The Executive Summary

The issues concerning North Staffordshire NHS Trust are complex. The case demonstrates a systemic effort to silence my concerns. It is important to grasp the concept that I was a very junior doctor at the start of my career - a pre-registration house officer who believed in the recommendations and the media hype of the Bristol Inquiry. This should be distinguised from the experiences of consultants who are publicised widely in the media. 

Having done my job in raising concerns on patient safety, I was forced on a journey that took more than 10 years. The journey to vindication is 10 years. In these ten years I experienced extreme circumstances from punctuated unemployment to financial hardeship to reprisal from the NHS. My case demonstrates the catastrophic failures of the British Medical Association and the Medical Protection Society who have failed to uphold the principles of patient safety. It also demonstrates the systemic failures within the General Medical Council. All of my challenges to vindicate myself were not done with the assistance of lawyers, they were done by my best friend DB who helped me for almost 12 years. He  is credited with many of the legal arguments that went onto win. I have attempted to summarise the events below but the issues are far more complex. I am thankful to my family and the friends who stood by me. I cannot say many of my medical friends from 1998 cared much or were considerate enough to support me but I am fortunate to have found better people in the world. Much is said about my dealings with Doctors.net.uk but I did what I had to survive and protect my employment in the NHS.

 

In November 1998, my main concerns were as follows :-

 

a) Lack of basic equipment such as drip sets 

b) Lack of adequate support for junior doctors 

c) Lack of basic care for patients 

d) Repeated DNR [Do not Resuscitate] notices 

e) Gross shortage in staffing levels. 
 

These concerns were outlined to the Trust.  Instead of taking this seriously, the Trust instigated a spurious complaint to the Health and Safety Executive over a needlestick injury to a clearner at a time I was not on the ward. By doing this, they attempted to persecute me hoping the Magistrates Court would prosecuted me and their failings would be hidden. It took many months for the Health and Safety Executive to clear me. Nevertheless, all this was communicated to the Department of Health

at a very early stage. Documents found at the Department of Health [ Entry date 1st March 1999] 

"The Executive is paricularly interested in this kind of event as they are actively seeking to prosecute a docor as an "example"
 

 

The concerns were reported internally and externally. At each stage, external organisations were unwilling to take the concerns seriously. My trade union, the British Medical Association failed to represent me in any reasonable form. They cited their preference at representing my consultant. The Medical Protection Society at the time requested that I conceal the evidence concerning patient neglect. 

Sally McGranaghan [British Medical Association] wrote on the 26.1.1999 

"This seems to me on the basis of conversation with Dr Pal to be a genuine case of a young doctor who should be protected for sticking up for her rights or in the alternative perhaps she genuinely is a pain in the backside"

Professor John Temple was contacted by a member of my family. He denied knowing about the problems. When I was eventually given an appointment, he offered me a second job in exchange for my silence. In terms of the London Deanery, Professor Lis Paice and Professor Temple decided the best way to handle patient safety concerns was by offering the junior doctor counselling. John Temple's manipulation of the truth can be read here. John Temple was never held accountable for his failures.

 

I raised the issues with the local paper then with the Sunday Times 2nd April 2000. One of the conditions of publication was to raise the issues with the General Medical Council. I did so. Unfortunately, the General Medical Council immediately reversed the investigation onto me.  In 2003, I found out that the GMC had been conducting a secret covert "discreet" inquiry into my apparent mental health. During this period, I was working as a locum psychiatrist in the NHS. I subsequently litigated successfully against the GMC. During the various issues I raised with the GMC, I discovered two internal Trust reports that verified my concerns [dated 1999 and 2001] in 2005. 

 

Professor John Temple and colleagues decided to instigate  a sham peer review with the assistance of Professor Rod Griffiths, the then Director of Public Health. Professor Rod Griffiths had advised the General Medical Council that my concerns on the ward were unsubstantiated. 

