Baby P: Great Ormond Street 'deeply mired in denial'

One of the best signs of a serious scandal is when the body concerned flatly denies facts which are provably true. By that criterion, Great Ormond Street Hospital is in desperate trouble today over its role in the death of Baby Peter.

Yesterday, one of the consultant paediatricians at the clinic which failed Peter, Dr Kim Holt, told me that she – and all her three senior colleagues – alerted managers, more than a year before Peter’s death, that the clinic was inadequately staffed, “falling apart” and that a child could die if action was not taken.

Instead of acting, she says, Great Ormond Street – which employed the doctors at the clinic and was the “lead agency” on the health side for child protection in Haringey – “bullied” her, forced her out of her job on “wholly spurious grounds” (meaning she was not around when Peter came in) and later offered her £120,000 to keep quiet.

“They were in a panic [after Peter],” she said. “They said I had to withdraw my allegations or the money was off the table. They wanted me to sign a statement saying that all my concerns had been addressed. I refused because it would have been a lie. They were trying to buy my silence.”

Great Ormond Street has issued a statement saying that it does not accept Dr Holt’s version of events. But the hospital’s statement casts far greater doubt on its own credibility than on hers.

Extraordinarily, the hospital claims that the offer of money “took place before any specific concerns were raised by [Dr Holt] around child protection.”

That simply isn’t true. As documents I’ve seen prove, the offer of money (initially a year’s salary, later rising to £120,000) was first made in November 2007 – eighteen months after Dr Holt and her three colleagues raised concerns about child protection, in writing, to their senior managers, Jane Elias (from NHS Haringey) and David Elliman (from Great Ormond Street).  You can see their very strongly-worded letter – which Great Ormond Street concedes was written in spring 2006 – here.

Great Ormond Street also claims that a report by NHS London into Dr Holt’s case – due to be published tomorrow – “broadly supports [the hospital’s] view of events.” Well, I have a leaked copy of the report – and that’s another clear misrepresentation.

This report isn’t a total slam-dunk for Dr Holt. It doesn’t find that she was “targeted” for complaining, something she takes issue with, although it does say she was right to feel aggrieved at the way she was treated.

It’s written in classic weedy, circumlocuted bureaucratese and does its best to underplay the failings it finds. In another favourite trick of official reports, its rather bland findings (at the front) are not fully consistent with the serious failings it outlines in the detail section at the back.

But, particularly if you read into that detail, it is far more favourable to Dr Holt’s version of events than to Great Ormond Street’s.

The version I’ve got says that there was was inadequate staffing at the clinic, “the workload of the consultant team was excessive” and “the concerns raised by the consultant team were genuine and well-founded.” It says that the consultants’ concerns were “taken seriously” (Dr Holt disputes this) and some action was taken on some of the complaints but there was “no evidence” that the consultants’ main concern, their workload, was “adequately addressed.”

The number of consultant posts at the clinic was in fact further reduced after the consultants’ complaints, from four posts to three. Since Baby P, consultant staffing at the clinic has been increased to nine posts. As for “taking the concerns seriously,” this seems to have consisted of drawing up an “action plan” almost entirely on paper.

The NHS London report quotes another doctor, Michelle Zalkin, saying that Great Ormond Street managers created a “very hostile environment” which became “pervasive, insidious and quite unbearable.” Managers communicated, she said, largely by “shouty emails and post-it notes.”

A team leader, Nicola Bennett, said she was reprimanded after voicing her concerns and told “that she should have adopted the management line.”

Another consultant at the clinic, Dr Sethu Wariyar, accused a senior manager of being “confrontational and divisive.”

The NHS London report says that David Elliman, the senior Great Ormond Street manager responsible for the clinic, claimed that the problems in 2006-7 did not affect patient safety. “That is a conclusion with which we would not agree,” the investigators say.

The NHS London report describes Dr Holt as a “highly committed, efficient and effective” doctor. It says: “We do not consider Dr Holt has been directly targeted, but we do consider that she is entitled to feel aggrieved… Dr Holt feels strongly that she should be entitled to return to Haringey, and that she has done nothing wrong which would prevent her from doing so. We accept that… We can see how she feels she has been penalised for [whistleblowing.]”

Were I a harsher person, I would say that some of Great Ormond Street’s claims about Dr Holt and the NHS London report are simple, straightforward lies. Let us instead simply echo the view of Dr Holt’s MP, Lynne Featherstone, that this prestigious and respected institution is “mired in denial”.

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