Posted by: John Brace | 21 November 2018

Employment Tribunal heard what happened when whistleblowing concerns were raised by doctors about patient safety at Alder Hey Children’s Hospital

Employment Tribunal heard what happened when whistleblowing concerns were raised by doctors about patient safety at Alder Hey Children’s Hospital


Liverpool Civil & Family Court, Vernon Street, Liverpool, L2 2BX (the venue for Employment Tribunal case 2420922/2017)

Liverpool Civil & Family Court, Vernon Street, Liverpool, L2 2BX (the venue for Employment Tribunal case 2420922/2017)

This continues from Employment Tribunal hears whistleblowing concerns about patient safety at Alder Hey Children’s Hospital.

It was put to Dr Ryan that she had confused the chronology and she was asked if it was possible that the meeting at which Dr McDaid and another doctor had sought to persuade her about the changes at which they’d provided a presentation was after the email, a few days after on the 25th January or the 27th January? Dr Ryan answered that she didn’t remember meeting them as a separate group if indeed such a meeting took place.

The representative said there was no doubt that there was a meeting when Dr McDaid was on sick leave. Dr Ryan answered that the only meeting she remembered was the large meeting in the Marlton Room at Marlborough House.

Asked if she knew she was on sick leave as Dr McDaid had a broken jaw, Dr Ryan said she knew that Dr McDaid had a broken jaw as Dr McDaid had wires in but she wasn’t aware that Dr McDaid had returned to work.

Dr Ryan was asked if she remembered the meeting where Dr McDaid had her jaw wired, she answered that it was a meeting with about ten other people. The representative asked her if Dr McDaid and Dr Andy had had a presentation to give to Dr Ryan designed to address their safety concerns? Dr Ryan said that she understood that now.

The representative said that that was the third attempt to bring to Dr Ryan’s attention the concerns of Dr McDaid and others following the email.

Dr Ryan referred to the email in her answer, the meeting at Mulberry House with the whole group to discuss the changes but how Dr Ryan didn’t understand the specific safety concerns.

It was put to her that the meeting was arranged before Dr Ryan knew of the concerns. Dr Ryan answered that the email expressed the view that they weren’t happy with the changes and worried about patient safety, but that she didn’t understand why, but she’d been happy to talk to the whole group about the proposed changes and model.

Dr Ryan was asked to think if she had a meeting in her diary to discuss the changes then or arranged this by email? She answered that she couldn’t remember.

She was asked about the meeting that was arranged for just Dr McDaid and Dr Andy. Dr Ryan said that she didn’t recall a meeting, but in answer to a further question did recall a meeting with Jackie Flynn. Asked if she remembered Jo Poitier at this meeting she said that she couldn’t see her present.

Dr Ryan was asked about comments that Dr McDaid recalled that made her feel uncomfortable and was it right that Dr McDaid felt she was not being given an opportunity to get across the concern she was trying to raise? Dr Ryan answered that the presentation of Dr McDaid and another wasn’t planned or on the agenda, the presentation was also extremely lengthy at perhaps thirty slides printed out and distributed. In Dr Ryan’s view nearly all of the presentation discussed the history. Dr Ryan was keener to move on with the arrangements in place for emergency patients late at night and therefore was quite dismissive of the presentation for that reason.

It was asked of her if she was dismissive of Dr McDaid? Dr Ryan answered, “No”. Dr Ryan was asked if she had said to Dr McDaid that she didn’t know what Dr McDaid was trying to say and to move on? Dr Ryan answered that she may well have said that, but what she was trying to convey was that in her opinion that they were going over old ground as she had not been around during the previous reorganisation. There were strong feelings over how it was done and she’d said she was previously frustrated by the obstruction. Dr Ryan was looking to move forward the discussions in response to the presentation and it was not directed to Dr McDaid trying to say something.

It was pointed out to Dr Ryan the obvious difficulty Dr McDaid would have in talking with her jaw wired and although it was not the purpose, the effect of her comments meant that Dr McDaid felt humiliated. Dr Ryan answered that this was not her intention.

Dr Ryan was asked if Dr McDaid might feel the effect of Dr Ryan’s comments were humiliating? Dr Ryan said she didn’t know why Dr McDaid would feel that as it was not a reference to her jaw, Dr McDaid had been there as a consultant psychiatrist as part of a group.

The representative said that Dr Ryan was very dismissive of Dr McDaid’s attempts. Dr Ryan answered that she was sure her frustration showed in the meeting.

Asked if Dr McDaid must have felt concerned by Dr Ryan’s comments to her, the other side’s legal representative intervened and said that he could not ask one witness how another witness felt.

Rephrasing the question, Dr Ryan was asked if a whistleblower might be put off raising an issue if told to sit with her discomfort? Dr Ryan said that was not her response to concerns about patient safety, she did not communicate well, it had been a poor meeting in general and did not go how anyone planned. Dr Ryan said that the whole encounter was not good. She had not understood the significance at the start of the meeting of the concerns and instead felt that Dr McDaid was struggling with change. Dr Ryan didn’t remember the context but accepts that it was something she could have said.

