Ramon Niekrash: There's nothing to stop this happening again

Wednesday 03 February 2010 01:00 GMT

There is no doubt that this whole experience has been incredibly difficult for my family and me, but the fact remains that reneging on my duty as a doctor by turning a blind eye to factors impacting patient health and safety was never an option. I am delighted to have been reinstated in my role for the trust as a urology cancer clinician – this is what I have always wanted to focus my energy on, rather than fighting legal battles.

However, one question remains: who will be held accountable for what went wrong? The employment tribunal was inexorably drawn to the conclusion that I had been suspended from my position at the Queen Elizabeth Hospital as a direct result of the concerns I raised in letters to the trust's management. Further, it was confirmed by the chief executive of the trust that my exclusion was not based on any clinical grounds regarding my practice, yet my suspension was maintained for a period of 10 weeks. This shows a complete disregard for the job in hand – to deliver care and services to patients.

The trust's whistleblowing policy makes it clear that staff have a right and a duty to draw the management's attention to any matters that they consider to be damaging to a patient or client. My experience has shown that clinical governance procedures and whistleblowing policies are not always effective in providing a framework through which the NHS organisations are accountable, nor for creating an environment in which excellence in clinical care will flourish.

So, what now? What measures will be put in place to ensure that another person within the NHS can raise legitimate and well-founded concerns about the impact that cost-cutting is having on the level of care that is provided by an NHS trust, and will not be silenced by the stigma of being perceived as a troublemaker?

There exists little in the way of a regulatory mechanism, punitive measures or indeed any general oversight to ensure we do not see any more highly skilled medical professionals removed from the NHS because they took their duty of care to patients seriously. What mechanism will deter any trust from pursuing this course of action again, without being held accountable or being severely punished for doing so?

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