Karen Woo Donation

I made a £3000 donation to the Karen Woo Foundation, in honour of Karen’s Woo’s courage and determination.

Dr Karen Woo was a British doctor, who trained at University College London, and was tragically killed by militants in Afghanistan in August 2010. The team she was part of had taken a week to trek to the remote province of Nuristan where, over the course of 8 days they treated in excess of 1500 people for ophthalmic, dental and general medical problems. Some of those seeking medical assistance had walked for 3-4 days to the village of Parun, where the group had based itself, upon hearing that medics had arrived in the area. She strived to increase access to medical care for those in the country who need it most. The Karen Woo Foundation has been set up in her memory to continue the work that she started.

Karen Woo showed great courage and resilience to do what she did. I promised myself that when the time was right I would recognize my gratitude for the inspiration I drew from Karen in my own life and for the wonderful example she set.

Karen Woo’s mother, Lynn Woo, accepted the donation, in front of the statue of Mahatma Ghandi in Tavistock Square, on behalf of the Karen Woo Foundation. The funds will be used to increase access to desperately needed health care for women and children in Afghanistan.

More details about the Karen Woo Foundation can be found at – www.karenwoofoundation.org.

 

From my perspective, the main purpose of that occasion was to remember a brave, intelligent and kind-hearted young doctor whose life was tragically cut short in the most awful of circumstances.

When a tragedy like this happens, a whole family is shattered and their lives changed for ever…I also wanted people to remember Karen’s mother, father and two brothers and the courage that they have shown over the past few years.

The ceremony was in front of the statue of Mahatma Gandhi. There was a reason for this. Gandhi stood up against injustice. Injustice can be manifest in a number of ways…injustice in poverty and in health, which Karen Woo did so much to alleviate, but also injustice in other settings, such as in parts of the National Health Service. Both I and many other NHS staff have felt that injustice at first hand. We should therefore in the name of Gandhi strive to remove injustice so as to make the world a better place, and thus cherish the ideals that Karen Woo stood for.

Gandhi articles, trip to India

Following on from the successful Gandhi-NHS conference at the House of Commons in March 2013, I wrote two articles on applying Gandhian principles to the NHS. Although the articles overlap a little, they do have a different focus. One is published in the Health Service Journal (PDF File), and the other came out in the British Medical Journal (PDF File). They both came out around the same time in mid-April.

I spent the last 10 days in March and the first 10 days in April giving lectures and workshops in India, along with a couple of other Professors of Neuropsychology from the UK. We firstly had teaching sessions in Calcutta, and we next gave talks in Bangalore. The latter talks were in association with the World Federation of Neurology. Everything went very well, and I have helped to set up a Neuropsychology website in India to try and promote and develop my discipline in India (www.neuropsychologyindia.com).

I took this opportunity to do all I could to support and help my Indian Neuropsychology colleagues, especially when I found out how little they earn and the very limited resources that they have. Together with some charitable donations, I think I must have spent around £2000 in the process, but I regard it as my moral obligation to help them. As well as costs in funding the website, I donated a set of four Neuropsychology books/booklets to each of the six centres – Delhi, Calcutta, Chennai, Mumbai, Bangalore and Hyderabad. Here is a picture from one of the handing over ceremonies –

My brother, Dr Davinder Kapur, kindly funded bursaries for six students to help them attend the Calcutta meeting, and here is a picture from one of those donations, which I gave on his behalf –

I also experimented with an idea, which I have called ‘conference kindness’. Essentially, I took surplus Neuropsychology books (mine, and my friends’ books), sold them off very cheaply at the two meetings in Calcutta and Bangalore, and gave the proceeds to a local charity. In Calcutta, we raised around 40,000 Rupees (£500) and in Bangalore we raised around 25,000 Rupees (£312). The money raised in Calcutta was donated to the Acid Survivors Foundation of India –

I chose the Acid Survivors because when I looked at the facial disfigurement I myself have suffered with my skin problems associated with the stress I have been through since my dismissal, I thought this disfigurement is nothing compared to what the acid survivors have to endure – usually pretty young ladies who are severely scarred for life after having acid thrown in their faces.

