27/10/2015 Scotland 2015

What protection is there for patients if NHS whistleblowers

As one NHS whistleblower is cleared of wrongdoing, we ask if patients

and staff are still being let down by Grampian Health Board.

And it's not just TalkTalk - we'll be hearing how small businesses and

students have been falling victim to the cyber attack blackmailers.

If patients are to receive the best medical care, the medical staff must

be free to raise concerns without fear of losing their jobs. But one

NHS whistle-blower who did just that in Aberdeen found his reputation

under fire. Now he has been cleared of bullying allegations by the

General Medical Council. The surgeon, Malcolm Loudon, was the

original whistle-blower who sparked a review that was critical of

Grampian Health Board. The board denies it takes punitive action

against off to raise concerns. Here is Fiona Walker from our

investigations unit. This all started with one surgeon

who blew the whistle. It went to the very top. The Scottish Government

intervened and the investigators were sent in. The reports that

followed, weaknesses, patient care compromise, significantly

dysfunctional. Those were some of the descriptions used. And this is

the whistle-blower. But as the health board was under

investigation, they investigated him. And Malcolm Loudon was branded

a bully. But today, this is a man who feels vindicated. The General

Medical Council has not only cleared him on all counts, but this is what

they said of NHS Grampian's bullying investigation.

The evidence falls far below the standard required to prove

We have comments, we find it difficult to understand how the

Which makes Malcolm Loudon think the health board was trying to

I think it's been an attempt to silence me.

It's been done in a way that's really quite ruthless.

It's recklessly irresponsible way to behave

merely to wreak revenge on those who have called the organisation's

conduct and indeed the values and standards into question.

And as every senior clinician leaves,

From your point of view, NHS Grampian were trying to silence you

because you raised claims, allegations, about patient care. But

by coming forward as it was a blower, it could be argued that

you're using that particular and to hide the fact that you've been

accused bullying? I don't believe that is the case.

Those allegations have been looked at and completely found to be

unfounded. Patients should be at the centre of

all of this. Are they? No, it would appear that the conduct of my former

employers is absolutely uncaring. You can talk about person centred

care and I think this has been ignored completely.

I've spoken to nine other doctors who either were suspended by

NHS Grampian at the moment or said they felt forced to leave.

Now the thing that these nine doctors have

in common is that they that they say they all raised concerns about care

The ones who are suspended are bound by confidentiality clauses, which

means they cannot be cowed, and that includes the Queen's surgeon in

Scotland. In fact, the only person he can operate on at the moment are

members of the royal family. That is evidence of a very

widespread problem in the culture. Doctors are crushed and got rid of

because they criticise the system. Or they criticise some aspect

of patient care. Now, actually,

doctors are supposed to do that. For Malcolm Loudon, this is not the

end of the matter. He wants the Scottish Government to intervene

once more. This time, investigating the way that staff like him have

been treated. The Government must actually get to

the heart of what went wrong. The Scottish Government must commission

a judge led inquiry into the actions and conduct of all the people

involved in this process. The health minister says the matter

has been investigated. But for the other and nine doctors who also said

they raised concerns, it doesn't feel like this is a case closed at

all. Well, earlier I spoke to Fiona

Walker. What are the chances of that judge

led inquiry that Malcolm Loudon is asking for?

Well, the initial indications was suggested that there isn't much of a

chance. The health minister has sent a statement today. In it, she says

that whistle-blower 's ' issues were fully investigated, they are acting

on all of the findings. That would seem to refer to the clinical,

medical issues that were raised by Malcolm Loudon and others, rather

than the way that the whistle-blowers were treated. I

don't think the calls for further investigation will be going away.

How does his treatment to compare with the treatment of management

within the health board? We saw what happened to Malcolm

Loudon. He actually left when he thought he was likely to be

suspended. That is what subsequently happened to some of his colleagues

who also raise concerns. On the other hand, when these very critical

reports came out about NHS Grampian, there was a loss of confidence in

some of the senior figures at the health board. If we take the chief

executive as an example, he as a result of this loss of confidence

took early retirement. I suppose the difference is that when he left, he

was given it a quarter of ?1 million to put into his pension pot. We also

know that seven others also received payments during that year, which

takes it to a total of ?1 million. The subway whistle-blowers are

treated have broader implications for patient care?

