Former head of Clinical Governance launches proceedings against GHA after making claims of preventable harm and deaths

Depopulation & WW3
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The former head of Clinical Governance at the GHA, Dr Derek Burke, has begun proceedings against the GHA.

This has been revealed by the Government in response to GBC questions, after Dr Burke sent an internal letter alleging that ongoing harm and preventable deaths are occurring at the GHA.

Number Six says the GHA will be strenuously defending itself against the claims by Dr Burke, and his right to bring them.

The above GBC news article follows a previous post related to it:- Preventable Deaths – GHA's Head of Clinical Governance vs Government of Gibraltar

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Edmund-Burke-good-evil-quotes

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Did I understand it correctly? Is the "Gibraltar Official Secrets Act" preventing GHA professionals from coming forward?

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That is what it sounded like to me. Preventing is putting it mildly. More like intimidating GHA professionals from coming forward. Tyranny. The gov't needs to keep its nose out of the public and private sectors and do what they (gov't) are told to do by the people. People are getting ill and /or dying as a result. The gov't is demanding allegiance at all times; "no discussion of matters of current or potential political controversy". Basically, shut-up and do as you are told even if it conflicts with what is deemed as good medical practice. Lawyers could get stuck in the middle of this grievance since they too are told to put gov't (Lizzie) first.

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6th August 2021

The former Head of Clinical Governance at the Gibraltar Health Authority, Professor Derek Burke, has raised serious concerns about the “collapse” of healthcare management in Gibraltar, which he said was putting patient safety at risk.

In a damning email to doctors first reported by GBC on Wednesday evening, Prof Burke reacted to concerns voiced by healthcare professionals about patient safety arising from decisions being made “at governmental level”.

Continued at the link.

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6th August 2021

Professor Derek Burke was appointed as the Head of Clinical Governance at the GHA in 2018, taking up the post in Gibraltar after a 40-year career in senior posts in the NHS. His knowledge and experience add weight to the concerns he has raised.

He was appointed after being approached by the then Medical Director, Dr Daniel Cassaglia, to help establish a framework to safeguard high standards of care and continually improve the quality of services to patients.

He was also appointed as the “Suitable Person” representing the General Medical Council [GMC], the UK body that registers and licenses doctors to practise, including in Gibraltar. It was a role that the GMC had to first approve.

Prior to taking up the post in Gibraltar, Prof Burke worked a consultant in paediatric care and in senior roles including long stints as Medical Director of an NHS trust in Sheffield.

He is a subject-matter expert on improving healthcare provision, having co-authored books on why hospitals fail and on how failing healthcare organisations can be transformed.

“As many of you will be aware, there has been a collapse of any semblance of a management structure at the GHA and Ministry of Health,” he wrote in the email to doctors at the weekend, adding that neither the GHA nor the Ministry of Health had responded to the concerns raised by doctors about patient safety “for some considerable time”.

“To compound their inaction, staff who have advised that they are considering escalating their concerns outside of the GHA in response to ministry and senior management inactivity have been threatened with action being taken against them for breach of contract and/or breach of the Official Secrets Act,” he added, insisting those contractual obligations clashed with doctors’ professional duty to patients.

Prof Burke warned doctors that if they raised issues about patient safety outside the GHA, they would “very likely” come under “personal attack”.

“Such acts of personal retribution are a tactic used within Gibraltar’s public sector in response to those who are considered not to be ‘toeing the line’,” he wrote.

“These actions are not only condoned by the government but are orchestrated by a cabal of senior members of the government and civil service.”

“These people will not hesitate to destroy your reputation, your career, and your family."

“The members of this cabal are viciously vindictive and petty minded.”

“However, they are powerful and well connected, sufficiently so that they can trample over Gibraltar employment law and organisational HR procedures with alacrity.”

Yet despite this “toxic environment”, he advised doctors to continue meeting their professional obligations and formally escalate their concerns within the GHA management structure, “…even though that structure is currently not functioning or responding to concerns.”

