An open honest culture

The following story shows just what happens to whistle blowers in the NHS, in the open honest NHS culture of ours:

"A junior doctor who was excluded from work for five years after she objected to the inclusion of patients’ medical records, including her own, on research databases without consent has received an unreserved apology from her employers in the High Court.

Named only as Dr Z to preserve her anonymity, she is subject to a gagging order and cannot discuss her case. However, the BMJ understands that she will not return to her job but has accepted compensation for the false allegations made against her and for the blight on her career.

Acting without a lawyer, she brought a libel action against her employers, Cambridgeshire Primary Care Trust, and the East of England Strategic Health Authority, which hosted her training scheme.

Damian Brown, for the trust and the authority, said in a statement in open court that Dr Z, whom he described as "a talented young doctor," had at an early age had a serious life threatening condition that attracted much research interest. She wanted the details kept private.

However, her medical details were disseminated for research purposes to Addenbrooke’s Hospital, Cambridge, and from there to personnel involved in her employment. Despite withholding her consent she was subjected to "uninvited, intrusive, and upsetting" phone calls from unknown researchers. She was also concerned that during her employment she and colleagues were expected to take part in research that used patients’ data without the patients’ consent.

In August 2002 she was referred to an occupational health consultant. As a result of communications arising from that referral she was put on special leave from her employment.

In September 2006 her employment contract came to an end and was not extended. She applied to the High Court and won a temporary injunction stopping the primary care trust from terminating her employment.

Mr Brown said that the trust and the health authority wished to make it clear that their suggestion that her fitness to practise was an issue was "groundless and unfounded." They unreservedly withdrew any suggestion that she was a candidate for referral to the General Medical Council.

They also accepted that accusations that she had given a false name and address to her doctor and had falsified sick notes were untrue. Despite a previous statement by the trust that it was "not possible" that her records were held in the research database, the trust acknowledged that her records were held there.

The trust and the authority admitted that they were misled by a third party, who had now apologised, and should not have placed Dr Z on special leave. They acknowledged that she had had "a long and distressing battle to preserve her medical privacy" and said that future employers should not regard the time she spent on special leave as "in any way a stain on [her] character or professionalism."

Dr Z said in a statement: "I raised concerns relating to unethical research practices which threatened patient confidentiality and were being conducted in breach of the law. I was then excluded from work for a period of five years, on the basis of allegations which the trust now concedes were groundless.

"After six years of medical training and several years working long hours as a junior doctor and dedicating myself to the health service, medicine was my life. Being excluded from work for five years has curtailed my promising career and caused absolute devastation to both my professional and personal life and to my family."

Peter Wilmshurst, a consultant cardiologist who advises whistle blowers, said, "The experience of this doctor shows that promises to protect NHS whistle blowers are hollow. Those who express concerns about ethical matters can still expect to have false allegations levelled against them, to be excluded from work, and to have little or no support from defence organisations or trade unions.

"We need answers to questions. Are the bodies involved now complying with the Data Protection Act? How many millions of pounds were spent in legal costs unsuccessfully defending the actions brought by this junior doctor and in complying with the instructions of the courts to delete computer records and destroy documents? Are the senior managers and senior doctors who failed to resolve this matter at an early stage being asked to account for their actions?"

A spokesman for the SHA said: "NHS East of England follows the national framework concerning the use of patient records for research purposes"."

An open honest culture catalyses improvements to the system, as errors and mistakes are fedback and acted upon.

A dishonest closed top down culture catalyses failure, as errors and mistakes are buried, they are not acted upon, they continue and perpetuate over time. This is the way of the DoH's top down NHS.