The ‘conference kindness’ idea was great fun…on the way back from India, around 35,000 feet above sea level, I wrote an article about the idea, and when I got back I sent in the article to the British Medical Journal, who published it in their Blog piece in April (PDF File).

When I was in Calcutta I managed to do two other things I had always promised myself. Firstly, I visited the center where Mother Teresa of Calcutta worked. Her tomb is in the actual building. Secondly, not far from her place, is a school called the Jewish Girls School. Two 7-year old girls from that school tragically died in a terrorist train disaster in May 2010….When I have felt a bit low over the past few years, I have compared my own situation with their tragic situation (their parents also died in the disaster), and just making that comparison has helped to lift me out of my despair. I vowed that if I ever went to Calcutta I would visit the school and make a donation in memory of the two children. I donated a music synthesizer, which is what the school requested. This is the story behind that donation – PDF File.

November 6, 2012 update from A Better NHS


I recently found out about another unjust NHS unfair dismissal case, that of Debbie McCoy, and I have told her story on the Stories of NHS Staff page of my website. She worked as an art therapist in the north of England, felt herself bullied and harassed, with little allowance for her disability (dyslexia). The Tribunal was severely critical of the behaviour of certain managers in the Trust. Just as in so many other cases, Debbie did not have the financial resources to fight her case all the way and she had to settle for relatively limited compensation, and no recovery of her legal costs. Another thing she had to endure was hostile cross-examination during the Tribunal hearing. This is something that the legal profession needs to address in due course.

Hurricane Sandy upset the broadcast schedule of radio programmes on the East Coast of the USA at the end of October, which meant the postponement of the broadcast of my interview by the USA National Whistleblowing Centre.

I have made a number of additions to my website, and so it may be worth anyone having another look at it again. I am hoping to set up a fund to help healthcare professionals who have suffered distress, such as ill-treatment by NHS management, and there is a place to ‘register interest’ while the fund gets set up. Too many staff have just had to cave in because they could not afford the huge legal costs, whereas NHS managers seem to be able to spend whatever they like on legal expenses. This is disgracefully unfair.

On Nov 3-4, I attended the annual meeting of the British Association of Physicians of Indian Origin (BAPIO), which was held in London. The first day of the two-day meeting took place in a conference suite within the Wembley stadium. Eminent speakers talked about a range of topics, including the impact of the NHS reforms. Attending the meeting was the Indian Nobel Laureate, Sir Venkatraman Ramakrishnan, who works in Cambridge. He is a close friend of many BAPIO members. The phrase ‘pleasure and privilege’ is perhaps a bit of a cliché, but in this case for me it really was a pleasure and a privilege to be able to talk with him during the meeting. He is a truly inspirational and wonderful person – there was not a single person at the conference who was not moved by his presence on the day. He sat at our table for part of the meeting, and this is a photograph of him with me at the table.

At the BAPIO meeting, I met a number of kind and supportive Indian doctors. Out of the blue, when I was sitting at my table, a consultant neonatologist from Oxford came over and told me he had seen my website, and that he admired my campaign and sympathised with the distress and loss that I had suffered. It is moments like that help to give me the strength to keep me going.

It was clear from a number of speakers that the mid-Staffs Hospital Public Inquiry Report may well help to generate a number of changes in the NHS. One of the doctors at the BAPIO meeting, a medical director, mentioned how nine doctors have committed suicide after having been reported to the General Medical Council. That led to a comment by another Indian doctor that such suicides should be formally classified as ‘Never Events’ (a term usually retained for describing serious medical errors that should never have happened). It just so happened that I had made a similar proposal on the Towards A Better NHS page of my website. One could argue that if an NHS Trust or other NHS body is willfully negligent by wasting more than £100,000 on expenditure such as needless legal proceedings, this should also be classified as a ‘Never Event’.

Gandhi was mentioned several times on both days at the meeting. I have decided to make my Gandhi booklet freely available for download from my website, and you can see it here (Download booklet). It is essentially the same as the Cambridge Happiness Manual, but has 20 Gandhi quotes on the inside front page.

