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LETTERS TO THE NATIONAL AUDIT OFFICE
5th December 2002
Karen Taylor
Director, National Audit Office
Dear Ms Taylor,
I wish to draw your attention to the desperate need for a local inquiry into suspensions and the conduct of the management at Walsgrave NHS Trust. Whilst the study by the national audit office is most welcomed and overdue, I am unclear as to whether your terms of reference are likely to unveil the truth behind the awful situation at our Trust, which may encroach upon possible fraudulent and criminal behaviour.
During the last decade, this Trust has eroded the standards of patient care at our hospitals, culminating in our Trust receiving the worst ever report produced by the Commission for Health Improvement (CHI), in September 2001. Patient safety and the management's creation of a culture of fear, leading to clinical staff unwilling to speak out when things go wrong, were two of the key problems identified in this report, two key sections enclosed for your attention. It is worrying for CHI to identify patient care at our Trust as below standard, and in some areas down right dangerous eg 5 patients in 4-bedded bays. However, it is alarming that Mr Loughton, former Chief Executive, has simultaneously created an environment whereby the caring and courageous staff who overcome the culture of fear and speak out for patient safety are victimised, intimidated, and then suspended.
Mr Barros D'Sa, recently retired Consultant Surgeon, warned that patients were four times more likely to die following gut surgery by a particular colleague, compared to the national average. Mr Loughton's response? To suspend Mr Barros D'Sa for about 20 months. The outcome? The case ended up in the High Court, where Judge Blofeld heavily criticised the Trust and Mr Loughton, and threatened to seize the personal assets of Mr Loughton and Mr Faulkner (Former Director of Personnel) and consider imprisonment, if they did not re-instate Mr Barros D'Sa. Furthermore, it is estimated that by victimising Mr Barros D'Sa in this manner Mr Loughton wasted over £500,000 of our valuable taxpayer's contributions from an already struggling NHS. Has Mr Loughton been held to account for his actions? NO. Like many local people, I ask why not?
More recently, Dr Raj Mattu, a cardiologist of international repute warned of the dangers of cramming 5 patients into 4-bedded bays. Even though his concerns were subsequently supported by CHI, Mr Loughton went onto television and radio to claim that no harm had come to any patients, because they were carefully selected. We now know this to be untrue, and Dr Mattu took the courageous step of risking his position and appearing on television days later, on 25th September 2001, to reveal the truth and that patient deaths had occurred because of overcrowding 5 patients in 4 bedded bays. Indeed, as early as December 1999 a death was reported through the Trusts procedures, which was ignored and eventually responded to in January 2002, five months after CHI forced the Trust to stop this practice forthwith. Mr Loughton's response? To declare that he wanted to end Dr Mattu's career. Prior to this Mr Loughton had already expressly stated that he wished to get rid of Dr Mattu and four other consultants in front of many witnesses, who had dared to speak out for patient safety. The outcome? The suspension of Dr Mattu on 21st February 2002, by using the same methods as for Mr Barros D'Sa.
There have been countless other high profile revelations of poor patient care at the Walsgrave Trust, such as avoidable deaths of head injury victims, the country's worst death rates following cardiac surgery, missing cancer diagnoses in patients, high hospital re-admission rates and 60% increased mortality following elective surgery compared to the national average. The list of misdemeanours and mishaps is frightening, such that it should not come as any surprise that the community has lost confidence in their Hospitals and their Trust.
In February 2002, the CHI revisit confirmed the lack of progress and improvement in the Trust, forcing the resignation of Mr Loughton. Rumours are rife, that he has received a dignified departure and a 'handshake' payment of the order of £200,000 plus. For years to come, the people of Coventry and Warwickshire will be paying the price for the way in which Mr Loughton has desecrated and abused local health care provision and left it destitute and desperate. Why was he not sacked, as he deserved? Who is protecting Mr Loughton? We have a right to know if he was given some of our money, and how much.
