SUSPENSION OF DR RAJ MATTU
SUMMARY
The
Commission for Health Improvement (CHI) and reports in the Times
newspapers confirmed serious deficiencies in the quality of care
at the University Hospitals Coventry & Warwickshire NHS Trust.
The CHI also identified and warned of a fear culture within the
Trust whereby senior clinical staff were too frightened to speak
out about patient care because of victimisation by senior
management, in a report that they described as the worst that
they had ever produced.
Those who
were exposed as responsible for the dangerous state of local
health care attempted a cover up and misled stakeholders and the
authorities, claiming for instance that the management’s
policy of overcrowding bays equipped and designed for 4 people
with 5, did not cause patient’s harm or deaths (Mr Loughton,
CEO, 25th September 2001). This claim followed
the Trust Management having disregarded over 150 serious clinical
incident reports being submitted to them. On 29th
September 2001 the Trust also received a Department of Health
zero star rating when Consultant Cardiologist & Physician Dr
Raj Mattu, under pressure from his peers and conscience,
reluctantly and bravely spoke out for the people of Coventry and
his own principles, and appeared on the BBC describing deaths of
patients related to the 5 in 4 policy.
During
this period Mr Barros D’Sa, Consultant Surgeon, 
was
suspended by the Trust with allegations of bullying after raising
clinical concerns regarding increased death rates associated with
colorectal surgery. Suspension lasted 20 months at an estimated
cost of over £500,000. He was reinstated after the Trust
lost High Court and Appeal Court hearings. The Royal
College of Surgeons shared his concerns and recommended the
cessation of that particular type of surgery by the specific
surgeon (a Clinical Director Appointed by the Chief Executive)
about whom Mr Barros D’Sa had expressed concerns. The
Trust allowed this surgeon to continue performing these
procedures for over two and a half years after concerns were
first raised, and even after a statement in the House of Commons
by the Junior Health Minister (Gisella Stuart) on 27 March 2001
reassuring the house that only designated and accredited Gut
Surgeons would perform these procedures from 1 April 2001. This
surgeon continued to perform these procedures until November 2001,
endangering further patients.
The
consultants passed a vote of no confidence in the Trust
Management and Board to administer and prosecute the disciplinary
procedures by an overwhelming 2/3 majority in May 2001, and then
a vote of no confidence in the Chief Executive, Mr Loughton, with
a similar majority in September 2001 following the CHI report.
From May
2001 onwards Senior Managers and members of the Trust Board,
including the former CEO, Director of Personnel and Chairman,
openly declared intentions to damage Dr Mattu’s career and
get rid of him, along with four other consultants who had raised
concerns. They have then made outrageous approaches to many
NHS staff to encourage complaints against Dr Mattu and even
sought to use a private detective to build up a file against him.
This continued despite CHI warning of victimisation of
consultants speaking out for patients.
This
attempt to destroy the career, reputation and livelihood of one
of the country’s leading and rising authorities in heart
disease led to more than 20 false complaints against Dr Mattu in
about 20 months, including fraud, bribes, absence from the
workplace and sexual assault. None were substantiated or
upheld. Dr Mattu therefore raised formal grievances against
the management for bullying and harassment, but the Management
either refused to investigate them or allowed the managers to
simply walk out of an inquiry hearing (21st September
2001), because they did not wish to be cross-examined and
investigated. The grievances remain outstanding. The
managers have had no repercussions or suspension for refusing to
cooperate with the Trust inquiry.
In
December 2001 the new Chairman Mr Stoten announced that no more
consultants would be suspended without his knowledge and
authority, and he curiously denied the fear culture identified in
the CHI report. He was personally informed about the
victimisation and bullying that Dr Mattu was suffering from
senior management, but he disregarded this and Dr Mattu’s
outstanding formal grievance, and instead allowed his continued
persecution. Indeed, over the ensuing months local
councillors, MPs, civil servants and dignitaries advised that Mr
Stoten told them that he had read a large file that the Trust had
built up on Dr Mattu, claiming that he was a serious problem as
he briefed them. The management proceeded to suspend Dr
Mattu in February 2002, under the very same allegations that he
had raised against the senior management, i.e. BULLYING. They
discriminated against Dr Mattu and selectively suspended him.