A piece of good news is that the other Indian consultant at Addenbrooke’s who was sacked around the same time as me, Dr Patrick Bose, won his case at a recent GMC hearing, and  this story was reported in the Cambridge Evening News (Download article). A correction to the published story is that the article states that he was ‘struck off’, but this is wrong and what it meant is that he was dismissed by management at Addenbrooke’s.

The case of Jimmy Savile has been in the news in the past few months. Although his case is very different in many ways to the wrongs in the NHS, there are a few similarities – suppression of news of alleged ill-deeds, the fact that generating lots of money somehow protected an individual from criticism, and the ‘system’ preventing the truth from being told – in his case elements of management in the BBC, and in the case of the NHS elements of NHS management.

One of the main challenges my colleagues and I face in our campaign is being able to stimulate and inspire others. There is a natural feeling – ‘What’s in it for me…Do I really want to take risks in getting involved?’ I trace this attitude back to ‘self-preservation’ instincts and people being worried about their self-image. On the front page of my website I have a picture of Edmund Burke, and his quote, The only thing necessary for the triumph of evil is for good men to do nothing. There is another, even stronger quote which I hesitate to mention, but here it is! It is by Dante Alighiere (1265-1321) who was apparently an Italian national epic poet. The darkest places in hell are reserved for those who maintain their neutrality in times of moral crisis.

Patient Safety, USA National Whistleblowing Centre

I decided to have a Patient Safety page on my website, so please have a look at this. Most of the articles are meant for health care professionals, but you may find some there of interest – e.g. there is an article by a medical student who compares safety measures when rock climbing with safety measures in clinical settings. The reasons I added a Patient Safety page were several – I have always been interested in how I can use my expertise and experience in Psychology to understand and improve the world around me. Thus, it is important to understand how doctors, nurses and others perform and behave in clinical settings. There is also a link between the culture of a hospital and patient safety – the quote on the front page of my website from the Harvard professor, Lucian Leape, sums it up well – A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect.

It so happened that around this time, Tuesday October 23, a Patient Safety meeting was organized by the Clinical Human Factors Group. This group was set up a few years ago by Martin Bromiley, an airline pilot whose wife sadly died as the result of medical mismanagement. He was appalled when he subsequently found out that simple safety measures, as are common in the airline industry, were not present in healthcare settings, and so he set about creating the Clinical Human Factors Group. It has done marvellous work over the years, and is influencing government thinking on patient safety, so hats off to Martin Bromiley for doing such a brilliant job! I had in fact been in touch with Martin a few years ago shortly after a radio programme was broadcast about his wife’s case, but with all the upheaval surrounding my dismissal I had not been in touch since then. I decided therefore to attend this meeting, partly out of my interest in patient safety and partly also to support the wonderful work that he and his colleagues are now doing.

It just so happened that the meeting was being held at my former workplace, Addenbrooke’s Hospital in Cambridge, so I had mixed feelings about going back there. As I walked through the hospital, some traumatic memories came back, but I mostly coped well. The opening address for the meeting was given by the medical director at Addenbrooke’s. He started by talking about recent ‘Never Events’ at Addenbrooke’s (‘very serious events that should never have happened’) and how Addenbrooke’s had lots of these events in recent years. He was quite apologetic about this, and I admired him for that.

The meeting itself was excellent, with lots of stimulating talks. There was one talk by Dr Nick Toff, advisor at Addenbrooke’s, who also happens to be a pilot, and he gave a very good overview of patient safety and Never Events. He has written an article comparing aviation safety and medical safety, and this is his paper (Download PDF File). At the meeting, there was an opportunity to have Poster Displays about patient safety, and I had a display on my Smart Papers diagnostic guidelines – this is my Poster Display (download PDF File).

At the meeting, the Clinical Human Factors Group produced a ‘Manifesto for Change’, which incorporated three programmes of action –

1. Human factors education and training

2. Building ‘high reliability’ organizations

3. Intelligent regulation and independent investigation

The third of these goals would address some of the management issues highlighted in this website.

