Plea to doctor over gagging clauses
Thursday 10th October 2013, 2:42PM BST.
One of Britain’s leading children’s doctors has been asked to submit evidence to a parliamentary inquiry into gagging clauses, after controversy over the terms under which she left the renowned Great Ormond Street Hospital.
The House of Commons Public Accounts Committee issued the invitation to Dr Hilary Cass – now president of the Royal College of Paediatrics and Child Health – to make a formal submission about the 2010 “compromise agreement” under which she left the London hospital.
The invitation came after Conservative MP Stephen Barclay raised concerns about NHS payoff deals at a hearing of the committee in the House of Commons. Grilling head of the civil service Sir Bob Kerslake, Mr Barclay demanded to know whether it would be “acceptable” for a hospital to threaten a senior clinician that if the terms of a gagging clause were broken, they would be denied access to training which could help them care for dying children.
Without identifying any specific case, Mr Barclay said he was concerned about the handling of an agreement that might be drawn up by “a hospital, like Great Ormond Street”.
He queried whether the Government would approve “a compromise agreement which would threaten to withhold training from a senior clinician unless they abided by a gagging clause in that contract” and asked Sir Bob: “Would you think the position of anyone who agreed to the imposition of such a condition on a senior clinician, it would be tenable for them to retain their post?”
The North-East Cambridgeshire MP, who has been a prominent parliamentary critic of the use of gagging clauses to silence NHS whistle-blowers, told Sir Bob: “I am trying to clarify whether it is acceptable for a senior clinician to be threatened with training being withheld that would benefit patients, particularly if those patients are dying children, if they were to break the terms of a compromise agreement.”
Sir Bob declined to comment on individual payoff deals.
But he told the committee: “In general, you would not want to see those sorts of situation occur, of course not. I wouldn’t expect that in the negotiation of their settlement, they would seek to put unreasonable clauses in on the individuals concerned, of course not. In general terms, you would not want to have onerous requirements written into agreements.”
Speaking after the hearing, Mr Barclay said: “It would be a cause of grave concern if senior executives currently working in the NHS imposed gagging clauses on one of the country’s leading clinicians preventing her from speaking out about any patient issues relating to decisions taken by management and also making a condition of her compromise agreement the provision of training to that clinician.
“The effect of such a provision would be to deny facilities to patients simply as a punishment for a clinician speaking out. Clearly that would not be acceptable.”
In June this year, Dr Cass told The Guardian that she had signed a gagging clause because Great Ormond Street had made its support for her training in palliative care for children “conditional on me signing the agreement”.
The hospital said in a statement in June that it was “not correct” to suggest that the agreement prevented her from raising concerns about patient safety, adding that the grievances raised by Dr Cass “were unrelated to patient care and concerned the way she felt she had been treated by the Trust at the time”.
The exchange came as Public Accounts Committee chairwoman Margaret Hodge issued a call for transparency about large payouts made by the public sector to senior staff leaving their posts.
Ms Hodge said that the identities of all senior civil servants receiving payouts should be made public, along with the amount of cash they receive. And she said that new guidelines requiring Government departments and quangos to publish the number and size of payments they make should also apply to local government and to private contractors delivering public services, like A4e and Serco.
The Treasury’s director general of public spending, Sharon White, said that mandarins believed it would not be “practically enforcable” to require private companies to release details of payoffs, and that any attempt to do so might discourage them from bidding for Government contracts.
But committee member Richard Bacon told her: “They should expect to endure a higher degree of transparency as the concomitant of receiving this public money. If they don’t want it, they don’t have to take the money – though many of them live on nothing else.
“I don’t get the sense inside government that there is the view that – in the words of Lyndon Johnson – `we have got them by the balls and so the hearts and minds should follow’. You are putting the bread on their table. Without you, they would disappear, and I think you should start negotiating a little bit harder and understanding whose money it is you are dealing with.”
Sir Bob Kerslake said that Government would “expect” local authorities to follow its lead in being more transparent about payouts to departing staff. And he said if councils did not do this voluntarily, ministers have indicated they are ready to “explore other measures” to force them to do so.
Committee members voiced concern about cases detailed in a National Audit Office report earlier this week, in which public servants were given payoffs to leave despite allegations of poor performance or inappropriate behaviour. These included one case in which a quango overseen by the Department for Culture paid £16,000 to an individual found to have harassed members of staff.
MP Fiona Mactaggart warned that allowing such individuals to leave under a gagging clause could mean “colluding” with a bully or sexual predator to keep their behaviour secret, while Mr Barclay warned that it could lead to them “popping up elsewhere in the public sector to continue that behaviour”.