South East Wales

NHS trust head Margaret Foster dealt with complaint concerning surgeon husband

Joan Pask
Image caption Joan Pask died in 2006 after going into hospital for a routine procedure

A health trust chief executive who dealt with a complaint about a patient's treatment failed to declare she was married to a surgeon involved.

Margaret Foster, who was then head of Pontypridd and Rhondda NHS Trust, wrote to the patient's daughter after complaints about a routine operation.

A health watchdog agreed that not revealing the relationship may have been seen as a conflict of interest.

Cwm Taf Local Health Board said it accepted the findings and apologised.

The hospital involved, the Royal Glamorgan in Llantrisant, was managed at the time by Pontypridd and Rhondda NHS Trust but is now run by Cwm Taf. Mrs Foster retired as chief executive in March last year.

Rhiannon Collinson complained to the Public Services Ombudsman for Wales in July 2007 about the care and treatment provided to her mother Joan Pask, 68, from Llantwit Fardre, near Pontypridd.

Mrs Pask's small and large bowel were perforated during a routine haemorrhoid procedure on 25 July 2006, and she died on 1 September that year.

An inquest was held and the coroner recorded that the probable cause of death was an intra abdominal infection caused by the perforations.

Mrs Collinson also complained that Mrs Foster, when responding, had not mentioned one of the consultants involved was her husband.

The ombudsman Peter Tyndall said the consultant had been "significantly involved" in one of the surgical procedures that had been complained about.

Mr Foster was the senior consultant surgeon on the day of the procedure and in a neighbouring operating theatre.

After Mrs Pask's deterioration, the following morning he became involved in the management of her problems and an emergency operation was carried out, which he supervised.

Following the coroner's narrative verdict, the ombudsman's investigation focused solely on the way the trust had dealt with the complaint.

The trust's policy was for the chief executive to respond to all complaints letters, although there was "clearly provision for this function to be performed by the deputy chief executive of the trust", wrote Mr Tyndall.

Potential for conflicts

"I found the failure of the former chief executive to declare her connection with the consultant to have led to a perception... of a conflict of interest and, accordingly, I upheld the complaint," he said.

He emphasised however that he had seen no evidence to suggest that the chief executive "had any influence on the content of the response letters sent..."

Mrs Foster told the ombudsman she accepted the failure to mention the relationship could have been perceived as a conflict of interest.

She said the trust's medical and clinical directors had felt her husband's involvement in the operation had been peripheral at that stage so she did not reveal her relationship.

"May I state at the outset that his complaint was taken very seriously as it highlighted areas where accepted practice within the organisation needed to change," her statement said.

Mr Tyndall said the successor Cwm Taf Local Health Board had since recognised the potential for conflicts of interest and had taken steps to address the issue.

Allison Williams, chief executive of Cwm Taf, said: "I would like to offer my sincere apologies to Mrs Collinson for the failures of the former organisation as identified in the report.

Failures in care

"We accept the findings of the ombudsman and will be issuing a formal apology as recommended."

Mrs Collinson, who now lives in London, told BBC Wales she was pleased her complaint had been upheld but was still very angry about how it had been dealt with and the way her mother had been treated.

In a separate case investigated by the ombudsman, Cwm Taf was criticised after the death of a 20-year-old woman with "complex health care needs".

The ombudsman said her clinical treatment at the Royal Glamorgan "fell below a reasonable standard".

The health board apologised for the failures in care identified and said it accepted the findings in full. It has also agreed to implement all of the ombudsman's recommendations.

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