Operation Scorch


Fire and flames.

Can you help detectives investigating the rape of a teenager in Southampton?

On Sunday, 2 December 2018, an 18-year-old woman was assaulted between 11pm and 11.50pm in Riverside Park just off of Woodmill Lane, Southampton.  Her name cannot be revealed for legal reasons. Read more here→.

So why, you may ask, it this relevant to Southern Health? Unforgivably, there is an alleged rapist at large as a result of its failure to report the alleged rape of a patient.

The Inquest into the death of Ellie Brabant, revealed that she returned to Antelope House, alleging she had been raped. Southern Health failed to report the allegation to the police.  CRASH believes the police would like to eliminate Ellie’s alleged rapist from their inquiries into the latest incident. It is only a possibility but such inquiries might also lead belatedly to an investigation into Ellie’s alleged rapist.

The Coroner’s Regulation 28 Prevention of Future Deaths Report on Ellie’s death identified this. The report by the charity Inquest records also that Southern Health:

  • Contaminated the scene of Ellie’s death by allowing her room to be cleaned before the police had finished their work.
  • Withheld a key document from the Coroner¹, Counsel for the family, and (to his great embarrassment) Counsel for the Trust. The Coroner’s diligence led to this being remedied on the last day of hearing verbal evidence: the document was key. 

Even more alarmingly sources close to Hampshire Constabulary inform us that Southern Health did not make a police report even after receiving the Coroner’s report.

Therefore, if you have any information, material or CCTV footage that can help in either incident, please dial 101 quoting Operation Scorch (Crime Number 44180450724). You can email postmaster@hampshire.pnn.police.uk too using these references We are sure you that it will be well-received. Please read on for more details.

Police Rape Map


For the assault on Sunday, 2 December 2018, the police have issued the route they believe the man they are hunting may have taken. Larger image here.

If any readers were in this area on 2 December and/or have any other information, they should contact the police.



The Coroner’s Regulation 28 Report and the charity Inquest’s report on Ellie Brabant says much about alleged improvements at Southern Health.

Even in the era of Katrina ‘Teflon’ Percy, I don’t recall, for example:

  • An informal patient telling clinical staff she had been raped, whilst away from the unit, and the Trust (?) not reporting it to the police. ***
  • An informal patient allowed to continue taking leave when she was returning high on drugs and/or drink and admitting to prostituting herself to raise the money.
  • I do not recall the Trust (?) failing to secure the scene of an unexpected death before the police had finished their work. ***

I do recall late disclosure of evidence being criticised by a Coroner but, on this occasion, it was only the diligence of the Coroner, who discovered, on the last day of hearing evidence, that the Trust had withheld a vital document. ***

22032231 - grumpy old judge in extreme wide angle closeup with hammer and wig*** Does failing to report alleged rape; failing to secure the scene; and withholding a key document from a Coroner, fulfil CPS Charging Standards for Perverting the Course of Justice² or Misconduct in Public Ofice³?


The charging decision is made by the police, working with the Crown Prosecutor. But, everyone can form an opinion⁴ using the information and links in footnotes 2 & 3. 

Finally, a reminder that BBC South Today’s report on the Inquest, is available here→.  

And for those who came to the Southern Health saga late, the BBC documentary ‘Broken Trust’ is now available too – here→.

¹ Senior Coroner, Mr Grahame A Short

² Perverting the Course of Justice is a common law offence committed when an accused:
does an act or series of acts; which has or have a tendency to pervert; and which is or are intended to pervert; the course of public justice. The course of justice starts when:
an event has occurred, from which it can reasonably be expected that an investigation will follow. The Trust knows there will be an Inquest and a police inquiry after an unexpected death so the question of reasonable expectation does not even arise. 

³ Misconduct in Public Office is a common law offence, which is committed when: a public officer acting as such; wilfully neglects to perform his duty and/or wilfully misconducts himself; to such a degree as to amount to an abuse of the public’s trust in the office holder; without reasonable excuse or justification. It normally includes elements of dishonesty, concealment and cover-up. It is often used when an alternative offence does not give the Court adequate sentencing powers.

