The targets say this is one of the best NHS trusts in the country. But this doctor has turned whistle blower to reveal a shockingly different picture…
To outsiders it seems like that rarest of things: a wildly successful NHS trust. South Essex Partnership Trust (SEPT) was awarded the top score of ‘excellent’ three years running by Government inspectors.
Its chief executive, Dr Patrick Geoghegan OBE, is a Government favourite, recently named the NHS’s Leader of the Year, and earned £200,000 last year, more than the Prime Minister.
He even has a hospital unit named after him. The in-house magazine reported, that, when unveiling the plaque in 2005, he had the ‘surprise of his life’ to find that admiring colleagues had secretly named it the Patrick Geoghegan Recovery Unit. It was, they said, an honour he ‘richly deserved’.
But not everyone is quite so enamoured of Dr Geoghegan’s work. ‘I wouldn’t trust SEPT to take adequate care of a hamster,’ says Dr Jennifer Blandford, who recently quit as a consultant for the trust.
‘I would rather stick pins in my eyes than let any member of my family go to a psychiatric unit it runs, or receive outpatient psychological therapy from it. The gulf between SEPT’s rhetoric and the reality is enormous.’
She claims that suicidal patients are dying unnecessarily through neglect, that inadequately trained staff are allowed to treat seriously troubled people and that treatment is brutally rationed.
Dr Blandford, 50, joined SEPT in February 2005 as head of the forensic psychology department. She worked for 13 years for Essex Police both in uniform and as a detective, but decided in 1995 to retrain as a clinical psychologist.
However, her professional approach to the SEPT job, her third in the field, soon brought her into conflict with the trust management.
Not long after getting the job, she discovered that two earlier staff appointees had misrepresented their qualifications, yet wrote crucial reports for mental health review tribunals.
‘God knows how many patients were either released into the community or detained in hospital further based on their lack of clinical training, skill and experience,’ she says.
She alerted management, and although both members of staff eventually resigned, ‘no disciplinary action was taken,’ says Dr Blandford.
And the more she learned about the prevailing culture, the more disillusioned she became.
‘SEPT’s patient care was sometimes like going back 30 years, a cross between One Flew Over The Cuckoo’s Nest and Alice In Wonderland,’ she says. ‘Patients were often over-sedated, just to keep them quiet, or not readmitted even when clearly in dire need.’
Dr Blandford found it near impossible to build a settled team. ‘I went on holiday in 2006 and came back to find half my team had been made redundant, yet two of them were excellent,’ she says. ‘There seemed to be a culture of getting rid of good people just to keep others afraid.’
However, a SEPT spokesman says that staff surveys reveal SEPT ‘is in the lowest percentile nationally in relation to staff feeling bullied’.The trust’s over-reliance on temporary locum doctors was criticised in May 2008 by two independent inquiries, following murders by schizophrenics Gary Roberts and Derek Field.
They had been compulsorily detained under the Mental Health Act at SEPT’s Runwell Hospital in Wickford but were freed – prior to Dr Blandford’s arrival – despite telling staff about their homicidal urges.
Field, 27, told medics he would kill a neighbour and talked of tying up a girl and dropping her down a drain. He was released without even being assessed and weeks later killed a friend.
Roberts, 41, was seen by six consultants but the views of two who wanted him detained were ignored. A month later he beat his girlfriend to death.
Dr Blandford says that under-qualified staff sometimes dealt with highly dangerous patients.
‘One SEPT psychologist was not fully qualified but was allowed to work with a man sectioned for a brutal murder. She advised that he go out into the community with a nurse for a meal, and told him to announce to the waiter, “I am a murderer.” I was appalled.’
In fact, there has been a catalogue of disasters at SEPT.
Carol Savage became suicidal in 2004 and was detained in Runwell. Like most schizophrenics, the gentle mother of two was a risk only to herself. Placed on an open ward, she tried six times to escape – and finally succeeded.
Despite being heavily sedated, she walked to the railway line at Wickford and threw herself under a train.
