SMEARED FOR TRYING TO SAVE LIVES
He’s a Doctor of the Year who dared to turn whistle-blower on three colleagues he said were putting lives at risk. So why was HE banished from the NHS he served so loyally — and cruelly branded a racist?
EVEN now, surgeon Peter Duffy has flashbacks about a particular medical emergency — the patient’s agonised screams, the race to save his life on the operating table.
The man in question, in his 40s, had Fournier’s gangrene, a ‘flesh-eating’ infection, and he was deteriorating rapidly, he says.
After Mr Duffy, a consultant urologist, performed emergency surgery, it was touch and go for a time, but the patient survived. The 56-year-old doctor could congratulate himself on a job well done. A life had been saved.
Yet, on the Sunday in question, when he had made the dash to the Royal Lancaster Infirmary, Mr Duffy was not, in fact, supposed to be working. The doctor who was on call that weekend in 2005, he says, was consultant urologist, Kavinder Madhra. Mr Duffy claims the ward sister had been trying to reach him since the previous day, but Mr Madhra was otherwise engaged. Playing golf, as it happens.
Indeed, when he finally turned up at the hospital on Sunday afternoon, after the operation had been done, he was still in his golfing gear, according to Mr Duffy.
This incident was not a one-off, he says. He claims that when Mr Madhra returned to work after a period of suspension, several other serious episodes of clinical negligence involving him took place.
If Mr Duffy is right, the difference in their present circumstances would seem rather odd — and unjust.
Mr Madhra, 63, who is under investigation by the General Medical Council on an undisclosed matter, has left his post at University Hospitals of Morecambe Bay NHS Foundation Trust, amid rumours of a pay-off. A statement said: ‘We can confirm that Mr Madhra left the Trust on Friday, September 28, 2018,’ but refused to expand further.
Mr Madhra continues to reside at his luxuriously modern property in Barrow-in-Furness, Cumbria. And now he has more leisure time, he can spend more time on the golf course, if he so wishes.
Mr Duffy, meanwhile, who has an unblemished record and won a Doctor of the Year award in 2016, is living in what he describes as enforced exile on the Isle of Man, working at a private hospital there, away from the family home in Lancaster where his wife and three sons live. He is estranged from the NHS he loved. And there is no hope of reconciliation. He will never work for the NHS again.
His crime — for that is how he feels it was regarded by his bosses — was to turn whistleblower against Mr Madhra and two other doctor colleagues, whom he believed were guilty of grave medical negligence. In response, he was labelled a racist.
When Mr Duffy found out about the allegations, he knew all was lost. He’d been warned by a colleague when he joined the Trust that the NHS tended to regard racism allegations as ‘guilty until proven guilty’.
In 2016, Mr Duffy felt forced to resign after a subsequent pay dispute. Earlier this year, he took the Trust to an employment tribunal.
His witness statement described the incident where Mr Madhra played golf instead of dealing with an emergency as well as other allegations against him and two other consultants, Ashutosh Jain and Saleem Naseem.
In July, the Manchester employment tribunal found Mr Duffy had been constructively unfairly dismissed and awarded him £102,000 in regard to a dispute over pay, but not over his disclosures.
And the nightmare isn’t yet over. He says the NHS is still ‘going after him’. He is being pursued for £48,000 costs and must attend a further hearing next month.
‘It has been very stressful,’ he says, in his first interview. ‘I feel a mixture of emotions.
‘I can’t believe that after having lost my vocation and having to live and work on the Isle of Man, away from my family, Morecambe Bay is still pursuing me.’ Growing up in Lancashire, Mr Duffy, who is married with three sons aged 21, 18 and 16, originally wanted to follow his father’s career path and become a pharmacist. But a day as a teenager shadowing his father’s golfing partner, a consultant urology surgeon, changed his mind.
‘I thought I’d faint, and I did faint. But I loved it,’ he recalls. ‘I said to my parents when I got home: “I’m going to become a urologist.” ’
Mr Duffy failed at his first attempt to get into medical school, and while he was studying to have another go, he worked as a theatre orderly and an auxillary nurse at a private hospital in Preston.
‘I started out at the coal face. You’re at everyone’s beck and call. You learn an awful lot,’ he says.
Mr Duffy studied medicine at Charing Cross Hospital Medical School between 1982 and 1988. He worked at a number hospitals, including in Guildford, Chertsey and Southampton, before joining the Royal Lancaster Infirmary in 2000, and was appointed Clinical Lead in 2003, a position he held until 2010.
He loved his work. He was proud of the department, too, which had a reputation for excellence. ‘I put every effort into building up the department and its reputation.
‘By the mid-to-late 2000s, we were being held up as an example of how a modern NHS department should run and won a very prestigious national award.’
But then, says Mr Duffy, standards began to fall alarmingly.
According to his tribunal witness statement, in 2005, there was that particularly staggering incident when a patient developed Fournier’s
gangrene and Mr duffy says he had to operate while Mr Madhra, the on-call surgeon, played golf.
hospital staff initially made contact with Mr Madhra, who said he would drive urgently to the hospital, but when he failed to appear they were unable to reach him on his mobile phone, according to Mr duffy’s witness statement.
Mr duffy claims Mr Madhra said the golf club required him to turn off his mobile while playing.
according to Mr duffy’s witness statement, Mr Madhra said he hadn’t come in because he’d been told the patient had a different infection, epididymitis, which he always treated with antibiotics.
Mr duffy says the hospital was also receiving calls from the laboratory saying prostate biopsy specimens taken by Mr Madhra contained no prostate.
‘It turned out he (Mr Madhra) had no idea of how to use the ultrasound machine he had been using to do the biopsies over a period of years,’ he said in his statement.
