Great Ormond Street Hospital 'victimising concerned staff'

Great Ormond Street Hospital
Image caption Great Ormond Street Hospital has an international reputation for excellence in children's health care

Great Ormond Street Hospital is facing accusations that it is downgrading child protection work and "victimising" staff who raise concerns.

Doctors claim the hospital has ignored warnings about the reduction in its specialist expertise in diagnosing abuse.

According to the former head of its radiology department, its withdrawal of services since the death of Baby Peter is putting children's safety at risk.

And a senior Conservative MP has also criticised the hospital over its treatment of another consultant, who was accused of falsifying expenses.

Former head of radiology Professor Christine Hall says the hospital has withdrawn from vital child protection work since the Peter Connelly - Baby P - case.

Radiologists at Great Ormond Street Hospital (GOSH) were relied upon to give their expert opinion on child abuse cases to doctors around the country.

From X-rays, they made judgements on whether injuries could be accidental or not. But they are now turning away requests for second opinions.

Professor Hall says she was referred scores of cases each year, many complex and time-consuming, which often involved preparation of reports for court cases.

She said: "Other people might be tempted to improve what we're doing, but it seems the opposite case here. They just wanted to withdraw from anything to do with child abuse.

Image caption Peter Connelly's mother, her boyfriend and his brother were convicted of causing his death in 2008

"I found this quite horrifying. It was an impossible situation to be in and whoever had dreamt this up obviously had no idea what it involved.

"The consultants were told they could no longer accept referrals of possible child abuse cases. I was shocked. This was the whole reason for Great Ormond Street existing, to help with difficult cases and to provide opinions for court appearances and things like that."

She claims concerns raised by staff about downgrading the service have not been treated appropriately.

"I think complaints are not listened to, not taken seriously, ignored, and often the person doing the complaining had been victimised."

Great Ormond Street say it had become "custom and practice" for Professor Hall to see cases referred by other hospitals, but this was stopped after she left in 2006, before Baby Peter died.

In a statement, they said: "Following her retirement, the radiology team decided, with management support, to stop accepting external requests for 'radiology only' second opinions because the hospital does not have an A&E and therefore, in the department's view, it was not an appropriate focus for the radiology department.

"Child protection work is a core part of the role of all paediatric radiologists, and GOSH is no exception."

Further concerns have been raised about the reduction of specialist work in the radiology department.

Karen Rosendahl was one of a three-member team, specialising in multi-skeletal (MSK) radiology. Since she left two years ago there have been no MSK specialists and the work is done by radiologists with general skills. She claims it has led to recent misdiagnosis of children.

"I have concerns about children's safety. One particular case was misdiagnosed and had the wrong sort of treatment. Another case was misdiagnosed as abuse when it wasn't abuse".

Great Ormond Street rejects this. It said: "Any concern raised by staff at Great Ormond Street is taken very seriously. We encourage staff to raise concerns.

Image caption Lib Dem minister Lynne Featherstone claimed there had been a "cover-up"

"On investigation we have found no evidence of any risk to patient safety."

At the time of Peter Connelly's death in August 2007, Great Ormond Street was responsible for child protection in Haringey, and recruited the locum, Dr Sabah Al-Zayyat, who examined the toddler two days before he died.

Last year Home Office Minister Lynne Featherstone claimed there had been a "cover-up" after it emerged the hospital withheld details of its failings from the original enquiry.

Criticisms were contained in a confidential report into Dr Al-Zayyat and the St Ann's clinic where she worked, but a number were not passed on to the serious case review.

The Sibert report - as it became known - revealed a shortage of staff, lack of nursing support and poor access to medical records. Consultants at the clinic had warned about the same problems a year before.

A BBC documentary reveals key failings - identified by Sibert - also didn't appear in a second serious case review. And the hospital pressurised the health regulator not to make criticisms in the Sibert report public.

Social care expert Professor Ray Jones said: "If at any point in time there's been deliberate editing and exclusion to make sure that information doesn't transfer from one stage of the process to another then that has got to be a cause of concern because you have disrupted and destroyed the purpose of the process."

Acrimonious dispute

Great Ormond Street says it withheld information from the first serious case review for legal reasons and to preserve confidentiality but gave the full unredacted Sibert report to the second serious case review.

Details have also emerged of an acrimonious four-year dispute involving another senior radiologist and Great Ormond Street.

Dr Cathy Owens faced an allegation of fraud in 2008 over her claims for reimbursement of the congestion charge. She was made to pay back the money but Great Ormond Street chose not to take disciplinary action at the time.

In 2010 she lodged a grievance about her treatment by the hospital. A few weeks later she was reported to the General Medical Council (GMC) by some of her own colleagues. They resurrected the previous investigation into her expenses as a basis for their referral.

Conservative MP Sir Peter Bottomley says the GMC should not have been involved, and has criticised the hospital for allowing it.

He said: "As soon as the hospital knew that there had been a referral of Dr Owens, it should have intervened and said this is a dead issue.

"Whatever the rights and wrongs may have been just over two years ago, it's not a matter to bring up in public now, it clearly doesn't affect a doctor's fitness to practice, it's been disposed of."

'Pure victimisation'

The GMC has now dropped the case, saying there was no prospect of proving dishonesty, and questioned why it was "silent for well over two years" before a formal complaint was made.

Professor Hall claims Dr Owens was targeted unfairly.

She said: "I think this is pure victimisation of Cathy Owens. My view is that they are trying to persuade her by one means or another to resign."

Great Ormond Street said it did not take disciplinary action against Dr Owens initially because it wanted to avoid further disruption in the radiology department. It says it was obliged to pass all information on to the GMC, after her referral.

"We were bound to ensure that the General Medical Council received a clear, transparent and accurate account of all the key evidence."

Great Ormond Street Hospital is broadcast on BBC One London on 18 April at 19:30 BST and nationwide on the iPlayer for seven days thereafter.

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