He advised them to keep written records of any issues they raised and to keep the GMC Suitable Person informed.
“Escalation through the line management structure and documentation of that escalation is key to protecting yourself both from retribution and from concerns about professional misconduct,” he wrote.

Prof Burke added that during his time as GMC Suitable Person at the GHA, he had kept the GMC “up to speed” on the issues in Gibraltar.

EARLIER CONCERNS

The email sent last weekend is not the first time that Prof Burke has raised similar concerns, both in internal correspondence and in different forums.

Earlier this year in Parliament, the GSD’s Elliott Phillips quizzed the government on another email sent by Prof Burke to his GHA colleagues in which he said some patients had suffered preventable harm and even death.

In that same email, Prof Burke claimed the GHA had been “... effectively taken over by a cabal of about a dozen individuals and their followers”.

“These individuals have paralysed the management structure and prevented a number of safety and quality initiatives from being completed,” Prof Burke said in the email, extracts of which were read out in Parliament.

“They are directly or indirectly the root of many of the preventable harm and deaths we have investigated in the past two years.”

The then Head of Clinical Governance had accused that group of “…intimidation, coercion and bullying of staff into their submission to comply with their views”.

Pressed by the Opposition, Chief Minister Fabian Picardo had told Parliament that the government had immediately sought more information from Prof Burke but had seen “not the slightest shred of evidence” to support the claims of preventable harm and deaths in the GHA.

Mr Picardo said he had asked Prof Burke to identify the names of the deceased so that the government could ask the Coroner to investigate the deaths, but that he had “not yet been provided with a name”.

“If there is a preventable death reported to the government, to the health authority or to any responsible person, that death must be investigated at the level of the health services and it must also, if it was preventable, be investigated by the Coroner,” Mr Picardo told Parliament at the time.

“That remains the government's position.”

“We have not been given any such names.”

Prof Burke may yet challenge those assertions in his claim before the Employment Tribunal.

In his weekend email to doctors, he voiced frustration that the GHA’s acting Medical Director, Dr Krish Rawal, had not publicly refuted the statements made in Parliament, despite, he claimed, being aware of Prof Burke’s long-standing concerns about patient safety.

At the time of the exchange in Parliament, Mr Picardo said considerable work had been done with the Ministry of Health, the Gibraltar Health Authority and the unions to investigate how different areas of the GHA that were the subject of the allegations were operating and how they could operate going forward.

“Given that we may not have the data that we need to have a Coronial investigation, we are certainly ensuring that we look at how we are doing things in particular areas and continue to learn from best practice,” Mr Picardo said.

For her part, Samantha Sacramento, the Minister for Health, told Parliament that she had met with Prof Burke to discuss the issues he had raised and that his reports were in the process of being investigated.

“There is a process, there is an investigation, there is an outcome,” she said at the time.

“These matters are something that we are engaging in.”

But the GSD said this week’s disclosure of another internal letter from Prof Burke alleging ongoing harm and preventable deaths called into question the government’s handling of this matter, raising “significant questions” about a “lack of leadership” by the Chief Minister and Minister for Health in the management of the GHA and in addressing the issues raised by Prof Burke.

The GSD said it was clear from the “unprecedented” email that there were “significant internal problems” in the GHA which had not been dealt with by the government.

Prior to the exchanges in Parliament and the email this week, Prof Burke had also raised similar concerns in sworn written evidence submitted to the Supreme Court during an appeal filed by the GHA’s former Medical Director, Dr Daniel Cassaglia.

Dr Cassaglia’s appeal was successful and overturned an earlier ruling by the Employment Tribunal that found he had bullied a GHA employee.

Dr Cassaglia had told the Supreme Court he believed the case against him had been “concocted” because of resistance to changes he wanted to implement in the GHA to improve patient safety.

In a witness statement in support of Dr Cassaglia’s case, Prof Burke said one of his main concerns was that patients in the care of the GHA were suffering preventable harm including death because of failings in the organisation.

He highlighted six key areas of concern including a “poor culture” within the GHA; poor quality of clinical notes; absence of robust systems to track the care of high-risk patients; unacceptably long waiting times for clinical services and treatments; multiple issues relating to diagnostic services; and a lack of systems within mental healthcare services to monitor compliance with legislation.