DISCLAIMER – facts around the incidents described in this post are attributed (as shown) to the Coroner and Hampshire Police. Related observations are opinion only and should not be interpreted as implying any misconduct on the part of any individual persons or persons. That is a matter for the CPS, police and/or relevant Regulators.    


Equality – the Indian Way

Panoramic view of Taj Mahal at sunset

India beat England – and not just at cricket.

On 12 April 2017, we referred to The Indian Lunacy Act 1912 and a paper, summarising the history of mental health legislation in Britain extending back 172 years. We noted the word, ‘Lunacy’ was not replaced in Indian Law until The Mental Health Bill 1986.

Now, in the field (pun unintended) of mental health, leading academics¹, write of the new Indian Mental Healthcare Act 2017  (“IMHA):

“In theory, the IMHA is a highly progressive piece of legislation, especially when compared to legislation in other jurisdictions subject to similar analysis.

“Overall, it is likely that India’s new mental health legislation will impact on more individuals than any other piece of mental health legislation in the world”

They found India’s compliance with the World Health Organisation’s ‘Resource Book on Mental Health, Human Rights & Legislation’ (“WHO-RB”) standards generally good and more compliant with these standards than legislation of Eire or England & Wales. 

In particular, they claim that the UK Mental Health Act inadequately addresses the fundamental rights of voluntary patients, vulnerable patient groups, emergency treatments and economic and social rights.

So let’s look at some important sections of the IMHA [paraphrased] in comparison with UK legislation:

S.18(1) and (2): Every person has the right to access mental health care treatment and services run or funded by Government which are affordable, of good quality, in sufficient quantity, available nearby, and without any discrimination.”

Are our mental health services of sufficient quality and quantity and always available locally? Clearly not. 

S.19(1): A patient with mental illness (“PMI”) has the right to live in the community and be part of and not segregated from society.”

Are UK Community Mental Health Teams (including Crisis Teams) adequate for this to be a realistic objective? Clearly not.

S.20(2): PMIs shall be protected from cruel, inhuman or degrading treatment and have the right to live in a safe and hygienic living environment, proper sanitation and facilities for leisure, recreation, education, religious practices and privacy.”

In the UK, the availability of a safe environment and adequate facilities, free from inhuman and degrading treatment, cannot be guaranteed. See also s.97(1) below. 

S.21(1): Every person with mental illness shall be treated as equal to persons with physical illness in the provision of all healthcare.”

Speaking on 10 October 2013, Norman Lamb MP said it all: 

“There is an institutional bias against mental health within the NHS.” (Read full speech here→.) 

Some politicians do tell the truth!

“S.21(4): Every insurer shall make provision for treatment of mental illness on the same basis as is available for treatment of physical illness.”

If UK insurers had to cover mental illness on the same basis as physical illness, it would relieve the pressure on NHS mental health services considerably.  

S.27(1): PMIs are entitled to receive free legal services to exercise his/her rights available under the Act.”

In UK, non-means tested legal aid is available only whilst a PMI is detained under a section. Otherwise a PMI, who wishes to take legal action, must fund it themselves, even if breaches of mental health legislation have life-changing consequences. 

S.97(1): Seclusion and solitary confinement is totally banned and physical restraint is to be used sparingly, when absolutely needed, and deemed the least restrictive method.”

The young woman, behind barSeclusion and solitary confinement are not unusual in the UK: ask Bethany, 17, who has autism and extreme anxiety; has been locked in a seclusion room for almost two years; and is fed through hatches. Her father had to fight off Walsall Council’s bid for a gagging order stopping him from speaking out about his daughter’s treatment. Read more here→


Straight Jacket reduced


Physical restraint (including ‘face down’ restraint) has increased in recent years with reports of PMIs being fed through hatches in seclusion, forcibly injected with powerful drugs to sedate them, and violently restrained by up to six adults. Read more here→


S.98 (1): When a PMI is discharged into the community or to a different mental health unit or a new psychiatrist takes over, the existing psychiatrist must consult the PMI, the nominated representative and the relevant family member or carer. (2): The existing psychiatrist will, in consultation with the persons referred to in s.98(1), ensure a plan is developed as to how treatment of services are to be provided.” 