We talk about patient care and safety, what we are actually talking

about is potentially life or death decisions that are made in

hospitals. So yes, there are management issues which also have

come up, but there were things that the whistle-blowers brought up

that, like a cancer surgery, mortality rates, care of the

elderly, things of that affect patients on a date in, day out

basis. There is no good news for the patient if these things are not

discussed. There is not the kind of environment where doctors, nurses,

any staff feel they can challenge any potentially dangerous

circumstances. So, despite all the policy, the aims, objectives, which

are stated by the Scottish Government, the health board, if

there is an entrenched culture of fear, no policy is going to change

that overnight. Thank you very much. I'm joined now from Aberdeen

by retired consultant Professor Jamie Weir, who chairs

the Patient Action Co-ordinating Team set up in response to

the poor standards being encountered We heard their about why protection

for whistle-blowers exists come it is this still an issue in NHS

grabbing? I think you heard from the news

today that there is concern for patients and concern by patients at

what is happening in Grampian. Some of it is historical, it has been

going back over ten years, which has really resulted from poor

management, poor clinical managerial cooperation and to the detriment of

patients and patient care. The exoneration of Malcolm Loudon today

shows I think that there is still a problem that exists. Grampian Health

Board may suggest that it doesn't exist, but I think they are not

looking deep enough into the cultural problems that Malcolm

Loudon described, the culture as toxic. I think other clinicians have

set this. Are you aware yourself of clinicians that have concerned

themselves at the moment that are afraid of speaking out?

Yes, there are clinicians who have spoken to us in confidence and I

have heard it from other sources as well that they raise concerns about

patient care and standards and the requirements necessary to fulfil

their jobs and look after patients properly, but they dare and do so

because they are targeted and told in no uncertain terms that they will

shall be, how shall he say, not victimised in so many words, but it

would be unwise for them to do so. That is a very sad situation as

being occurring in Grampian for about ten years. I sincerely hope

and I think our group sincerely hopes that the new management that

is in place will change this culture. It has to change, it is not

good for patients, it is not good for staff. Staff morale is low at

the moment. It takes 20 years to build up a wonderful reputation, it

takes 20 minutes to destroy it and until the change is there and the

funding, which is really what it amounts to, which I would like to

talk about, is in place to look after the patients, our patients, in

Grampian at a standard that is acceptable, then this is not going

to change. What is the problem here? Why is

this not changing the smack we are told everything has been addressed.

--? They may have been told it has been

addressed, but it hasn't been. Since 1992, Grampian has been receiving

less funds of about ?2 billion as comparison to Teesside. There is no

difference to the disease profile across Teesside then Grampian. Why

are they... You think this is affecting staffing

and resources? You think this is having an actual impact in the care

that clinicians are able to give patients?

Yes, it is bound to. The point is if you're on 20% less staff and you

want to do the same for patients and you want to produce the same high

quality of care, you're going to be working hell of a lot harder than

the people next door. That does not engender good patient care and

continuity. It puts stresses on the people who are left to be here --

might do it, you only have to look at the figures to show the cancer

waiting times, the A times, the number of agency nurses employed, to

see that there is a retention problem in Grampian. It has got to

be addressed in a has to be addressed essentially and it has to

be brought forward so that there is proper funding throughout the NHS in

Grampian. ?200 per person per year less that we get in Grampian then we

get in case I. Why? There we must leave it.

Thank you very much for coming on this evening.

Cybercrime, the act of breaking into people's computers and other IT

devices is on the rise. The large-scale hacking of phone

provider TalkTalk has been served as a reminder of the problem.

provider TalkTalk has been served as not just big businesses

provider TalkTalk has been served as and all of her information had been

encrypted and if we wanted it back, we would have to contact and e-mail

address. He was forced to pay a ransom of

1000 euros to regain access, but even then, much of the information

stored on his database was gone. An average

seriously. Back at the hair salon, can hopes to

be fully up and running in the next day or so, but it has been a

sobering experience. There is a terrible feeling in the

pit of your stomach, fear, emotional issues. I was terrified, but over a

period of time, as a businessman and self-employed, you have just got to

get on with it. His message to other business

owners, and get protected or risk an attack from cybercriminals.

