HC Deb 15 January 2004 vol 416 cc1047-54

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kemp.]

6 pm

Mr. Geoffrey Robinson (Coventry, North-West) (Lab)

First, may I say how grateful my hon. Friend the Member for Coventry, South (Mr. Cunningham) and I are to Mr. Speaker for granting the debate? My hon. Friend wishes to contribute to the debate, although we are both conscious that we must allow time for the Minister to respond.

This is the third debate that we have had on the Walsgrave trust and the suspension of Dr. Mattu. On 20 March 2002, shortly after Dr. Mattu was suspended, we held a debate in which we welcomed the new management at the hospital and said that we hoped that the suspension would not be a repeat of the previous two—one ended in the vindication of Mr. Alban Barros D'Sa after nearly two years. Unfortunately, our hopes have been shattered and we are in the same position as we were during the second debate, which was held on 28 October 2003, when we could see that little, if any, progress was being made. During that debate, we asked the trust management, the NHS and the National Clinical Assessment Authority to make every effort to resolve the problem by finding a compromise agreement because the soundings that we were receiving were not good.

We are now three months further on—two years into the suspension—and, far from making progress, we have gone backwards. My hon. Friend the Member for Coventry, South will agree that I say that in the light of a meeting that we had on Tuesday of this week with the highest representatives of the NCAA and, indeed, Mr. Ian Stone, who has been appointed by the chief executive of the national health service himself to—as he put it—speed up the job of getting doctors back to work. I am sure that both gentlemen are fine civil servants, but they live in a different world from us. Indeed, I think that they live in a celestial world, so I am reminded of the hymn that goes:

"Oh Lord A thousand ages in thy sight are like a night gone by".

It seems as though the investigation and those that preceded it have gone on for ages, yet despite the bureaucracy surrounding the case, the NCAA, the NHS, and the trust seem unable to grasp the fact that it costs money and causes pain and aggravation for the people of Coventry. Everyone would agree that the situation has gone on for too long and at too great a cost, and that it has caused too much personal suffering to the doctor involved.

It is all very well to say that suspension is a neutral act, but it is not a neutral act in the real world. It is a harsh act that is imposed on a doctor who thus suffers—perhaps rightly, perhaps wrongly. The fact of that suffering must carry with it a deep moral obligation to expedite the process as quickly as possible. On Tuesday, we quite reasonably asked how much longer the suspension would last. We were told, as if it did not matter at all, "Oh, at least another six months." Costs will probably therefore greatly exceed £500,000. It will probably be another nine months, or two or even three years before a solution is reached. The parties could have sat round a table at the beginning of this process to reach such a solution, had there been the will to do so. I shall return to that in a moment.

Essentially, the charges amount to bullying of a subordinate doctor by his superior. Bullying is a serious charge, and I do not wish to minimise its significance. My hon. Friend the Member for Coventry, North-East (Mr. Ainsworth), who is in the Chamber, is Deputy Chief Whip, but when he was just a Whip he was accused of bullying somebody in the Lobby. We did not take three years to sort that out—it was done via the usual channels in a week or two. So why is it taking so long to sort out Dr. Mattu's case? The National Audit Office has pointed out that £14 million has been wasted on suspensions. The Government and the NHS have finally been prodded into action by issuing many new guidelines to speed up the processing of suspensions.

However, those guidelines cannot help us in this case. We were told on Tuesday that we could not invoke them as the matter had gone too far. I want to alert the NHS and the NCAA to a new development. Dr. Mattu's principal accuser, Dr. Gieowarsingh, has now been reported to the General Medical Council—I cannot comment on the rights and wrongs of the allegation, just as I cannot do so in the other case—for serious misrepresentation on his CV. We will not prejudge the outcome or comment on the case, but we understand that the GMC is likely to respond and commission its own inquiry. There is therefore an inquiry into Dr. Mattu's chief accuser, and Dr. Mattu himself has been suspended for two years.

