“Patronising disposition of unaccountable power!”

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In commenting on his Panel’s report on deaths at Gosport War Memorial Hospital, The Right Reverend James Jones KBE likened it to the title of his Report on Hillsborough, which  concerned the death of 96 Liverpool football fans at the 1989 FA Cup Semifinal:


Departmental sign at Gosport War Memorial Hospital, Gosport, Hampshire UK. Image shot 2009. Exact date unknown.His Panel concluded that the lives of over 450 people at Gosport War Memorial Hospital were shortened owing to an, “Institutionalised regime” of prescribing and administering opioids without medical justification.



Gosport War Memorial Hospital in now managed – you guessed it – by Southern Health, which issued a public statement containing the usual duck-billed platitudes¹. Read its statement here→ and the Panel’s Report here→

So we have:

So, from babies undergoing heart surgery (Bristol) to adults with physical ill-health (Mid Staffs and Gosport) to dying patients (Liverpool and elsewhere) to maternity and neonatal services (Morecombe Bay) to those with mental health issues and learning disabilities (Southern Health), it appears that all are at risk of similar patterns of behaviour by NHS clinicians and executives, as described in these Inquiries.

In his report on the high mortality rate of babies undergoing heart surgery at Bristol Royal Infirmary, Sir Ian Kennedy QC referred to:

“‘An old boy’s culture’ among doctors, a lax approach to safety, secrecy about doctors’ performance and a lack of monitoring by management [and] an arrogance born of indifference [our emphasis].”

And in the Liverpool Care Pathway review, Baroness Neuberger (and others) wrote:

“It is clear to us [from verbal and written evidence] that there have been repeated instances of patients dying on the LCP being treated with less than the respect that they deserve. It seems likely that similar poor practice may have taken place in the case of patients with no close relatives, carers or advocates to complain, or where families have not felt able or qualified to question what has taken place. This leads us to suspect this is a familiar pattern, particularly, but not exclusively, in acute hospitals.

“Reports of poor treatment in acute hospitals at night and weekends – uncaring, rushed, and ignorant – abound [our emphasis].”

Patronising, unaccountable power, institutional regime, ‘old boy’s culture’, lax safety, secrecy, lack of monitoring, arrogance, indifference, disrespect, poor practice, uncaring, rushed and ignorant? Surely not!

Headless Chicken - reduced


And when ‘found out’, NHS executives run around like headless chickens to cover their backs rather than adopt recognised Crisis Management techniques and learn.



business-people-silhouette-clipart-panda-free-clipart-images-DZ4NzG-clipart reducedAnd, as soon as the crisis appears to have been resolved, let’s return to square one.

¹ More on duck billed platitudes here→

Polishing a turd

Turd V2

CRASH prefers to avoid the vernacular but, if, “Polishing a turd“¹ is OK for UK Cabinet Meetings, it’s OK here. Also, we found it had already been used about Southern Health [Sloven] – on December 5, 2015 at 7:16 pm – by ‘thelovelywibblywobblyoldladyon Dr Ryan’s blog (here) in the run up to publication of the Mazars Review:

“It must by now be plain and obvious to all (including Sloven) that the report is so damning, Sloven are attempting to polish a turd before the report is (finally) released.”

Unfortunately, after a brief clean up by second Interim Chairman, the excellent Alan Yates, it’s time to get the shovels out again. Southern Health has revived its slippery complaints handling (and other) tactics. For example:

  • Disclosing data without third party consent, when it suits the Trust to do so and especially when the data is grossly inaccurate.
  • Withholding third party data, on which consent has been granted, when it suits the Trust to do so.
  • Refusing to disclose data relevant to a complaint.
  • Appointing a senior official to liaise with a complainant and supply evidence, rather than the Complaints Manager and her staff.
  • Deny complainants equal access to evidence, especially transcripts of interviews with those accused of misconduct.
  • When this skulduggery is identified, instruct the investigator to publish a draft report and set an unreasonably short deadline for the complainant to comment.
  • Recommend an advocacy organisation, which is, “Rationing” services and, “Driving towards getting people ‘self-helping'”, owing to lack of funding – ideal [for the Trust]in dealing with complaints from mental health and/or learning disability patients!
  • Offer help and advice from Advocates who are not permitted to advise.
  • Appoint an official, who is explicitly engaged in an incident, to handle the resulting complaint and check the draft investigation report for factual accuracy!
  • Attempt to trick complainants by quoting GDPR³ and The Data Protection Act 2018 as a defence to data breaches when the breach occurred under The Data Protection Act 1998, i.e. before the new legislation came into force³.  

Probably more bullet points to follow!

Southern Health has not responded to a request for comment.

And the Chief Executive of an Advocacy Service commented recently, in writing:

“It is clear from my conversations with [advocate] that [Southern Health]  managers have put their own spin on the recorded communications that date back to 2016 and these have been embellished to their advantage, which is highly unprofessional.”

36657660 - cartoon of businesswoman, the dilemma of a whistle blower.


And what of Southern Health’s whistle-blowing policy, in which CRASH was consulted at the instigation of Alan Yates.



We believe Southern Health’s Freedom to Speak-up Guardian is a decent and professional individual but cannot be expected to be available 24/7. So the Trust decides Complaints Team members should act as back-up contact for whistle-blowers, despite that they report to an Associate Director, who does not believe complaints staff should take whistle-blowing disclosures and has already identified one whistle-blower.

94237238 - girl collecting horse excrement in shovel at stableyard


It’s time to get the shovel out again Alan.

Next [and related] post: “Patronising disposition of unaccountable power!”²




Turd Polish


¹ Trying to make something hopelessly weak and unattractive appear strong and appealing. An impossible process that usually results in a larger, uglier turd [Urban Dictionary]. Buy your own sewage polishing filter pads from Amazon here→!

And proof it can be done→

²  Title of Hillsborough Report by Bishop James Jones.

³  General Data Protection Regulations (“GDPR”). The Data Protection Act 2018 received Royal Assent on 23 May 2018 in advance of the application of GDPR on 25 May 2018.