Monthly Archives: April 2015

Health chat with Roy Lilley and Julie Mellor – 20th April        

Health chat with Roy Lilley and Julie Mellor   

On Wednesday last week I attended a ‘health chat’ with Julie Mellor hosted by Roy Lilley. I wasn’t planning on going but a friend offered me a ticket the day before. As I was at a spare end and in London, I went along. 
The conversation started with a discussion about Mellor’s upbringing and personal journey towards becoming the current Parliamentary and Health Service Ombudsman (PHSO). The conversation might have been a little more interesting had Mellor’s intriguing family connection with the Wolf of Wall Street been explored, but alas it wasn’t to be.
Whilst I’m sure this part of the discussion would have been of interest to some in the room, I was waiting for the conversation to come around to the important issues.
Over the last year, PHSO has not been out of the news, having repeatedly been accused of badly letting patients and their families down.
In June last year, in a rare move, Mellor was lambasted by the Secretary of State for Health Jeremy Hunt, over her organisations appalling handling of its investigation into the tragic death of Sam Moorish.
More recently the Patients Association have released two damning reports detailing case studies highlighting how the PHSO continue to let down patients and their families.
The Patients Association’s work prompted their Chief Executive Katherine Murphy to state:

 We have no confidence in the Parliamentary Health Service Ombudsman to carry out an independent, fair, open, honest and robust investigation.

Even a brief read of the latest Patients Association report and it’s not difficult to see why.
When the conversation did eventually get around to touching on these issues, we heard how PHSO were part way through a transformation ‘journey’ and that the first phase, increasing the number of investigations, was now complete. Mellor stated that this has been achieved without any additional staff being employed – impressive stuff.
The second phase of PHSO’s transformation journey we were told, is to improve the quality of their investigations. 
It strikes me that there is something a bit back to front about this approach. If you know that the way you investigate isn’t robust enough and sometimes fails to uncover the truth, surely you should address this issue first, before subjecting even more vulnerable patients to the same flawed investigative processes?
A telling moment during the evening came when Roy Lilley himself commented that he wouldn’t consider referring a complaint to PHSO because he had ‘no confidence that they would investigate properly.’ 
Who can blame him?
My own experience was summed up perfectly in Private Eye last month.
Still, Mellor refuses to withdraw her organisations report or admit to having made a serious mistake.
The concerns have gone on and on. Last month, The Public Administration Select Committee (PASC) stated:

….we are aware of the considerable anguish and disquiet where Parliamentary and Health Service Ombudsman investigations fail to uncover the truth, and of pain inflicted by the Ombudsman when it has been defensive and reluctant to admit mistakes.

The final question of the night came from Chief Executive of Patients Association, Katherine Murphy herself. Katherine gave a summary of the Patients Association’s concerns from their casework and asked why PHSO appeared so defensive and reluctant to admit mistakes. There was loud applause from the audience. Mellor’s reply was that it was like ‘being stuck between a rock and a hard place’. 
The analogy that ran through my mind as the evening drew to a close was that of a flight attendant flying the airplane. But then I realised that with the right training and support, this was something not outside the realms of being achievable. The issues we are dealing with here are about culture, insight, openness, honestly and human understanding.  The current crisis in leadership of PHSO is in my view, much more dangerous.
James Titcombe – 20th April 2015

Recent Reflections – 14th April 2015

Over the last couple of weeks I seem to have become embroiled in row on social media that started with a tweet from Jim Thornton, professor of obstetrics at the University of Nottingham.
I won’t repeat the full background as Jim has recently written an excellent blog summarising what happened here.
I first became aware of Jim’s tweet from the responses to it, which included allegations that Jim’s actions were ‘very unprofessional’, a comment that was intentionally copied to the RCOG. This reaction, Jim admits, made him feel sufficiently ‘nervous’ to ‘keep his head down’.
As Jim mentions in his blog, the main reason for this reaction was the fact that he had copied in Amy Tuteur. Tuteur is a retired US obstetrician who blogs about homebirth and normal birth.  Tuteur’s views are considered very controversial by some, especially her uncompromising opposition to homebirth. Over the years (and I get the feeling that the history goes back some time), the levels of animosity between Tuteur and some UK midwives and midwifery leaders (at least those active of social media) has risen to extraordinary levels. Tuteur is regularly dismissed as a ‘troll’. The exchanges that do happen are usually acrimonious and heated on both sides.
For my part, I’ve been aware of Tuteur for a number of years and have regularly read her blogs (by no means agreeing with everything but certainly feeling that some of the issues raised are important and valid). It was reading one of Tuteur’s blogs back in the early days after the death of my son following care at Furness General Hospital (FGH) that made me first aware of the RCM’s ‘campaign for normal birth’. Around this time, I started to learn more about other deaths at the maternity unit at FGH that seemed to paint a similar pattern of midwives acting inappropriately to keep doctors away and thus preventing interventions that could have resulted in different outcomes. Tuteur’s blog resonated with my experience and made me question what the RCM’s campaign was trying to achieve and what influence it had on the problems at FGH that contributed to so many avoidable deaths.   
More recently, Tuteur has written blogs about observations made relating to the way I’ve been treated on social media as I’ve attempted to debate some of the issues relating to maternity care that I feel strongly about. Being honest, it’s been a real struggle. There have been times when I’ve felt dismissed, disheartened and even hurt. Whilst I’ve been saddened and frustrated by this,  I haven’t had any involvement in the blogs that Tuteur has written which mentioned me and having read them, I’ve made it clear that I don’t approve of their personal nature nor do I condone the approach. 
What has really surprised me though, is observing that even the mere act of copying Tuteur into a tweet led to a respected professor of obstetrics being accused of being ‘very unprofessional’ and the veiled threat of copying in the RCOG. For me, this crosses a line. As users of social media we have an absolute right to choose who we engage with and to block/ignore or mute those we wish. However, I don’t think it’s right that any person or group of people should decide that someone is so unacceptable to them, that they monitor who else engages with them and make very serious and public accusations about the professional conduct of anyone who does. 
I do think that this is a form of bullying.  At the time I expressed a view that Jim had a right to copy in whomever he wished. Since doing so, the attention quickly turned to me. I was accused of having some form of ‘liaison’ with Tuteur and attention quickly drawn to my role on the national maternity review panel. Tweets have also been copied to my employer. 
So, let me be clear about my position. I don’t agree with everything Tuteur writes. I do however think some of the points she makes are valid. If Tuteur makes a comment on Twitter that is valid and thought provoking, like the Tweet Jim refers to at the end of his blog, I won’t be intimidated into feeling that I can’t retweet it. We can’t seek to close down people simply because we don’t agree with their views. However, I also think that it’s important that when using social media we are mindful and considerate of people’s feelings and sensitivities. I won’t contribute to any debate, on social media or otherwise, that is deliberately antagonistic or disrespectful of people’s experiences and professionalism. 
Having seen (and been quite shocked) by the debate which has unfolded following Jim’s tweet, I think this is something others would do well to reflect on.