‘It was found that…’ A reflection on grief spaces

The General Medical Council (GMC) tribunal examining Valerie Murphy’s fitness to practice starts again tomorrow. Monday. And next weekend. Next Saturday and Sunday. And two more days possibly still to schedule. The findings so far are summarised here:

During the August hearing I was cross-examined by Murphy’s barrister. He said the way I described her in my witness statement upset her. We aren’t allowed to read her statement. We’ve no idea what she’s said. About LB. About what happened. About anything.

I was unwell after that hearing. Having just about managed to duck and dive the  traumatic, unexpected and preventable death cloak over four years, the calculated and deliberate questioning/non-questioning (and giant arch lever file action) by the barrister floored me.

Anxiety, panic attacks. Distraction, agitation, worry and more anxiety.

I worked today. I often work weekends but this was in anticipation of possibly becoming unwell again. And the late realisation it will be impossible to work on Monday (possibly Tuesday, Wednesday, Thursday…)

I was talking to someone recently about how NHS investigatory processes interfere with or even obliterate grief spaces. Spaces people have a right to inhabit after the death of a loved one. About how the ‘National Health Service’ generates further harm with little apparent thought. Even glee. [The slightly hysterical briefing to the then CEO of NHS England about how #JusticeforLB campaigners were hacking into Sloven staff Twitter accounts springs to mind…]

I thought about these spaces during my recent trip to Canada and the US when I experienced unexpected and breathtaking waves of intense and deep sadness. I don’t know if the lengthy bus and train journeys were a mechanism to re-enable grief thoughts. Or the space itself.

The determination of facts can be read here. George Julian will be live-tweeting tomorrow and Monday. A remarkable open justice service you can follow here.

Here’s to ‘finding’ sense. And space.

The Percy Problem?

Oh my. A piece in the Mail on Sunday* today about Katrina Percy, former Sloven CEO, touting leadership expertise on LinkedIn.  During twitter exchanges across the day I was bounced back to exchanges around our referral of Percy to the Care Quality Commission (CQC) for investigation under the Fit and Proper Person Regulation (FPPR) back in the day.

A right old dogs dinner that spanned more than 18 months. Littered with a remarkable number of non-responses. Demonstration of the disregard and disrespect bereaved families can expect from the NHS and wider bodies. Brutal non-responses…

2015
17 March 15 We refer Katrina Percy for investigation.
[No response.] Please reply even if only to say you’ve received the email. Families are in a terrible, brutalised position. To ignore is to simply add a size 10 Doc Marten kick in the gut to the experience.
27 May 15 I tweet about this non-response. Andrea Sutcliffe steps in to mediate. Good for Andrea but it shouldn’t take a tweet and the potential for reputational damage to generate action.
29 May 15 An apology from Mike Richards, then Head of Inspection, for the delay in response.
1 June 15 A letter from Richards with the panel decision:
Richards bollox

No words.

2016
3 Jan 16 After publication of the Mazars review we ask the CQC to reconsider their decision.
[No response.] As above. I tweet and Andrea Sutcliffe again steps in to mediate This flags up some communication type issues that really need addressing.
1 Mar 16 Email from Mike Richards’ executive PA to say our referral is tabled for the FPPR management review meeting on 11 Mar 16 and we’ll hear after that.
‘Thank you’ I reply. The differential in power laid starkly by the ‘thank you’ emails.
31 Mar 16  Hello, I email… Again.  Is there any news? As above.
1 Apr 16  Email from Paul Lelliot (Deputy Chief Inspector for Mental Health) to say the Chair, PA and Mike Richards are on annual leave. We should hear soon. A holding email takes about 1 minute to write and send. There is no excuse to piss off on leave and not reply. 
4 Apr 16 The Chair replies:

The panel concluded that any further action should be considered once CQC had concluded our most recent review and have an understanding of the position of NHS Improvement in relation to the trust.

6 Apr 16 A warning notice (and no action) from the CQC is announced.
7 Apr 16 I email to ask what the CQC are going to do about Katrina Percy.
14 May 16 I chase up my email.
15 May 16 Apologies for not updating I’m told. We will provide an update shortly.
29 July 16 I email for an update. [Note we’re leaving gaps of 5/6 weeks before recontacting. The spectre of the vexatious family/mother ever present. This consideration is not even a whiff among CQC business. Kind of reminding me of a paper we wrote about the ringside seat autistic people can have to mainstream life with little or no reciprocated thought from mainstream society.]
29 July 16 An email response: they are waiting for Tim Smart’s review of board capability and governance.
22 Aug 16 I email to ask if there is any decision about FPPR.

No reply. They didn’t bother to reply. As above. With bells on.

Katrina Percy ‘stepped down’ at the end of September 2016.