The next day, Wednesday October 24, I gave a radio interview in response to a request from the USA National Whistleblowing Centre. That Centre has a weekly radio programme that is broadcast on an online radio channel, and they were interested to hear of my story, and in particular my hunger-strike. It is only when I described everything that I have gone through that I realised it brings back memories of unpleasant and traumatic events, and surprisingly I find it more upsetting when describing the events than I was when the events actually took place. I suppose there must be a good psychological explanation for this – I think at the time, you put yourself into ‘survival mode’ and shut-off any feelings you may have so that you cope as best you can, whereas when you look back, you have more time to reflect and are more aware of how traumatic and upsetting it all has been.

Doctors in Distress, Hubris Conference

It was only when I looked in detail at some of the pages on the website, www.doctorssupportgroup.com, that I realised there have been cases of suicide and cardiac illness in doctors that were probably directly or indirectly related to the stress that they suffered after being subject to investigations, suspension or dismissal. I repeat what I intimated earlier, namely that one cannot comment on the rights or wrongs of individual cases, and there are likely to be instances where doctors and other health professionals need to have action taken against them in the interests of patient safety, and even in their own interests. However, there are almost certainly cases of miscarriage of justice in many such instances, and that is a major focus of my campaign. I also at the same time came across some interesting articles, including one from the British Medical Journal in 2000 (Download BMJ article) that not only highlighted cases of distress and hardship in doctors who found themselves unjustly treated but also cited a campaign around that time by Baroness Jill Knight of the House of Lords to bring about some changes in the NHS system to make it fairer. So, what I am trying to achieve at the current time has echoes from a number of years ago.

I have found out that my Remedy Hearing will now take place in April 2013. At that hearing, the judge will decide whether to ask the employer to give me my job back, what compensation I might receive, and whether one side or the other has to pay Costs. It is of course disappointing that I will have to wait a full year from the time of my original employment tribunal hearing to find out all of this, but c’est la vie.

On Tuesday October 9, I attended a conference at the Royal Society of Medicine in London entitled, The Intoxication of Power: From Neuroscience to Hubris in Healthcare and Public Life. It was organized by Lord David Owen (who started his career as a doctor specialising in neurology) and his colleagues. It was an excellent meeting, and below you can see a photoshot that includes Lord Owen. Hubris generally refers to excessive pride and arrogance by those in power, usually with untoward consequences. For those of you who are interested, this is the seminal article on the subject by Lord Owen (Download hubris article). At the meeting, hubris was discussed in a number of domains of public life, including politics, healthcare, business and journalism. There were also scientific papers on how the concept of hubris related to concepts and findings in research on addiction, trust, and empathy. It was nice that Gandhi was mentioned by several speakers in the symposium. I was lucky enough to grab a few words with Lord Owen during the tea-break. I also managed to speak to my fellow Northern Irishman, Lord John Alderdice, who is both a politician and a psychiatrist by profession, and who was also a speaker at the meeting.

Symposium on Hubris at the Royal Society of Medicine, with Lord Owen at the lectern.

Day 5 of my hunger-strike

The last day…. and in the morning I did feel some lack of energy, but apart from that I was fine. I’ve lost around 5 Kilograms in weight, which is about par for that reported by other hunger-strikers – you usually lose 1 Kg a day. Today I had a journalist from a Japanese news agency and one from a UK-based Indian agency come to interview me. A Neuropsychology colleague from Cambridge visited, and he updated me on events there. Two policemen visited, but after a quick call to their HQ, which presumably told them I was harmless, they wished me well and went on their way.

One thing about a hunger-strike is that you will invariably get disturbed sleep, often because you are waking up in the night with thoughts on your mind as to things to prepare, how to deal with situations, etc. Both physically and mentally, I have been fairly pleased with how I have coped – I think the secret is both physical preparation (I had fasted for one day a week for the past few months) and mental preparation.

