Staff were scared to raise concerns over patients, whistleblower tells inquiry

A whistleblower who raised concerns about infection control at a superhospital said staff were terrified due to a “culture of bullying”, the Scottish Hospitals Inquiry has heard.

The inquiry is investigating the construction of the Queen Elizabeth University Hospital (QEUH) campus in Glasgow, which includes the Royal Hospital for Children.

It was launched in the wake of deaths linked to infections, including that of 10-year-old Milly Main.

Dr Penelope Redding worked as an infection control doctor until 2008 and was involved in the preliminary planning for the QEUH, which opened in 2015, and acted as a whistleblower before she stepped down as a consultant microbiologist in 2018.

There were a lot of occasions concerns had been raised but the reports were never really shared

The former clinical director for diagnostics at NHS Greater Glasgow and Clyde (NHSGGC) told the inquiry her opinion was sought at QEUH after it opened, amid concerns it had “three air changes per hour” – rather than six – and that she urged for expert advice to be sought.

Dr Redding said she believed “problems” began after the Vale of Leven Hospital inquiry report in 2014, which addressed outbreaks of Clostridium difficile (C. diff) in the Vale of Leven Hospital in Dumbarton , West Dunbartonshire , in 2007.

She said: “There were a lot of occasions concerns had been raised but the reports were never really shared.”

She cited changes to management structures as a result of the report and said she believed in “teamwork”, and was concerned that infection control nurses may be making “autonomous” decisions without having sufficient expertise, the inquiry heard.

Dr Redding criticised “a culture of not putting things in writing, in emails, not putting things in minutes, an atmosphere of intimidation and bullying” within the NHS, and said she felt able to support staff due to her own experience of management, and as she was approaching retirement.

She said ventilation concerns had been raised when the QEUH opened, but she could not recall water infection being discussed in 2016.

In September 2017, she emailed from a holiday in Vienna, to call for an urgent meeting – which was arranged at 8am during her annual leave, the inquiry heard.

She agreed that her attitude was to “slavishly follow the guidelines”, and said: “Why would you deviate from the guidelines?”

Giving evidence, she was critical of a decision to close an orthopaedics ward after the Vale of Leven report, and said it took “45 seconds” to establish there was no “outbreak” based on her experiences as a microbiologist by looking at test results.

She said it was “ridiculous” that doctors were saying they were “too scared” to work and called for a “common sense” approach.

Dr Redding said: “For me, it was quite simple that it was not an outbreak. I don’t know if a microbiologist didn’t sit down or look at results. My feeling is that infection control is moving towards autonomous working and decisions are being made without infection control doctors.

“There are certain times you need to have input with microbiologists.”

She added: “Wards had been shut, patients weren’t allowed to go home, which was ridiculous; doctors were saying they were too scared to go on the wards, which again is ridiculous. I said, ‘this isn’t an outbreak’.”

She said there was a “culture of bullying” within the NHS trust, and condemned working practices – alleging meetings were held with instructions that no minutes should be taken, and that she urged staff to put concerns in writing so there was a record.

Dr Redding said: “My view was that if you’ve not put it in writing, if anything arises in the future, people will deny that they have been told. You have a responsibility to patients – you take an oath that if you have any concerns harm could come to patients, you have a duty to record it.”

She told the inquiry “personal bullying” – including shouting and criticisms – meant “people were terrified of speaking up”, and would be “challenged”.

Counsel for the inquiry, Fred Mackintosh, said: “Some of the people doing things you didn’t approve of would have been younger than you?”

Dr Redding said: “It was a culture of bullying. Right from the top, all the way down.”

Mr Mackintosh said: “You’re saying that in a public inquiry. Why should we accept that this is something you have seen?”

Dr Redding said: “I ended up being involved because people were afraid to speak up. The whistleblowers were very much criticised. People forget what we were doing was not expressing just our own views, but views of very senior, experienced colleagues.

“In the end, whistleblowers were very careful about not mentioning people’s names. We only put forward information which we had evidence to support. We felt from our credibility point of view, we wanted to be sure what we said was supported by evidence.”

She said that she called for an external expert to be brought in, and that a document from 2015, titled Informal Review of Infection Control Issues, was never shared with her.

Dr Redding said: “There were a lot of occasions concerns had been raised but the reports were never really shared.”

Mr Mackintosh said: “Should there be another way which doesn’t rely on the serendipity of a senior former manager being willing to listen and pass on messages?”

Dr Redding said: “These people would have been reporting through their management structure. I had to be sure all that was being done.”

Dr Redding said she was accused of “harassment” due to sending emails.

She told the inquiry: “We tried to get information, we said there were new problems, asked what is happening. I was accused of harassing people for sending emails.”

She said that “repeated concerns” were raised by microbiologists and doctors in 2017 but “nothing seemed to be improving”.

In February 2018, “step two” of the whistleblowing process was launched, and Dr Redding wrote in an email, “the situation is actually getting worse”.

She told the inquiry a 27-point action plan had errors and inaccuracies in it.

Dr Redding said: “We were still raising problems. It says in one of my emails, “the situation is actually getting worse”. I can understand why you would want to ‘give us a chance to sort it out’ but there’s no evidence that is happening.

“There were errors in the action plan and inaccuracies in the action plan. We never saw any amendments. I would have thought it would be a sensible thing to do to meet with us and say, “here’s the minutes, here’s the action plan”.”

She met then-shadow health secretary, Anas Sarwar, to raise concerns that the ventilation did not meet the guidelines, and also met Health Secretary Jeane Freeman who set up the inquiry.

Mr Mackintosh said: “How do you respond to one of the submissions from NHS that going public meant, ‘false allegations against colleagues and the health board and publicising inaccurate information’?”

Dr Redding said: “I don’t believe we did anything we didn’t believe was true.”

The inquiry continues in front of Lord Brodie in Edinburgh.