Dr Narinder Kapur

Dr Narinder Kapur, a consultant neuropsychologist was Head of Neuropsychology at Addenbrooke’s Hospital, Cambridge. Both prior to Cambridge (at Southampton General Hospital) and after Cambridge (at University College London, Leeds Teaching Hospitals NHS Trust, Hurstwood Park Neurosciences Centre in Sussex, etc), he had an exemplary record of working relationships with clinical or management colleagues, junior staff and students. He is past-President of the British Neuropsychological Society and a fellow of the British Psychological Society. In 2017, he was awarded a Lifetime Achievement Award by the British Psychological Society. He set up the Neuropsychology International Fellowship scheme, sponsored by both societies, which enables Neuropsychologists from developing countries to visit the UK. He is currently visiting Professor of Neuropsychology at University College London, and honorary consultant Neuropsychologist at Imperial College Healthcare NHS Trust.

Dr Kapur had won awards for the clinical excellence of his work at Addenbrooke’s hospital, part of Cambridge University Hospitals NHS Foundation Trust, and had published an award-winning paper entitled, On the Pursuit of Clinical Excellence in the same year that he was subject to an unfair dismissal. He had edited an award-winning book, The Paradoxical Brain. He had published papers on patient safety and on clinical ethics. He wrote an article on the lessons to be learned from the Francis Report into Mid-Staffordshire Hospital, and this article was published in The Psychologist, the professional journal of the British Psychological Society (Article). He has written papers on the application of Gandhian principles in healthcare (HSJ Gandhi article, BMJ Gandhi article), and has put these into practice by setting up Gandhi scholarship schemes and Gandhi book fairs (Supporting Neuropsychology in India). He had won a prize in Addenbrooke’s own Staff Suggestions Scheme, a prize he donated to Addenbrooke’s overseas charity. Even the Trust acknowledged that his clinical performance was, in its own words, ‘exemplary’, and that he had shown great generosity to patients and to staff. He had received scores of letters of appreciation and support from colleagues and from patients, including a heartfelt letter of support from his junior staff (Letter).

In his spare time, and without any remuneration, he agreed to become a member of the surgical incidents review committee which meets at the Royal College of Surgeons (CORESS – Confidential Reporting System in Surgery). He is the human factors / psychology advisor to that committee, and has published two articles emanating from that work (www.coress.org.uk)

While at work, on 13 separate occasions over a space of seven years, Dr Kapur had repeatedly complained about the use of unqualified staff in neurosciences clinics that he argued was endangering patient care and about staff shortages which he constantly had to face during his seven years at Addenbrooke’s, and which he also felt were endangering patient care. An internal report commissioned by the Trust later found Dr Kapur’s concerns about the use of unqualified staff to be justified, and recommended that this practice be stopped, which eventually happened, but only after a number of years. In its 2013 Remedy Hearing judgment, the Employment Tribunal noted that the unqualified staff member in question ‘was now being supervised in line with the recommendations of the internal inquiry that had agreed with Dr Kapur’s professional stance on the matter’. Expert advice that supported some of Dr Kapur’s concerns was covered up and kept secret from him by NHS managers, and was also not revealed by the then Divisional Director Professor John Pickard to the panel at his dismissal and appeal hearings. The Trust dismissing officer, Richard Howe, later indicated in court that he should have been told of this advice at the time. In the case of harm caused by the use of unqualified staff, there was a particular patient who only had a mild head injury, and who was told by the unqualified staff that he had suffered a severe brain injury. He then travelled the world looking for a cure for his brain injury. Dr Kapur had to see him and educate him about his false belief. There are published brain injury papers on the harm associated with this phenomenon, called ‘diagnosis threat’.

It was the clinical director of the clinics, Professor John Pickard, who was behind the use of unqualified staff,  and he played a key role in my dismissal. He has since retired and got a CBE!

Another person who played a key role was Prof Peter Hutchinson, consultant neurosurgeon who still works at Addenbrooke’s. His wife, Libby Hutchinson, worked as a nurse in neurosciences, and he helped her write a letter which was a complete lie about me. She effectively later had to withdraw the letter, and did not have the guts to appear at my Employment Tribunal hearing…her husband did appear, and when there he admitted to helping her write the letter.

