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SPEAK OUT SAFELY WEEK

David Drew: ‘Every professional needs to fight for a better NHS culture’

I have just received some bad news. Three years after being dismissed by my NHS trust for “gross misconduct and insubordination”, my appeal against dismissal at the tribunal has failed.

I’ve put a lot of time and effort into getting justice. I’ve lost a huge amount of income and spent a small fortune in legal fees. Stress has been my daily diet.

Yet I do not have a single regret. The same goes for my wife and family who have born the emotional brunt of these difficult years.

In the week I received my news, the Commons health select committee, in its response to the Francis report, advised:

“Disciplinary procedures, professional standards hearings and employment tribunals are not appropriate forums for constructive airings of honestly held concerns about patient safety and care quality.”

From 2008 to 2010, as the senior paediatrician in my trust, having been clinical director for seven years, I raised honestly held, serious concerns about patient safety and care quality. I was dismissed by a disciplinary procedure. I turned to lawyers and the employment tribunal as my only way of getting redress. The General Medical Council was not involved. My employer described me as an excellent doctor.

It’s a relief to hear that, although I have been forced down the wrong road by my trust, there is hope others may avoid this in future.

The committee also reaffirmed its previously expressed view that:

“The effective exercise of professional responsibility is the bedrock on which high standards of patient care are built. It also continues to believe that there is an essential public interest in ensuring that professionals are protected against punitive action when they raise concerns about professional standards at their place of work.”

The explanation for this punishment-based culture is found in Robert Francis QC’s report, in which he delivers a typically polite but damning criticism of some NHS management:

“A greater priority is instinctively given by managers to issues surrounding the behaviour of the complainant, rather than the implications for patient safety raised by his complaint.”

In my case this was true of the trust chief executive, chair, medical director and clinical director responsible for my dismissal. Framing my own story as an employment dispute rather than a senior, experienced doctor advocating for his patients was the work of the trust solicitor, whose professional responsibility is to the trust, not to patients. As at Mid Staffs, this poses a threat to patient safety.

The mistreatment of  whistleblowers is an abuse of power and results from a clash of cultures. Management has a business to run. Whistleblowers rock the boat and are seen as troublemakers.  On the other side of the divide, the whistleblowers represent a minority of professionals prepared to stand up when they see patient harm and refuse to be bullied into silence. David Morgan – a psychoanalyst with experience in caring for NHS whistleblowers – explained this behaviour in a recent talk. “The whistleblower is more likely to be concerned about moral security than personal security,” he said.

My chief executive offered me a choice; accept a six-figure severance payment and sign a gag or we will dismiss you by disciplinary procedure. At least three other professionals involved in my case were gagged. Everything about this is contrary to the transparency that current wisdom demands for safe patient care. I refused the offer, knowing this would trigger disciplinary action against me. “All I need for a happy retirement is a clear conscience,” I wrote to my CEO.

It’s over for me now. I will not work as a paediatrician again. After three years’ absence from work, I am deskilled. I firmly believe that the Francis report and Don Berwick’s response to it offer a kinder culture and a better future in which professionals will be able to Speak Out Safely for patients.

But this will not be achieved without a fight. Every professional has a responsibility to engage. I intend to be there cheering you all on.

David Drew is a retired consultant paediatrician

Readers' comments (7)

  • tinkerbell

    You're an inspiration. If I were a soldier I would salute you. You couldn't be bought, they couldn't brow beat you. You have my utmost respect. You stood up for all that is good and decent. You are one of a 'few good men'.

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  • Wow tinkerbell is right that is a truly inspirational story. Hopefully if all healthcare professionals and their representative bodies stand firm together we can change the way concerns about patient safety are dealt with.

    As my Irish parents would say
    "good man yourself David!"

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  • I will not work as a paediatrician again. After three years’ absence from work, I am deskilled.


    Never say never, you don't know where your skills and abilities will and can be put to good use. 3 years may take the edge off your cutting edge knowledge but it will not deplete your "laid down over the years knowledge and experience" Certainly, I am sure the NHS has lost an excellent Paed and an honest employee but they are very good at weeding out their brightest, best and most morally sound.... And all those silly billies involved will face accountability for this eventually, make no mistake.

    I don't know whether we ever know what the right road was, until we have been down the wrong one and can look back and say, "no, I was ill advised". But perhaps even in that , you can be of help to those who come after you and there will be others. I fear that although Francis was a good man it will take a lot to shift the bullies out of the NHS they are so very well embedded.

    We are put through these things so that we grow, horrible though it is in the process. But there are better things to come David.

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  • Rosa Sanchez

    Take a look pre/nursing students
    A great option to hands on in the medical fields
    www.handsonperu.org

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  • David Drew is owed much, he has shown enormous courage and strength – we all owe a debt of gratitude.

    Blowing the Whistle should not be this hard.

    There is something pretty rotten with any system that does this to someone who has stood for the right and proper action.

    Shame on the people and the system that let this happen.

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  • I can't understand what is happening here. I am just about to embark on nurse training and have been set to read a Dept of Health paper, 'Developing the Culture of Compassionate Care'. One of the 6Cs is courage and the article outlines the need to be able to 'speak up when things are wrong' and, on the subject of observing poor care, it states that we have, '....a duty to challenge it'. How then is it that a man of integrity and compassion can be so wronged?

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  • Anonymous | 24-Oct-2013 4:56 pm

    You are quite correct, but unfortunately the reality is very different. The best way seems to be to very closely follow the press, read the comments and speak to as many other hc profis. as you can, especially those who work or have worked recently in the NHS, to answer your questions rather than learning yourself by bitter experience as so many have done to their serious detriment.

    It is impossible to try and understand the incomprehensible.

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