How many Inquests identify lack of adequate care plans as a contributor to suicide when PMIs are discharged? How many PMIs and families complain about lack of consultation before discharge; transfer between units and/or a change in Consultant Psychiatrist? 

Regarding family involvement, it is worth noting that WHO-RB specifies:

“Two occasions exist when the family and carers are automatically involved; these are: when planning discharge and in the case of a person found wandering in the community.”

Incorporating this into the Mental Health Act would put an end to Trusts using data protection legislation as an excuse not to involve the family at key stages. 

S.108: Any person who contravenes any provision of the IMPA (or related rules and regulations) is liable to imprisonment for up to six months or a fine of up to 10,000 rupees [£110³] or both for the first offence and imprisonment for up to two years or a fine of up to five lakh rupees [£5,500³] or both.

We believe it oppressive to incorporate criminal law against individual clinicians in the Mental Health Act. There are sufficient sanctions in UK law (including common law) to cover serious cases, such as manslaughter, false imprisonment and Misconduct in Public Office. Other aspects of professional misconduct are for Regulators to determine. 

The difficulty is that the police are reluctant to investigate medical professionals (save in the most blatant cases, such as Dr Shipman) and UK Regulators are insufficiently robust to hold medical professionals to account. 

“S.109: Where an offence is committed by a company or organisation, every person who, at the time the offence was committed, was in-charge of and responsible to the company as well as the company shall be deemed guilty … and be punished accordingly.”  

At Southern Health (and probably elsewhere) we know the difficulty (some may say impossibility) in holding Trust Directors to account. For this reason, we believe there are benefits of incorporating a clause based on S.109 of the IMHA into the Mental Health Act.


Of course, there are common barriers to full implementation of the IMHA, including inter alia funding, staffing, public health priorities and stigma, which cast a shadow on the new legislation. But then, don’t these barriers apply in UK too?

Also, adequate diagnosis of mental illness is essential for high quality mental healthcare, as is the need for high level clinical training and judgement for accurate diagnosis. In UK, it is evident that accurate diagnosis and effectiveness of training is patchy, and revalidation and regulation of psychiatrists is poor.  

But overall, Duffy and Kelly¹ conclude:

India realistic waving flag vector illustration. National countr“Other countries revising their legislation would undoubtedly benefit from studying India’s constructive, pragmatic and enlightened approach to this matter.”



¹  Richard M. Duffy and Brendan D. Kelly

² International Journal of Mental Health Systems

³ Exchange rates on 26 November 2018 

Car Crash

Car Accident CartoonWith three (possibly four) fatal incidents coming to light, last week was truly a Car Crash for Southern Health. The media reports largely speak for themselves.

Especially disturbing was the Inquest into the tragic death of Ellie Brabant, which commenced on 5 November and ended on 12 November. The Forum for Justice, Accountability and Equality at Southern Health (“the Forum”) was well-represented – five people ensuring that one member was present for part/all of every day.

karl marlowe - Spin DoctorBBC journalist, James Ingham produced a superb report for BBC South Today and presenter, Sally Taylor interviewed the family solicitor. Producer: Ian Lauchlan¹: view full report here→.

Perhaps the most unedifying and (to the family) disrespectful images are the sight of Medical Director, Dr Karl Marlowe, scurrying away with his ‘spin doctor’ hurrying along behind.

Email your views to Dr Marlowe here→


There is also a written report here, which summarises the criticisms of Southern Health, which the Coroner will write in his Prevention of Future Deaths Report [“PFD”].