Mr Stoten, new Trust Chairman, was received in November 2001 with great enthusiasm and anticipation. However, he has been a resounding disappointment, and has failed to deliver important and real improvements. It is during his Chairmanship that Dr Mattu has been suspended and this has continued for 10 months, to date. Furthermore, Mr Stoten appears content to allow the utilisation of the same tactics as used by Mr Loughton. Regrettably, it appears that he is busier with a Public Relations exercise than facilitating true service improvements. Patients and staff therefore continue to suffer.
Despite his claims of non-involvement with the suspension of Dr Mattu, there is emerging evidence that fails to support his claim. Indeed, there are growing and serious concerns about Mr Stoten's integrity. We needed a new start with a clean break from the previous management and their techniques, and this does not appear to have happened. This is totally inappropriate for local health care and the NHS.
Despite his own claims of a long, distinguished and respected career in local health care provision, Mr Stoten's first 9 months at the Trust fail to support his contention. Instead, he appears pr-occupied with his own ambitions of personal development and Public Relations, and he manifests only secondary concern for real improvements in health care provision for local residents. It also appears that any regard for Mr Stoten is predominantly amongst the small number of inappropriately empowered health care bureaucrats and not widely amongst many health care professionals. It is also of considerable concern that he appears to have co-opted a number of acquaintances/ supporters onto the Trust Board of Directors, weakening further the independent balances and checks that protect the interests of the people of Coventry & Warwickshire.
We desperately need outside help for our Trust to ascend to its former standing as a centre providing competent and reliable health care. We do not need a major public relations exercise that addresses the Trust's image rather than providing real improvements in health care.
There is also growing concern over possible financial irregularities within the Trust. For instance, consider the case surrounding the suspension of Dr Mattu. He had successfully raised about £600,000 for improvements of the NHS service. We are informed that, prior to his suspension, Dr Mattu had formally raised concerns about these funds, and the Trust declined to account for the monies that they had received. To date, the Trust has declined to account for the monies that Dr Mattu had raised for the Trust, which has certainly not been spent upon the service improvements for which it was awarded.
Similarly, there appears to be misappropriation by the Trust of Dr Mattu's research/ endowment funds, amounting to about £140,000. We know that in February 2002, about £100,000 of research money had failed to appear in any of Dr Mattu's three research funds, despite being directly awarded to him, even though the Trust has been receiving the award over a two year period from the National Heart Research Fund on a three monthly basis.
Furthermore, Dr Mattu's research exchequer account had about £14,500 on 30/03/02; his charitable fund had about £16,500 on 31/05/02; and his Equipment fund had about £8,000 on 31/05/02. There should therefore have been about £30,000 remaining in these funds on 31st May 2002, after accounting for outgoing costs and additional income. Considering that during June only about a further £2,300 should have been expended on salaries and a further unaccounted sum of income would have been expected, you will appreciate our surprise at the Trust's claims that these accounts are overdrawn. On 4th July 2002, Mr John Richardson, Trust Press Officer repeatedly declared on radio and television that Dr Mattu's accounts were £10,000 overdrawn. Where has a further £40,000 gone?
These combined funds approach close to about ¾ of a million pounds, and relate to just one consultant. What is the likelihood that this Trust activity is unique to this one individual?
There is also a disturbing lack of transparency about the affairs of our Trust. This public body, which we all help to fund in order that it may serve us, is falling short on most milestones. Yet we are not readily permitted to know about the workings, records of the performance markers and accounts. What are they trying to hide? We have a right to access them, and I for one wish to better understand how our Trust has come to fail us so badly and to learn from the information as to what is required to resurrect a hospital service of acceptable and appropriate standard.
The local situation is now critical, where the inappropriateness of the suspension of our senior doctors who speak up for patients, is just a symptom of the dire state in which our Trust continues to languish. We must get help and establish a local formal inquiry to determine what has happened, such that important lessons can be learnt. Not just for local health care but for the broader NHS.
We are in urgent need of
your help and from any other agency that may assist. Our Trust
must be audited and a public inquiry urgently established.
Yours sincerely,
Mr Brian King