While Dr Kapur was away in Ireland in July 2005 giving a paper at a conference, the neurosciences manager, Mrs Kathy Haynes, who was directly accountable to and worked very closely with Professor Pickard, searched his office and hacked his computer, without Dr Kapur’s knowledge or consent. Professor Pickard later claimed he knew nothing about this violation when it happened, something which many would regard as quite implausible. This action by Mrs Haynes, which may have been illegal, was covered up and kept secret for over six years, when it only came to light in documents required to be released for an employment tribunal hearing. The tribunal viewed this action by Addenbrooke’s managers as ‘entirely contemptible’. From the very early stages other attempts were made to discredit Dr Kapur. In 2005, the then divisional director Professor John Pickard tried to get Dr Kapur to admit that he had a mental illness and should seek assessment by Occupational Health. The then neurosciences manager, Mrs Kathy Haynes, the person who searched Dr Kapur’s office and hacked his computer, tried to suggest that Dr Kapur suffered from Asperger’s Syndrome. Dr Kapur considered these insinuations to be malicious, and to be both hurtful and distressing.

A junior psychologist who worked in Dr Kapur’s department, Dr Annette Farrant, who had previously worked as a professional actress, made what turned out to be false and malicious allegations about Dr Kapur to the then clinical services director, Professor John Pickard, who appeared to be gullible enough to swallow whole what she fabricated. Dr Farrant never put her allegations in writing, and she was not called by the Trust to present her complaints to any of the Trust hearings or employment tribunal hearing. As indicated above, a nurse who worked in the Neurosciences Unit at Addenbrooke’s, Mrs Elisabeth Hutchinson, husband of the consultant neurosurgeon Peter Hutchinson, also made what turned out to be false and malicious allegations about Dr Kapur. She put them in writing, but was effectively forced to withdraw them when the Trust told her it would not pursue her allegations. She was never obliged by the Trust to apologise for her hurtful remarks.  The absence of these key witnesses at the employment tribunal hearing is all the more extraordinary as Professor Pickard and his management colleagues relied so heavily on them for their criticisms of Dr Kapur. At the employment tribunal, Professor Pickard also lied when he told the court that he had invited Dr Kapur around to his home. When, in his various statements, he claimed that he could not remember key events, this seemed implausible and also raised the question of his truthfulness.

Dr Kapur felt that he was bullied or excluded after he repeatedly raised concerns, and also felt that lies were told or the truth was distorted in order to cover up for this bullying. On one particularly distressful occasion where Dr Kapur felt he was being bullied by the divisional director Professor John Pickard, who shouted and screamed at him, the other witness present – Mrs Kathy Haynes – thought Professor Pickard was so out of control that he was going to have a heart attack. At the employment tribunal hearing, one of Professor Pickard’s former colleagues in Southampton, a senior consultant neurologist (Dr Lee Illis) recounted an almost identical episode that happened to him at the hands of Professor Pickard when Professor Pickard worked in Southampton. Another former colleague in Southampton, the late Mr Jason Brice, who in fact was a key person in the panel who appointed Professor Pickard to his post there, recounted how when Mr Brice pointed out to Professor Pickard that his infection rates after surgery were higher than those of other neurosurgeons, Professor Pickard became very irate at being told this. Professor Pickard reportedly also tried to bully senior colleagues in his Cambridge research team, and one of the senior members of his research team – Professor Adrian Owen – told Dr Kapur that he thought Professor Pickard was ‘an evil, evil man’. Professor Owen initially promised to Dr Kapur that he would readily testify at any court hearing, but he later withdrew that promise, stating that he had grants and publications with Professor Pickard, and that he did not wish to compromise those. Narinder Kapur was very disappointed at the reversal of his decision. Professor Michael Kopelman also let down Narinder Kapur by agreeing to writing a witness statement and give evidence in person, but then deciding at the last minute not to attend the hearing. When Dr Kapur first raised concerns about John Pickard to the Head of Neurosciences, Professor Alastair Compston, the latter said, ‘You are not the first person to raise concerns about him‘. A consultant stroke physician at Addenbrooke’s, Dr Elizabeth Warburton, also indicated to Dr Kapur that on occasions she felt under inappropriate pressure by some of Professor Pickard’s behaviour. On another occasion, a junior female research assistant felt distressed after being rebuked on the phone by Professor Pickard. In some people’s eyes, Professor Pickard was a ‘serial bully’ who was able to use his power and influence to get away with unacceptable behaviours. The fact that, after considering elements of Dr Kapur’s concerns, including those of bullying, an Independent Mediator awarded Dr Kapur £20,000 and also his full legal costs, confirms that he was fully justified in considering he had been very badly treated. Although one of the Addenbrooke’s managers, Kathy Haynes, was obliged by the then Operations Director, Richard Sunley to apologise to Dr Kapur, when Mr Sunley met up with Professor Pickard in person and asked him to also apologise to Dr Kapur, Professor Pickard reportedly got angry, and in a threatening manner insisted to Mr Sunley that he would never ever apologise to Dr Kapur.

