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Croydon University Hospital sacked doctor for blowing whistle on failings that contributed to patient's death


A SENIOR doctor was sacked for raising concerns about the safety of patients and staff at Croydon University Hospital, an employment tribunal has ruled.

Dr Kevin Beatt, a consultant cardiologist, took action against the trust which runs the hospital after he was fired following the death of a patient during a routine operation in 2011.

He claimed Gerald Storey died because a nurse had been suspended without his knowledge, meaning she was unable to help him with the procedure.

After informing the coroner and a senior GP of his concerns, he was sacked for gross misconduct by Croydon Health Services (CHS), which claimed his version of what had happened was "unsubstantiated" and made to "serve an ulterior motive".

Those claims have been rejected by an employment tribunal which found Dr Beatt, 63, raised "genuine" concerns only to be unfairly dismissed because he was a whistleblower.

A CHS spokesman said the trust was "very disappointed" with the judgment and was in the process of appealing.

Dr Beatt worked as a consultant cardiologist at the hospital from November 2005 until he was dismissed in September 2012. During that time he set up what was described by his manager as a "beacon cardiac service".

The working atmosphere in the cardiology department deteriorated rapidly at the beginning of 2008 following the appointment of  two new doctors and a clinical director.

Dr Beatt raised issues about bad management and bullying, concerns supported by an independent Royal College of Physicians investigation in September 2009, which found the issues were affecting patient care.

A year earlier, Dr Beatt had raised serious concerns about safety in the cardiology department, describing the standard of facilities as "appalling" in a letter to medical director Tony Newman-Sanders.

In January 2010, Dr Beatt questioned the safety of radiation equipment used in the cardiology department. He said the equipment was the oldest in clinical use in the country and was exposing staff to unsafe levels of radiation.

In July of that year a complete equipment failure the middle of a procedure meant a patient had to be transferred to another hospital. Dr Beatt claimed that, by ignoring his previous concerns, the trust had put lives at risk. He told the tribunal he experienced "resentment" as a result of raising the issue.

His complaints brought him into regular dispute with Dr Asif Qasim, one of two consultants who joined the cardiology department in 2008. Dr Qasim made numerous allegations to the tribunal about Dr Beatt but they described his evidence as "inconsistent", "incoherent" and "contradictory".

Dr Beatt told the tribunal that anyone who stood up to Dr Qasim was "removed from the trust", giving the example of Sister Lucy Jones, who took out a grievance against him and was subsequently dismissed.

It was Sister Jones who was suspended without Dr Beatt's knowledge on the day he performed a routine angioplasty on Mr Storey on June 9, 2011.

The cardiologist later told an inquest that the laboratory descended into "chaos" when the operation ran into complications and it became apparent Sister Jones was absent. Had he known she was not available he would not have gone ahead with the procedure, he said.

Dr Beatt told the tribunal it was "by far the most upsetting day I have experienced in my medical career and it is still difficult to comprehend how the sequence of events could possibly occur in a civilised health system".

He described Sister Jones' removal as "the most overtly reckless act I have experience. It was my view that this action had directly contributed to the death of the patient."

Dr Beatt voiced this opinion to senior managers at the trust, who later claimed his complaints were motivated by a desire to have Sister Jones reinstated. The tribunal found he was genuinely worried for patient safety.

A serious untoward incident (SUI) investigation was launched under the supervision of Juliet Kenney, clinical director for cancer and core functions. 

The tribunal found Ms Kenney and Dr Qasim tried to focus the investigation on Dr Beatt, who had not lost a patient during an elective procedure in 25 years in medicine.

Dr Beatt was suspended without explanation on June 15. He was later told he was undermining the investigation, but the panel could find no evidence to support that claim.

Five days later he submitted a statement about Mr Storey's death in which he said the decision to suspend Sister Jones had been a key factor. He made the same point in his report to the coroner on June 29.

Dr Beatt says the subsequent dismissal resulted from his refusal to amend his version of events. A colleague, Dr Martos, told the disciplinary hearing he too had been asked to change his SUI statement.

He said Wendy Riddle, interim project manager, asked him to "produce more details" and Dr Qasim requested he be "more specific about what happened with Dr Beatt during the procedure".

