Two former United Lincolnshire Hospital Trust executives have described the NHS as having a “culture of threats and intimidation” and not putting patient care first.
Former ULHT CEO and whistleblower Gary Walker and former Trust chairman David Bowles gave evidence as part of the Mid Staffs NHS Foundation Trust Public Inquiry by the Health Select Committee looking at high death rates on Tuesday, March 19.
Gary Walker and David Bowles described to the panel their time at ULHT, and the problems the Trust faced, particularly in 2008, and Mr Walker’s dismissal.
David Bowles described how there was a culture “to make things look good, rather than things being good”, and that other trusts in the country faced the same problems.
Too many targets
Problems centered on patient care versus targets, and how the likes of East Midlands Strategic Health Authority (SHA) were too focused on hitting targets than the welfare of patients.
Walker and Bowles described how the focus on targets put Lincolnshire hospitals and their patients at a “tipping point”.
Gary Walker described that after paying off the Trust’s debts from previous administrations and reducing waiting times by half, he then had to deal with capacity issues, because hospitals like Lincoln County were “over-full”.
He mentioned that there had been plans in place to add 100 more beds due to demand increase, but these could not happen due to lack of resources.
He described how there was a choice between meeting targets and patient capacity, and that despite applying for a capacity review with the Health Authority, he was advised not to raise it.
The committee asked why Walker did not fight to get a capacity review during his time as CEO, to which he replied the situation went “beyond needing a capacity review, as the Trust went into crisis management”.
The beds were added after Walker was dismissed from his role for alleged gross misconduct, which he argues is testament to his point.
He also accused the Health Authority of being at times heavy-handed and even bullying.
Walker mentioned that the ULHT was threatened by SHA and Lincoln County Hospital subsequently put into red alert if it did not stick to targets.
To help make hospitals safer, Walker made a decision within his role to cancel 700 operations so hospitals could focus on the high number of emergency cases, despite getting pressure outside the Trust to stick to the targets.
Scared to speak up
Even managers within the hospitals could be too target driven to look at patient safety, and staff would be too scared to speak out in fear of losing their jobs.
Bowles mentioned that he raised a complaint with the Trust’s board every time a staff complaint was raised.
During the period, there were a number of complaints from staff regarding both patient care and staff being bullied. At the time, he assured staff the Trust would protect them if the case went to be reviewed.
None of the staff were confident enough to pursue their complaints further for fear of being let go.
David Bowles said: “I feel I let everybody down.”
The committee argued that his concerns for staff had not been raised with the SHA effectively, but Bowles said he raised concerns with the SHA regarding its tone and the pressure applied to stick to targets.
Bowles mentioned he had also been bullied over his concerns around targets, and that Walker had struggled to continue his career after whistleblowing.
The pair also received emails from outside the Trust containing threats. One regarding A&E admissions said that if the Trust did not meet national targets, there would be “serious consequences”. Neither knew what these consequences would be or meant.
Walker was sacked over a row regarding long non-emergency waiting lists within the Trust. He was not allowed to talk about the row between waiting lists, patient care and targets until now due to a gagging order.
He described how he was intimidated into leaving his post, and that he agreed to a gagging order compensation worth £225,000.
Walker accepted the sum as his lawyer fees reached £100,000 and he grew “exhausted” of battling NHS authorities.
He also told the select committee that he was not the only executive Trust member to be given a gagging order, and many others across the country were also in the same position.
Gary Walker said: “We don’t know what’s being covered up. Public money is being used, and that’s a problem.”
Bowles concluded the two-hour meeting: “The current culture is inconsistent with care… we have to tackle the culture. We can’t change the NHS without changing the leaders. We need to stop staff being too scared to speak out.”