In his written evidence to the court, Prof Burke said that in 40 years working within the NHS including in senior management roles, he had never seen the like of some of the problems he had witnessed in the GHA.

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The GSD and Together Gibraltar are calling for an urgent investigation into issues raised by Professor Derek Burke alleging ongoing harm and preventable deaths at the GHA.

As reported by GBC, The former head of Clinical Governance at the GHA has begun proceedings against the organisation, with his claims including allegations against the organisation and against individual medical professionals.

The Government has said the matter is sub judice, and that therefore it will not comment further in relation to any matter raised by Dr Burke.

Both Opposition parties describe the mater as serious, calling for an inquiry that is independent and thorough.

Continued at the link.

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Over 300 people have signed a petition calling for Civil Servant General Orders not to be applicable to GHA doctors and healthcare staff.

The petition says the current contracts are archaic and throttle the freedom of our healthcare professionals, meaning they're not allowed to escalate issues or discuss them publicly if they could be politically controversial.

It was launched by a group calling itself Freedom Gibraltar. Last week, the former head of Clinical Governance at the GHA began proceedings against the Health Authority.

Dr Derek Burke has argued that GHA contractual obligations conflict with General Medical Council good practice.

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The former head of Clinical Governance at the Health Authority says he remains committed to pursuing "unresolved patient safety issues". In an email to all GHA doctors, Dr Derek Burke, who recently began proceedings against the GHA, reiterated his claim that there is a "cabal" of individuals at the GHA who are working for their own interests, and not those of patients or staff - adding that these are holding both the Government and Unite the union to ransom. For its part, Unite has described what it calls "these tiresome claims of a cabal" as "baseless ramblings".

BURKE EMAIL

A month ago, Dr Derek Burke sent an email out to all doctors at the GHA, alleging that ongoing harm and preventable deaths are occurring, and that GHA doctors who speak up come under personal attack orchestrated by "a cabal of senior members of the Government and civil service".

In his most recent email, Dr Burke refers back to these claims - saying he highlighted what he calls a "toxic environment" at the GHA, where concerns about patient safety are not acted on, and where staff who wish to escalate their concerns are threatened with breach of contract or the Official Secrets Act. He says the cabal at the GHA have "rendered its management structure ineffective", with a "complete breakdown in communications" between the Ministry of Health and the acting Medical Director, Dr Krishna Rawal.

Dr Burke goes on to say that Unite the union - along with the Government and Dr Rawal - are being "held to ransom" by the cabal - with Unite threatened with having its members moved to another union, and the Government threatened with industrial action. He also claims that members of the cabal put demands to senior members of the Government, including whom they wish to be "hired and fired".

Dr Burke says this is the first in a series of emails which will document the events he's observed, as well as the work Clinical Governance has undertaken and how - he says - some in the Government and GHA have "actively worked to obstruct" this.

UNITE RESPONSE

Unite sent its own email out to all the recipients of Dr Burke's, regardless of whether they were union members. In it, National Officer, Stuart Davies, says Dr Burke demonstrates a "complete lack of understanding" as to how Unite - a "democratic, member-led organisation" - operates. He says with over 1.2 million members across the entirety of Unite, it "would not compromise its position" because of the threat of losing members. Mr Davies says it is "unacceptable" for Dr Burke to suggest Unite representatives are responsible for compromising patient safety.

Stuart Davies says he has contacted the GHA to encourage it to "take the necessary steps" given that Dr Burke is planning future communications. Asked by GBC for clarification, he said this was because Dr Burke is using email addresses and information that he should not be holding onto post-employment, and communicating with GHA employees from a personal email address.

On Dr Burke's assertion that employees are threatened when seeking to raise concerns, Stuart Davies says he is "genuinely unaware" of such issues. He says if "members are genuinely feeling cowed by these alleged threats", they're encouraged to discuss these with their union representatives. Stuart Davies states Unite has always acted independently and will continue to do so, in the interest of its members.