Joining me now is Professor Bill Buchanan from Napier University.

Good evening. That was a pretty worrying case study we heard there,

how widespread is the problem? It is pretty widespread, we have seen it

in major industry, typically they will attack targets like the finance

industry where you have sensitive data, so obviously they are looking

at extortion, if they can get control of systems they will then

encrypted with a special key and then it is almost impossible for it

to be unbroken, the only way it can be unbroken is to pay the money so

it is a very difficult crime to follow up and limit the damage. It

is not even just small businesses like we heard in the report, even

students are being attacked in this way. Anyone who clicks on a link in

an e-mail is in danger of this, it might contain an executable

programme which contains the ransom ware, once it is on the machine it

will contact the headquarters of whoever is involved and create the

encrypting key, encrypt the files and tell the user that they need to

pay the money to get the encrypting the back. You can also get things

like a drive-by download or someone visits a website and it contains the

piece of malware in there. The advice and keeping your virus

scanner up to date and also having Web protection on your e-mail is a

very good thing to do. Who are the people doing this? Where are the

base? I could not name, we can trace IP addresses to many regions of the

world as they are probably the same countries that appear again and

again, whether those people are actually based in those countries is

debatable. They tend to be using what is called proxy system, a proxy

system is when the attack might source itself from a certain

computer but there are a whole lot of other computers behind that

computer. It is almost impossible for the police to retrace the actual

end source of it so the hackers tend to be based in countries that have

got lower threshold for their lives than they do in this country. How

lucrative is it for these cyber criminals? The FBI reckon there has

been an $18 million hits just this year alone and that is likely to be

the tip of the iceberg. Many people probably through the embarrassment

of getting a crypto wall will not actually reported. These types of

crimes go unreported. If you have a Ph.D. Dissertation that you have

written and it has to be handed in and you have not backed up then of

course you will pay out because every minute that was passed by the

be a greater risk of you not getting your data back. And you have heard

of examples like this with students? Yes, there are many occasions.

Students visit sites they maybe should not be visiting, you might

click on links they should not be, so even computing students are open

to this type of attack. The main thing is if you receive an e-mail

then you have to watch when you click on it. We have seen cases

where a fishing e-mail is sent and it sent a message of your daughter

has fallen at school, please contact us, attached is a document that will

outline what happened. The parents will panic and click on the length

and are affected by the software. What would you suggest people can do

to protect against this? Users really need to back-up your files as

much as possible and probably disconnect from the network. In

order of protecting against something they just need to be savvy

about some of the things that they actually get and to make sure that

they are wise in changing passwords and so on. We have observed on

broadband providers that a simple password reset is done with

someone's mother 's maiden name, these days that kind of data can

actually be sourced fairly easily, such as through Facebook. Thank you.

If you are concerned about online security and want to

find out more about precautions you could take, Police Scotland

Joining me now to discuss the rest of the day's news are

Shabnum Mustapha, former Liberal Democrat advisor and Ewan

Welcome to you both. Let's kick off this evening with the fallout from

last night the Lords revolt over working tax credits. Will the

Chancellor wreak revenge over all of this? It certainly sounded like it

today. Personally I have always supported and voted for an elected

House of Lords but to be frank I have not been able to persuade the

majority of the House of Commons. So while we have the House of Lords as

it currently is I think it should respect the Constitutional

convention that says the elected part of our Parliament votes on the

financial matters and the unelected part doesn't. The government has

announced a review into the workings of parliament, it will examine how

to protect the ability of elected governments to secure their

business. Is this the beginning of the end for the Lawrence? It could

be, in the last parliament the Lib Dems and Tories had a deal to have

the form of the House of Lords and the Tories broke that deal, we had

90 Tories rebelling. This could have been done in the last Parliament and

the could have had an elected chamber and we would not have had

what happened last night so this has been a smoke screen to cover up the

fact that George Osborne was humiliated yesterday. So you think

it is all about revenge? Years trying to deflect attention from the

bad use the and manufacture a constitutional crisis, there is no

constitutional crisis. The House of Lords were within their rights do

what they did. It was a statutory incident and was not a financial

bill. If there is to be reform of the House of Lords then bring it on.