"It was clear," the tribunal said, "that Dr Qasim has asked Dr Martos to change his statement. The tribunal conclude that this was an instruction to focus his report more on the behaviour of the claimant."

Dr Beatt then raised concerns about safety standards and the way the investigation was being handled with Agnelo Fernandes, a senior GP heading Croydon Healthcare Consortium, which is now Croydon Clinical Commissioning Group.

This disclosure was given as one of the reasons he was sacked by Michael Parker, then chairman of Croydon CHS, for "gross misconduct". His appeal was later rejected by chief executive John Goulston. The trust also submitted a formal complaint about Dr Beatt to the General Medical Council (GMC).

The tribunal, however, had serious misgivings over the conduct of several members of staff during the investigation into Mr Storey's death.

They were "troubled" that Dr Qasim had described Dr Beatt's behaviour in the aftermath as "crazy", a serious allegation which appeared "unsupported by any evidence".

The tribunal also had "great concerns" with Ms Kenney's failure to give consistent or credible evidence to the panel, and that she had allowed three members of staff to amend their accounts of what had happened.

"Ms Kenney told the tribunal that the SUI enquiries should be open and transparent, however the tribunal were concerned that the process followed by her was not open or transparent."

The tribunal, which released its judgment in late October, was suspended twice after the judge ruled the trust must disclose documents it had failed to provide.

It ruled that Dr Beatt had been dismissed for "raising concerns about patient safety and reporting those matters to the coroner which he was obliged to do and to the GP commissioner, which the trust was obliged to do."

The judgment added that Mr Parker and Mr Goulston had "failed to carry out a fair process" because there was no consistent evidence that Dr Beatt had committed an act of misconduct. The fact that he was a whistleblower, the report adds, was a "principal factor operating on the decision maker's mind".

"We conclude that the claimant was dismissed for escalating…genuine concerns via the appropriate procedures. As a result the dismissal was automatically unfair."

Tribunal criticises hospital's chief executive

THE tribunal was heavily critical of the role played by hospital chief executive John Goulston.

After Dr Kevin Beatt was dismissed for gross misconduct, Mr Goulston oversaw the consultant cardiologist's appeal.

The tribunal was "struck by how little understanding he had of the facts, the issues before him and of the evidence that had been presented by [Dr Beatt] or his role as appeals manager".

In its evidence Croydon Health Services described the appeals process as "quasi-judicial". The tribunal said the presentation of the evidence could be described as such "but not the approach of Mr Goulston to the evidence before him".

They added that an expert had conceded Dr Beatt had raised "genuine concerns" about patient safety, "however this view appeared to carry little weight at the appeal".

"Mr Goulston again appeared to focus exclusively on the evidence against [Dr Beatt] and was not seen to be even handed in his consideration of the considerable weight of facts and evidence before him.

"The tribunal have concluded that the appeals process was incapable of addressing the obvious shortfalls in the disciplinary process and the appeals process itself was unfair and showed very little understanding or analysis of the evidence."

The report added that Mr Goulston had admitted in cross-examination that Dr Beatt was dismissed for reasons relating to the death of Mr Storey, confirming he had been sacked for "raising concerns about patient safety".

Doctor says hospital's safeguarding process is "corrupt" 

DR KEVIN Beatt believes Croydon Health Services systematically manipulates and undermines the findings of investigations into serious incidents.

"There is a habit of falsifying the outcomes which the trust were, and I think still are, covering up," he said.

"The trust thinks they can get away with it. They tell the commissioners and the Patient Safety Agency they have conducted an investigation and found no fault, and nobody questions it.

"The only reason I won my case is because the judge insisted they disclose all the relevant documents.

"It came to a head because I wouldn't change my report to the coroner. They tried to convey a set of events which were untrue and I refused to do that. It's not an open and fair process as it is meant to be. It's a totally corrupt system."

Despite the tribunal's decision Dr Beatt, who was legally represented at the tribunal on a pro-bono basis, fears he may not be able to rebuild his shattered career, as the trust also reported him to the General Medical Council.

"I think it's unlikely," said Dr Beatt. "The NHS does not reemploy whistleblowers." 

Croydon University Hospital sacked doctor for blowing whistle on failings that contributed to patient's death

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