2017

There are three criminal prosecutions against the Trust in 2017. All cover Percy’s period of ‘leadership’. The Health Service Journal awarded her a ‘CEO of the Year Award’ back in the day which features on her LinkedIn profile. This was, according to a HSJ journalist, awarded by an independent (non-HSJ) panel, nothing to do with the HSJ and ‘before the issues were known‘.

We all know the issues now. Many of us recognised them before weighty (bloated, worn out and toxic seeped and steeped) senior NHS (Improvement/England/CQC/Dept of Health figures) eventually stopped slumbering. We all now know.

There is no more pretence. No more shonky little (and big) practices covering up, denying, bullying, bouncing and battering blame onto bereaved families.

The questions that whizzle around our brains/discussion relentlessly (raised by all sorts of people we meet, bump into or who even pull over to talk to us on the street)… Questions any sensible, non-NHS befuddled (at best) person asks and continues to ask remain unanswered. Not least how the hell could any of this happen? 

I don’t know if I want to ever know the answer/s to this. I just hope that those senior bods who were, and continue to be implicated, take a long hard look at themselves. That they start to polish their murky and corrupt stained goggles. Set aside the lure of the rewards for not seeing, not listening and denying and breath in some fresh air.

You’ve been arsewipes of fuckwhattery proportions. There’s no doubt about this. There is also time to change.

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*Our experience of sensitive and thoughtful exchanges with journalists continued with Jonathan Bucks. Thank you.

They put their cameras down

On Monday Sloven pleaded guilty to the HSE (Health and Safety Executive) charges. It was a short hearing. The district judge referred the ‘case’ to Oxford Crown Court for sentencing. He stressed it was important that time was factored in for the crown court judge to carefully read the papers and for a full day to be scheduled for the hearing. He was deeply kind and sensitive, recognising how awful and serious it was that LB died. He made a point of acknowledging our family (my mum, sister Agent T and Tom attended).

We met with the HSE and their barrister, Bernard Thorogood, before and after the hearing. They explained the process and answered questions carefully and thoroughly. At the end they went to let the various press (including the BBC and ITV) outside know we didn’t want to be interviewed. We’d been filmed walking into the building.

They’re still outside. I’m sorry but we can’t do much about it. If you’re prepared to stay till 5pm or so they may have given up and gone… A bit of advice is to try and keep a fixed expression on your faces when you leave.

We grimly walked out of the Banbury Magistrates Court and passed the gaggle of journalists and camera people.

They put their cameras down.

And more…

It was an unexpectedly moving day. With the kindness and respect shown by the judge, the HSE and Bernard T, the media. Julie Dawes, Sloven CEO, attended.

The hearing date has yet to be set but will be in the next few months, possibly early January. Bryan, the My Life My Choice coordinator, emailed this afternoon:

The trustees want to attend on mass (probably 12-15 people) Oxford Crown Court for the SH sentencing.  They wanted to know how you might feel about this rather than them just turning up unannounced.

What do we feel? What a bloody brilliant  idea!

Let’s make it big. Let’s make it colourful and let’s mark this milestone in the lives and deaths of learning disabled people in typical #JusticeforLB chaotic and love coated fashion.

Who knows who may turn up.

 

 

The afternoon before the hearing

 

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I spent the afternoon with Tom trying to get photos from an old mac that’s been gathering dust and more upstairs. Eventually, after exemplary focus and persistence by Tom, and a few chuckles along the way (yep, yep, my computer smarts are shite, I’ve a desktop that demands a cone of shame and I’ve not updated anything since about 1749), 451 pics from the (g)olden days are now on my desktop. (A fair few have an alarming luke white question mark but we can save that battle/puzzle for another day).

Above is LB ploughing his own path up a hillside holding tightly onto to his i-summat music player. The gadget he produced myriad playlists on, back in the day. Each with one song on.

It was our last family holiday in 2010. He did what he typically did; stuff (the day out in the Black Mountains with a makeshift picnic) in his own way, own time while breaking nonsensical and meaningless rules along the way. So what if he was far behind? He got there in the end.

Before we got stuck into this task Rich and I walked into town to get a hard drive. On the bus home Julie Dawes, Sloven CEO, rang in response to my email from Friday. Good for her for calling back. I want to present the gist of our conversation here because I think it contains or flags up important elements/ingredients for the relationship between Trust staff and bereaved or harmed families.

The Sloven board apparently made the decision that no board member would attend the Health and Safety Executive hearing at Banbury Magistrates court tomorrow for ‘various reasons’. This was because they decided it would cause us further distress and it was ‘usual’ to send the communications manager to such hearings.

Julie Dawes rang me out of the blue on Friday because she was worried about the distress their planned press release would cause us. We weren’t asked whether the attendance (or non-attendance) of a senior exec at the hearing would cause us distress. This suggests that baby steps of improvement (concern about press release distress) remain coated in relentlessly longstanding concern about Trust reputation. And an accompanying lack of really understanding what is important to families.