She was asked if the message that Dr Ryan conveyed was to keep quiet? Dr Ryan answered that she didn’t know how Dr McDaid interpreted it. It was put to Dr Ryan that it could be interpreted as meaning keep quiet, keep your head down? Dr Ryan answered that she never instructed and that was not her practice now, not her methodology and not something that would’ve been meant that way. Had Dr Ryan understood there were serious safety concerns and what the serious safety concerns were she would have been the first to listen.

The email on page 146 was referred to, so was the bottom of page 147. The representative said that Dr Ryan had told a formal meeting that Dr McDaid was not allowed to speak, despite the fact that the concern was about the safety of patients being compromised. Dr McDaid and Dr Andy couldn’t have been clearer that it was safety concerns that were raised. Dr Ryan said that they did not say what the concerns were.

The representative said that people were encouraged to raise concerns, but there had been no response from Dr Ryan in response to the email to escalate the concerns up the management chain. Dr Ryan said that there was no indication at that stage what the concerns were but that Suzanne Edwards had been tasked to plan a meeting to sort it out at that stage. Without more concrete discussion the problem was that Dr Ryan didn’t feel she should go to the Medical Director about it.

Dr Ryan was asked if she was embarrassed that her proposals were thought dangerous by the consultant psychiatrists? Dr Ryan said that she understood that they didn’t like them, but it was unclear as no none had articulated the reasons or detailed an alternative model. Dr Ryan said that she wouldn’t use the word embarrassed.

The representative asked Dr Ryan if she would agree that safety concerns being raised to her as the author of the changes, that she was not the best person to judge whether the proposals were safe or unsafe? Dr Ryan answered she was not the author as it was a joint proposal with Jackie Flynn, followed by a comment about being unable to understand exactly where safety was compromised.

Dr Ryan was told that she could only articulate the detailed specifics if there was the opportunity to raise them with her. Dr Ryan replied that there was every opportunity in the email. A further question about the email was answered that a meeting had been arranged. The representative said that Dr Ryan didn’t listen to the specific details, to which Dr Ryan replied that specific concerns weren’t articulated.

Asked about the general policy on taking minutes of meetings, Dr Ryan said that there was very little administration support and they did not have the ability to administer meetings, it was not her role to take minutes of meetings. The consultants raised various issues and Dr Ryan had frequently to write a note if action was to be taken about it.

Dr Ryan was asked if she knew who took their concerns to Mr Turnock? She was asked about staff who felt safety concerns were not listened to escalating it to a more senior manager? Dr Ryan answered that it was entirely appropriate.

Referred to paragraph 20 of her witness statement, she was asked that when they went to see Medical Director Mr Turnock bypassing Dr Ryan was there an element of petulance? Dr Ryan answered no, she had no issue with them seeing Mr Turnock and raising safety concerns, but they had also said extremely personal things about Dr Ryan, that they were unhappy with her, had lost confidence in her, she was not an appropriate leader and a whole raft of things.

Asked if anyone had raised an issue about her management style or ability before, Dr Ryan answered, “No”.

Dr Ryan was asked about the complaints about their safety concerns not being listened to and her inappropriate management style? Dr Ryan answered that her understanding was that they went to see Mr Turnock because they were annoyed and fed up with Dr Ryan, they felt they weren’t led properly, didn’t like the changes, weren’t listened to and she didn’t remember safety as a big issue. Mr Turnock had asked to see Dr Ryan in his office, the psychiatrists as a group had seen him. Dr Ryan didn’t like being shown a letter as what was written was undermining, personal and upset her. She tried not to be upset, meet as a group and figure things out. There was not an emphasis on safety or would she say she ignored a safety concern but very much on collaborating and working together.

The representative asked if she had had an opportunity to look at the minutes of the meeting with Mr Turnock on page 148? Dr Ryan answered that she didn’t remember seeing them and in answer to a follow-up question that they weren’t seen as part of her preparation.

Referring to page 148, a reference was made to the second paragraph, which indicated surprise that no concerns had been raised by the Leadership Team and that the genuine safety concerns about the Change Programme ought to have been escalated to Mr Turnock. Dr Ryan answered not necessarily as it depended on the content.

It was pointed out to Dr Ryan that there was no other reason why Mr Turnock was surprised if she ought to have escalated the whistleblowing. Dr Ryan said that it wasn’t discussed as whistleblowing, that Jackie Flynn and herself were unclear why the group were unhappy with what was offered. A lot had articulated safety concerns but she was unable to get to the bottom of it, until she did and had a grip on what the issues were she was not in a position to escalate to Mr Turnock. They only became real safety concerns and issues once Dr Ryan understood them, therefore there was no issue to raise with Mr Turnock.

Dr Ryan was told that as a group the consultant psychiatrists were well qualified experts in the field, articulate and intelligent. Dr Ryan said that she didn’t think they were articulate at the time.

The representative put it to her that in a supportive environment that they would have had no problem with their safety concerns. Dr Ryan said that she needed specific concerns which were not forthcoming.

Referred to meetings at which these sorts of concerns were raised, where Dr McDaid was tutted and laughed at, she was asked if this was not providing a supportive environment?

Employment Judge Ryan asked for clarity as to when the meeting was. The answer given was the 14th January meeting when Dr McDaid had her jaw wired shut but had raised safety concerns.

Dr Ryan answered that the meeting was with a large group.

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