The head of the NHS in England is facing renewed calls to quit over the use of pay-offs to prevent “whistleblowers” speaking out publicly about concerns over patient safety.
During a bruising appearance before the Commons Public Accounts Committee, Sir David Nicholson, the chief of NHS England, angrily denied staging a cover-up in order to mislead MPs.
But in a series of heated exchanges, he was forced to concede that he had not found out how many staff had received pay-offs from NHS trusts, despite having previously promised the committee he would do so.
Following the hearing, committee member Stephen Barclay accused Sir David of a “real abdication of responsibility” and called for his immediate resignation.
“There is an old culture within the NHS really which comes from Sir David where whistleblowers weren’t encouraged,” Mr Barclay, a Tory MP, told the BBC Radio 4 PM programme.
“The culture associated with Sir David Nicholson is one where people are often suspended for very long periods of time and then paid off, often with gagging clauses attached.
“That is the old culture.
“Sir David is really part of the past, not the future.”
Prior to the hearing, Mr Barclay said figures obtained under the Freedom of Information Act showed that since 2008 at least 52 staff had been prevented from speaking through the use of confidentiality clauses at a cost of £2m to the taxpayer.
Mr Barclay told The Daily Telegraph that Sir David - who retires next year - had either been complicit in a “systemic cover-up” or had failed to ask questions about what was happening in the NHS, with the result that Parliament had been misled.
Sir David - who is stepping down after strong criticism over his role in the Mid Staffs trust scandal - told the committee that he had always acted to support whistleblowers in the NHS.
“I can absolutely refute that I have ever been involved in any kind of cover-up in relation to the expenditure that’s identified,” he said.
“I have been absolutely honest and truthful with this committee.
“Compromise agreements of whatever level are used widely both in the NHS and the private sector and other public sector.
“They do not necessarily mean that someone has been stopped speaking about patient safety.
“To connect the two all the time I think is erroneous and wrong.”
Sir David said he had not written to NHS trusts after his last appearance before the committee in March about pay-offs made under the system of judicial mediation - which are not required to to be signed off by the Department of Health or the Treasury - as his priority had been to close down the loophole.
He said that under the NHS re-organisation, his responsibilities had changed in April and it had been more appropriate to pass the matter to the DH.
“I have always supported people who have stood out against the system,” he said.
“It is a very, very important part of being a health professional and being a leader in the NHS, to support people who speak out.
“To connect me with some kind of cover-up I think is entirely and utterly inappropriate and I completely refute it.
“There has been all sorts of stuff that has been said this morning that is completely untrue.”
He was sharply rebuked by the committee chairman, Margaret Hodge, who described the failure to hand over the data - or even to inform the PAC that it would not be forthcoming - as “impertinent”.
Mr Barclay told Sir David: “You gave an undertaking… and you decided that you would decide the priorities of Parliament and not even have the courtesy to write back to the committee and tell us about what is self-evidently a potential conflict of interest within hospital trusts.”
But senior DH civil servant Charlie Massey said that NHS trusts across the country had been asked to deliver the figures, but that many had replied that, because of the upheaval of recent NHS reorganisations, any information they could find would be “partial, costly and inaccurate”.
He said that NHS trusts had been told that in future settlements made through judicial mediation should not prevent staff raising issues of patient safety in public.
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