‘a colleague and I spent several of our free half days doing all his biopsies again, finding several missed cancers . . . Mr Madhra was suspended.’
then, in 2009, two other asian consultants, ashutosh Jain and Saleem naseem, joined the department. One of them had been appointed by Mr duffy himself, and he’d voted in favour of the other to join the staff.
Initially, he got on well enough with them, but over the next few years he began to clash bitterly with them, as well as Mr Madhra. In 2014, Mr duffy claims there occurred what he describes in his statement as a ‘truly huge clinical error’, again involving Mr Madhra.
It concerned a patient who needed to have a kidney removed, but Mr Madhra had listed him to have the healthy one taken out.
‘luckily, I picked up the error immediately before the patient was due to be transferred to theatre. I declared this as a major clinical incident, which it clearly was.’
Mr Madhra was suspended for a second time. three months later, there was another near disaster, Mr duffy alleges, when a patient in his 60s was ‘completely inexplicably’ discharged by Mr Jain and Mr naseem with untreated advanced bladder cancer, sepsis and renal failure.
he was to be readmitted on Mr duffy’s operating list in six weeks — time, Mr duffy says, he really didn’t have. Profoundly concerned, Mr duffy felt duty bound to report the incidents — and did so — but was terrified of potential consequences.
‘I knew, and I was repeatedly warned by colleagues, of the risks,’ he says. ‘But you have to cling onto the morals that took you into medical school in the first place.
‘It was heartbreaking to watch the department disintegrate. But I always swore I wouldn’t betray the standards that I had aspired to in my teens and 20s. I was determined that I wouldn’t allow myself to be worn down into cynically tolerating poor and dangerous practice. not speaking out would have betrayed everything I believed in.’
By now, tensions were running high in the department.
around november 2014, an anonymous letter was sent to lancaster police accusing Mr duffy of racism and saying he had caused ‘ much difficulty’ for urology consultants at the hospital.
the police passed the letter back to the hospital, but despite the nature of the claims, highly detrimental to Mr duffy, the hospital management failed to inform him.
Instead, he says he heard about the letter from a colleague a few months later. ‘ he said he felt I should know,’ says Mr duffy. ‘I was upset and shocked. My colleague advised that as no action had been taken, it might be best to keep my head down.’
It wasn’t until nearly two years later, after he had tendered his resignation, that Mr duffy learned that, around that time, he had been accused of racism during a meeting.
‘I wasn’t told at the time, he says. ‘I was never given the opportunity to defend myself, to say that I wasn’t a racist. that these claims were ludicrous.’
So, despite the hostile atmosphere, Mr duffy resolved simply to try to get on with his job.
then, in december 2014, came an incident that Mr duffy said he had ‘long dreaded’.
a patient had a serious infection, requiring emergency surgery. It was Mr duffy’s belief that Mr Jain and Mr naseem had ‘missed an opportunity’ to act two days earlier. Mr duffy performed the operation — ‘scraping together an anaesthetist and surgical team during everyone’s lunch hour’, but it was too late and the patient died on January 2, 2015.
Mr duffy says the department’s report to the coroner about the death glossed over any missed opportunities. It was, he says ‘unbalanced, out of context and ignored the substantive service failings that probably contributed to the death of the patient’.
In response to Mr duffy’s accusations, david Walker, the medical director of University hospitals of Morecambe Bay nhS Foundation trust, maintained the trust has always been ‘open and honest with the Coroner. In the case of Patient a, clinical evidence was provided at the inquest by Mr duffy and an independent investigation was subsequently conducted with the agreement of the Coroner’.
the atmosphere in the department had become unbearable. Mr duffy had discovered, he says, that overtime payments he was due had been queried and not paid.
In 2015, it was agreed he would move to Furness General hospital, another hospital run by the trust.
With almost farcical timing, in February 2016, he received the ‘doctor of the year’ award at a ceremony in Kendal, Cumbria, having been nominated by staff, patients and members of the public.
the award ‘celebrates doctors who continuously go “that extra mile”, showing strong leadership and professionalism’. as well as bringing waiting lists down at Furness General hospital, Mr duffy ‘was praised for treating all members of the team equally — getting stuck in — even mopping the floor between theatre cases!’
Mr duffy managed to smile graciously as he received his trophy, but inside, he was marvelling at the irony of it all. In July 2016, by now deeply unhappy, he felt he had no option but to resign.
‘I believed in the nhS — it was a shattering outcome, to be forced to submit my resignation.’
Feeling deeply betrayed by the nhS, Mr duffy launched his legal action in October 2016. he is grateful for the support of the British Medical association, which has paid his legal fees.
In december 2016, he joined noble’s hospital on the Isle of Man. ‘It’s a beautiful island, and a pleasure to work here, but I’m separated from my family, living on my own, coming back to an empty rented flat every evening.’
Mr duffy believes the nhS needs to change its attitude to whistleblowers. ‘I don’t feel at all that the nhS is genuine in its pledge to protect whistle-blowers.
‘the nhS has always tended to punish or destroy whistle-blowers or tactically look away.
‘Once senior managers realise their own jobs will be forfeit if they don’t act over critical care issues, avoidable deaths and whistle-blower retaliation, then — and only then — will there be real culture change.’
When contacted by the Mail, the trust pointed out that Mr duffy substantially reduced the scope of his claim, meaning that the issues regarding the three asian doctors were not tested by the tribunal.
the trust, which still employs Mr Jain and Mr naseem, ‘continues to work hard’ to ensure a culture where staff can raise concerns without fear and where ‘safety is paramount’.
all clinical concerns raised by Mr duffy were investigated, the trust said. the trust was also aware of ‘interpersonal relationship and behaviour issues’ between members of the urology team and took action to remedy concerns.’
Mr Madhra, Mr Jain and Mr naseem all declined to comment.