You can’t assume distress in one area (attendance at the hearing) while checking it in another (press release content) without raising questions about what is actually ‘important’ here. Our feelings as a family or Sloven comms/reputation.

And when you’ve endured the extraordinary through Trust actions like we, and so many other families, have the ‘usual’ is irrelevant and obscene.

It’s really time to start walking up hills using the example of LB (and others) if you mean business around changing practice. Chuck out the grotesque, the turgid, the meaningless, the offensive and step up. Demonstrate the ‘impact’ a patient’s death has had on your organisation with actions. Not talk. [As an aside, and a frankly unapologetic plug for my book, one of the things I learned from early readers was ‘show don’t tell’.]

Think about the thin arguments you’re making and challenge them yourself. Instead of sending the comms manager ‘as usual’ (I struggle here with what ‘usual’ is in such circumstances), make sure a board member pitches up, even if you anticipate a five minute hearing. LB wasn’t given the chance to live. Don’t show further disrespect or worse by thinking it’s only a ‘five minute hearing’, or because you want to downplay the importance of the hearing.

Stand up publicly and show you fully understand and recognise that your organisation is responsible for the preventable death of a patient. Until you do this, no other fucker is going to.

Julie Dawes said on Friday she wanted to offer any personal help she could. It turns out this was distinct from arrangements around the hearing tomorrow and board decisions about attendance. A revealing comment (which is not to knock the offer of help which we appreciate). For families ‘the personal’ is too often the process. And the obliteration of humanity through that process.

By the end of the conversation I think we were sort of on the same page. I appreciate her sticking her neck out by ringing earlier. I hope productive discussion followed our fraught conversation. And I hope some respect will be shown to our beautiful boy who died in the cross hairs of a greedy, arrogant and failing Trust, local authority and CCG, tomorrow.

He deserved so much more.

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Imagining a guilty plea

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The Health and Safety Executive (HSE) prosecution against Sloven is scheduled for 2pm Monday at Banbury Magistrates Court. If the Trust plead guilty it will be a short hearing adjourned until a sentencing date in the next few months. This is a criminal prosecution. A guilty plea is pleading guilty to a crime. A crime that caused LB’s death.

Katrina Percy, then CEO, consistently distanced herself from the dire happenings she presided over between 2011-2016 with the apparent blessing of those who should know better.  Even after the jury at LB’s inquest found serious failings:

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An ‘absolutely tragic failure’. I don’t know what these words mean. Other than it was nothing to do with me guv. But no one (no one) who should have, challenged them. For Percy, the unit and not her leadership was to blame. Before and during LB’s inquest, the argument was LB died of natural causes and it was my fault. The difficult mother and the pesky blog.

Sloven smeared here and they smeared there. Across the years. Embarrassing briefings outlining the wrongdoing of #JusticeforLB campaigners. Hacking, trolling and persecuting hapless staff members. And more. Blaming staff. Blaming everyone but themselves. There was no looking glass among the Sloven senior exec. Or Oxfordshire County Council and the Clinical Commissioning Group. No reflection whatsoever.

A tawdry soup of typically self-serving, smug, arrogant and sometimes nasty individuals. With inflated salaries and no understanding of what it is to be human.

Percy took her massive pay off, disappearing in to the early winter sunset last October. Waiting in the wings to re-launch herself as a leadership consultant on Linkedin.

Meanwhile, the new and remaining board members took it upon themselves to exonerate her in the recently published (and now suddenly removed from their website) 2016/7 annual review. She displayed neither “negligence or incompetence” apparently “during her time with the Trust to the extent that would warrant her dismissal”.  Despite two prosecutions underway.

Psst… board members – past and present – do you really not understand that patients have experienced serious harm or died under Percy’s leaky leadership?

Really?

Imagining a guilty plea

Just imagine. A guilty plea from a Trust who have forced us to fight every step of the beyond distressing way for accountability. Full pages of black redacted pages while other people leaked key quality reviews, briefings and more. Lies, more damn lies and non-disclosure across 51 months to us, to the coroner, and I assume to the police… Smears, delay and prevarication. Desperate attempts to prevent an Article 2 inquest and jury.

Valerie Murphy recently sharply shifted from a four year blanket denial of failings to partial admittance at her tribunal. Will Sloven, having steadfastly trawled through the darkest of dark practices, suddenly shift to a guilty plea?

If they plead guilty what does it mean? Can we can expect an apology for everything we’ve endured since LB died? The mother-blame shite. The staff witness statements with their ‘my relationship with Dr Ryan’ sections. The #fuckingpest commentary from the Berryman board member’s son. Will the abusive caller acknowledge I wasn’t a vindictive cow…?

Will there be recognition that we were collectively trying to get accountability for LB’s death?