In addition, the Coroner will write separately to the Trust re: disclosure and preservation of evidence after a serious incident. Yes – the Trust was caught withholding key document (where have we heard this before?) and failing to secure the scene.

Unusually, Sarah Hemingway,  Counsel for Ellie’s family, who met members of the Forum present at the Inquest, wrote to CRASH:

“Thank you very much for your email below and your input during the course of the inquest…. I wish you and the families’ campaign group all the very best in holding SHFT to account.”

Sarah and her instructing solicitor, Alice Stevens, did sterling work in exposing Southern Health’s failings, making a compelling (and successful) case for a PFD.

We know less about the other three cases but press reports largely speak for themselves:

Martin Pope: Mr Moth’s family and friends had concerns about support from Southern Health in the weeks before his death with an apparent breakdown in communications. Assistant coroner Simon Burge said:

“As a result of the breakdown (in communication) there was a failure to appreciate how desperate Paul was.”

Sheriden Harris: We quote Fareham MP, Suella Braverman:

‘This is a tragic loss of life, we must think of Sheriden’s family and friends at this time.

‘It highlights the need for serious and meaningful change to ensure more patients are not failed, and to protect the most vulnerable.’

Southern Heath said it has learned from mistakes in caring for a woman with learning difficulties: they said they have worked hard on addressing failings identified by the report, following the Sheridan’s death in May 2017.

Where have we heard this before? Oh yes! Connor Sparrowhawk and Edward Hartley, young adults with learning difficulties, who passed away respectively in July 2013 and May 2014.

Connor’s family finally got justice on 26 March 2018, when Southern Health was fined £1,050,000 (excluding costs) for an offence under The Health and Safety at Work etc. Act 1974. Read more here→and Mr Justice Stuart-Smith’s sentencing remarks (on this and another case) here→.

Edward’s family are still waiting for justice even to this day.

Baby Stanley: WARNING: some might find this case distressing.

We  cannot prejudice a continuing trial in Winchester Crown Court and, at this stage, Southern Health’s involvement (if any) is unclear too. There is simple reference in the BBC’s report to a Health Visitor: Fareham & Gosport Clinical Commissioning Group inform us that Southern Health employees Health Visitors in its area.


¹ Ian Lauchlanalso an, “Obsessive Quins rugby fan.”

Bedlam,’barbaric’ secure hospitals


via Bedlam¹,’barbaric’ secure hospitals, #rightfullives

37765453 - the bethlam royal hospital also known as bedlam

“At least 40 people with a profound learning disability or autism have died while admitted to “barbaric” secure hospitals the government has promised to close since 2015, a Sky News investigation has found.” Read full story here→

Most alarmingly, the number of cases of restraint in England rose from 16,660 in 2016 to 28,880 last year, a rise of 73%. NHS England alleges that the increase is explained by better reporting of incidents. [Oh really?] If we believe that, 12,220 cases of restraint went unrecorded in 2016 – 235 per week. Who’s being held to account for that?  

And the allegation that health services in Scotland, Wales and Northern Ireland were unable to provide figures is simply scary.

Sir Stephen Bubb² said that government’s failure to act was putting patients’ lives at risk:

“There are deaths of people in these institutions, some of them unexplained. We know there are significant problems and there will be at some stage another scandal, and yet we know what we need to do.

“The idea that in the 21st century you lock people up, you restrain them, you use prone restraint, you hold them down, I think is disgusting, it is barbaric and it is unacceptable, and it needs to be made unlawful.”

ignorance Plato


Adapting the words of Greek philosopher, Plato, in the context of mental health & LD:



¹ People with illnesses, which we now recognize as schizophrenia, depression, autism, and epilepsy, might all have found themselves in Bedlam.

² Sir Stephen Budd led the work, commissioned by NHS England, to support and enhance existing activity, to ensure thousands of people with a learning disability, who are still stuck in Assessment and Treatment Units, are supported to move back to their local community. The press release about the work with links to the full report is here→

Our strategy is to wear them down!