GOVERNMENT RESPONSE

In response to GBC questions, the Government has said the allegation that there has been "a complete breakdown in communications" between the Ministry of Health and the acting Medical Director is not true - adding the Minister and Dr Krishna Rawal are in constant communication on a daily basis in person and on the phone. Regarding Dr Burke's other claims, the Government said these are subject to court proceedings, and that it is therefore unable to comment.

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6th September 2021

The GSD has again called for an “immediate and independent” investigation into allegations by the former Head of Clinical Governance at the Gibraltar Health Authority that healthcare management in Gibraltar has collapsed, putting patient safety at risk.

In a statement, that party said the issues raised by Professor Derek Burke “cannot be simply brushed away”.

The GSD was reacting after Professor Burke sent a series of emails to former colleagues describing a “toxic environment” at the GHA that was hindering efforts to improve patient safety.

In the emails, he alleged that “a cabal” of individuals was looking after its own interests and holding both the government and Unite the Union “to ransom”, rendering the management structure ineffective.

Professor Burke, whose emails are supported by images and documents including correspondence with officials and ministers, has now initiated legal claims against the GHA in the Employment Tribunal.

The Gibraltar Government has said it will “strenuously” defend those claims but will not comment further given the ongoing legal process.

For its part, in an email to it GHA members and other staff, Unite National Officer Stuart Davies dismissed Professor Burke’s allegations “fantastical” and “baseless”.

But the GSD said the government’s position that the issue was sub judice was “lame” and that the allegations raised by Professor Burke, a seasoned professional with decades of experience in hospital management, will not go away.

The GSD said the proceedings in the Employment Tribunal – “whatever they are” – could not substitute an independent investigation.

The Employment Tribunal, it added, was not the proper place for an investigation into allegations of a clinical nature which may have impacted on patients.

In his role as Head of Clinical Governance, Professor Burke was intimately involved in patient safety.

“The allegations cannot be simply brushed away without providing the public with a serious degree of reassurance as the provision of health services to our community,” the GSD said.

“This issue is too important to lie like this and will be of concern to the public. It needs to be dealt with decisively by an independent investigation.”

Elliott Phillips, the GSD’s Shadow Minister for Health, said the party would continue to press for an investigation into the claims.

“The Opposition will not rest until the allegations are fully and independently investigated,” he said.
“Any delay by the Government in relation to the allegations will not be tolerated by the people of our community.”

“The Opposition will pursue this matter inside and outside parliament.”

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Written by YGTV Team on 27 September 2021.

The GSD says that the Chief Minister “seriously misled Parliament and the people of Gibraltar” when he said that there was “no shred of evidence” of preventable deaths or harm to patients handed to him by Professor Burke. The party says that this much “is clear” from communications sent by Professor Burke to doctors.

A statement continued: “Far from the Chief Minister not having been presented with a “shred” of evidence it is clear that papers were provided to him by Professor Burke and offers of further presentations made which should have caused further enquiries and an independent investigation to be set up. Additionally, the Government should have set up an immediate clinical governance review to introduce improvements that would tackle the root of the issues Professor Burke was highlighting.

“Professor Burke had raised allegations of preventable deaths and harm to patients caused by clinical governance deficiencies in GHA. He had also highlighted what he called the “unresolved patient safety issues” and the control of a cabal of individuals which was worsening the situation. He also said to the Chief Minister in May 2020 that “patients are dying unnecessarily and suffering avoidable harm at the GHA” because of a number of deficiencies in care and administration of records.

“Additionally he gave the Chief Minister a Report of 20 anonymised individual cases of preventable harm and deaths where there had been alleged misdiagnosis or delayed diagnosis which had caused or potentially caused the patient harm.

“The chronology is damning and demonstrates that the Chief Minister misrepresented what had actually happened when he spoke in Parliament in May this year and said that “there is not one shred of evidence that there is anything behind those allegations.” The papers sent to doctors show that Professor Burke has been warning about patient harm for 2 years.

“On 24 November 2019 Professor Burke sent a Report containing an anonymised list of 20 sample cases to the Minister for Health at the time.