Will Oxfordshire County Council and the Oxfordshire Clinical Commissioning Group hold up their hands and finally admit their role in commissioning and enabling crap care on their watch?

Will people/organisations actually take responsibility for LB’s death and their subsequent actions?

An unexpected call

On the bus to work this morning, my phone rang. It rarely rings. Sloven CEO, Julie Dawes. Ringing to update me about Monday. She wanted to run her statement by me, given we’ve been upset about earlier Sloven statements. Reflecting on our upset over previous statements is good. The statement she read out was an improvement on previous Sloven statements. More heartfelt and human.

It was missing any reference to the impact of Sloven’s actions on us since LB died though. What they forced us to endure. Walking through Cornmarket I tried to explain to Julie what it was like to listen to the Sloven barrister argue that drowning was a natural cause of death during LB’s inquest. Just one example of the slippery dishonesty the Trust demonstrated. I tried to explain how damaging this process has been.

Julie listened and said she’d try to reflect this in the statement. She said she wouldn’t attend the hearing on Monday ‘for various reasons’, she recognised how distressing Monday will be be and said if there was anything she could do to help I should get in touch. She reiterated this a couple of times. She asked if I was going to read out my witness impact statement on Monday. No, I said.

I thanked her, hung up and an hour or so later wondered why she, or the board chair, weren’t going to attend the hearing. It’s a criminal prosecution and most people don’t get to not attend ‘for various reasons’. If nothing else, it’s a simple sign of respect.

Given the earlier offer of ‘anything she could do…’ I thought I’d call her back to ask her. Number withheld. She could phone me, generating distress, but I couldn’t call her back.

I’m left wondering how much of the call this morning was driven by an underlying concern about reputation and managing comms. I mean if the Trust seriously wanted to demonstrate evidence of change the CEO or Board Chair would attend the hearing on Monday. And I wouldn’t be asked if I’m going to read out our victim impact statement.

The day after LB died Sloven wrote ‘Mother’s blog may cause a risk to the reputation of the organisation’. Over four long years later the only risk to this organisation remains themselves. And their actions.

 

Trivialising trauma

I revisited the letter from the Oxfordshire County Council commissioner this week. Christallbloodymighty. The 9 page letter sent to a disability rights activist a year or so after LB died and passed on to us just before his inquest in October 2015.

With increased incredulity, rage and distress, I googled her. Blimey. A more recent local news story. Mrs Cross of Oxford. Sent a free lesson at a now closed leisure centre. She seems more outraged by this than what happened to LB.

The first part of section 10 of the letter begins:

vmletter2

So much so fucking wrong.

  • The erasure of LB.
  • The diminishing of what happened to one ‘frustration’ (of many?)
  • The removal of agency; I’m out of control, irrational, hysterical.
  • Blaming the blog
  • Checking people are still alive [howl]
  • Blaming admin
  • Prioritising the absence of a particular colleague
  • Erasing LB.

Sending a letter to a patient who died a preventable death on your watch is more than ‘crass’, ‘upsetting’ or ‘unfortunate’.

Writing this letter and bleating about a random promotional freebie exercise class to a local paper screams so much so wrong with values.

Has (the audacity of) publicly documenting poor provision on ‘the blog’ and the light shone by #JusticeforLB turned senior public officials into monsters?

Or just exposed reams of rubbish wrapped up in ‘No one will ever know about or expose our inadequacies’ complacency parcels?

‘Upsetting’

I’m struck by the use of the word ‘upsetting’. In Josh Halliday’s Guardian piece about the tribunal, the MPTS responded

We are sorry to hear how upsetting Dr Ryan found the process of giving evidence to the tribunal.

An extraordinary trivialising of trauma.

‘Upsetting’. They heard how upsetting I found it? How? Through Josh’s questions? From MPTS staff present? From jibber jabber by the coffee machine?

From the clearly upset clerk who led me into that vicious den, removed me from it for a few minutes and then returned me to it?

Upsetting. What is ‘upsetting’?

LB missing his beloved Olympia Horse of the Year Show because of whooping cough. [We both had whooping cough, as did Fran’s son, James. I have a tear inducing fondness/nostalgia remembering those whooping cough weeks]. I was upset that LB missed the horse show.

Upset seems to relate to missing things. An event, a job, an exam pass, a promotion, a ticket, an opening, a closing, a dying plant, a building, a pub, a writer, an actor.

But it ain’t receiving a letter addressed to your dead son telling him how well the hospital he died in is going to care for him in the coming year.

Or being forced to answer a battery of nasty, credibility shredding non-questions for two hours in front of a tribunal panel and the clinician responsible for your child’s care.

As time drags on, space emerges to reflect more clearly on what happened. To make reflections, sense or no sense. There are clear similarities between the responses of the commissioner, Murphy, Percy and others.