BCC4In advice to it’s staff, Southern Health publicises that Gloucester Police have been fined £80,000¹ for disclosing 56 names and email addresses by failing to use the BCC facility! The police realised their error two days later and recalled the emails.

The words, POT, KETTLE, BLACK come to mind. Southern Health made the same mistake in September 2017. At a Board Meeting on 26.09.17, a member of the public stated:

Bcc Q & A 4

To avoid breaching the addressees’ privacy again, CRASH will not be publishing the errant email – just the Trust’s answer – also from the Board Meeting Minutes:
BCCs Trust Answer 002

In short, no answer at all. Kicked into the long-grass: to the best of our knowledge and belief, the ‘offending’ email was not recalled.

And note that the full public statement is ‘sanitised’ in the body of the Minutes as, Issues relating to data security, whilst the full statement is posted separately from the Minutes on Southern Health’s web site as an Appendix here→. How many just read the Minutes and then look for separate document? There is no logical reason why the Minutes and Appendices should not be in one document.

CRASH, Dr Sara Ryan and others have considerable experience of Southern Health’s compliance (or lack of it) with information governance legislation over the years. The Trust clearly has been reading Dilbert.com.Dilbert

Dilbert by Scott Adams © 2018, Andrews McMeel Syndication

Recently, there has been another very serious breach of data protection legislation, which cannot be reported for legal reasons.

In Memoriam – ‘Vital Interests‘ Exemption

Despite Southern Health’s record on data security , when they can disclose data legally in the ‘vital interests’ of a patient (Sch. 3(3) of The Data Protection Act 1998¹), they don’t.



Wherever we go, it’s hard to avoid Southern Health. This sad epitaph is at Hythe Marina overlooking Southampton Water. 

A 20-year old lad told a therapist at Antelope House that he intended to end his life.

They told the family he had made an appointment, but not that he had threatened to kill himself.


Read full story here→ but note the comments of Dr Cory De Wet (amongst the usual duck-billed platitudes):

“Our staff work hard to assess risk and agree a balanced response with each patient, taking into account their wishes about confidentiality.”

Nonsense! Many staff work hard, but, in this case, aside from the obvious ‘vital interests’ test) Southern Health had broken confidentiality already in telling the family he had an appointment at a mental health unit. Common sense might have been a useful asset too!

Perhaps Dr De Wet, you should work harder to train your staff in matters relating to The Data Protection Act and also tell them to use their common sense if there is a threat to life. ‘Data Protection myths and realities‘ is perhaps one of the best papers published by the Information Commissioners Office:

“Data protection law reinforces common sense rules of information handling, which most organisations try to follow anyway.

“Some organisations understandably err on the side of caution and do not release information when they could do so.”

¹  The Data Protection Act 1998 was replaced by The Data Protection Act 2018 and The General Data Protection Regulations (“GDPR”) from 25 May 2018. Harsher penalties are available under the 2018 Act and GDPR but they cannot be applied retrospectively – or Gloucester Police’s fine might have been even higher.

Spinning around, spinning around

KONICA MINOLTA DIGITAL CAMERAWe thought we had written enough about poo but found some for sale very close to Southern Health’s HQ shortly after seeing their take on the latest CQC report. It appears to us that Southern Health have been busy polishing again.

CQC report (lower half of page 1):

CQC Report ReducedNo ‘Outstanding overall ratings: read the full CQC report here→

Southern Health’s News Release, paragraph 1:

“Today (2 October 2018) the Care Quality Commission (CQC) have published their comprehensive report into Southern Health NHS Foundation Trust. Whilst the Trust remains rated as ‘requires improvement’ overall, the CQC have found many signs of progress across the organisation, with over 84% of service areas now rated as ‘good or ‘outstanding’.”

Whirligig icon cartoon


(Spinning around, spinning around)
I’m spinning around.¹  


Read the spin news release here→. Sadly no mention  here of the leadership requiring improvement.

Readers can compare the two and draw their own conclusions. 