“On 20 January 2020 he sent the same Report and list of cases to the Chief Minister.

“On 13 February 2020 there was a meeting with the Chief Minister and at least four other Ministers. At that meeting Professor Burke discussed his findings and went through the list of cases in detail. These cases were only a sample kicked up by an audit of some patient records. He expressed concern about the “...thousands of sheets of patient records...in storage and unfiled” which, in his view, posed a risk to patient safety if papers were not filed or went astray.

“On the same day he offered to give a 45-minute presentation to the Chief Minister and Ministers on patient safety and preventable harm in hospital. According to Professor Burke this offer has not been taken up.

“After that meeting and at the suggestion of the Chief Minister, Professor Burke met with the Coroner even though he had advised the Chief Minister [and then the Coroner] that the issues he had discovered resulting in patient harm were not for the Coroner as they related to systems or organisational issues for GHA to resolve.

“On 4 May 2020 he submitted a strategy to the Chief Minister to address these issues. The strategy was prepared at the Chief Minister’s request.”

The Leader of the Opposition, Keith Azopardi said: “That chronology suggests there is plenty to investigate and is far from the situation described by the Chief Minister in Parliament. The anonymised list of cases show a summary of the condition, the possible diagnosis/misdiagnosis, delayed diagnosis, the consequence for the patient and the link to possible harm or accelerated death. This was a sample only and suggested a wider and systemic issue in the care of patients worthy of investigation to see if improvements could be made and to see whether the conclusions of the sample were justified. Instead Mr Picardo has trashed Professor Burke effectively as a charlatan who has presented no evidence. This is far from the truth and is a serious misrepresentation of what has been happening.”

Shadow Health Minister, Elliott Phillips said: “It is a scandalous state of affairs for the Chief Minister to behave in this way and deeply irresponsible of his role. The proper course would have been to investigate this fully and ask independent external clinicians or the Care Quality Commission to do so.

“Professor Burke was hired by the GSLP Government to head up the Clinical Governance area in 2018. His complaints should be taken seriously rather than wiped away as a political inconvenience that the Chief Minister prefers not to hear.”

Mr Phillips added: “The Government needs to concentrate on the serious issues raised by Professor Burke rather than try to dismiss what he has been saying as nonsense. He raises very important issues central to the health of patients. They deserve an independent clinical investigation and the GSD in Government will commit to do that. We won’t brush things under the carpet. We have been calling for an independent investigation for some time and this latest turn of events as well as the allegations raised justify holding one. This cannot be left as it is.”

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The Former Head of Clinical Governance at the GHA has sent doctors details of specific cases of patient deaths he thinks were preventable.

Dr. Derek Burke describes instances in which - he claims - a lapse of care has directly resulted in the death of a patient. The correspondence shared with GHA doctors suggests that the Ministry of Health has been aware of such issues since 2019.

Dr Burke recently began proceedings against the GHA. He has been sending emails to his former colleagues claiming that preventable harm and deaths continue to occur at St Bernard's Hospital.

In his now third address to former colleagues, he says he intends to reveal who was aware of this and when they were made aware.

This is the first in a series of reports that we bring you on the recent information sent out by Dr. Burke.

Clinical governance put on hold

Dr. Derek Burke was brought to the GHA to implement clinical governance in 2018, by then Medical Director Dr. Daniel Cassaglia. The intention, according to Dr. Burke, was to implement significant and sustainable changes at the GHA over a two year period.

In his email and attachments, he says that once Dr. Cassaglia stepped down in 2019 the entire clinical governance project was put on hold.

That same year, Dr. Burke said he was concerned with the lack of progress and growing information on preventable harm and deaths at the GHA. He contacted the then Minister for Health Paul Balban, the Principal Secretary Evelyn Cervan, Deputy Principal Secretary Martin Ullger and the Acting Medical Director Dr. Krishna Rawal, as well as those he had worked with on the cases, Toni Sanderson and Richard Roberts.

20 real-life cases

He provided a sample of 20 real-life cases, assessing whether deaths were preventable and if they were, to what degree.