I believe that my hon. Friend the Minister is aware of the nature of the allegations against Dr. Gieowarsingh, which have been forwarded to my hon. Friends the Members for Coventry, North-East and for Coventry, South, as well as me. I shall not trouble the Minister with them now, but I shall send them on to him in case they have not reached his office. To use layman's terms, it appears that Dr. Gieowarsingh may have exaggerated the number of his quasi-surgical interventions by a factor of between three and five. There is therefore the prospect of new allegations, counter-allegations and an investigation of the person who called for the initial investigation. Neither the House, nor the Minister, nor anyone concerned could view such a prospect with equanimity.

I therefore urge the trust, via the Minister's good offices, to proceed carefully. It appears that it has looked at the allegations against Dr. Gieowarsingh which have been in existence for some time, and agreed on the nature of the figures that I shall send to the Minister. When it talked to staff—those conversations are not documented or recorded, and I am not aware of any signed affidavits—it concluded that he had performed far more procedures than were recorded. We have to wait to see what the GMC will make of that—I do not want to prejudge the outcome, as I have already said. It will also have to take into account representations by the clinical director at Walsgrave and David Edwards of the University Hospital of Wales, the hospital to which Dr. Gieowarsingh moved. Walsgrave has said that none of the allegations against Dr. Gieowarsingh calls into question the integrity of his CV.

We shall have to wait for the outcome of that case, but the prospect is a big mess—more costs, more delay and more personal suffering, which is to be shared by those who inflicted it on Dr. Mattu. However, there is an alternative, as a compromise agreement could be reached. If a compromise is to be successful, as I said in the Adjournment debate on 28 October last year, it must involve two things. First, allegations must be dropped by both sides—there can be no fault and no admission of fault. Secondly, it must reflect sincerity and good will on both sides. It is no good the trust asking where all the information came from, as one of our purposes as elected representatives in the House is to make representations on behalf of people who feel that their voices are not being heard. So it is no good the trust objecting to our using that information.

If the trust wants to know where the information comes from, I will tell it. It comes from Dr. Buckley, who is Dr. Mattu's GP. Dr. Buckley has circulated all that information to everyone involved, including the Prime Minister. I think that the only person to be exempted from his intentions is Her Majesty the Queen herself. Everyone else knows everything. He writes, quite clearly, that the trust recommended, as part of the so-called compromise agreement, that Dr. Mattu should see Professor Flahey. I called up his record on the internet, and he is an expert in pathological tendencies. So perhaps the trust got the two doctors mixed up: perhaps it thought that Dr. Shipman should be counselled, not Dr. Mattu—I do not know, but clearly neither of those points in any way shows good will on the part of the trust. So we are doubtful, and I think that I speak for my hon. Friend the Member for Coventry, South, who will speak in a few minutes' time. Everyone agrees that those two aspects of the so-called compromise that we can now bring into the public domain have to eliminated if the agreement is to be seen as genuine.

There is an alternative: perhaps those involved cannot bring themselves to settle on reasonable terms for whatever reason—perhaps loss of face or other irrelevant personal considerations. I do not understand why that should be so because, after all, the chief executive was not even there when Dr. Mattu was suspended, although the chairman was. Indeed, the case dates back to the previous chief executive, who left the trust precisely on the grounds of intimidating, bullying and suspended doctors, as about six of our colleagues know, and some of them have joined us this evening.

If the trust cannot enter into the spirit of compromise, the alternative is that we should have an independent investigation—but a genuinely independent one, not one commissioned by the trust, or under the auspices of the NHS or the NCAA, all of which seem to be on the side of the trust. This has become a confrontational arrangement, as nothing about suspension is neutral. How can it be neutral? The doctor was accused of something one day and was suspended one and a half days later. That does not even allow for the barest examination of the merits of the case.

I am sure that a compromise would be every hon. Member's preferred solution, as it is in the House. Otherwise, let us have an independent investigation and face all the resulting consequences, which would be grave for the trust, grave for Dr. Mattu and, indeed, grave for the public interest.