CRASH is sure there are caring and responsive staff at Southern Health, who warrant a ‘Good’ rating but what is the point of caring and responsive staff when patient safety, effectiveness of services and leadership all require improvement?

Indeed, we can reasonably argue that Southern Health would recruit even more permanent caring and responsive staff (saving money on locums, freelancers and ‘bank staff’), if prospective recruits believed they were joining a safe, effective, well-led Trust.  

2013 MTV Movie Awards


(Sorry boys – Royalty Free images, very limited)

¹ Kylie Minogue

Lyrics here




The ‘Do nothing’ Advice


“Do nothing … if you can, take the rest of the day off.”

5892231 - crying crocodile


via Crocodile tears and the ‘do nothing’ advice




As usual, inciteful and poignant observations by Dr Sara Ryan, this time on attitudes to complaints and complainants within the NHS. It follows an article by Clare Gerada, Lady Wessely, an ex-chair of the Royal College of GPs and member of the Council of the British Medical Association. She is a Fellow of the Royal College of Psychiatrists too.

On receipt of a complaint, Gerada advises doctors to:

“Do nothing … if you can, take the rest of the day off.”

That’s not a luxury available to bereaved families or those suffering harm as a result of clinical negligence.

Extracts from Gerada’s twitter account (#FBPE @ClareGerada) also posted at Crocodile tears and the ‘do nothing’ advice include the following gems:

“It’s easy to complain. No risk to complainant. Sadly they kill doctors.¹”

And after a reply pointing out that it’s not always easy to complain, Gerada responds:

“It should be difficult. And patients should think very carefully. Complaints kill.¹”

So now folks, we (complainants) kill doctors!

And yes, there is a risk to complainants, who often suffer symptoms of stress in ‘taking on’ the (already far too ‘difficult’) NHS complaints system. We know one complainant, who suffered PTSD as a result of complaining about clinicians, and others whose mental health has been harmed.  One would expect a reasonably skilled Fellow of the Royal College of Psychiatrists to appreciate the risk of psychological harm to complainants.

What are the chances of transforming the NHS if Gerada’s ‘old-school’, defensive attitude prevails? Contrast this with the patient-centered culture of Virginia Mason Medical Centre, the world’s leading authority on Total Quality Management in healthcare:

“Stories have a profound impact on medicine – patient perspectives have the power to inspire an organization and strengthen the commitment to improving the quality, safety and delivery of health care.

“Capturing the patient voice opens the floodgates to know when the patient is feeling more vulnerable, lonely, worried, empowered or happy along each point of their care journey. Their experience can help inform where improvements can be made along the way.

“Through empowerment and solicitation of patient input, the patient experience can be fine-tuned, even perfected.”

Perhaps Gerada could attend ‘Eliminating Preventable Patient Harm‘ – a two-day course at The Virginia Mason Institute™ (please, not at taxpayers’ expense) or watch the webinar: Capturing Value in Patient Voices and Perspectives‘.

Very sad for a leading GP not to understand that, if the NHS is to become a safer place, complaints should be encouraged, investigated diligently and lessons learnt. Gerada’s attitude reminds us of the, “Patronising disposition of unaccountable power!” 

We are all for taking a break from the stresses of working life but the recipient of a complaint should (and must) ‘Stop the Line‘; report the incident; and ensure it is investigated immediately, especially if it represents a serious risk of harm if repeated.

Indeed, an inciteful clinician, who makes a mistake, should not be surprised by a complaint – he/she should have self-disclosed it already and have an answer before the complaint is received.

The goal should always be to achieve a zero defect healthcare system, in which customers always come first. 

And after the problem is solved and the risk eliminated, then take the whole of the next day off, relax and do something different (preferably with exercise), confident in the knowledge that the incident will not recur.

For example: take an alpaca for a walk²!

¹  We do not trivialise situations in which anyone has died, including clinicians: all deaths (or harm), suspected of being preventable, should be investigated with the same speed and vigour, regardless of the patient’s profession.

