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Ex-council chief exec quits top health post

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A former council chief executive, forced from office after exposing a leader’s criminal misconduct, has quit a senior health role and called for an investigation into the behaviour of a strategic health authority.

David Bowles

David Bowles

David Bowles, chair of the United Lincolnshire hospitals trust, wants NHS chief executive David Nicholson to investigate the behaviour of East Midlands authority in pressurising him to meet access targets.

He says he refuses to work in a system which he says has not learnt the lessons of Mid Staffordshire and which has lost sight of patient safety issues, and that it is his duty to resign and bring attention to that.

His stance has been supported by the other non executives at the trust, who have also written to Mr Nicholson asking him to investigate.

Mr Bowles said he was repeatedly asked by the SHA to give an “unequivocal guarantee” the trust would meet the 18 week referral-to-treatment target.

Mr Bowles refused to give a categorical assurance, emphasising the pressures the trust was under from increasing emergency demand, the need for effective demand management in the local health economy and that extra capacity to deal with demand could not come on stream until later this year. 

“I would like to know from David Nicholson whether he thinks it is fair and reasonable to ask for that guarantee,” he told HSJ. “I would like to know whether this is a renegade SHA or do ministers agree with unconditional guarantees on non-urgent targets.”

What I have witnessed from outside the trust appears to be a substitution of bullying for performance management and an obsession with targets rather than safety

David Bowles

In an email, seen by HSJ, to shadow health minister Mark Simmonds, who is MP for neighbouring Boston and Skegness, Mr Bowles said: “What I have witnessed from outside the trust appears to be a substitution of bullying for performance management and an obsession with targets rather than safety.”

“It is often said that the culture in the NHS, particularly at the more senior levels, is not to listen, not to understand, to avoid responsibility, and to blame others.

“In the interests of patient safety I can not and will not give the unequivocal assurance that the SHA is seeking on non-emergency targets especially at a time when the Lincolnshire health economy is out of control with the highest ever level of weekly emergency admissions this month.”

He added that he had had allegations from staff about bullying by NHS staff from outside the trust.

HSJ understands Mr Bowles told the Appointments Commission that he intended to step down and that the commission then made moves to suspend him, prompting him to leave immediately.

Mr Bowles is a former chief executive of Lincolnshire County Council and in 2004 he called in external auditors and the police. The leader of the council was jailed for misconduct.

A Department of Health spokesperson said: “Providing patients with high quality, safe care is our top priority. Targets have played an important role in delivering real improvements in services for patients and have revolutionised a once failing system, where 12 years ago it was not uncommon for patients to have to wait over 18 months for an operation.

“The NHS Constitution has set out the right for staff to have healthy and safe working conditions, one which has no place for bullying, harassment or discrimination. The NHS has taken strong steps to eliminate bullying and harassment in the workplace and all NHS employers are expected to have policies and procedures in place to tackle this.”

  • 2 Comments

Readers' comments (2)

  • Jon Harvey

    The moot question is - do targets really help anyone...?

    http://jonharveyassociates.blogspot.com/2009/07/bonfire-of-targets.html

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  • Jon Harvey

    "Dr Ian Bogle, retiring from five years as Chair of the BMA in June 2003 said 'I am absolutely appalled by the cheating going on and by the Government having put human beings in such a position that they feel that to preserve their jobs [they must do it]. The pressures are obscene and the Government should be ashamed of itself for the consequences."

    http://www.guardian.co.uk/politics/2003/jun/29/nhs.health

    the debate is not a new one!

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