6.12 pm
Mr. Jim Cunningham (Coventry, South) (Lab)

First, I join my hon. Friend the Member for Coventry, North-West (Mr. Robinson) in thanking Mr. Speaker for granting us this Adjournment debate tonight. Secondly, I congratulate my hon. Friend on securing the debate. I shall not repeat what he said because he has covered the issue adequately, and I am conscious of the fact that we want to try to give the Minister adequate time to respond because it is no good our having a debate without a proper response. That is what the debate is all about.

We recognise that a lot of good things have happened, certainly since the change in chairman of Walsgrave hospital. I would not want to detract from the fact that a lot of positive things have happened at that hospital. I want to make it perfectly clear—I am sure that my hon. Friend would agree with this—that this is not an attack on staff or anything like that and it is not necessarily an attack on the management, but some of us come into politics because we have a sense of justice and we want to see justice done. It is not for us to judge who is right or wrong in this case, but I am alarmed that this is probably the third case that we have been involved in that has taken nearly two years to resolve.

Of course hon. Members will know that, fairly recently, the National Audit Office drew attention to the costs in these cases and to the length of the procedures. In fact, it made about 10 or perhaps 12 recommendations, if I remember correctly off the top of my head. In fairness to the Government, I have to say that they have made suggestions on implementing some of those recommendations. However, I would disagree with the Government about the six-month time frame. Most cases could be resolved in about three months. Many years ago, I used to be involved in industrial relations—I am not an expert in them, but I have a shrewd idea of how those things can be conducted.

Given that there had been a change at the top at Walsgrave, we took the view that the slate should have been wiped clean. The charges against Dr. Mattu were made before the new arrangements came in at Walsgrave, and we must be clear about that. I hope that the panel that has been set up will be totally independent, and I want reassurance from the Minister on that. We know that a list is used, but we have not had too much detail on that.

My second concern is that, if the panel recommends reinstatement, we do not have the situation in which the trust says no. That has happened before in one or two cases, but I hope that, in this case, the trust will feel bound to accept a person back into a job that he is well qualified to do. In fact, anyone who has considered Dr. Mattu's qualifications knows that he is extremely well qualified.

That leads me to the next point that I hope the Minister will consider. Given that the doctor was not suspended for medical incompetence—on the contrary, he is an able cardiac specialist—I would have thought that the investigation should have been carried out before the suspension was proceeded with. However, in this and other cases, someone is suspended straight away and the matter may not be resolved for two years. The individual and his family suffer much hardship and, whatever we might think about the individuals involved, we must recognise the effect on their families. The Minister should seriously consider that point. However, when it can be proved that a doctor is guilty of medical incompetence and medical malpractice, it is right and proper that they should be suspended right away. I make that distinction.

My hon. Friend touched on another point that I wish to make. Rough estimates suggest that, over the past two, three or probably four years, the three cases together have probably cost the national health service £1.4 million or £1.5 million. The costs have not stopped yet, because the doctor is still suspended. That is a lot of money that could have been used in a far better way for health service delivery or care.

As I have said in previous debates, it is also strange that someone should be suspended within two or three days of an attempt at whistleblowing. Someone may put their neck on their line to expose something that they think is wrong, and Dr. Mattu exposed the practice in the hospital of what I term "five in a four-bed ward" that has been investigated and may be the subject of further investigations. He certainly thought that patients were at risk, and I am alarmed that suspension should result from that.

One would not have to be a very good shop steward to know that one can put a case together if one is determined to put a case together. That is the easiest thing in the world. The hardest thing in the world is to make a case that stands the test. My hon. Friend has already demonstrated that there are question marks against the case against Dr. Mattu to say the least.

I am conscious of the fact that we want the Minister to have adequate time to reply, but we cannot reinforce often enough the point about these lengthy suspensions. If they relate to a non-medical issue, the doctor should remain in post until such time as the case is properly heard—not the other way around. I have already drawn a distinction on that.