 

During a subsequent complaint to the General Medical Council by me, Professor Rod Griffiths was forced to admit he was wrong. Details of that challenge can be read here. 

This was assisted by the Expert Report on Ward 87. This was written by Professor Steve Bolsin of the Bristol Inquiry. It can be downloaded   here.

 

In the Pal v Griffiths case, I won a Presidential Review at the General Medical Council against the Department of Health lawyers. Despite the lack of sanctions, the General Medical Council wrote:-

“ As an experienced practitioner, Professor Griffiths will be aware of the guidance in paragraph 47 of the GMC publication Good Medical Practice. In future he will wish to ensure that comments about colleagues are not misinterpreted as unfounded criticism.”

 

“It is accepted that the specific case of Mrs EP may have involved a standard of care that was sub-optimal, as Dr Pal has alleged. Professor Griffiths’ conclusion that there was no evidence of lack of medical care for patients (including Mrs EP) is not supported by an examination of Mrs EP’s medical records, nor by the “Report of the extended investigation into the allegations made by Dr R Pal in November 1998” conducted by North Staffordshire NHS Trust. The Case Examiners accept, therefore, that Professor Griffiths’ view about the care provided to Mrs EP was inaccurate.”

 

“Dr Pal had to leave a critically ill patient to go to another ward in order to find a drip set (a means of administering intravenous fluids). That this is unsatisfactory is not disputed. The letter of 17/1/05 from his [Professor Griffiths’] representative to the GMC responding to the allegations stated: “An alternative available to the complainant was to call a crash team herself and not leave the patient. The crash team would have had a drip set and would have provided more experience”
 

During the GMC Complaint, an Expert report by Professor Steve Bolsin was provided. 

 

The summary the unearthed 2001 Creamer Report concealed by the GMC stated as follows 

 

(a) “Patient care was clearly affected by the failures identified”;

(b) “The Directorate failed to take appropriate action when the allegations were made in a statement by Dr Pal”;

(c) “Although medical and nursing staff were concerned about the range of issues...no one voiced their concerns except Dr Pal which either demonstrated a general acceptance of the issues or staff felt unable to raise concerns”.

 

The ward finally shut down in 2005.

 

Instead of conducting an investigation into the deaths on Ward 87, in the year 2000, the GMC conducted a unlawful "discreet inquiry" into my fitness to practise. On discovery of this in the year 2004, I sued the General Medical Council successfully. During the litigation, the GMC instigated a complaint on defamation. They later admitted their procedures do not deal with defamation despite subjecting me to a six month investigation before clearing me.

 

The General Medical Council subsequently instigated a spurious complaint on a "link" on the internet and my use of the term "psychiatrist".Having subjected me to a six month investigation while recklessly spreading dishonesties to the Trust I was working for, the GMC cleared me. The Trust in question fired me on the GMC's word and the General Medical Council subsequently went on to term it a "resignation" in court. To date, the General Medical Council have not been able to establish a resignation of any kind. Effective as of 2007, my references were stigmatised with a termination of employment and all my future application forms required a declaration of the GMC's spurious investigation. This prejudice to future employment is well understood by all doctors.

 

To prevent vexatious complaints against doctors, I challenged the General Medical Council in court in 2009. Unfortunately, due to judicial errors, the case did not have the result we expected. Permission to hear the case was won. Sadly, the actual case did not succeed at final hearing. It was heard by Justice Collins who was effectively persuaded by the GMC's blatant dishonesties.

 

 

The GMC currently takes no responsibility for their conduct. 

 

The court transcript from the case of PAL vs GMC, May 2004 before Judge Charles Harris is of interest. The judge remained unimpressed after the GMC tried to argue that the high watermark to justify an assessment on my mental state was a typographical error. This is what he stated. 

 

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: 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 transcripts for the case can be downloaded and read here. 

This is a landmark case as no other junior doctor has sued the GMC successfully during its existence.