Cut from the same cloth. Cloth woven with a thread that obliterates humanity, reflection and recognition of people and their families. No remorse, no genuine sorry, no regret, no nothing. Just blame. The mother, the blog, the frontline staff.  [Dip into the Katrina Percy reply for an extraordinary letter with 40 or so mentions of ‘I’, ‘me’ and ‘mine’ in just over two two pages.]

I’m wondering how far the stain of this model of ‘leadership’/senior NHS staff spreads. Are commissioners, learning disability psychiatrists, Trust CEO’s typically petty minded, self obsessed and ignorant of the lives and love of the families they are supposed to be serving? Is this unchecked or even encouraged by their peers/the culture of the senior tier?

And to those of you still monitoring this blog with a defamation lens. In case you still ain’t got it. Our beautiful boy died. He died.

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A levels, love and waiting for the tribunal

A ‘day off’ from the GMC tribunal which continued in private today. Day three of deliberations to determine the facts.

A level day.  Early morning jitters (and humour) from Tom:
Tom
He stormed it. We could not be prouder.

Funnily enough, a photo of Tom and Owen from 2012 popped up on Facebook. A day out in London months before Tom’s childhood was to change irrevocably. Owen, then 17, turned turned 18 the day before LB died. [I know].

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A friend messaged earlier saying congratulations and Tom has ‘done his part in saying ‘fuck you’ to the system and not allowing it to control’. Rosie, Will and Owen have also done their part in doing this. They have, in addition to the death of their beyond loved brother, endured home becoming a site of activism, anger, rage, despair, distraction, tears and more tears.

About a year ago now, at some particularly low point, Rich and I decided during an unusual weekend home alone that we would chuck in the towel on the fighting front. It was too much. It wasn’t fair on the kids. We were trying to climb a super smooth glass NHS mountain coated with a combo of pig grease, melted butter and olive oil.

We told Tom on his return expecting relief. A levels looming and all. He was shocked we’d even consider it. The love, concern, steadfast and unquestioning support and humour they have demonstrated over the last four years, mirrored in the actions and support of their partners and friends, is something we treasure beyond words.

These last few weeks have been particularly unpleasant. We’ve been shoehorned into even more extreme spaces by the careless fuckwaddery actions of the Nursing and Midwifery Council sharing our personal details and Mr P’s brutal and unnecessary cross-examination last Tuesday.

Wilful attempts to discredit without any relevance to the allegations under examination.

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On Wednesday we waited for the tribunal to begin again in public. A inhumane waiting even without the unchecked, salacious and unnecessary savaging. I lay on the settee, under my Routemaster blanket, refreshing twitter repeatedly. Bess dozed on the chair opposite. I took a pic of her on my ipad and tweeted it.

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#Waitingforthetribunal

This generated an unexpected and hilariously heartwarming set of photos; the pets of twitter. Waiting in solidarity for the tribunal. Including a plant (a groot?) which I can’t find now (sorry).

Names, spaces, commentary and love.

I’ve written about pets and health, we’re currently putting together a funding proposal with vet colleagues to further explore this area and yet I didn’t expect to find such solace in the sharing of photos of much loved animals on twitter. It made me chuckle. It was grounding. It was kind of reassuring.

Yep, I thought. These non humans could teach us a lesson or ten. If we would only start listening.

Late morning tomorrow (Friday) the panel are due to announce their determination on the facts (whether the doctor is guilty of the remaining charges she has not admitted to). The tribunal will then be rescheduled to continue at some point in the future.

We will continue waiting. Four years and six weeks on.

Being (in)sane in insane places… in four parts

Part I

Waiting for the GMC tribunal to come back from ‘in camera’ (secret) discussion today. It’s impossible to do anything constructive. Wait. Mope about in bed. Play Candycrush. Clean the floor badly. Answer a few work emails. Pace around the house. Play Candycrush. Poke at weeds for a bit. Mope. Back to bed. Wait.

Agitate.

Part II

We’ve waited four years. But the events of last week make it impossible to concentrate. The cross-examination brutality, the revelation that this blog was causing anxiety among consultants before LB was admitted to the unit and other outlandish arguments by the doctor’s barrister, RP.

Including his bizarre claim he had no computer access to produce submissions for the Friday morning. In central Manchester… sitting next to a colleague with a laptop.

There was incredulity and practical info on twitter.

The next morning RP circulated a set of handwritten bullet points ‘not in narrative form’:

He later argued:

Not all of us are au fait with narrative… You have to find a computer first and then go into free text…

Oh my. Did he handwrite a set of bullet points (a day or so after deftly destroying me as a reliable witness) to demonstrate the point that computers aren’t necessary to do a good job as a consultant?

The day ended with this comment:

Part III

The GMC are keeping us informed about the timetable and process of this hideous process with thoughtfulness and sensitivity.