I agree with my hon. Friend that, to re-establish credibility in the personnel system and the disputes procedure, an independent body should have a good look at not necessarily the merits of the three cases, but the way in which they have been handled by the trust. There is a tremendous sense of anger among the public in Coventry not necessarily about who is guilty of what, but about the length of time and the costs that it has taken to try to resolve the matter.

Having made those points that reinforce my hon. Friend's argument, I shall leave the Minister adequate time to reply. However, once again, my hon. Friend and I wish to thank Mr. Speaker.

6.19 pm
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman)

I congratulate my hon. Friends the Members for Coventry, North-West (Mr. Robinson) and for Coventry, South (Mr. Cunningham) on their tenacious campaign to right what they see as an important wrong. Both have substantial experience of trade unions from different aspects, so I challenge them to put themselves in the place of a shop steward representing the individual who originally made complaints against Dr. Mattu and the others who made complaints against him. If they were in the position of that shop steward, would they be happy to listen to the comments that have just been made? Would they be happy to reinstate somebody against whom serious complaints have been made, knowing that the complainants still have to work in that environment?

Would my hon. Friends be happy to hear my hon. Friend the Member for Coventry, North-West make unsubstantiated allegations against an individual involved in this case, knowing that the trust cannot respond like for like because this matter may go to court one day and the trust must make sure that the proceedings are not prejudiced; and knowing that I, as the Minister, cannot respond like for like, because that might prejudice future proceedings? I challenge my hon. Friends to put themselves in the position of people representing the accusers or alleged victims of Dr. Mattu.

Mr. Geoffrey Robinson

I would be unhappy to hear my own remarks but it is entirely right to make them. There was only one accuser and one allegation. Two days after that allegation was made, Dr. Mattu was suspended for alleged victimisation without any investigation, That is the worst practice and procedure to adopt.

Dr. Ladyman

Surely my hon. Friend accepts that whether or not it was appropriate to leave Dr. Mattu in place depends on the nature and seriousness of the allegation. Although there was only one complainant initially, subsequently more than one person was shown to have a grievance against Dr. Mattu. We could debate the case ad nauseam.

My hon. Friend is right to say that it is the job of the House to bring facts into the open but it is also the job of the House to be even-handed. The position in which my hon. Friend places me does not allow me or the trust to be even-handed in the public domain. These matters must be handled in the proper way by due process, allowing both sides to have their say, to allow a judgment to be made.

Mr. Robinson

I take my hon. Friend's argument that it is difficult for him to reply to some points but when it comes to even-handedness, that is precisely the subject of our principal charge against the trust. It has not been even-handed. Dr. Mattu made a number of serious allegations against other people working in the hospital but they have not been investigated. Nobody else has been suspended. Equally, the charges against Dr. Gieowarsingh remain on the table. They have not been properly investigated and the trust refuses to do anything about them.

Dr. Ladyman

Even-handedness is important but I challenge some of my hon. Friend's interpretation of events.

As this is not the first debate on the subject, I shall reiterate some of the points made by the Under-Secretary my hon. Member for Welwyn Hatfield (Miss Johnson), when she responded on the last occasion. I will not deal in detail with national health service disciplinary procedures, other than to acknowledge that the Government have already said that they are not fit for the purpose and we are in the process of dramatically transforming them.

I, too, am worried about the length of time that it is taking to resolve the case. Some of Dr. Mattu's supporters alleged that he had been suspended not because of bullying but because he was a whistleblower. It was said in the previous debate that the Government expect a climate of openness and dialogue in the NHS and that we will not tolerate the victimisation of whistleblowers. As part of that, I would expect all NHS employers to operate in the spirit of the guidance that we issued in 1999 and updated in July last year.