The Trust repeatedly declined to follow line management guidelines from Dr Kapur’s professional body, The British Psychological Society, and ignored the advice of its own commissioned review that called for a ‘radical overhaul’ of management. This lack of respect was also evident at both his dismissal and appeal hearings, where no-one independent of the Trust was on either panel, and where senior management refused to have on the panel experts in Dr Kapur’s field, Neuropsychology, with the then medical director and appeal hearing chair Dr Ahluwalia claiming such expert peer input was “not necessary”, even though this is standard practice for medical consultants, for bodies such as the General Medical Council and the Health Care Professions Council, and always occurs for consultant appointment panels. Where patient safety concerns are raised, it is also common practice to have an external ‘college review’, with experts brought in from a relevant professional body, but no attempt was made to carry out such a measure in respect of Dr Kapur’s genuine patient safety concerns. Pleas for independent, external advice and input were repeatedly ignored or belittled.

The dismissal panel in Dr Kapur’s case consisted of one person, RIchard Howe, along with a note-taker from human resources. Richard Howe was an engineer who had no clinical qualifications and had never run a clinical service in his life. Mr Howe insisted that attending management meetings was more important than engaging in clinical activities related to patient care, and criticised Dr Kapur for arguing otherwise. At the end of the dismissal hearing, which Mr Howe later claimed was fair and at which he had not yet made up his mind, he winked at the union official who was present as if to indicate the likely outcome and presumably thus to do some sort of deal which would involve Dr Kapur resigning, signing a compromise agreement and accepting what would in effect have amounted to a ‘bribe’ to stay quiet. The Employment Tribunal ruled that aspects of the hearings resembled ‘a show trial’, gave ‘a pronounced advantage to management side witnesses’, and produced evidence that was ‘forensically meaningless’. It also ruled that in not properly exploring alternatives to dismissal Addenbrooke’s did ‘not conduct itself as a reasonable employer’.

The Trust used a legal loophole, ‘Some Other Substantial Reason’ (SOSR), to dismiss Dr Kapur. SOSR is used to dismiss staff where competence and conduct are beyond reproach, but where something such as a breakdown in relationships with a manager is alleged. It has now effectively been outlawed in the NHS following a 2019 circular from the NHS Chief People Officer to professional and regulatory bodies.

In his 2015 inquiry into Whistleblowing in the NHS, Sir Robert Francis heard that some disciplinary hearings are little more than one-sided kangaroo courts: “Repeatedly we hear of unaccountable managers protecting themselves and undertaking biased investigations, character assassination, lengthy suspensions, disciplinary hearings which resemble kangaroo courts, and ultimately dismissal of staff who previously had exemplary work records . . .” This closely mirrors what Dr Kapur suffered.

After he was dismissed, Addenbrooke’s managers such as Kathy Haynes set about ‘digging for dirt’ and tried to find evidence of financial impropriety, attempts that failed and in fact brought to light Dr Kapur’s generosity and willingness to put the needs of his NHS Department before personal gain during his period at Addenbrooke’s. This action by Addenbrooke’s to raise allegations of fraud was ‘condemned unreservedly’ by the tribunal, and termed ‘a most unsavoury incident’. The Trust also contrived allegations of bullying, which Dr Kapur found particularly distressing, as he had gone out of his way to ensure excellent working relationships with junior staff and senior colleagues alike. Dr Kapur considered such allegations from Addenbrooke’s management to be wholly false and seriously defamatory. In another unsavoury incident, Richard Howe was directly observed by Dr Kapur to have been in uncontrollable, hysterical giggles in the gents’ toilets at Addenbrooke’s shortly after hearing remarks from one of Dr Kapur’s witnesses at his appeal hearing, Dr Lee Illis, who compared some of Addenbrooke’s management procedures to those used in Stalinist Russia.