During the last 5 years there have been over 15 formal complaints
of bullying against consultants. Only 2 (including Dr Mattu)
have been against non-whites and they are the ONLY consultants
suspended by this Trust. Coincidence?
A number
of serious and worrying irregularities surround the suspension of
Dr Mattu and the ensuing investigation by the Trust, with
countless procedural breaches manifesting obvious continued
discrimination. National NHS procedures (HSG(94)49) require
the Trust to serve the oral suspension order whilst allowing Dr
Mattu to have a witness present. The Trust failed to do so.
This also obliges the Trust to substantiate the particulars of
the allegations within 10 days. The Trust Failed to do so.
“Where this is not possible, the practitioner should be told
why and informed when the particulars will be provided.”
The Trust failed to do so.
In fact
it took the Trust more than 3 months to obtain a signed statement
from the complainant and one from the key witness. The
Trust then refused to provide Dr Mattu the particulars by
claiming that they were not obliged to let him have sight of the
witness statements and any allegations that they contained.
After 6 months the Trust eventually released the two witness
statements and first demanded that Dr Mattu attend for interview
before he had even received them and then within 72 hours after
receiving them. More than 7 months after suspending him the
Trust appeared to eventually give Dr Mattu the chance to make
representations on his behalf and rebut any allegations. However
after allowing him the opportunity to address less than 1% of the
witness statements of these two people, the Trust abandoned the
interview giving an undertaking that they would reconvene after
reading the written statement by Dr Mattu. The Trust
reneged upon this, as they had done on many other undertakings
during the investigation, and even denied having ever made the
pledge to reconvene. Dr Mattu has never been allowed to
complete his evidence to the investigation.
The Trust
also reneged upon their undertaking to interview witnesses that
Dr Mattu put forward, with less than 50% being interviewed.
In spite of repeated appeals by Dr Mattu and his advisors the
Trust declined to interview the two longest serving researchers
in Dr Mattu’s team, even though they were frequently cited
as having been present at incidents where harassment was alleged
to have occurred.
The Trust
elected to record the evidence from witnesses put forward by Dr
Mattu using “witness summaries”, whilst witnesses that
the Trust considered hostile to Dr Mattu were allowed to provide
“witness statements”. The Trust summaries had
extensive material inaccuracies and serious distortion of
emphasis, in a manner that was consistently prejudicial to Dr
Mattu. In so far as they have been interviewed by the
Trust, 91% of witnesses objected to the way in which the Trust
sought to misrepresent their evidence to the investigation, and
made formal complaints and refused to sign and accept the
summaries as their evidence. Even though the witnesses
forwarded extensive corrections, the Trust failed to incorporate
the changes and produce amended summaries for over 91% of cases.
Instead The Trust insisted on utilising disputed inaccurate Trust
summaries as evidence on behalf of witnesses in spite of constant
protests and objections from them, Dr Mattu and his advisors.
The Trust
then enforced a panel even though Policy #16 does not provide for
one; Dr Mattu was suspended and investigated under this Policy.
When the Trust first announced its procedural change to use a
panel, Dr Mattu and his advisors explicitly agreed only to
consider constituting a panel contingent on the terms first put
forward by the Trust and in accordance with Trust Policy 3(a)
para 5.1c. Even though this is the only Trust Policy that
provides for a panel to investigate allegations about the conduct
of one practitioner towards another, and it gives clear guidance
on the constitution of such a panel, the Trust went totally
outside its policies and procedures and also reneged upon the
earlier undertakings that they had given about the panel. Consequently
the Trust had never secured agreement from Dr Mattu and his
advisors regarding constitution of a panel.
The panel
should have comprised three practising doctors, with one being a
Consultant Cardiologist and the third member being an independent
practitioner from outside the Trust selected by the Chairman
Senior Hospital Medical Staff Committee (practising doctor).
The panel
actually comprised only one practising doctor and two senior NHS
Managers, where the third member was instead selected by the
Trust Management and not even agreed by Dr Mattu and his advisors.
One senior manager was a member of the Trust Board and her
husband was understudy and trainee to the second manager during
his 10-year period in Sheffield. The Trust’s
contention that this was an independent panel cannot be a serious
one. The Trust made the remarkable claim that this third
member was not known to the management.