This is where we are at:

The panel are currently reviewing and considering the evidence given last week and need to agree the position on each charge that has not already been admitted and draft a full decision referring to the evidence, setting out their reasoning for each of the charges.  
 
The hearing will reconvene in public and the determination will be read out. Parties may need time to fully consider the determination then the hearing will move to the second stage. Further evidence can be called and submissions will be made on behalf of the GMC and the doctor in relation to whether the doctor is impaired. At this stage, the Tribunal meet alone again and need to make a decision on two matters: 1. whether the facts found proved are serious misconduct (the meaning of which is set out in various case law) and 2. if so, whether the doctor is impaired by reason of her misconduct.  It is not known how long it will take for the Tribunal to make this decision.
 
Depending on the Tribunal’s determination on impairment, the panel will consider the position of sanction. This would involve further submissions by both parties and another determination by the Tribunal.
Apparently the panel are unlikely to give a determination on the facts tomorrow.  The determination (the next step before the next stage) will likely now happen on Thursday. Coinciding with Tom’s A level results.
Part IV
This hearing has dominated the last few months for us. The Nursing and Midwifery Council (NMC) data sharing breach-too-far is bubbling on in the background. We’re less than four weeks from the Health and Safety Executive prosecution. We managed to polish off the personal impact statement yesterday, thank fuck. In less than a page.

You should include the fact you haven’t had a bath since LB died.” said Rosie. “And you loved them. I remember when we were little and we used to come in and chat to you. Sitting on the toilet…”

My definition of crap has taken such a battering I no longer have words for what we’re enduring.

We’ve been pushed into such an extreme space now that daily interaction with people is becoming difficult. Throwaway conversations in the street about the weather, summer holidays, dogs are hard to engage with. You can’t lay the shit storm we’ve been subjected to on any passerby or acquaintance. At the same time, saying, vacuously “Yeah, fine” is harder to say.

This led me to think about another layer to the campaign and social media activity; the sharing of rage, distress, incredulity and bafflement. The discussion and commentary. We know we wouldn’t have got ‘this far’ without social media. I hadn’t thought about how we would have personally been derailed months or years ago if we were experiencing this in isolation.

An hour into Mr P’s interrogation last Tuesday I was doubting myself.

It’s harder to doubt when so many others express sense, offer expertise (in any shape or form) and solidarity. And genuinely care.

 

‘I want to ask you a little about your blog…’

This blog has again loomed large. It did at LB’s inquest and again this week at the ongoing GMC tribunal. Dr Murphy’s respective barristers both presented it as a transgressive space/action that somehow underpinned or fed into what unfolded. It was a malign catalyst for something (I’m not sure what either barrister was trying to argue other than the blog damaged the relationship between some consultant psychiatrists and a patient’s mother).

How social media ‘feedback’ is ‘used’ by health and social care is the subject of considerable research, some of which is happening in our research group. A colleague has been interviewing people who document their health experiences online to explore why they do so.

When I started writing the blog back in May 2011 ‘online patient feedback’ was not a twinkle in my eye and possibly wasn’t even a thing. I wanted to capture the funny stuff that happened in an online diary. I didn’t expect it would be read beyond close family and friends (or even by them). In fact it became quite widely read and a few hundred people started to follow it. The fun focus sadly disappeared towards the end of 2012 and it became an account of trying and failing to get support for LB and subsequently the 107 days he spent in the unit.

This week the blog questions unfolded like this [RP is Dr Murphy’s barrister] :

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This was ground already thrashed out during LB’s inquest nearly two years ago now [VM is Dr Murphy talking about a community psychiatrist].

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A different view was presented by the Band 6 nurse during his evidence:

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I was told a few years ago that a STATT staff member was warned about LB’s imminent admittance four days before he was admitted. I thought this must somehow be wrong. I mean we didn’t know the unit existed until the day we took him there. It was almost in the realm of Mulder and Scully terrain to think that discussions were going on, without us, about a specialist unit we were to find out about from a mate on March 19th.

This week it became apparent that Dr Murphy and other consultant psychiatrists had discussed LB’s potential admittance to STATT (unrecorded discussion) in the weeks before it happened. I spoke with one of the consultants from back in the day earlier today and it turns out that my blog was known about before LB was admitted to STATT. My blog (and my aggression or forthright communication depending on where you sit) generated strong emotions, anxiety, irritation and distrust. There was, as JC said ‘an irrational fear of the blog’.

Social media activity like this was unprecedented and no one who was bothered about it knew how to deal with it. Appeals were made to senior Oxfordshire County Council (OCC) levels to somehow close it down. These were robustly rebutted by a redacted person who, like JC above, suggested that it created an opportunity for engagement.

