March 7, 2013Kirsty Matthewson
Dr Rita Pal talks to Expolink about her experiences as an NHS whistleblower, the trials of stigmatisation and taking on the General Medical Council.
Dr Rita Pal is an independent medical journalist and well established, evidence-based NHS whistleblower, based in the UK. Between 1999-2007, she worked as a psychiatrist in the National Health Service and was the first whistleblower to raise concerns in the Midlands hospitals run by the same local health authority. Her concerns were ignored, with the net result that many patients died needlessly. Her name was placed on the Royal Society of Medicine Wall of Honour following support from a number of doctors.
This is the first in a series of three interviews with Dr Pal that Expolink is serialising over the course of the next few weeks; covering incentivisation, the Public Interest Disclosure Act, public and media attitudes to whistleblowers and preventing whistleblower retaliation.
You were the first doctor to successfully conduct civil litigation under the Human Rights Act, the Data Protection Act and in Defamation against the General Medical Council UK. Can you tell us more about your experiences with this?
Junior doctors are usually represented by defence unions. My defence unions have never been supportive of me since my early years as a whistleblower. It is extremely dangerous to litigate without the support of a defence union. I therefore risked losing what little I had.
The background to the case is as follows – I raised concerns on substandard patient care at North Staffordshire NHS Trust in 1999. Following that, the complex set of events that followed can only be described as medical mobbing.
Investigations were focussed on me while I was told that my concerns had no basis in fact. I continued to raise these concerns locally, to the Department of Health then the national papers and finally to the General Medical Council. Each organisation took no action. Character assassinations began at the Trust and were subsequently spread widely to the West Midlands Deanery and eventually to the General Medical Council.
The chronology of events is set out in the particulars of claim in the case Pal v General Medical Council, Catherine Green, Sarah Bedwell, Peter Lynn. Essentially, I was rendered unemployable after obtaining registration from the General Medical Council. My references were effectively ruined. I struggled to obtain a locum post and finally was able, with difficulty, to work in the NHS on short term contracts so no one would know my past.
I did this successfully until untrue rumours began to circulate about my so-called “mental state” on a doctors-only website. This started to infiltrate my work place, to such an extent that I was carrying a medical clearance in my bag so that I could clear up any rumours. Work became almost impossible.
In my quest to discover the source of these rumours, I made a Subject Access Request under the Data Protection Act to the General Medical Council. The results were shocking. In a series of internal memos, the General Medical Council discussed conducting a “discreet inquiry” into my mental state.
This did not involve contacting me by telephone (or at all!), or assessing my medical records. Instead, the GMC conducted covert, discreet inquiries into my life. I have not been able to access all of the records relating to their activities, but those that I have indicate that the GMC had collected copies of my website criticising the NHS, comments I had made about the author, Stephen King, of whom I am a long-time fan, and poetry that I had written.
Then, as now, locum employment forms demanded that candidates declare both ongoing and completed GMC investigations, and it was (and is) common for Trusts to cross-check applicants’ responses with the GMC. I felt this covert inquiry that had been ongoing for two years without my knowledge was damaging to my employment prospects as it “raised a question” over my fitness to practise.
Facing impending unemployability, I asked the GMC to remove their damaging memos immediately. They refused to do so. At the time, many lawyers I had consulted felt the GMC could not be sued. I was left with little alternative but to act as a litigant in person until I could find a lawyer. The initial claim form was written by two of us after we had read the legal textbooks. I decided I had nothing to lose as I would be unemployable soon enough – the stigma of an illness I did not have was already becoming catastrophic. Eventually, my colleague’s friend, a solicitor called Richard Price, agreed to run the case for me with payment up front.
Believe me, paying lawyers for practically every breath they take is not easy for any junior doctor. My task was to find £30,000 within 1.5 months. Along with this came the risk of more than £90,000 costs if I lost the hearing.
The GMC continued to refuse the removal of the memos despite numerous requests in court. They proudly cited a typographical error as a high water mark for questioning my mental health. To my knowledge, they still stand by this. The transcripts and case commentary can be downloaded here.
Eventually, the first hearing was won by my barrister Robert Jay QC [currently famed for the Levenson Inquiry]. In it, Harris HHJ was scathing. He stated as follows :
JUDGE HARRIS: For myself I don’t really see why somebody complaining about the behaviour of doctors or the GMC, if that is what they are doing, why that should raise a question about their mental stability, unless anybody who wishes to criticise “the party” is automatically showing themselves to be mentally unstable because they don’t agree with the point of view put forward on behalf of the GMC or the party.
MISS COLLIER (barrister representing the GMC): That in itself certainly would not be enough.
JUDGE HARRIS: It is like a totalitarian regime: anybody who criticises it is said to be prima facie mentally ill – what used to happen in Russia.
MISS COLLIER: My Lord, that is very far from the circumstances of this case.
JUDGE HARRIS: Of course it is…
The GMC eventually agreed to remove the damaging memos. They issued me with a letter stating that they had no concerns about my fitness to practise and we settled the case. There was no national media coverage of this case. The legal implications of this case can be read in an article by a legal firm.
You have requested an inquiry, by way of a petition, to establish proper evidence-based research into whistleblowing. What has been the response so far and why should people sign it?
The petition is for a Health Select Committee Inquiry into Medical Whistleblowing. I have requested a HSC Inquiry for many years now via my MP. Each request has been refused. If the system didn’t have anything to conceal, there would be no harm in having an inquiry.
I have sought this inquiry because there is very little research into medical whistleblowing. At present, we have a situation where everyone purports to know what is best for whistleblowers – but no one has asked the whistleblowers what problems they have faced.
There are a number of high profile whistleblowers, but they are not quite representative of the majority, who don’t have the advantage of publicity to open various doors for them. It is these ordinary, voiceless whistleblowers that should be interviewed by the HSC.
The current approach by the Department of Health will not work because it is not based on scientific research.
“In order to make a difference and improve patient safety, we need a logical way of investigating the problems faced by average whistleblowers, so that recommendations can be made to protect future staff and improve patient safety.”
People should sign it because, quite simply, if they don’t, patient safety is at substantial risk. The response is always good to a petition but the publicity is poor. The national media are often reluctant to feature this one, for reasons unknown to me. The petition is currently publicised on the internet daily by my wonderful friend Mary Foord Brown, who works tirelessly to circulate it.
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