I stress at the outset that, after the previous Adjournment debate on the subject, I took note of the points that were made because the hospital falls within my regional responsibilities. I had a meeting with my hon. Friends the Members for Coventry, North-West and for Coventry, South, at which they reinforced many of those points. I looked into the matter and I did not find evidence of improper behaviour by those who decided on the action against Dr. Mattu. After examining the nature of the complaints, and with due regard both to the rights of Dr. Mattu and those of the complainants, whom, I reiterate, appear to be ignored in the debate, I reject the idea that the action resulted from any whistleblowing for which he may have been responsible.

Let me outline the background. Dr. Mattu has been employed at University Hospitals Coventry and Warwickshire national health service trust since May 1997 as a consultant cardiologist. He was suspended from duty on full pay on 21 February by the then joint medical director at the trust, following allegations of serious bullying. A further allegation was made after Dr. Mattu had been suspended, corroborating the original complaint. As my hon. Friend the Under-Secretary confirmed, the suspension was and remains neutral, pending investigation of the allegations. I accept the point of my hon. Friend the Member for Coventry, North-West that suspension is distressing and not neutral from a personal point of view. However, the circumstances are not ideal.

On the one hand, we have a person against whom serious allegations have been made and, on the other, an individual who believes that they have been victimised and bullied. We have to take into account the best way in which to manage the needs and feelings of both people.

I stress that the complaints against Dr. Mattu are serious and originate from more than one source. They cannot be ignored. If they were swept under the carpet, it would be unfair to those who made the allegations. A formal investigation was therefore conducted in accordance with the trust employment procedures for clinical staff. They have been agreed by the trust's local negotiating committee and are recognised as fair and appropriate.

During the investigation, statements were taken from people who were identified in the complaints about Dr. Mattu and several interviews were held. Dr. Mattu remains suspended. The joint medical director of the trust has reviewed his suspension fortnightly. After the investigation, an independent panel meeting was held on 30 January 2003, in accordance with trust procedure and agreed with relevant parties, to review the evidence and consider what, if any, further action was necessary on the continuing suspension. The panel undertook a preliminary assessment and found that a prima facie case of personal misconduct needed to be answered.

Dr. Mattu engaged the services of the Hospital Consultants and Specialists Association and a solicitor. The trust has been required to seek legal advice to reduce the risk of any legal breaches that may compromise the progress of the case. Not compromising any future procedures limits the trust's ability to respond publicly to some of the things that Dr. Mattu's supporters allege.

It is fair to say that progress has been slow. That is due to lengthy and complex disputes between the trust, Dr. Mattu and his representatives about the application of trust procedures. Dr. Mattu's unavailability due to sickness has also been a factor in the delays and it is therefore important not to attribute all the delay to the system.

Representatives of West Midlands South strategic health authority met the trust on 30 July 2003 to review the trust's processes and to ensure that the fundamental principles of due process and natural justice had been followed. The meeting was followed by a further meeting with the trust and Ian Stone.

I shall briefly summarise the remaining details of the proceedings because I want to comment on the current position before I have to resume my seat. Ian Stone, who is the chief medical officer's adviser on disciplinary procedures, has also examined the case. He acknowledged that it was complex but he has advised that the only appropriate way in which to resolve it is through the disciplinary process.

My hon. Friend the Member for Coventry, North-West knows that we suggested that a further attempt should he made to obtain a compromise solution. Such an attempt was made early in December. Consequently, meetings were held on 10 and 12 December between the trust and Dr. Mattu. Both sides agreed that the most appropriate way forward was the disciplinary process. I am sorry that Dr. Mattu's support group has tried to portray that differently, but it was a joint decision about the right way in which to proceed. In my view, it is the only possible forward. We must take into account the needs of Dr. Mattu and the accuser. There is no prospect of doing anything other than allowing the disciplinary process to run its course. I know that that will be a great disappointment to my hon. Friends, who have been tenacious about the matter. However, given the complexity of the case, I see no alternative but to allow the disciplinary process to continue.

Question put and agreed to.

Adjourned accordingly at half-past Six o'clock.