable to a third world country, following leaks from drisgruntled medics. Dr David Nicholl offers advice to whistleblowers.

The front page report in this week’s Observer about Birmingham Children’s Hospital reminded me about the times I have blown the whistle.

I am not in a position to comment about the report, as I don’t work at the Children’s Hospital, but I sincerely hope that all the clinicians have got their facts absolutely straight before they went to the Press.

Long after the journalists have moved onto the next story, the staff (and patients) will have to live with the consequences of the story for many years to come- after all how many tertiary referral centres have had difficulties finding beds? Answer- all of them, this is something that by the nature of such a complex service will always be the case.

The question really is, is there evidence of poor care at the Children’s Hospital compared to other comparable units?

I have been very fortunate in the two times I have blown the whistle, I’ve never had any action taken against myself - others have not been so lucky. I’m only happy to talk about these two instances publicly so that hopefully I could help others in similar circumstances and that a number of years have passed.

Almost 10 years ago, I was a neurology registrar at Walsgrave Hospital in Coventry. I was approaching the end of my training, so I was by no means wet behind the ears. Nonetheless, I was truly shocked by the standards of basic care at that time, especially the policy of the hospital to squeeze 5 patients into 4 bedded bays.

It was clearly inherently dangerous - I can still recall being called to resuscitate a patient and the cardiac arrest team struggling to get around the patient. I raised the issue with consultants and nursing staff only to be told that they agreed that it wasn’t right but nothing could be done.

I then decided to write to the medical director and chief executive (which looking back was pretty brave for a humble registrar) but kept being fobbed off. I felt that I had approached all the relevant parties but was not getting anywhere, so I wrote to the President of the Royal College of Physicians citing that I was concerned that was this was not an appropriate environment for trainee doctors to be in, if we all agreed this was poor practice.

I was unaware that others, such as Dr Raj Mattu at Walsgrave, had raised similar concerns- he ended up being suspended on full pay for over 5 years at a cost of literally millions of pounds. (I should add that Walsgrave in 2008 is a very different place from 1999 - indeed the Department of Health’s stroke czar singled out Walsgrave for the high quality of its stroke and neurological services recently)

Last year, I spoke to Channel 4 news over the junior doctors scandal as I felt the then Minister of Health had misled the country over the numbers of doctors affected by the MMC. I was only prepared to do that as I was absolutely 100% sure that my data was correct and the government’s was wrong (I had a source on the MMC panel so I knew I was correct).

The things I have learnt from these 2 instances are this.

  • never blow the whistle alone (- check with colleagues that you have your facts right)
  • go up the chain of command first (your medical director, chief executive etc). If they don’t reply or fob you off, write to them again- this time get a letter signed by your colleagues in your department - and - if the problem is still ongoing and is risking patients, and you haven’t had a proper reply following the above, you are duty bound to go to the press in my view.
  • make sure you are 100% sure of your facts, would you be prepared to swear on oath in court that your evidence is correct? Whingeing is one thing, but being sued for libel doesn’t do anyone, least of all your bank balance any favours.

Your first duty as a doctor is the care of your patients and if you have good grounds to suggest that their care is being threatened, you are quite within your rights to go to the Press, but ONLY do so if you have tried every other measure.

Would I blow the whistle again? Absolutely, I think the public would expect me to do so, as a healthcare professional, if there was evidence of poor care. I only hope that whoever contacted the Observer did follow the above suggestions, otherwise they may have caused an awfully big storm in a awfully big teacup.

DISCUSS THIS ON THE STIRRER FORUM

Google

The Stirrer Forum

The Stirrer home

valid xhtml

©2006 - 2009 The Stirrer