The panel
was given NO investigative powers or facility to interview a
single witness and therefore could not test the evidence or
determine any facts for itself. Instead it was told to make
a decision based upon a highly selected bundle of documents under
direction from a report made by the Trust Management. The
Trust refused to allow Dr Mattu and his advisors to appear before
the panel to present a defence.
The Trust
also prevented Dr Mattu and his advisors from having sight of
this report before it was put before the panel and therefore
denied him any opportunity to check it for factual accuracy and
make representations in response to its contents and any
allegations it contained. The day after the panel had made
a decision, the Trust provided only the report and prohibited Dr
Mattu and his advisors from having sight of the other documents
considered by the panel. The report had substantial
material inaccuracies and misrepresented facts in a manner that
was prejudicial to Dr Mattu. Further bias and unfairness
became apparent because it also transpired that the Trust was
very selective by NOT putting all the documents and evidence
before the panel.
The Trust
sought to corrupt the procedure by amalgamating steps and
pressing the panel to decide on whether Dr Mattu should face
disciplinary action, instead of presenting the panel with the
correct terms of reference to determine whether Dr Mattu should
face a disciplinary inquiry. Over 360 pages of
documentation was considered by the panel in just 7 hours, having
to simply take the allegations & Trust report at face value
to make a decision.
This
hardly constitutes a proper investigation and involved
interviewees who had not been questioned to test the allegations
and evidence. The Trust investigation has been highly
irregular and failed to meet its obligation of being thorough,
impartial and objective or fully establish the facts.
The
complainant (Dr Shane Gieowarsingh) and key witness (Dr Lencioni),
were having difficulties in working to the required standard.
Serious doubts hang over their integrity and therefore the
reliability of their evidence, which is also manifest in their
stories having changed dramatically. They started working
with Dr Mattu in February 2001.
Dr
Gieowarsingh started working with Dr Mattu in an honorary
observational capacity for his first 8 months and received no
salary during this time. He got into financial difficulties
and admitted to running up debts of £20,000-£30,000. As
part of the ongoing victimisation and harassment of Dr Mattu, the
Trust sent Dr Mattu’s researchers letters of termination of
contract within 1 week of Dr Gieowarsingh receiving his first pay
cheque in December 2001. Just days before registering his
complaint, he told a number of colleagues that he had been
promised a discretionary payment of about £20,000 by the Trust
Management, without good cause. About 5 weeks after
registering his complaint against Dr Mattu he was strongly
supported by the Trust Management to gain promotion to Cardiff,
with an alleged fraudulent CV. Over 4 months after leaving
the hospital he was caught having stolen Dr Mattu’s lap top
computer worth about £1800.
Dr
Lencioni signed his witness statement on 28 May 2002, tampered
with and deleted Dr Mattu’s files and data on 30 May,
prevented Mr Needham (researcher) rightful access to Dr Mattu’s
data and files on 30 May (claiming this was on senior advice),
threatened Mr Needham on 30 May, left Dr Mattu’s team on 31
May after irregularly securing promotion to a position working
alongside Dr M Been, having also tampered with and removed Dr
Mattu’s name from Dr Mattu’s own research. Dr
Lencioni appears to also commit perjury by indicating that an
earlier 9-page sworn affidavit he had composed in support of Dr
Mattu, with his own solicitor and at his own expense, was neither
his own composition nor truthful position. Other witnesses
testify that Dr Lencioni provided the affidavit of his own
volition.
Dr Mattu’s
only crime is that he courageously spoke out for the people of
Coventry & Warwickshire, for which the Management has
persecuted him for over 3 years. We request that Dr Mattu’s
punishment is ended immediately with reinstatement, and urge that
the investigation be conducted outside the Trust by a truly
independent forum. This Trust continues the fear culture
and persecution of senior clinical staff and cannot be trusted to
ensure justice and fair treatment for Dr Mattu, who continues to
suffer blatant discrimination. The Trust falsely claims
that an independent panel reached an independent decision that
concluded there was a prima facie case for disciplinary action,
misleading the public and authorities further, and therefore this
Trust warrants urgent investigation or a public inquiry.