²  Petlake Alpacas of the New Forest  [Image © CRASH]  

Alpaca Walking Experience RECOMMENDED   Gold Star Minute   Gold Star Minute   Gold Star Minute  Gold Star Minute  Gold Star Minute    or Gifts

Reminder to self: if relocating to London do not register at a Hurley Group Medical Centre – of which there are many – your GP might have taken “The rest of the day off.”

Money, Money, Money

“If I got me an NHS fat cat, I wouldn’t have to work at all I’d fool around and have a ball,

40261762 - cat with the computer mouse.

“It’s a rich man’s world”¹

In a comment on ‘mydaftlife‘, we questioned the need for more money in the NHS – at least before layers of non-clinical managers are stripped out; bureaucracy reduced dramatically; fat-cat salaries of non-clinicians brought under control. We should add clinicians acting as bureaucrats and improved debt-recovery from health tourists.


Last year ‘The Daily Telegraph‘ alleged amongst other things that:

  • Over 600 NHS quango chiefs earned in excess of six-figure salaries.
  • Doubling in the number earning more than the Prime Minister in three years.
  • The nine main health quangos employed 628 officials on salaries of over £100,000.
  • NHS Improvement alone had 79 officials on six-figure salaries.

Many of these high earners make frequent repeated demands on Government [i.e. us, the taxpayers] to increase NHS funding. Read more→

And it doesn’t end at national level. On 27 July 2018, ‘The Daily Telegraph‘ reported that Clinical Commissioning Groups in Sussex propose rationing hip replacements. Patients are expected to endure “uncontrolled, intense, persistent” pain for six months before referral for operations. Coastal West Sussex CCG employed an Interim Chief Finance officer at an annualised salary of £330,000 a year. This could have funded around 60 hip replacement operations². Read more→

Comparison: The Prime Minister is paid £150,402 a year, including the basic salary for an MP, which is currently £74,962. It doesn’t factor in the value of the Prime Minister’s flat in Downing Street, or other official residences – but then, who wants to have two jobs and live ‘on the job’ too? [Source: Full Factthe UK’s independent factchecking charity.]

Perhaps the salary of Simon Stevens, CEO of NHS England should be capped at the same level as the PM and other senior NHS officials at the level of equivalent Secretaries of State, Ministers and so on down the slippery pole. NHS England’s 2017/18 Annual Report shows that Simon Stevens earnt £190-£195K plus £45-£47.5K pension.

Solution: To his credit, it is reported that, in 2017/18, Simon Stevens voluntarily took a £20,000 per annum pay cut for the fourth year in a row, i.e. circa. 10%.

So, even if the 600 NHS quango chiefs and 628 officials are only earning £100,000 each, a 10% salary cut over for the next four years, would save the NHS £49.12 million.  

This would fund dialysis for up to circa 396 patients with renal failure every year.³


41498855 - medical tourism vector background


There are two types of Health Tourist:

1. ‘Deliberate’ users of the NHS.

2. ‘Normal’ users of the NHS— foreign visitors who’ve ended up being treated while in England.

© Sayan Bunard


We concentrate here on ‘Deliberate users’ – those who come specifically to receive free treatment or who come for other reasons but take advantage of the NHS when here.

In July 2014, the Department of Health published its: ‘Visitor and Migrants NHS Cost Recovery Programme‘. Despite this, the ‘Mail on Sunday‘, reported recently that, NHS Improvement estimates hospitals should be collecting £167 million/year from overseas visitors, but are only recovering £113 million, a £54 million shortfall. Read more→

Labour wards are especially affected: two years ago, St George’s Hospital in London admitted that a fifth of its deliveries – up to 900 births – were to women who flew in from outside Europe. That’s a cost to the taxpayer of £6 million – at one hospital..


Recently, NHS Un-Improvement (as it’s sometimes known) launched a crackdown on health tourism sending ‘hit squads’ into 50 NHS Trusts – no doubt at great expense.

