Great Ormond Street Hospital

I had hope they do it fast and openly. We ask why this has been

allowed to happen. Is Great OrMonday -- Ormond Street simply

too important to fail? Great Ormond Street is one of the

most famous children's hospitals in the world. Its work captures the

hearts and minds of the British public. We're running for a great

charity. With a PR machine second to none, it's one of the most

donated to children's charities in the UK. I have raised about �500.

Hopefully the company I work for Microsoft are going to match that.

Receiving �50 million last year alone. I raised a lot for Great

Ormond Street. �200 so far. Under if the First and Always", the

hospital has become an international brand. But behind the

golden image and well-oiled funding machine there are concerns among

medical professionals at the length the hospital will go to protect

their precious reputation. There are certainly concerns around

the country within paediatrics and Petiat Rick radiology that the

system at Great Ormond street is not what it should be.

Christine Hall was a radiologist at the hospital for over 30 years

before retiring. She was one of just a few specialists in the

country highly trained to recognise the difference between child abuse

cases and rare genetic bone conditions. When a decision was

made not to appoint further experts in this field, staff felt these

vital skills were being lost. There was another edict issued that

everybody would do everything in the department. So dumbing down

everybody's level of expertise, and if I may say so, at the same time

compromising patient care. We can see the obvious fracture. It is

quite a severe one. Yeah. It appears fresh. These concerns are

shared by radiologist Karren Rosendahl. Since she left the

hospital, she feels children are no longer receiving the high quality

care they should have. When I first came to the hospital, there were

three specialists. At present, there is none. So that's really

concerning. One particular case misdiagnosed had the wrong sort of

treatment, for example. Another case, misdiagnosed for abuse,

wasn't abuse. Are you aware of cases that...

yes. I think there have been mistakes, yes. Why do you say that?

Because I am aware of patients that have suffered. The hospital say

they take concerns raised by staff very seriously and have found no

evidence of any risk to patients, certainly compromising patient

safety, misdiagnosis and a lack of expertise are not things you

associate with this world-class institution, but this isn't the

first time Great Ormond Street Hospital have come in for criticism.

The hospital has a great reputation as a foremost children's hospital,

so one treads very carefully about beginning to think things may not

be correct, but in the end you have to speak out for the children. You

can't say, I mustn't damage the reputation. Great Ormond Street has

just achieved foundation trust status that gives them greater

independence allowing them to continue as a centre of excellence

for children. It was the desire for this which first led them from the

state-of-the-art hospital here in Bloomsbury to one of the most

deprived communities in Britain. Haringey has one of the highest

levels of child poverty in the country. After the death of

Victoria Climbie this hospital has struggled to recruit doctors.

It looked really exciting. The advert was basically saying we want

people to come and develop high- quality paediatric services for the

community in Haringey, and as I had had a lot of experience in

developing new services, you know, I thought, great. This is the sort

of job for me. Kim Holt was recruited by Great Ormond Street

Hospital in 2004 under this new partnership with Haringey. She was

part of a team of four consultant paediatricians including three

others. The Great Ormond Street Hospital

has a name internationally. It has the reputation of - for, you know,

hosting some of the best doctors of the world. This was the job that

came my way at the time, and seeing the label of Great Ormond Street

attached to it, I jumped when I got the job. Much was riding on this

partnership for great hor Monday My expectation was they'd be

putting children first that their aim would be to really bring

excellence into the community in Haringey. Great Ormond street,

dealing with a wide range of issues in the community meant they were

venturing into unchartered territory. It was a very different

type of service from the work they were famous for. The work came as a

surprise to some senior consultants at the hospital. Great Ormond

Street is dedicated to looking after complex patients - children -

and they're referred there on the basis of their complexity. Haringey

is the local area that deals with general paediatrics which nobody at

Great Ormond Street has experience of. Before long, serious cracks

began to appear. When examining children, doctors couldn't access

medical records. You would see the child and you wouldn't have the

notes. Then obviously you have to trawl back through some of the

history. We don't know whether this child was admitted a few years ago

for broken bones or bruises, where he has been presented to A&E

locally. We have no information whatsoever about that. It left the

doctor who was doing the medicals All four consultants raised their

concerns in a co--signed letter to management. There's no doubting

when you read that letter that there were serious concerns about

patient safety, but also about the culture. In my opinion that service

wasn't fit for purpose. We had raised concerns about this disaster.