In six cases, a lapse in care was assessed to have directly caused the death.

Some viewers may find the following details upsetting.

In one of the cases highlighted, a vulnerable patient’s CT scan showed a carcinoma with no spread, but that scan result was not reviewed. The patient, who had a learning difficulty, was lost to follow up. The patient’s main carer died and a year later they re-presented, this time with advanced cancer. The patient died two months later. At the time of the first scan, there was reportedly a good chance of curative treatment.

Death was found to be probably accelerated in another six cases.

The email says that this is when a patient was likely to die but the lapse in care almost certainly contributed to an earlier death.

Some issues arising in this category relate to poor pre or post operative care and follow ups.

In one such case, a patient’s blood tests indicated the likelihood of cancer and the need for further tests - these were not carried out. The patient was eventually diagnosed with cancer, at which point it had widely spread. At the time of the document being sent, the patient was undergoing treatment.

Five of the cases studied were near misses for death or cases where death was possibly accelerated.

One case of the latter details a patient whose blood test result for a tumour was not reviewed by their GP. A year and a half later they were diagnosed with advanced cancer and died four months after that. The documents state that the tumour probably wasn’t curable but that an earlier diagnosis could have prolonged life.

Near misses are cases where patients have survived but were at high risk due to a lapse in care.

Three cases identified that a risk of death was not increased. This means that the lapse of care impacted the quality of care but didn’t pose a risk to life. Some such cases involve issues of poor coordination.

In one instance, a patient being treated with chemotherapy required a leg amputation in 2017 because of a delay in diagnosing a vascular occlusion, however the patient died that same year. The case study says that the amputation was probably avoidable and that palliative care was poorly coordinated, but that this patient’s death was not accelerated.

Lack of records and certification information in Gibraltar

Dr. Burke's email also includes deaths of patients referred to Spanish hospitals by the GHA between 2017-2018, however, he claims there is a lack of records and certification information in Gibraltar. In 2017 there were reportedly 21 deaths between Xanit and Quiron Palmones. In 2018, there were 30% fewer patients referred to Spain for tertiary services, and 12 deaths occurred between Xanit and Quiron Palmones and Marbella.

He highlights issues with reviewing and investigating deaths here, such as a short time from death to burial and the non-registration of deaths in Spain for patients refrerred by the GHA.

What action has or will be taken?

According to UK studies, issues with preventable harm and deaths are not uncommon in hospitals; in 2017, the NHS committed to publishing estimates of how many patients may have died because of problems in their care.

Dr. Burke has shared a large amount of information in this most recent contact with GHA doctors. His letters describe the GHA as a failed organisation that needs to be placed in a turnaround state with a strategy laying out a one to two year work programme.

Over the coming days GBC will bring you further details on who, according to Dr. Burke’s email trail, knew about his findings on preventable harm at the GHA and when, what progress was made, what Dr. Burke’s recommendations for the GHA are and the state he claims the GHA is currently in.

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Meanwhile in answers to questions from GBC following the latest set of correspondence, the GHA maintains it will not engage in details concerning professor Burke as these are subjudice.

In answers to GBC as to who has taken over the role of Clinical Governance since the expiration of the contract of Dr Burke, the GHA says the quality of care delivered is the responsibility of each registered clinician. It says Clinical Governance is an assurance system that sits on top of this responsibility, and comprises a broad range of service providers including those responsible for clinical information management, patient engagement and investigations and learning processes. The Government now claims Professor Burke was employed as part of this wider team as a provider of clinical governance services, and not as the head of the department; however, in Parliament in May, the Chief Minister referred to him as as having been "appointed to be Head of Clinical Governance", and the General Medical Council has also referred to him as such.

The Government says his engagement was primarily to set up this service and put structures and policies in place, and the team continue to provide this service.

The GHA says all complaints, cases where some aspect of care was not optimal and cases where a patient may have come to harm, are investigated from not only the perspective of the individual clinician, and staff involved, but also a close examination of the systems within which the staff work to determine if something went wrong and if so what.