Last month, the High Court ruled that SEPT breached Mrs Savage’s right to life through its negligence, and awarded £10,000 damages to her daughter Anna.
The court heard that only one nurse on the team supposedly caring for Mrs Savage had even read her history and realised she was tormented by voices instructing her to kill herself.
Dr Blandford says: ‘Runwell has real difficulty filling posts. Many nurses were agency staff and only there one night or so. Of course they don’t get to read the histories.’
SEPT vowed to reform following Mrs Savage’s death. But The Mail on Sunday can reveal that Chelmsford coroner Caroline Beasley-Murray recently ruled that its neglect was central to the death of a 29-year-old bipolar disorder sufferer who threw herself from a multi-storey car park on March 29, 2008, shortly after being sent home from a brief in-patient stay.
In a devastating ten-point catalogue of woeful SEPT errors, the coroner noted that the patient was discharged despite her exhibiting ‘obviously abnormal behaviour’, having received ‘inadequate and inappropriate treatments’, and her recent admission that she felt suicidal. Staff even failed to ask her consultant or care coordinator if she should be released.
The coroner made a Rule 43 recommendation, which means she considers the trust contributed to the death, so it must legally respond within eight weeks with detailed proposals for reform. The Health Secretary and the Care Quality Commission, which regulates healthcare in England, have been made aware of the findings.
A SEPT spokesman said the trust was ‘unable to comment as legal proceedings are still live’.
The toll of arguably preventable suicides also includes Karen Crews, a 50-year-old mother of three, from Rayleigh, Essex. Her husband Steve begged SEPT for help after she handed her son a knife and asked him to ‘finish her off’.
She had previously attempted suicide and been under SEPT care, but an agency nurse told Mr Crews it would be 48 hours before a consultant could see her. The next day, May 13, 2008, she threw herself in front of a lorry.
Returning an open verdict, the coroner accused SEPT of ‘gross failure’. Dr Geoghegan said afterwards: ‘This is a very sad incident.’ As with other suicides, he promised an investigation and reforms.
Married father-of-two Neil McGregor, 45, was another victim. His son Paul, 20, says: ‘My mother called an ambulance after discovering Dad had written suicide notes and was roaming the streets. The ambulance took him to Basildon Hospital A&E but he was left alone. He walked straight out in front of a van.’
Mr McGregor recovered physically but, by February 2009, Paul says: ‘He was again talking of suicide. One day we called an ambulance. He tried three times to jump out of it. I followed him to Southend hospital to find him alone again.’
The hospital asked Paul, who was then just a teenager, to drive his distressed father to SEPT-run Basildon mental health unit.
‘My dad was crying but was left waiting there to be assessed from Saturday night until Tuesday. Then they only did a physical assessment and told my grandad to pick him up as they needed the space. My dad committed suicide by walking in front of an articulated lorry the next day.’
An inquiry later confirmed that Mr McGregor was released by under-qualified staff and, in that hollow and all-too familiar phrase, SEPT promised to ‘learn lessons’.
Mr McGregor’s death prompted several SEPT staff to contact this newspaper. Most requested anonymity because of alleged workplace bullying, but Dr Blandford agreed to be named, although she accepted ‘SEPT will probably attack me’.
She said: ‘SEPT is basically run as a private business. It was made very clear that the aim was to have ” surplus” money at the end of each financial year, and woe betide any manager who didn’t.’
Dr Blandford clashed with SEPT bureaucrats over the limits imposed on patients’ treatment. Staff vacancies went unfilled, and some gravely ill patients never saw a consultant, or never saw the same one twice, leading to the tragedies already outlined as well as a rise in the number of patients detained under the Mental Health Act who absconded – from 17 in 2004 to 89 in 2006.
‘The consultants work an extra average-of 15 to 20 hours’ unpaid’
Yet when, in 2007, the trust’s board discussed the staff shortages and consultants’ regular excessive hours, it concluded that these had no detrimental effect.
