Since the publication of the report last week into Kim Holt’s (one of the Senior Consultant Paediatricians in the Haringey Child Protection team) allegations of bullying by management – which have seen her on ‘special leave’ for two years – I hear tell of what appears to be intimidation, or at very least, harassment.
Many professionals who work in the various departments associated with child protection – health, children’s services, etc. – gave witness statements to the report’s authors supporting Kim – stating how valuable her work was, what an excellent professional she was and what an advocate of good practise in child health care etc etc etc. In fact, the report itself praises her and states there is no criticism of her professionalism whatsoever. What the report doesn’t do however is investigate the bullying or the management’s ignoring of warnings about danger to the children it is meant to be protecting.
These witnesses were (and still are) pretty scared of speaking up and coming forward. I know – I spoke to several during the course of Kim’s case and they all spoke to me on the basis that I would not name them. I think this speaks volumes for the case that Kim makes of management bullying and the very serious outcomes that a bullying and silencing management begets – in that warnings are ignored and people are too scared to go public.
Kim was one of the four consultants who signed a letter to the management of Great Ormond Street Child Protection team saying that children were in danger because of a variety of things not being done properly. The letter also stated that the consultants were concerned because management was ignoring their warnings.
Now – post publication of the report – it would seem that those witnesses who were promised anonymity may find themselves being approached by their management and asked if they have given evidence on Kim’s behalf. News has reached me – as they say.
I would say this is a classic example of bullying. Now who is it who could possibly want to know who may have supported Kim against the establishment?
Lynne Featherstone 
Well, this is a tricky mess. The report doesn’t look into the matter because there’s no real evidence, and neither the authors nor anybody else has a mandate to go on a general fishing expedition in search of some. Which is, of course, normal in cases like this, because it’s not something that tends to leave any evidence, unless you get lucky and the people responsible are careless. It’s an old and common problem, and I’ve never heard of anybody solving it.
Personally, I can’t even form an opinion in this case, having heard neither side of the story.
When I read this I wondered why anyone might consider intimidating witnesses after the report is published. A possible reason might be that further trouble is anticipated. This might be nothing to do with Baby P. Or it might relate to further implications of the NHS London report.
Evidence of systemic management failings might help those individuals who currently face disciplinary proceedings and/or unemployment as a result of the rush to blame individuals for the death of Baby P.
There is also the question of whether those in management positions might themselves now be subject to professional scrutiny by their regulatory bodies.
General Medical Council (GMC) Guidance for doctors is clear about the professional duty to raise concerns about threats to patient safety. Good Medical Practice states at paragraph 6:
“6. If you have good reason to think that patient safety is or may be seriously compromised by inadequate premises, equipment, or other resources, policies or systems, you should put the matter right if that is possible. In all other cases you should draw the matter to the attention of your employing or contracting body. If they do not take adequate action, you should take independent advice on how to take the matter further. You must record your concerns and the steps you have taken to try to resolve them.”
http://www.gmc-uk.org/guidance/good_medical_practice/good_clinical_care_raising_concerns.asp
Paragraph 45 states:
“45. If you have management responsibilities you should make sure that systems are in place through which colleagues can raise concerns about risks to patients, and you must follow the guidance in Management for doctors.”
http://www.gmc-uk.org/guidance/good_medical_practice/working_with_colleagues_conduct_and_performance.asp
The GMC document, Management for doctors, may be found here:
http://www.gmc-uk.org/guidance/ethical_guidance/management_for_doctors.asp
Paragraph 4 states:
“4. You continue to have a duty of care for the safety and well-being of patients when you work as a manager. You remain accountable to the GMC for your decisions and actions even when a non-doctor could perform your management role.”
Paragraph 45 states:
“45. If you are responsible for investigating incidents or complaints you should make sure that:
…
o clinical staff understand their duty to be open and honest about such events with both patients and managers
o all other staff are encouraged to raise genuine concerns they have about the safety of patients, including any risks that may be posed by colleagues
o staff members who raise concerns are protected from unwarranted criticism or actions
o systems are in place to ensure that incidents, concerns and complaints are investigated promptly and fully
o the person or people being investigated are treated fairly”
It seems to me that managers who are also doctors are already at risk of disciplinary proceedings at their professional regulatory body. It would be in their own interests, as well of the interests of patients and colleagues, to stamp on any intimidation of witnesses. Such intimidation, if it were to be carried out, would make their position more hazardous than it already is.
Dear Lynne,
It is more than 24 hours since my posting above, and no-one has challenged it, so I take it that the authorities have no problem with my view.
Great Ormond Street has committed itself to children’s services in Haringey:
Dr Jane Collins, ‘Baby Peter Pledge,’ The Guardian, Friday 29 May 2009 http://www.guardian.co.uk/society/2009/may/29/letter-baby-peter
Surely the time has come for Great Ormond Street publicly o distance itself from any attempt to intimidate witnesses and reaffirm its recent commitment to children’s services.
Yours sincerely,
Peter Gooderham
I think a timely bump is called for.
It is now clear that this “metastasis of retribution” is not uncommon when public services deal with whistleblowers.
How sad, and what a danger to patient safety!
The government should act, and I don’tean tinker with the NHS constitution.