Mental preparation is the key. For me, as you can see from my earlier ‘What Inspires Me’ blog, I had many reasons for the hunger-strike that drove me. I also thank key organizations and individuals who have supported me. In the case of organizations, three stand out – the British Association of Physicians of Indian Origin, The British International Doctors Association and the British Indian Psychiatric Association. Gandhi’s words and actions were always with me this week, especially as it was his birth anniversary, but I was also inspired by Irish hunger-strikers and in particular by Terence MacSwiney. He was lots of things – a playwright, an accountant, a teacher with a degree in ‘Mental and Moral Science’, Mayor of Cork, and a devoted husband and father to his one year-old daughter. He went on hunger-strike in 1920, after being imprisoned by the British, and he died of starvation in October 1920. His story has been told many times, but a recent book by Dave Hannigan is worth reading, as is the book that MacSwiney himself wrote, Principles of Freedom, where he has an interesting chapter called Moral Force. MacSwiney inspired people such as Gandhi and Nehru in their freedom struggle in India, and in many ways he was ahead of his time. His sacrifice, in dying for his principles in spite of his having to leave behind his young wife and baby, is simply remarkable.

In the case of individuals who have helped me, these are too many to mention, but my long-standing colleague Dr Veronica Bradley has, as usual, been a gem. I needed computer support throughout, and Adam Sutcliffe has been invaluable. I was inspired and touched by the complete strangers who came along to my demonstration site and said how much they admired and supported what I was doing. Some of them must have travelled some distance to specially come to see me. Those visits almost brought me to tears. Last but not least, my wife Ritu has been marvellous. We had to take around six bulky items each day on the train, and she did this cheerfully. She also had to fend off calls from family members who asked all sorts of daft questions, such as – Are you supporting him?

I read that if you eat fruit it should if possible be on an empty stomach, so my first taste of food after five days was a banana, some raspberries, and later some lentil soup.

Since I lit a candle at the beginning of my hunger-strike, I thought I’d also light one at the end, with my statue of Gandhi to hand, sort of to thank him for the inspiration he has given me, and here is the photo of this.

Day 4 of my hunger-strike

Today was a dry, mostly sunny day, but it was on the cool side, and that made it a little less comfortable. I had a visit from a Neuropsychology student I had known from my Cambridge days, and who was doing a placement at St Thomas’ Hospital. It was good to see a familiar face, and I appreciated her coming to have a chat. A husband and wife couple, both doctors, also stopped by for a chat and were sympathetic and supportive. Another couple stopped by, and they told me that their daughter was a nurse working up north, had experienced problems with management in her workplace, and had asked them to pay me a visit and offer their support, which I thought was very nice.

I had the usual number of people asking me for directions, but the most hilarious visit was from a group of students who decided to ‘take the Mickey’ out of me. They made comments such has – You must be really wishing you were eating a delicious Kentucky Fried Chicken. So I had to firstly explain to them that I was a vegetarian….it was all good banter, and it lightened up my day.

My story has generated lots of on-line comments in Indian Newspapers, almost all positive and supportive, but there was one comment along the lines of – He deserves what he gets because he should be back in India treating patients there. I never reply to online comments, but I had to reply to this one, and to explain to him that I was only three years old when I came to this country and that I can barely speak a word of any Indian language, so I would probably be useless if I tried to work there!

I am still feeling fine, both physically in terms of any adverse side-effects on my health and psychologically in terms of my ability see this through to the end of Day 5.

This is a photo of me on Day 4.

Day 3 of my hunger-strike

My wife received frantic calls in the middle of the night from her family members in India (India is several hours ahead in time) as my story had hit the newspapers there. Since we had not told them in advance of my hunger-strike it was alarming news to them! With Gandhi’s birthday being yesterday, and with the fasting component of my protest, the media in India apparently picked up the story quickly from online sources. I therefore had three correspondents from India come today for interviews, two associated with a TV station and one with an Indian newspaper. A few freelance photographers also took shots of me. The photo below shows me on Day 3.

If I had the foresight and the enthusiasm of 19th century medical scientists I should have been recording some observations of my body’s reaction to the fasting, but alas I did not. So far, no discernible problems, though I do feel the cold a bit more, which apparently can happen, and I realise how pleasantly warm tube stations are. When returning from central London to head home, you instinctively think of and look forward to a cup of tea and food when you get back, so I have to suppress those thoughts!

