Govt faces call for inquiry after senior GHA doctor warns ‘collapse’ of healthcare management puts patients at risk

The former Head of Clinical Governance at the Gibraltar Health Authority, Professor Derek Burke, has raised serious concerns about the “collapse” of healthcare management in Gibraltar, which he said was putting patient safety at risk.

In a damning email to doctors first reported by GBC on Wednesday evening, Prof Burke reacted to concerns voiced by healthcare professionals about patient safety arising from decisions being made “at governmental level”.

He acknowledged that there were “a number of such patient safety issues currently in the GHA”.

“Some are leading directly to harm or preventable death now but for others harm resulting from the issue is either not imminent or it is difficult to relate specific harm events to a specific patient safety issue,” he wrote in the email, a copy of which has been seen by the Chronicle.

Prof Burke said there was a “conflict” between doctors’ contractual obligations to the Gibraltar Government as civil servants and their professional duty to highlight issues that impacted on patient safety, suggesting doctors were being prevented from speaking out.

He urged doctors to continue formally raising concerns but warned of a “toxic environment” which he alleged could lead to retribution from a “viciously vindictive and petty minded…cabal senior members of the government and civil service”.

Prof Burke, whose contract ended last month after four years in the post and has not been renewed, has now filed claims in the Employment Tribunal against the GHA.

The Gibraltar Government said it would “strenuously” defend the claims and Dr Burke’s decision to file them.

“The claims made by Dr Burke contain allegations against the GHA as an organisation and against individual medical professionals that are therefore sub judice,” a spokesman for No.6 Convent Place said.

“The GHA will therefore not comment further in relation to any matter raised by David [sic] Burke other than to say that the GHA will be strenuously defending the claims made by him and his right to bring them.”

But the contents of the email, which echoed earlier allegations raised by Prof Burke in separate internal correspondence and other forums, drew immediate reaction from the Opposition, which said the government could not “brush them aside” and had a duty to respond openly in order the ensure public confidence in the GHA.

The GSD called for an expedited independent investigation to assure the public that the matter was being dealt with seriously and transparently.

“Irrespective of the outcome of the legal proceedings brought by Dr Burke the immediate priority must be providing the public with reassurance that there is no risk to patient safety,” said GSD MP Elliott Phillips.
 
“Whilst the matter is before the courts the disclosure by Dr Burke is not new as he made similar allegations back in November 2020 which the Government appears to have dealt with internally.”

“The GSD Opposition also heavily questioned the Chief Minister and the Minister for Health earlier in the year to try to ascertain what the Government were doing about the serious concerns being expressed.”

“I said at the budget that there is a crisis in the GHA which the Government clearly is failing to address and that ultimately responsibility rests entirely with the Government.”

“The Government must act now and provide leadership at this critical time by offering all the support that is necessary to those working in the GHA and importantly reassuring the public that the management structure is robust.”

“This can now only happen with the reassurance of a full and independent investigation.”

Together Gibraltar also demanded an urgent inquiry and said it was “extremely concerned” about the contents of the leaked email.

“These words, coming from a doctor in a position of great responsibility, simply cannot be ignored,” the party said in a statement.

“These accusations, which will certainly ring true to those who have had the courage to expose bad practices within ministries or the civil service, should be more than enough to spur an urgent and in-depth inquiry into the issue of patient safety in the years leading up to Dr Burke’s dismissal."

“In this inquiry, all relevant staff should be allowed to give open and free testimony and protected from any form of retribution, as is supposed to be the case due to their commitment to the General Medical Council of the UK, the entity that protects patient safety standards across the UK.”

“Doctors and medical professionals who violate the codes of the GMC risk getting struck off and prevented from professional practice in the entire UK, yet doctors in Gibraltar appear to be being silenced by inadequately using legislation such as the Official Secrets Act.”

TG asked who was now the Clinical Governance Lead at the GHA and what measures were in place to guarantee patient safety standards and avoid preventable harm and death.

The party said Gibraltar needed healthcare services to operate efficiently and transparently to guarantee that mistakes were acknowledged and processes improved. 

“The information included in the leaked email from Dr. Burke, if true, amounts to a scandal of unprecedented proportions that should have serious political consequences,” the party said.

“It is for this reason that this inquiry must be urgent, strict and thorough.”

Last night No.6 Convent Place said the Opposition was asking the government to do what it was already doing, adding that every allegation made by Prof Burke was being investigated.

“That does not change the fact that Dr Burke is suing the GHA, and the GHA and the government will therefore not comment publicly on the allegations or the claims made by Dr Burke,” it said in a statement.

“The government owes an obligation to the course of justice and to Dr Burke to ensure that any reaction or comment is made strictly in the ambit of the tribunal in which Dr Burke has made his claims.”

“Any clinical matters, including any necessary investigations, will be addressed within the clinical governance mechanisms within the GHA.”

“Public comment at this stage serves no purpose other than party political expediency [and] this matter is too serious for party politics to be involved.”

Pressed by the Chronicle on the serious issues raised by Prof Burke in his email and the Opposition’s call for in inquiry, Chief Minister Fabian Picardo insisted the GHA was acting properly in response.

“No one is saying there is nothing wrong in the GHA, not least because of Covid but not just because of Covid,” he told this newspaper.

“The answers this community needs do not lie in leaked letters or exchanges of press releases.”

“They lie in the hard work that is being done to address the issues we face.”

“The public can have confidence in the GHA and the professionals who make it up and in the work being done in those areas that require it.”

“That is the challenge on which we should concentrate.”

Read full analysis here.