Dr Blandford says: ‘The consultants work an extra average-of 15 to 20 hours’ unpaid every week, trying their best. Without exception they are deeply stressed. How can that be good for anyone?
‘SEPT lies even to itself. We used to have faux “surveys” on our internal website’s home page, where you couldn’t ever enter a negative vote. The questions were, effectively, along the lines of, “Is SEPT doing: a) well, b) very well, or c) brilliantly?”. It was like something out of 1984.’
She and other senior colleagues accuse Dr Geoghegan – who is actually a nurse whose doctorate is an honorary one – of ‘McDonaldising’ mental health care. SEPT tops league tables, they say, only because it cynically manipulates worthless Government assessments and inspections.
It is estimated that only about one health trust in 25 is now fully assessed externally. The majority are trusted to assess themselves.
One SEPT clinician whom Government inspectors had selected to question about the trust’s performance was assured that interviewees could ‘give frank answers’ as they would be ‘completely anonymous’.
Some staff were also invited to lunch with inspectors, but before that Dr Geoghegan wrote to all interviewees to say the quango had given him their names, and their line managers would ‘help prepare you for the interview’.
The clinician showed The Mail on Sunday a SEPT manager’s letter saying: ‘I do not need to stress how important this is . . . we all need to be upbeat and positive – talk the team and our work up and not down.’
Patients were rebranded as ‘ customers’, while the chief executive personally picked patients for surveys to rate the trust’s performance.
Minutes of the SEPT board meeting in November 2007 note that ahead of a patients’ survey, ‘Patrick advised that he has also randomly selected some clients, with their permission, to contact regarding their experience’. The minutes do not explain how randomness was ensured.
A SEPT doctor told The Mail on Sunday: ‘Mental health patients are particularly vulnerable to pressure to say the “right thing”. If patients were really randomly sampled and allowed a genuine voice, a much lower rating would result.’
SEPT says its chief executive does not have a role in personally picking patients to participate in such surveys, but added that Dr Geoghegan interviewed discharged patients whom he chose at random.
SEPT maintains that its patients’ suicide rates are within national norms but in September it was asked under the Freedom of Information Act to reveal the number of patients in the past five years who were confirmed to have commited suicide, whose deaths were recorded as open verdicts at inquests, or who were apparent suicides yet to be confirmed.
Authorities are bound by law to respond within six weeks but SEPT has still failed to provide this information. Mental health trusts were, until last year, partly SEPT’s response to increasingly bad publicity has been to spend a fortune on management consultants and corporate self-congratulation.
In 2008, a close ally of Dr Geoghegan launched a ‘renewed customer service strategy’. Peter Wadum-Buhl is an occupational therapist with a master’s degree in business administration. He engaged management consultancy April Strategy which, according to the depressingly familiar jargon on its website, was to teach ‘customer service’ to staff and rebrand the trust.
The SEPT spokesman admits: ‘During 2006 and 2007 we employed an external consultant (costing £72,000 over two years) to assist the trust in developing and enhancing our productivity and efficiency, improving staff attitudes, and focusing on customer service practices.’
Dr Blandford is scathing about this ‘colossal waste of money’.
‘We were ordered to wear black uniforms, and lectured by someone from Marks & Spencer on how their staff loved wearing theirs,’ she says. ‘We are supposed to be a mental health service, not a version of M&S. We don’t have “customers”.
‘I eventually refused to attend any more management-speak courses. The bullying then began in earnest – endless snide criticism and constant undermining of my staff.
‘I realised I would rather stack shelves in Tesco than stay there. So in March 2008 I walked out of a £65,000-a-year job with nothing to go to. Sadly, I would never, ever work for the NHS again.’
http://www.dailymail.co.uk/news/article-1280504/I-wouldnt-trust-hamster-Whistle-blower-lifts-lid-wildly-successful-NHS-trust.html?cmp.consent=true
Leave a Reply
You must be logged in to post a comment.