When they felt management failed to respond to their concerns, staff

resorted to filling in critical incident forms to report problems

in the system. These are designed to pre-empt major accidents but

managers felt too many were being filled in. You were almost told off

like children, saying don't be so dramatic. We raised the concern and

I was the most vocal and then I'm referred to occupational health,

you know, allegedly with mental health problems. The timing

suggests that they were actually targeting me. Just months after

raising these concerns, the named doctor resigned. This pivotol

position was a key recommendation introduced as a result of the

Victoria Climbie inquiry. For a hospital like St Anne's the named

doctor was a fundamental requirement. The Great Ormond

Street Hospital management failed to fill the role. It's a crucial

post for child protection and it shocked me that in Haringey after

Victoria Climbie that they actually saw that it was appropriate to cut

the named doctor post. It's just unbelievable. We lost that support

from within the organisation of somewhere to go if you needed to

speak to somebody to get some advice regarding whether you had

concerns about a child being abused or not. In a statement Great Ormond

Street Hospital told us: However the hospital accepts that it: With

no named doctor and patient notes always missing this doctor felt he

no alternative but to resign and return home to Newcastle. I thought

I couldn't work in an environment like that. That's the reason why I

left. By the end of 2006 this clinic was running on two very

exhausted consultants and double the workload that we had had the

year before. Kim Holt went off on extended leave embroiled in a

battle with Great Ormond Street over a battle with workload and

stress. Over the four, just one renaind Dr Banejee. -- remained.

She was off with bouts of sickness, but Dr Sabah Al-Zayyat was brought

in. It was an accident waiting to happen in that clnic. The brutal

death of a toddler in north London has been described by ministers...

A man and woman have been arrested and released on bail by police

investigating the spish death of... The court had heard that the

injuries inflicted which increased in intensity would fill any

reasonable person with revulsion. I've decided to take immediate

action. Haringey council will now remove the current director of

children's services from her post with immediate effect. Sharon

Shoesmith was sacked along with four others, but no-one from the

management at the hospital was held to account. Children's services and

Sharon Shoesmith carried the can. There's no doubt, but we certainly

are now very clear that health had a very large responsibility. I

think health got off relatively Scott free. But was this the whole

story? From what people started telling me, this was more than just

an overwhelming failure of social work. From leaked documents,

talking to whistleblowers and freedom of information requests, it

became clear that the hospital were hiding something and my reports

were prompting others to ask questions about this famous

hospital. Last year, the editor of thelancet questioned whether Great

Ormond Street Hospital is just too porn to be seen to fail even when a

child dies. This was followed a few months later by the Britsh Medical

Journal, which asked: What has emerged is just how far the

management were prepared to go to conceal the full picture about

their involvement in the death of baby Peter. It all started when two

eminent pedestrian tritions, professor Joseph and Dr Deborah

Hoaves were commissioned to look at the practice of Dr Sabah Al-Zayyat

and the clinic where she worked. What they were to find is toxic for

Great Ormond Street Hospital. Potentially very damaging. The

report, as it was, outlined not only the failings of Dr Sabah Al-

Zayyat, but also serious concerns at the way this clinic was being

run. But the official review into Peter's death never got the full

picture, because Great Ormond Street Hospital chose to conceal

some of the most damaging aspects of this report. The truth remained

buried for two years. When I learned about this report, I tried

to get hold of it through freedom of information requests. The

hospital refused to release it. What are the public interest tests

here? It was only after the Information Commissioner intervened

that it was finally disclosed a year-and-a-half later. It was

immediately clear why Great Ormond Street Hospital didn't want this

made public. They had uncovered flaws in the whole system, concerns

that the management had been warned about over a year before Peter's

death. The report described St Anne's as clinically risky, saying

there were grave concerns with missing notes, too few staff and

crucially, no named doctor. The report recognised that Dr Sabah Al-

Zayyat who examined baby Peter two days before he died was

inexperienced in child protection. It said she should have been given

more training, but she didn't meet the core requirements of the job.

Great Ormond Street Hospital had known that when they employed her.

I had seen the job description for this locum and she could not said

to be filling the requirement of that post. Should Great Ormond

Street Hospital have appointed Dr Sabah Al-Zayyat? No. They write a

job description that says you must have a certificate of completion of

training as a consultant. She did not have that. You are putting the

doctor in a position and the doctor isn't - is quite likely to fail.