Is it fair enough, you? You might be happy with the result that this is

an unelected house taking action. The House of Lords itself is a

constitutional crisis, it is ridiculous that you have an elected

peers and awful I was agreeing with Church of England bishops and what

they were saying about tax credits you have to remind yourself that

this is a Church of England bishop in the legislature taking decisions

about the laws of our country for no other reason than the are Church of

England bishops so I think the House of Lords should be abolished, as it

is we have the House of Lords and I do not think the Conservatives

notwithstanding what George Osborne was seeing about an elected house,

the majority of them support the House of Lords and if that is the

system that supports, they have put in place, they refused to reform

than what they should do is get out of it. They cannot complain when the

system they support exercises their rights that done. The dead Sea in

their manifesto that they saw a strong case for introducing an

elected element into the House of Lords. It is very conveniently

priority now, at the RCA 's about this then let's see what the review

has got to say. It is the that in 21st-century Britain we have in an

elected second chamber that make decisions about our day-to-day

lives. It is right it is sorted but we must not forget about the serious

debate about tax credit cuts that will impact on the working poor.

There will just be a delay to aid rather than the bill being killed

off so there is still concern out there for working people. Living to

Catalonia, the Catalan parliament has declared the start of a process

to create an independent Catalan state. The Spanish Prime Minister

has vowed to use all political and legal means to block Catalan

independence. How do you think this will play out? Just seeing the

present they're point towards a podium talking about the

constitutional issue brings back bad memories to the time when he used to

push a podium to talk about the catastrophe of independence, he was

normally talking about Scotland. I think some of his interventions were

disgraceful and here we have a situation in Spain where unlike the

British garment and you must credit the British government to recognise

the mandate of the SNP which held a legal valid well-run referendum we

have the situation here where he and his party will not even allow a

referendum despite the fact that you have a majority in the Catalonian

Parliament for independence. There is only 48% of seats, is it a bit

risky to try and push ahead so aggressively with this? They want to

hold the referendum and to be told you cannot hold a referendum, they

then hold an election in which they say this is in effect an independent

referendum and get the majority of seats, they are engaging in the

Democratic process and the president is not. What do you think? Like you

said they got 48% of the share of the public votes they did not quite

reach the majority they wanted so public opinion is not all in favour

of cessation so I am quite cautious on this because I am in favour of

the UK but I think in terms of the processes they are going through I

do not think this is the right way to do it, I would have preferred a

referendum model. The wattage to hold a referendum and the Spanish

government said you can't have that, they are actually threatening the

Catalonian president with legal action for having the temerity to

try and hold a consultative referendum. Before we end I want to

talk about the BBC licence fee, the Culture Secretary has been talking

about the BBC charter renewal process, he spoke about concerns

that BBC online is causing problems for print journalism. The problems

of newspapers go beyond the BBC but the express a firm view that the

fact that you can access content that looks like longform journalism

on the BBC website is clearly something they are unhappy about and

phrases this question as to whether or not the BBC should be essentially

entering the printed news market and that, I think, is a legitimate

concern for them to express. Is BBC online killing local newspapers? I

don't think it is, I think it is a tragedy what is going on in relation

to the printed press in Scotland that I do not think that is the

issue, there is a big issue across the western world with regards to

print circulation. The issue with regard to the BBC in Scotland is do

we want a proper national public service broadcaster in the way that

we probably do not have at the moment, that would be good for

newspapers and creative industries and democracy. It would be good to

discuss that at more length. But we are out of time. Thank you both.

I'll be back same time tomorrow night.