The tribunal described Dr Kapur, who is a former Rotarian and who has donated royalties from all his books to healthcare charities in India (India charity), as ‘a gentleman of the highest integrity‘. Sir David Nicholson, Chief Executive of NHS England, indicated in a letter he wrote to Dr Kapur in March 2013 that ‘the actions taken by the Trust were unacceptable‘.

When Dr Kapur decided to take the case to an employment tribunal, Addenbrooke’s offered £70,000 for him to drop his legal case, and Dr Kapur was also made aware of the legal threat of major costs being awarded against him if he pursued with the employment tribunal hearing. Dr Kapur regarded these approaches as bribes and threats, and as an attempt to avoid accountability in the public domain, and refused to give in to the demands.

As a result of his dismissal, Dr Kapur and his family have suffered major distress and hardship. As well as losing out on over four years’ salary, he incurred around £250,000 in legal and related expenses, with an overall schedule of loss amounting to over £1million, and he had to sell his home in Southampton, ‘downsize’ and move to London. The Trust itself has spent around £300,000 of public funds and taxpayers’ money in fighting this case. All of this expenditure could have been avoided if professional guidelines and expert advice had been followed by those in management. ‘I drew inspiration from Gandhian principles and from others who had suffered hardship and been through terrible ordeals, and one of those was Dr Karen Woo, a UCL-trained doctor who was killed by terrorists in Afghanistan in 2010 while providing medical care to the poor and needy. As a thanks for the inspiration I gained from her example, in May 2013 I made a £3000 donation to the Foundation set up by her mother, Lynn Woo‘ (Karen Woo Donation). I also drew inspiration from three others who sacrificed their lives as part of their journey to make the world a better place, Shabaz Bhatti, Ursula Schmitz and Maria Gorrostieta (Shabaz Bhatti, Ursula Schmitz, Maria Gorrostieta). In my clinical practice and clinical research, I have also come across inspiring case stories, stories which helped to keep me resilient in the face of distress and suffering. One story that has particularly moved me, and helped me see my own predicament in context, is that described by Dr Ian Carr when his daughter fell ill (Dr Carr article).

Prior to a Remedy Hearing in April 2013, Dr Kapur was threatened by Addenbrooke’s lawyers with over £100,000 in Costs if he did not agree to an out-of-court settlement. Dr Kapur regarded this as a form of bullying, and ignored the threat. At the Remedy Hearing, Dr Kapur offered to drop the case and reach an out-of-court settlement if Addenbrooke’s introduced fairer PIE disciplinary procedures, namely Plurality (more than one member on a panel), Independence and Expertise, but Addenbrooke’s rejected this offer. These PIE principles have now been recommended by NHS England for adoption by HR directors across the NHS, and circulars to that effect have gone out from the NHS Chief People Officer.

Addenbrooke’s indicated that they had no intention of filling his post, effectively abolishing it. This was seen by Dr Kapur and others as a ploy to make it difficult for the judge to recommend his reinstatement. Both Dr Kapur and eminent colleagues in the field of Neuropsychology issued a letter of concern that such a decision would be detrimental to patient care, to the needs of staff, to teaching & research, and to the reputation of Addenbrooke’s (Letter of Concern). This further instance of disregard for professional standards and refusal to listen to expert professional advice parallels similar behaviour by the Trust when Dr Kapur raised concerns about patient safety during his employment, and provides further justification for his case that he was treated badly as a whistleblower. Even though Dr Kapur did not consider the criticisms of him to be justified, he offered to go back to his previous job on a probationary basis, but this offer was flatly refused by Addenbrooke’s.

For a more detailed account of Dr Kapur’s case, the reader is referred to this article