Is there an alternative?

UK-aid-logo reduced


UK Aid from the British People, doled out by the Department of International Development (“DFID”), is detailed in ‘Statistics on International Development: Provisional UK Aid Spend 2017


Total provisional expenditure for 2017 by “The British People” was £13.933 billion, including £3.828 billion from other Government Departments and organisations.

Notably, one of the other government departments was Health & Social Care: it contributed £101 million of our money – an increase in £55 million over 2016

So, rather that hiring ‘hit squads’, why does the Secretary of State not just set up a system whereby NHS Trusts simply bill DFID, which pays the Trust and deducts it from its overall budget. Is that too simple for the Sir Humphreys in Whitehall?

After all, one of the objectives of Overseas Aid is to promote economic development and welfare of developing countries as its main objective. What better way of promoting welfare than to pay for the healthcare of their citizens, who come here.


Talking of fat cats, in our main source of images this week, we found this – genuine original – no photo-shopping:

48116033 - percy word on banner and bikiny womanThis one said farewell taking circa £250K (including pension and benefits) for being “Bad at her job.” As ‘Scotlander’ commented in ‘The Oxford Mail’ on Katrina Percy:

“She could be a poster girl for NHS incompetence, waste and indifference to public opinion.”

© icetray



Comments on West Hampshire CCG’s Annual Report & Accounts: download here→

Red Mist


¹ Adapted from ABBA “Money Money Money“: writer(s): Bjoern Ulvaeus, Benny Anderson, Stefano D’Orazio

² Based on £5,431 – £5,625 for “Very Major Knee Procedures for Non-Trauma” – Best Practice Tariff, NHS Improvement and NHS England: prices in 2017/18.

³ The National Kidney Federation – average cost of dialysis £30,800/patient in 2010.

Mental Health Man of the Week

KONICA MINOLTA DIGITAL CAMERAToday’s post was to be titled ‘Red Mist owing to recent interactions with Southern Health and others in the last two weeks.


At the last minute, we came across a much needed ‘good news’ story. (‘Red mist‘ follows.)

It is the heartwarming story of Chris Ryder (@CWRyder), lifelong supporter of Barnsley Football Club, who tweeted about his “anxiety, stress and depression” on 8 August. He then shared an image of a letter he received from the Club’s Chief Executive, Gauthier Ganaye (@GGanaye), who opened with an apology for writing at random and wrote:

“I felt like I wanted to reach out to you and get in touch.

“I’ve noticed through social media that you’ve had a bit of a hard time recently, I’m not sure what it is but I hope everything improves for you as soon as possible.

“You’ve been a fan of the club for many years and always supported us, so we want you to know that if the favour needs returning and we need to support you, please do let us know.”

Dkjc-BpWsAAlcsVGauthier continued:

“You are welcome to swing by any time. My office door is always open….”

Having urged Chris to contact MIND,  if he needs to, Gauthier closed:

“Keep supporting the Reds, Chris. We’ll keep supporting you.”

When the letter went viral, a spokesperson for the club told HuffPost UK:

“We feel that every comment we could make is in the letter, other than that obviously the door is open to anybody in the community [bold added] that needs us.”

Has anyone received such a kind, empathetic and sympathetic open invitation from a Southern Health Director – or a Director of any NHS organisation – much less an “open door” to anybody in the community who needs their organisation? 

Gaultier was the youngest Chief Executive in the football league when he was appointed to the role at Barnsley FC in May 2017, at the age of 29. Before that, he was on the executive committee for French team Racing Club de Lens.

MONSIEUR GANAYE: Southern Health is currently recruiting Non-Executive Directors. Its service users and bereaved families need your empathy and understanding – even more so to ‘balance’ its Board with Directors with experience of the ‘real [commercial] world.’

Other like-minded, experienced persons should also apply!

Information here→            To learn more email Company Secretary here→.

Come on you Reds“: … and for balance … “You ain’t seen nothing like the Mighty Quins.”





“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→