A spokesperson said since the Chief Minister said in Parliament last May there was not a shred of evidence behind allegations made by Dr. Burke, he has made no further allegations and nothing further has come to light.

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‘ALLEGATIONS OF PREVENTABLE DEATHS AND HARM TO PATIENTS CAUSED BY CLINICAL GOVERNANCE DEFICIENCIES IN GHA’

The Chief Minister seriously misled Parliament and the people of Gibraltar when he said that there was “no shred of evidence” of preventable deaths or harm to patients handed to him by Professor Burke.

So much is clear from communications sent by Professor Burke to doctors.
Far from the Chief Minister not having been presented with a “shred” of evidence it is clear that papers were provided to him by Professor Burke and offers of further presentations made which should have caused further enquiries and an independent investigation to be set up.
Additionally, the Government should have set up an immediate clinical governance review to introduce improvements that would tackle the root of the issues Professor Burke was highlighting, the GSD claims.

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Written by YGTV Team on 28 September 2021.

The GSD says that the reply from the Government on the Professor Burke scandal is a “classic smokescreen.”

A statement continued: “First they play the man and not the ball - as usual. Then they say they will not reply on the substance for legal reasons. All of that is nonsense and simply an attempt to avoid the key questions.

“The Government contracted Professor Burke in 2018 to head up Clinical Governance at the GHA. They presented him as a leading expert in the field having published extensively about patient safety and harm in hospitals. Now they are trying to trash the credentials of their own contracted expert because his conclusions aren’t convenient to their narrative.

“Mr Picardo told Parliament there was “no shred” of evidence of patient harm or preventable deaths. In fact, we now know he was sitting on a Report of 20 sample cases sent to him by Professor Burke. Additionally, Professor Burke had told the Chief Minister this was just a sample and there were potentially many more cases of failures in care or communication causing harm to patients.

“Mr Picardo therefore clearly misled Parliament when he said that there was “no shred” of evidence. He needs to say why he chose to give the impression that there was nothing in the allegations and that he had received nothing from Professor Burke when, in fact, he had received information of individual cases and more information had been offered to him.”

Leader of the Opposition, Keith Azopardi said: “Instead of sitting on the issue or being in a state of denial Mr Picardo should, at the very least, have commissioned an independent investigation into these matters to see if the allegations were correct and whether improvements could be made to the health service. Mr Picardo’s reply is just a sign he has lost all touch with the core issue at stake which is about ensuring the highest quality of care to patients. Instead, he is just interested in safeguarding his own reputation and trashing everyone that shows dissent. Last week he attempted to trash Henry Pinna and Action for Housing. This week it’s Professor Burke. This is an emerging pattern. Everyone who criticizes Mr Picardo is wrong and subjected to personal attacks. The people of Gibraltar will see through that and want better. On this issue it is obvious there should be an independent investigation.”

Shadow Health Minister, Elliott Phillips said: “There are high quality and dedicated staff at GHA who deliver excellent care in many cases. But if there are deficiencies in care or administrative practices that impact on some cases any issues should be identified and dealt with. It’s in the interests of all patients and families that this is so. Government needs to stop acting like an ostrich.”

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The Gibraltar Health Authority is a "failed organisation" that would be subject to special measures were it part of the NHS, according to the former Head of Clinical Governance at the GHA, who has recently begun proceedings against the authority. In his most recent email to doctors, Dr Derek Burke includes a comparison between the situation at the GHA and that dealt with in the notorious Mid Staffordshire hospital inquiry, described as one of the worst hospital care scandals of recent times.

Continued at link.

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The GHA's former Head of Clinical Governance, Dr Derek Burke, has withdrawn his claim against the Health Authority; the Medical Director, Dr Krishna Rawal, and Health Minister, Samantha Sacramento. The claim at the Employment Tribunal was dismissed following the withdrawal.

Dr Burke had been critical of the GHA in emails to his former colleagues there, where he denounced the Health Authority for what he said was an inadequate response to concerns raised.