I appreciate the frank discussion which happened with no notice today. I was also shocked that consultants could be so discommoded by the blogging of a parent, that none of them were able to read, discuss or engage with what was being written in a constructive way. I’d been carefully documenting the complete lack of health and social care support for an increasingly anxious and unwell young man for three or four months by then, or possibly longer.  This is remarkably similar to the Blog Briefing Sloven circulated the day after LB died in which concern focused solely on reputation and professional pride.

I wonder if my writing style somehow added to the fear and distrust. The irreverence and liberal swearing. If I had written a more conventional and ‘polite’ account would it have been better received? I suspect not given the consultant I spoke with denied actually reading it. This was irrational fear.

I’m baffled that not one of these consultants was able to speak to me about their concerns. (Interesting we could have an open discussion today… I assume the toxic mother label is finally shifting as Sloven failings are finally recognised.) I’m deeply horrified we were oblivious to this consternation about the blog when we admitted LB. As the GMC argued this morning, it was Dr Murphy’s responsibility to talk to me about LB’s treatment. It was also the duty of these consultants, surely, to share their concerns with me about my blog?

I suggested to the consultant that the extreme response at the time was generated by the lack of actual challenge to medics by patients or families who are too easily silenced in different ways. The blog created a space of challenge but instead of being used to improve practice, or even engage with and consider the limitations of practice, it was despised and I suspect had an impact on how LB was treated. The veneer of professionalism can be shown to be very thin when ‘transgressional’ activity takes place.

There is some irony that #JusticeforLB is now used in health and social care learning and teaching. The blog also created an unusual contemporaneous record of what happened. The power of the posts that reviled or worried staff before LB died formed part of the evidence at his inquest. The typically disempowered position family members occupy when their testimony is dismissed as ‘anecdote’ differed here. Lowly families aren’t allowed the defence of ‘I did it in my head’ like Dr Murphy has used this week at the tribunal but I had written it down.

There is much to think about, discuss and chew over here in some ways. In other ways there ain’t. Health and social care professionals should be engaging with patients and families in different ways, at different times and in different spaces. They should be encouraging comment and feedback. I hope our experience is already historical and within the ivory tower of unassailable medical practice medics are learning to be more humble and take public accounts of patient experiences as opportunities to better understand the consequences of their actions, or non-actions, and the interaction between the various individuals involved. These accounts should be treasured not vilified.

 

 

 

Writing trauma

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I want to write this post as close as possible to giving evidence at the General Medical Council (GMC) tribunal investigating Dr Murphy’s fitness to practice. To capture the essence and rawness of the experience.

The unnecessary and unchecked brutality. And destruction.

It’s a pretty and long detailed account. That is writing trauma.

[I also acknowledge our GMC solicitor and colleagues who have done what they can to try to ease this journey.]

Weeks of dread led to Rich and I setting off to Manchester (earlier than planned) by train on Monday. Summer holiday travel. Young kids and families. Excitement and crisps.

Our summer has been blighted by the timing of this tribunal.

Rosie decided to come too after I was unable to speak to her on the phone on Sunday evening (after writing this post). I simply couldn’t speak.

Stirring up the horror of what happened four years ago now is, as you’d expect, deeply distressing. LB died. He died. The shite we accepted or were made to endure back in the day is harrowing. And increasingly baffling as we grow further from the cosh of typical learning disability offerings.

Following the @JusticeforLBGMC twitter feed on the train we were surprised when Dr Murphy accepted 28-30 of the allegations raised. Not the Dr Murphy we’d so far come across. With so few allegations left to deal with our thoughts turned to the apology I would probably receive when giving evidence the next day. An apology four years in the making. But an apology.

The next morning, we gathered in the hotel minutes from where the tribunal was being held. George and Charlotte left for the tribunal just before 9.30am. I switched my internet off. Witnesses are not allowed to hear witness evidence and LB’s neurologist was due to give evidence before me. Rich, Rosie and I sat around. Anxious and agitated. Rosie followed the twitter feed passing her phone to Rich every so often. It’s fine, they said. Looking grim. The GMC solicitor called to say the 10.30am start for my evidence was looking on time.

Rich answered the phone. I was on the toilet. Again.

We walked up the road. A couple of men with television cameras at their feet were outside the building chatting. On the 7th floor, we were shown to an inevitably bleak witness room. The GMC solicitor and barrister came in and described what to expect.

We waited. There was an unexpected delay of about 45 minutes as the tribunal panel questioned the first witness.

We flicked through photos of LB on Rosie’s phone.

 

“So cute…”

“Look at that baguette he’s holding!” [sob]

IMG_2810Then it was time. The clerk took us into the tribunal room (left). Rich and Rosie sat in the public bit at the back while I was taken to a large desk facing the tribunal panel. It had a white arch level file with over 1000 pages of documentation, glass of water and microphone.  Before sitting I had to read an oath from a laminated coloured sheet. I couldn’t read it without crying. I couldn’t at LB’s inquest. I don’t know why. Maybe it’s such a stark reminder of the horror that is this (public sector generated) experience and the layers of utter shite that have been woven through it since.