Great Ormond Street Hospital say: We now know that in the months

after baby Peter's death Great Ormond Street Hospital not only

gave Dr Sabah Al-Zayyat a positive appraisal, they also offered her a

permanent consultant's post here at St Anne's, but when the hospital

received the report they cut their own employee loose. Tonight on BBC

London - the last doctor to examine baby Peter will face a panel.

Great Ormond Street Hospital made public the short comings of Dr

Sabah Al-Zayyat by sacking her and reporting her to the G MC, but

minimised their own failings. was no way that Dr Sabah Al-Zayyat

deserved the scapegoating and vicious media campaigning against

her. The doctor got the blame, but the systems seemed to have got away

with it. I would hope that a hospital like Great Ormond Street

Hospital would be willing to look where there were serious failings

to correct them. And wouldn't see themselves as being above that.

they done that in this case? They hadn't done it in this case, no.

You have to think that is a cover- up, but ultimately while the doctor

was clearly failing, so was Great Ormond Street Hospital. If they

knew all of those things were not at a level that provided safety and

security around child protection, then they were at fault and the

fact that didn't come through into the Serious Case Review, why not?

Why are they keeping it secret? Those are questions that need to be

answered. Great Ormond Street Tonight, a BBC London exclusive,

the author of the Serious Case Review into the death of baby Peter

says she wasn't given crucial facts. Throughout my investigations Great

Ormond Street Hospital have maintained that they withheld key

information in the Sibert report for legal reasons. We believe in

being open. Always telling the truth and sharing everything we can.

One of our problems is we have responsibilities to our employees

as well. Great Ormond Street Hospital has always maintained that

the findings of the Sibert report were passed on to the second or

final review into Peter's death. But we can now reveal, after months

of investigation, that the full failings of Great Ormond Street

Hospital never made it into any official inquiry. Over a year after

baby Peter's death the role of Great Ormond Street Hospital was

re-examined. A second review was carried out by a company. We have

now seen this confidential report and can revuel what it says for the

very first time. -- reveal what it says for the very first time. It

reports to be a full assessment, how the Health Services failed baby

Peter. But the key failings of Great Ormond Street Hospital are

simply not in it. Great Ormond Street Hospital say they did

receive the full Sibert report. I showed both documents to Ray Jones,

an expert in social care, to see whether they thought the findings

Paediatrician Leonard Williams, who has a special interest in child

protection agrees. You do not read this report and get the same

impression as you do from the Sibert report. Because the Sibert

report painted a picture of what? clinically risky situation. Great

Ormond Street said Verita did receive the entire Sibert report

and they had been open, providing all necessary information, but

reading through Verita, it paints a different picture. Crucially, the

report says there was a named doctor. When we know from Sibert

that there wasn't. Verita was told staff investment in St Ann's Clinic

had increased, when a year before, the number of consultants was cut

from four to three as part of Budget cuts of �350,000. And on the

key question of why Dr Sabah Al- Zayyat was appointed, the report

says that Great Ormond Street failed to provide the documentation

to explain that. If at any point in time there's

been deliberately, if you like, editing and exclusion to make sure

that that information doesn't transfer from one stage of the

process to the other, then that's got to be cause for concern because

at the end of the day you have disrupted and destroyed the purpose

of the process. 18 Months after Peter's death, the

country's health regulator took a look at how Great Ormond Street had

responded to the tragedy. Even here, the hospital tried to exert

pressure. In Plymouth, I met Heather Wood, a

former senior investigator for the Care Quality Commission. I showed

her correspondence we'd obtained through Freedom of Information

requests between Great Ormond Street and the regulator. It was a

missed opportunity perhaps to hold Great Ormond Street, well, to

account, really, on the face of it. E-mails and letters reveal how the

hospital pressurised the regulator not to publish its review

containing the Sibert report. you surprised to learn that Great

Ormond Street wanted this report not to be published? I think that's

very unusual.? Another e-mail, they tried to get Sibert's criticism of

Great Ormond Street removed altogether. Having looked at some

of the correspondence that you have shown me, I am certainly aware that

Great Ormond Street was uncomfortable with the publication

of the Sibert report. It certainly leaves an impression of an

organisation that doesn't want a light shone into particular corners.

