The failure of the NHS to use mortality data effectively is worrying to put it mildly and it seems clear from comments from other, such as Sir Brian Jarman, that Nicholson must take some responsibility for that. Nicholson may argue that he did not know, cannot remember, did not see the emails etc and play the role to quote from the Daily Mail of the ‘man with no answers’. Perhaps in the wake of his climbdown to the Public Accounts Committee and his eventual admission that Gary Walker did blow the whistle to him he should now be called the ‘man with no memory’.
Well here is another one where he cannot say he was not told. It is an extract from my evidence to the Health Select Committee dealing with a report Nicholson personally commissioned into allegations of bullying:
‘a) The report when it was released was shocking. At paragraph 15 it stated ‘we frequently encountered differing accounts of the nature [of meetings and telephone conversations]’ in the face of conflicting evidence about what happened in meetings and in phone calls they decided to ‘principally use extracts from relevant correspondence and reports as a more reliable account of the tone and style of communications and therefore relationships…’.
b) I considered this an absolutely extraordinary approach when dealing with allegations about bullying and amounted to suggesting that bullying must be in writing either for it to count or for it to be investigated. It is extraordinary to suggest that correspondence and reports would be a ‘more reliable’ account of relationships. If, as a former Chief Executive of a local authority employing 20,000 staff, I had allowed such a criteria to be used in such an investigation I would expect to be strongly ridiculed. If I had been David Nicholson I would have binned the report as soon as I got to that paragraph.
c) Last year I was asked to conduct a review of the culture of NHS Lothian, one of the largest health organisations in the UK, after the manipulation of waiting lists. I was commissioned to submit a confidential report to Nicola Sturgeon, Deputy First Minister and to produce a public report. We conducted around 60 one to one confidential interviews and were informed of numerous incidents where staff were either told or witnessed others being told that they would ‘get their P45’ or be ‘parted from their livelihood’ if they did not meet targets. These threats were never in writing. If my review of NHS Lothian had been based on the Goodwin criteria as set out in paragraph 15, its conclusions would have been very different and completely inaccurate.
d) I remain appalled at the quality of the report and it is difficult to conclude other than the results were a foregone conclusion and just part of the culture of cover up evident elsewhere in other parts of the NHS. I referred to it as whitewash.
e) However the position is even worse than that in that David Nicholson ignored limitations of paragraph 15 and added further whitewash. In spite of the report making it clear that there were conflicting accounts of meetings and phone conversations, David Nicholson issued a statement saying that there was no bullying ‘whatsoever’. The word whatsoever does not appear in the report.’
Now the Mid Staffs report refers to bullying and makes it clear that it exists in other parts of the NHS. In this brave new post Mid Staffs world we need leaders who will challenge such conduct and make it clear that it is unacceptable and inconsistent with safe care. In this case you may well conclude that Nicholson was party to the use of whitewash as alleged above or he genuinely believes that correspondence and reports can be more reliable in the assessment of bullying. Either way……..