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Whistleblowers ‘undermined’ efforts to protect patient safety, inquiry hears

The Scottish Hospitals Inquiry is currently investigating the construction of the Queen Elizabeth University Hospital campus in Glasgow.

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The medical director of a health board has told a public inquiry that the behaviour of whistleblowers who raised concerns about issues at a Glasgow hospital “undermined” efforts to protect patient safety.

The Scottish Hospitals Inquiry heard evidence on Thursday from Dr Jennifer Armstrong, the medical director of NHS Greater Glasgow and Clyde (GGC), which runs the Queen Elizabeth University Hospital (QEUH) campus in Glasgow.

The inquiry is currently investigating the construction of the QEUH campus, which includes the Royal Hospital for Children.

It was launched in the wake of deaths linked to infections, including that of 10-year-old Milly Main.

Dr Armstrong told the inquiry that she stood by comments in a paper submitted by GGC to the inquiry, which criticised the behaviour of hospital staff who raised concerns about problems with the ventilation and water systems at the new hospital.

The document, which was shown to the inquiry, listed 15 “quite serious allegations” about their behaviour, including that they provided “inaccurate information to patients and families,” and that they made “false allegations against colleagues”.

The list is introduced with the statement: “The following are examples of conduct by ‘whistleblowers’, or in (two examples) believed to have been the actions of ‘whistleblowers’, which undermined the efforts taken to manage infection control, and protect patient safety and welfare.”

Senior counsel to the inquiry Fred Mackintosh KC queried why no action had been taken at the time to address the allegations, which the inquiry heard related to Dr Heather Inkster and Dr Christine Peters.

“You’re agreeing … that these doctors have undermined efforts taken to manage infection control and protect patient safety and welfare, and you’re saying that’s not something you should have taken up as a matter of grievance, or, frankly, have reported the General Medical Council (GMC)?” he said.

Dr Armstrong replied that there had been an “attempt to do so”, and that they wouldn’t go straight to the GMC “for that kind of thing”.

She continued: “You have to use a graded process, where you try and start off with ‘this happened, this did not go well’, there’s a reflection on it, and then you hope to put in place behaviours that change that.

“And that takes time to do, but when you see behaviours recurring, then it can become quite, quite tricky.”

Dr Armstrong was also critical of Dr Inkster’s behaviour as chairwoman of the hospital Incident Management Team (IMT), which investigated infection issues.

She said the IMT “degenerated” in part because Dr Inkster was too focused on proving the hypothesis that infections in a children’s ward originated in the hospital environment and that this detracted from a focus on patients.

“I think the focus had become about the environment, and I think that led to a lack of focus on the children,” she said.

“I wouldn’t go as far as to see that doctoring so wasn’t focused on patients, but I think the actions she took led to a lack of focus on on the children.”

Mr Mackintosh responded: “It’s a very serious suggestion you’re making, that a clinician, while in a serious position in your organisation, who you kept in post for three years, was focused on proving herself right rather than focused on children.”

Dr Armstrong said the IMT ended up not focusing on the best outcome for patients, but said she “wouldn’t go as far as to say (Dr Inkster) was not focused on patients”.

She also denied that criticism of Dr Inkster and Dr Peters was an attempt to discredit their version of events or detract from the real issues they were raising.

“I would absolutely reject that,” she replied.

Sign outside the Queen Elizabeth University Hospital
The inquiry is currently examining the construction of the Queen Elizabeth University Hospital campus in Glasgow (PA)

“I believe that people in my team, clinical team, people at the board, we all were focused on fixing the issues with environment.

“We got a hospital handed over to us, which had issues with it, and we’ve spent the last nine years trying to address them for the good of patients.”

Earlier, Dr Armstrong told the inquiry the hospital had not been “what we expected”, and that she first became aware of issues with wards for bone marrow transplant patients and infectious diseases in the middle of 2015.

Lead counsel to the inquiry Fred Mackintosh KC challenged her on whether she had become “suspicious” and asked what else might have been wrong, given the problems that were later found with the ventilation and water systems.

She replied that this was the responsibility of the project director, the director of estates and the general management system and that it wasn’t in her remit as medical director to “go into the estates side and be able to ask questions around, ‘what was the water system like?'”.

She was also asked whether it would have been better if the hospital had been built “in conformity to the guidance” in the first place, given its £800 million price tag.

She replied: “I think if it would have avoided all the issues that we had, that would have been fantastic, because the stress the patients were put under, particularly the 2A (paediatric bone marrow transplant) patients, was enormous.

“So absolutely, I think that we should have had that.”

The inquiry continues.

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