I was curious as to the effects of prolonged starvation, and looked up the internet to see if any hunger-strikers had kept diaries. I saw one by a Palestinian prisoner, but the one that caught my eye was a diary kept by Bobby Sands, the Irish hunger striker, for the first 17 days of his hunger-strike in 1981. He began to notice some effects by day 5, but surprisingly by day 17 he was still in good spirits. I have the luxury of fasting while spending part of the time at home with some family support. He had to fast while in prison, and with prison officers as company – sadly, he was subject to cynical jokes from one or two of them, such as ‘You should best stick to reading short books, since you may not get to the end of longer ones’. I read Bobby Sand’s diary while returning by tube from a lecture on Gandhi in central London, and I was so absorbed by his diary that I missed my station stop!

As on the previous day, a few people stopped by to express sympathy and support, including a neuropsychologist from St Thomas’ Hospital who kindly paid me a visit. A lady doctor from the Soviet Union, who said she had fasted there, kindly advised me when coming off my fast to stick to vegetables and fluids, and to avoid dairy produce and meat.

Day 2 of my hunger-strike

I attended the conference on NHS whistleblowing that was organized by the British Medical Association and an organization, PatientsFIrst, that campaigns for whistleblowers. It was a packed meeting, with lots of stimulating talks and good discussion. This is a picture of the meeting.

 

Health wise, I am coping fine. I took flavoured water today, which was much better than plain water. It was not easy seeing all the delegates at the meeting have tea, biscuits and lunch, while I just took water!

 

My story appeared today (October 2) in the Cambridge Evening News, the London Evening Standard and Mail Online. In the afternoon, I gave a telephone interview to a local Cambridge radio station.

Since the conference was held at the British Medical Association headquarters, which is across the road from Tavistock Gardens, after the meeting I went to Gandhi’s statue in Tavistock Gardens. Today, Tuesday October 2, happens to be Gandhi’s birthday. As always happens on that day, people leave lots of flowers around his statue. The photograph below is of me in front of the statue, along with my poster.

What do I want the government to do?

There are some general things and some specific things that I would like the government to do.

At a general level, I would like them to be more aware that there are many miscarriages of justice in the NHS, often involving whistleblowers, but also other staff. They should carry out a listening exercise and talk to staff who have been wronged, they should gather the views of a wide range of clinical staff and managers, and they should look at scientific evidence and academic resources such as those on my website, www.abetternhs.com.

More specifically, I would like two things to happen –

Firstly, I ask that the Department of Health undertakes an urgent review of grievance, suspension, dismissal and appeal procedures in the NHS. They should draw up specific guidelines for these procedures to prevent ‘show trials’ and miscarriages of justice, and the terrible distress they cause, happening in the future. All dismissals of NHS staff in the past five years should be urgently reviewed by Trusts, with independent expert input, to decide if there have been instances of a miscarriage of justice. Some dismissals or suspensions may of course be fair and justifiable for reasons such as patient care. However, where suspensions or dismissals are deemed to have been unsatisfactory, appropriate action should be taken. Thus, for example, where dismissal of a staff member now appears to have been unsatisfactory, in appropriate cases such a dismissal should be downgraded to suspension on full pay pending the outcome of the Department of Health comprehensive review. In all cases where dismissed NHS staff have subsequently been cleared by a professional regulatory body, or by an employment tribunal or related legal authority, this downgrading should be automatic, and in some cases compensation should be offered to individuals who have suffered a miscarriage of justice.

Secondly, I ask that the Department of Health, in its response to the mid-Staffordshire Public Inquiry Report, which it will receive in January 2013, takes into full consideration specific proposals I have outlined on the ‘Towards a Better NHS’ page of my website, www.abetternhs.com

I of course hope that the Department of Health will show some flexibility and respond to my concerns, but if they do not, then I will have no option but to consider further, longer hunger-strikes. It is possible that other NHS employees might join me in any further hunger-strikes.