It doesn't give an impression of an open and transparent organisation

that is looking to ensure that lessons are fully learned. Great

You would assume the affect of Baby Peter's death would be to make

Great Ormond Street rethink its commitment to child protection, and

it has, but not in a way you would imagine. It's now withdrawn from

its partnership with Haringey. Other people might be tempted to

say we must improve what we're doing. It seemed to be the opt is

it case here. They just wanted to withdraw from anything to do with

child abuse. So why when Baby Peter died nearly

five years ago now does this still matter? Well, it's important

because by trying to hide this information, Great Ormond Street's

failings in child protection appear not to have been properly addressed.

Since Baby Peter's death, child protection in Britain has undergone

a radical change. Some say setting it back because the right lessons

may not have been learned. The repercussions are still being felt

at the hospital today. At Great Ormond Street, radiologists were

relied upon to give their expert opinion on child abuse cases to

doctors around the country. But in the last few years, a decision has

been made to withdraw this service. I found this quite horrifying. It

was an impossible situation to be in, and whoever had dreamt this up

obviously had no idea what is involved. There was an impression,

a feeling that the Chief Executive didn't want radiology to do non-

accidental cases anymore. Child protection cases? Yes. Great Ormond

Street say they took this action 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. But when radiologists

in the department raised concerns that Great Ormond Street was

failing to put the child first, they felt management weren't

listening to them. There was a culture of fear, so if we raised

our concern, we were just ignored. According to some staff at the

hospital, there is a culture of fear and bullying within this

famous institution. Four years ago, senior radiology Dr Cathy Owens

found herself facing an accusation of fraud over claims for

reimbursement of the congestion charge. She was made to pay back

the money. In 2008, Chief Executive of the hospital Jane Collins sent a

letter to staff stating that she now considered the matter closed,

but rather than being the end, this proved to be just the beginning for

Dr Owens. Every person I know who has looked at any of the facts

would say what's happened is wrong. They need to put it right.

Supporters of Dr Owens say she has been the victim of a smear campaign.

This has made her life miserable for the last few years. I think

this is pure victimisation of Dr Cathy Owens. My view is that

they're trying to persuade by one means or another Cathy Owens to

resign. It's a very serious claim to make against a hospital. It is,

yes. In 2010, Dr Owens lodged a grievance about her treatment at

the hospital. A few weeks later, a complaint was made against her to

the General Medical Council. As soon as the hospital knew there

had been a referral of Dr Sabah Al- Zayyat, the hospital should have

intervened and said this is a dead issue. Whatever the rights and

wrongs may have been just over - just under two years ago, it's not

matter to bring up now. It clearly doesn't affect a doctor's fitness

to practising. It has been disposed of. They didn't. But now we have

learnt the General Medical Council has dropped the case against Dr

Owens, saying there was no prospect of proving dishonesty. Peter

Bottomly says the hospital needs to admit they have made a mistake.

hospital has to act, and if they don't, they will join the group of

hospital Trusts who in my view the Secretary of State and the Select

Committee need to investigate if this issue of having good doctors

referred to the GMC and the Trust either initiating it or going along

with it continues. This is one of the worst cases I have come across.

Great Ormond Street say they tried to resolve the matter informally to

avoid disruption in the radiology department. They go on to say:

"With the benefit of hindsight, informal resolution may have been a

mistake, and a formal disciplinary hearing may have been more

appropriate. We were duty bound to ensure that the General Medical

Council received a clear, transparent and accurate account of

all the key evidence." But Dr Cathy Owens isn't unique. We have learnt

of the case of another doctor, Hillary Cass, the former Medical

Director of the hospital. Colleagues say she was hounded out

by management after raising safety concerns relating to junior doctors.

Both draw parallels with the case of whistle-blower Kim Holt, who

raised concerns at St Ann's Clinic. Great Ormond Street decided not to

comment on Hillary Cass's case, but told us she continues to develop

specialist practising at the hospital. Great Ormond Street is

gaysing an emergency. I think the chairman should ask the Chief

Executive to produce a list of the consultants who have been

disciplined, the ones who left in a compromised agreement, the

outstanding case they have got, look at that schedule and say, is

there a pattern? Great Ormond Street now has the foundation trust

status it so wanted. It's got it despite these failings in child

protection and concerns about patient safety. Some think it's a

mistake to have given it this independence from Government. So

what next for this famous institution?

Great Ormond Street has just become a foundation trust. That means it's

trusted to run its own affairs. This is an affair it needs to run

properly, and up until now they haven't shown they have done that.

They have done the opposite. They're in the process of losing

competent, well qualified, well- trained consultants because of this

whole attitude within the hospital. I'm extremely disappointed. I'm