The GHA had begun proceedings against Dr Burke, which has resulted in the Supreme Court granting an injunctive order against him - preventing him from disclosing any further information from his tenure in the GHA at the risk of being imprisoned or fined.

In an agreed statement published by the Government, Dr Burke has now said that the GHA has set its compass in the right direction, and is on a journey that will benefit the health and wellbeing of the people of Gibraltar.

Continued at the link.

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Written by YGTV Team on 15 October 2021.

The GSD has said that Professor Burke has not withdrawn the truth of his original allegations.

A statement continued: “He may have withdrawn his employment case against the Government but the undeniable fact is that his central complaint that there were systemic issues in GHA that were affecting patient safety and causing preventable harm and death has not been withdrawn. The “agreed” statement is a whitewash plainly entered into after pressure was brought to bear.

“Nothing in the agreed statement addresses the systemic issues at the heart of his 2020 complaints on harm and death. Only an independent investigation on those issues will properly shed light on these serious issues which the public are entitled to have clarified.

“What has actually happened is that the Government has brought pressure to bear on him on the side issue of disclosure of information and forced him to withdraw. This does not affect the issue of the truth of his original allegations or the need for an independent investigation and clinical governance audit of the GHA arising from the issues kicked up by those allegations.”

Leader of the Opposition, Keith Azopardi said: “There is clearly more than meets the eye on the Burke proceedings withdrawal and the Government cannot airbrush away the widely disseminated allegations of systemic failures, patient harm and preventable death. Indeed the Government has now felt able to explain in detail what it is doing and what it says it was committed to do since they received his Report in 2020. That’s as good as saying the allegations must have been true. They did not do so when questioned in Parliament. If they were doing all these things why could they not have said so in Parliament when the GSD raised questions in May 2021? In fact they then disparaged Professor Burke as a charlatan and dismissed his allegations. Is this a recent repackaging of events? The GHA is one of our most important institutions. We all want it to succeed but the Government need to take criticism of systemic failure seriously. Brushing things under the carpet or trashing those who speak out is not the right way to do things.

“Besides it will not be lost on people that the thrust of the “agreed statement” is that the Government is now saying it is dealing with issues brought up by Professor Burke when only a few months ago the Chief Minister misled Parliament by saying there was no shred of evidence on the allegations being made by Professor Burke. It needs to decide which it is. Is it that the allegations were untrue as they said in Parliament or is it that they were true and that they are now dealing with it in accordance with Professor Burke’s report of 2020 to which the Chief Minister is now saying he was committed all along.

“What has really happened here? Has Professor Burke been threatened with the full might of the legal resources of Government as it has previously to silence other critics? Are we seriously being asked to believe that Professor Burke wrote the line that he was worried about the issue being “party-political.” That line can only have come from the pen of the Government which wants to stifle political debate on the truth of these matters. This is a Government that introduced whistle-blowers legislation but when a senior doctor blows the whistle on the way the GHA is run its instinct is to silence criticism. It should, instead, hold an independent investigation to deal with the allegations and allay public concerns. The reality is Professor Burke was sued. When faced with a Government which has the attitude that money is no object in silencing its critics it is not surprising that he would cave in.

“It is completely lacking in credibility to present a statement in which Professor Burke praises the Minister who he now says he worked well with when only a few weeks ago (in an email dated 6 September 2021) he said he only met the Minister for 30 minutes in December 2020, that the Government never took up the offer of a presentation on patient safety and that the Minister “did not discuss my patient safety concerns with me between my email [of October 2020]...and the statement to Parliament on 19 May 2021.” In Parliament the Chief Minister denied the truth of the original allegations and misled Parliament by implying he had not received any material to substantiate the claims.”

Mr Azopardi added: “This is akin to a condemned man signing any piece of paper with a gun to his head. The Government cannot audit and congratulate itself on dealing with the systemic issues. Confidence will not be restored until there is an independent external audit. This self-congratulatory statement is a monument to a rewriting of the truth of what happened and does not affect the original allegations which have not been withdrawn.

“No one believes this is a conversion on the road to Damascus by someone who was ill at the time and missed the departmental memo.”