Whistleblowers reject Care Quality Commission's evidence as chief executive accused of conflict of interest
The public inquiry into the Mid Staffordshire hospital scandal has been reopened after two whistleblowers agreed to give evidence calling into question the "leadership, capability and culture" of the NHS regulator that oversees hospitals and care homes.
The inquiry, which had officially closed its evidence hearings, will hear on Monday from Kay Sheldon, a prominent psychiatrist on the board of the regulator, the Care Quality Commission, and Amanda Pollard, an investigator for the same group.
The commission is already the subject of an unprecedented investigation by the Department of Health over its performance. In September the prime minister endorsed a damning report on the commission by the health select committee, which accused the regulator of neglecting its core duty of scrutinising patient care in favour of bureaucratic "registration" of care providers.
Sheldon and Pollard have given signed witness statements to the inquiry that are critical of the performance of the watchdog's leadership. Both contradict evidence given to the inquiry by the regulator.
They have disputed, for example, claims that the disbanding of the commission's investigation team was a "collective board" decision, alleging it to have been a choice made by a small team led by the chief executive, Cynthia Bower.
Bower has declined to comment on "speculation" about the evidence.
Bower has been facing claims that as a regulator she "did not wish to criticise organisations" she had previously led herself. She was formerly chief executive of the NHS West Midlands' strategic health authority, where she was responsible for supervising the performance of Stafford hospital.
Pressure groups have called for Bower's resignation from the regulator because of this seeming conflict of interest.
A critical report is expected early next year from a public inquiry into the scandal at the hospital – where poor care led to hundreds of needless patient deaths between 2005 and 2008 – and the reasons why it went undetected for so long.
However, even more damaging claims have been made over the commission's most high-profile investigation into the private care company Take Care Now.
This firm had provided out-of-hours GPs to the NHS. It employed the German doctor Daniel Ubani, who accidentally give a 10-fold overdose of the painkiller diamorphine to David Gray, a Cambridgeshire patient he treated in 2008. It was Ubani's first UK shift and Gray died.
Take Care Now had contracts with two NHS regions: the East of England, and West Midlands strategic health authority.
It has emerged that the commission's investigators had raised concerns after being blocked from interviewing staff at the West Midlands health authority, and that this was communicated to Bower.
"I was concerned about the propriety of this, and CQC's governance, since Ms Bower had been chief executive of the [health authority] for much of the time covered by the investigation," Heather Wood, the commission's former chief investigator, told the public inquiry.
Wood's suspicion turned to dismay when she discovered that sections of the report on the private company, which outlined the role of the West Midlands health authority, had been deleted.
Gone were references into how the NHS authority did not have a "strategic vision" and claims that it ran up deficits that could affect care.
Another passage that had been removed concerned a West Midlands authority director not following up a letter of concern from the regulator because he "did not understand it".
Evidence to the public inquiry has claimed that "a possible explanation for diluting the thoroughly evidenced findings in the report was because the CQC did not wish to criticise an organisation that had recently been led by the CQC's chief executive".
Stuart Gray, a GP and a son of David Gray, said: "To hear that the report has basically been doctored is disgraceful and abhorrent. It beggars belief, because what is the point of having the CQC investigate to see what errors and mistakes have been made and should be corrected, if it is told to reduce the impact on the powers that are responsible for the overall running of the system?"
Gray said he and his brother, Rory, who lives in Germany, had met Wood and been in contact by email during her investigation. "She seemed reasonable and seemed to take things on board."
The Gray brothers approached the Guardian in April 2009 because they felt the authorities were not acting swiflty enough, an accusation that was denied because, it was said, there was a possibility of criminal charges against Ubani.
In the event Ubani pleaded guilty by letter to the German authorities. He admitted causing death by negligence and was given a nine-month suspended prison sentence and ordered to pay €5000 costs, thus scuppering possible extradition to the UK on a possible manslaughter charge.
A spokesperson for the Care Quality Commission said that an internal inquiry into the Take Care Now investigation had vindicated management. She added that there was "no evidence to substantiate any undue influence by persons within or outside CQC".