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Mulholland: “Safe, sustainable Leeds children’s heart unit can finally move on but NHS England must learn lessons from their serious errors including dealing in future with abuse of NHS whistleblowing”

October 28, 2014 12:50 PM

Greg Mulholland, MP for Leeds North West, has said Leeds children's heart surgery unit can now move on following the publication of the third stage of the review into the unit and the decision to suspend children's heart surgery taken by NHS England Medical Director Sir Bruce Keogh in March 2013.

This decision caused uproar at the time, as it came just a day after a High Court decision to quash the decision to close Leeds in favour of the Newcastle unit and because it was reported at the time that it was based on incomplete and flawed data and on complaints from rival units, notably Newcastle who had contested the judicial review by saying Leeds staying open meant that Newcastle would close, under the terms for of the now discredited Safe and Sustainable review. Surgery resumed the following month after the first of three reports commissioned by NHS England said it was safe to do so and this was followed by a second report in March 2014 which made clear that the unit had been safe all along and that the data did not give cause for concern. The latest reports deal with the complaints forwarded by Newcastle and an overarching review into the whole saga.

Greg Mulholland led a high profile campaign for accountability into the decision, which actually put children a more risk, which is the reality of closing a safe unit. The new reports make clear that not only was the data incomplete and flawed and not therefore a reason to suspend surgery, but nor were the complaints made by rival unit Newcastle - and the report is very critical of their actions and their confusing campaigning with reporting genuine concerns.

Greg Mulholland was informed at the time and went public with the fact that so-called "whistleblowing" about Leeds was being done by those involved with the campaign to save the Newcastle unit, which would have closed under the terms of the Safe & Sustainable and some people involved, including medical professionals, were seeking to discredit Leeds as part of this. This has been strongly borne out by the review which is damning of the actions of the Newcastle NHS Trust and it also exposes that those involved in the campaign to save Newcastle had approached people to encourage them to add their cases to their document.

As the report says, "Reporting the unchecked allegations of others is not whistleblowing, and

Newcastle should have made the status of their concerns clearer when they reported

them". (P.67, overarching report).

9.114 (p. 68) "Newcastle clinicians were aware of the campaigning of some of the patient's families, which should have alerted them to the need for caution in this regard"

9.115 "We are...surprised at their willingness to put their reputation behind the parental concerns by transmitting them to commissioners without even elementary checking.

9.116 "Newcastle should have carried out basic checks before they passed on the stories of

these families, whether or not they knew that some families were campaigning on their


P. 67 "This is a troubling statement. If Newcastle thought that patients had come to real harm at Leeds they should have taken action as their concerns crystallised, rather than

collecting evidence for later reporting".

Greg Mulholland is now calling for better guidelines on NHS whistleblowing, so that this hugely important ability of medical professionals and staff to report problems is not abused as it clearly was in this case. Mr Mulholland has always made absolutely clear that any patient or family who has concerns about any NHS case must be fully and properly heard, but this must never again be used for campaigning purposes - and worse still unfair discrediting purposes - as was the case here.

The reports have said that the evidence does not support the majority of complaints made by the Newcastle NHS Trust, agreeing with the accuracy of the Newcastle case summaries in only 2 out of the 14 cases. In the other cases it considered that the summary did not present the full picture, or it disagreed with some of the assertions in the summary. The report also states that that the number of cases needs to be placed in context. There were only 14 complaints spread over 10 years from 2003-2013, this is out of around 100,000 cases handled by Leeds during this period.

The reports also bear out what Greg Mulholland was saying about the disastrous and flawed Safe & Sustainable Review and the decision making process around that. The report makes clear that this very review had the possibility of putting children at greater risk with the effect it had on some units, driving senior clinicians away and creating a culture of despondency.

The overarching report also criticises the Safe and Sustainable process as it "put centres in competition with each other". It goes on to say on Page 9 (2.16) that "this damaged the trust that some parents had in the neutrality of the advice given to them by those treating their children". (2.17) "We also found that the competition set up by the Safe and Sustainable process has damaged the trust and confidence that we are told used to exist between the practitioners in this specialty".

On p. 56 it underlines the damaging effect this had in this situation, 9.53 The Safe and Sustainable review created rivalry between Leeds and Newcastle which "set up anxieties in local families".

Commenting, MP Mulholland said:

"We already knew that the decision to suspend children's heart surgery at Leeds was made on the basis of flawed and incomplete data, now we know it was also done on the basis of a complaints that we made by a rival unit that we now know was done improperly and without adequate checking. There was a smear campaign against the Leeds unit, something that people in Leeds were aware of at the time and the fact that the report confirms that people at Newcastle were contacting families and actively encouraging people to complain about Leeds is very disappointing. This is a clear abuse of NHS whistleblowing, which is hugely important and there needs to be guidelines to ensure that the right of staff to report problems is never again abused for the purposes of campaigning and unfairly discrediting a rival unit, as was the case here.

"It is hugely important that any patient or family who has concerns about their NHS case must be fully and properly heard and they must be treated with respect and compassion at all times. Where something has gone wrong this must be properly dealt with. However complaints must never again be used for campaigning purposes - and worse still unfair discrediting purposes - as was the case here.

"This is the sad reality of the climate of mistrust and smear created by the Safe and Sustainable review process and Sir Ian Kennedy and all involved should hang their heads in shame. As the report makes clear, the Safe and Sustainable review pitted heart surgery units against each other and undermined the care patients could expect to receive and as could have led to serious concerns over safety and well as destroying staff morale. It is disappointing that all of those who were involved in this disastrous and costly process, which of course included an illegal decision, have not been held to account for this.

"Sir Bruce Keogh was wrong to order the suspension of surgery at Leeds when the data was known to be incomplete and the complaints, made by a rival unit, had not been looked into and were always likely to be motivated by the situation created by the Safe & Sustainable review and the judicial review. His unwise knee jerk decision caused huge distress in Leeds but also put children at greater risk, which is the reality of a snap decision to stop surgery at a safe unit, which it has been shown Leeds has been all along. He should apologise for this but also should introduce much clearer guidelines for any such surgery suspension, so that this only happens when the evidence backs this up to avoid such mistakes in the future.

"What is important now is that the Leeds children's heart unit is allowed to carry on its important work and that the new review into children's and adults heart services is open, transparent and avoids the damaging situation created by the Safe and Sustainable review. Trust needs to be restored and all units need to have the same chance to reach new standards, so that people in all parts of the country can be confident they will get the best care. We know that all units have till 2018 to prove they can be part of national configuration and I very confident that Leeds, which is clearly a safe, sustainable and important heart unit serving a huge population can and will be part of this".