The panel chair introduced the people around the table. The GMC barrister checked I’d signed and re-read my two statements which were in the front of the white file. Then it was over to Dr Murphy’s barrister, Mr P.

There was no apology. Our naive optimism was instantly crushed. Mr P asked me to turn to page x in the file and began a meticulous questioning that involved turning backwards and forwards between my two statements in the front of the file and medical records 700 or so pages towards the back of it.

He had a skimpy pile of the relevant pages laid out in front of him. He didn’t have to lob wedges of 1000+ pages backwards and forwards over a metal lever arch file bridge and leaf through numerous pages to find the relevant page, and section of text.

Briefly scanning through pages of painful words about LB’s horrific last few months.

His lightness of documentation and organisation of the ‘cross-examination’ meant he effortlessly lined up question after question after question. I felt I was being repeatedly sliced open with such a sharp knife there was no trace left on the blade.

“If you could turn to page x… Dr J is summarising his thoughts here, in this paragraph. Did he share them with you?”

“He made a phone call to Dr M. Can you remember how long that call lasted?”

“Turning back to page y. Do you recall Dr Murphy introducing herself in this meeting? In your statement on page j, you said…”

“If you could turn to page z of your statement. CTM meetings were held every Monday, you describe them as 10min meetings. Dr Murphy recalls the meetings being much longer…”

“Turning to page a, another meeting you did not attend, the notes state…”

A masterclass in something.

Over time, photos can become defining memories of particular events as the broader context fades away. Under Mr P’s questioning, on the 7th floor of that imposing building on Oxford Street, Manchester, LB’s medical notes became photo-like. It became impossible to think about and answer the questions that kept coming. To think beyond the words I was being directed to on different pages at different ends of the lever arch file. My heart started to thud so hard and erratically I thought it would knock me off the chair. Black edges creeping around my vision made it harder to find or read the notes. I became fearful of fainting and began to doubt my ability to answer questions truthfully.

“I don’t remember.” “I’m not sure.” “I just don’t know…”

Mr P continued asking questions. Apparently at ease with an approach that unsettles,  distracts and confuses. Seemingly oblivious to my distress. No one intervened. I had no representation.

“On page j of your statement you describe Dr M as dismissive, arrogant and distant. Do you think that’s a fair assessment of Dr M’s conduct or is it coloured by what happened?”

“It might be coloured by what happened but I was expecting a knight in shining armour from a lead consultant who would do something.”

“It’s very upsetting for Dr Murphy to hear any patients’ relative describe her as such…”

Something stopped. An almost powerpoint presentation (and I fucking hate powerpoint) started to run through my mind. LB holding a giant piece of baguette on holiday. The indescribable pain of his death. What we’ve endured over the past four years. Dr Murphy suddenly admitting 30 odd failures in LB’s care a day earlier. Rich and Rosie sitting behind me listening to this inhumane and barbaric form of questioning with no recourse to action.

I gripped the edge of the table and asked the panel chair for a break.

The clerk took me to a room on the other side of the building. By this time, I was sobbing and repeatedly asking “How could they do this?” without expecting an answer. She was very kind but couldn’t ‘talk’ to me. I was left on my own with a glass of water and tissues for five minutes. There are no words for how I felt. They don’t exist.

Walking back towards the tribunal room with the clerk the blackness came back and I briefly stumbled. ‘Do not pass out’ I steeled myself. The thought of delaying this foul process was too awful to imagine. There was a delay before going back into the room as the tribunal were deliberating something. I stood in a section of the corridor with Dr Murphy and her legal team. Rich, Rosie and other members of the public were waiting in a different section of the corridor. I stared out of the window. Half seeing the Manchester skyline, Oxford Road rail station. The clock tower. Grey and threatening skies.

We were allowed back in the room.

Mr P started:

“I was asking about personality side of things and dynamics and wanted to ask you a little about your blog…”

And so it went on. The same questions that had been asked, answered and dismissed during LB’s inquest. Pages to manoeuvre. Notes to look at. Mr P didn’t miss a beat.

After two hours it was finally over. We left the building ignoring the television cameras outside and walked back to the hotel.

I can’t make any sense of experiencing harm in a medical tribunal. One held to explore the fitness to practice of our son’s responsible clinician. How on earth can this be possible and apparently acceptable?

And Mr P? You have taken crapshite to a new low.

Postscript: After Valerie Murphy spent the entire day giving evidence (well worth a catch up at @JusticeforLBGMC with a blood pressure warning for being chillingly shit) it became clear my evidence contributed nothing to the defence case. Nothing whatsoever. It was the equivalent of a kicking down a dark alley by a gang of thugs.

Grotesque.