Workers’ Weekly Interview with Charlotte Monro:

Speaking Out in Defence of the NHS and Fighting to Safeguard Its Future

Charlotte Monro

WW: What was the climate behind your dismissal from Whipps Cross Hospital?

At the time of my dismissal, Whipps Cross Hospital was part of a newly merged NHS Trust. The management seemed to have no accountability to our local population served by my hospital Whipps Cross, or our patient organisations and other “stakeholders”. At the time, many people suspected an agenda to run down Whipps Cross hospital and centralise services in order to fund the massive PFI debt from the new buildings at the Royal London and Barts hospitals.

The disciplinary process was initiated against me two weeks ahead of the Trust’s being placed into financial turnaround with management consultants brought in to address a £77.5m deficit. As a senior union rep I found myself suspended from attending the meetings at which joint staff side union business was done with the Trust. A key plank for financial savings was the mass scale downbanding of nursing and other staff, and loss of posts, which has now proved so disastrous for the services at the hospital.

I was one of the senior union reps, from an active branch of UNISON, who would challenge issues with the Trust quite strongly and was vocal in raising concerns. I also had chaired the successful 2006-2008 campaign to save Whipps Cross Hospital.

WW: What do you think is the significance of your fight for staff in the health service and for the workers’ movement overall?

I think one of the most significant things is that it will help health workers and other trade union reps speak out. In my particular case, it was to speak out about cuts to health services that I knew were going on within the hospital and that were raised as concerns within the community. I spoke at a local council overview and scrutiny committee (OSC) for health about staff concerns about the impact of planned cuts to our stroke service in the hospital. That seems to have triggered the action against me which was started within six days. A key allegation was that I brought the Trust into disrepute by providing inaccurate information to the OSC, although they could not tell me what it was that was “inaccurate”. I had explained the concerns of the stroke specialist clinical staff. The local Save Our NHS campaign had asked me to address the councillors alongside them as a trade union rep involved with staff in the consultation. That was considered to be beyond the pale by my Trust. In the Tribunal, it became very clear through the evidence that I had given no inaccurate information, but rather I was simply giving a different opinion – the views and opinion of the staff as to the impact of the changes proposed.

I think this is a very important principle. I have often heard about campaigns at other hospitals where staff have been told that they are not allowed to talk to people or to campaigns from outside their trusts about what is going on in their hospital. I remember that last year when the 999 NHS march from Jarrow arrived in London, a number of midwives from Mid Staffs had planned to come and address the march, but, we heard, they were told by their Trust that they were not allowed to speak about the closure of their services at Mid Staffs. My case has clearly established that we have a right to speak about cuts to services and that is a matter of public interest. Barts NHS Health Trust eventually accepted in my case that my speaking at Scrutiny Committee amounted to a “protected disclosure”, and that speaking about cuts to health services would be in the public interest.

Behind that principle is that the health service is everybody’s business. I think it is very significant that I have been re-instated into my job because that is a very rare thing to happen. I have been told that out of 40,000 cases in a year only about five to ten people actually achieve re-instatement. In the recent Francis review “Freedom to speak up” in the NHS, which specifically dealt with problems of raising concerns, and the treatment of staff who have, one of the recommendations is that people dismissed where whistleblowing is involved should be re-instated if practical, i.e. if the person is capable of doing their job. It could be said therefore that my case is in a sense an early positive example and could set a precedent for others to follow as there are still many, many people whose lives have been destroyed by the attacks against them for having raised concerns about their health service. Those injustices need to be addressed from the point of view of whistleblowing and also from the point of view of health unions and health staff wanting to save services.

Another significant issue in my case was the attack on trade union rights. All of the allegations but one were related to my trade union work. The Trust was very aware that to dismiss an employee for trade union activity was illegal. So the Trust in making these allegations simply asserted that it was not about my trade union activities but that I was acting in a personal capacity. That a Trust, or other employer for that matter, can simply assert that what you are doing in your trade union work is not trade union activity but being carried out as an individual employee rides roughshod over the collective rights we have fought to establish as trade unions and the right to organise and represent the voice of staff without suffering a detriment as an individual for doing that. This is another issue that has been really important to have established in my case, and that came out clearly during the Tribunal. Another lesson coming from this is to use the legal fight. The trade union and employment rights that have been won must not be lost de facto through employers taking no notice of them and this going unchallenged.

I hope this case will be a block to this steam-roller climate of diktat that is going on throughout the public services and the NHS in particular, where employers think that if someone stands in the way of some agenda they can just remove them.

WW: Did Barts want to pre-empt the judgment of the Tribunal do you think?

We can only speculate. What is a fact is that the decision to invite me to return to work came after the hearing was concluded. As the evidence came out in the hearing, from the discussions between the judge and the barristers during their closing submissions on the final day, and the questions the judge was putting and points he was making, it seemed pretty clear to all present that any judgment was likely to be highly critical of the Trust.

That is one factor. But another is that on the penultimate day of my tribunal hearing the Care Quality Commission issued a damning report into my hospital Whipps Cross, and Barts NHS Health Trust itself was put into special measures. The report highlighted bullying against staff, and low staff morale as key findings, alongside shortage of staff, over-reliance on agency workers, and loss of experienced staff. These are key problems that have to be addressed in order to prepare and protect our services within the hospital. In the statement the Trust issued on my return to work, which had been jointly agreed, they did acknowledge that I am an energetic campaigner for patient issues and anticipated I would make a contribution to the improvement work now embarked on at Whipps Cross.

Through the campaigns calling for my reinstatement, articles in the press, the statement from my union general secretary, and so many letters from individuals and organisations, the issues were brought out into the light of day. Public opinion was strong that such unjust action against a health worker and union rep, the growing diktat it reflects, and attempt to create a climate of fear, this is incompatible with health care. I don’t think that can be underestimated.

WW: What do you think are the lessons for the way forward in safeguarding the future of the health service?

One of the lessons is that of standing up for the right to health care and the rights of health workers and not to back down but to see things through. Don’t just believe they have the all-embracing power to push through things that are wrong. Since I have been back at Whipps Cross after being re-instated, people have repeatedly said to me that it is so good that you saw it through. It is tough but if you know you are right it is so important to take this stand because that is the only way you are going to get change.

When people speak out in the interest of patient care, or in the interest of staff organising in their defence through trade unions, this is in fact everyone’s concern because it is everyone’s health service. It is also about a democratic environment and how decisions should be made as well as about our rights as human beings. The point is that it should not suddenly be a matter for the individual when it has an impact on the whole community and on society. There is a drive to prevent health workers and health reps talking to communities about potential changes and the potential impact of those changes because health workers have far more of a grasp of the reality of those changes which is different from the glossy picture that may be presented by those that are trying to justify the changes to services. The community heath campaign in Waltham Forest actually wrote a letter and got signatures of over 1,000 people and local organisations that went to the Trust to oppose my dismissal for standing up for the health services that they were concerned about.

The decisive question here is that the community and hospital staff stood together. Whenever that happens it is far, far easier to achieve success in safeguarding our health service. This campaign, the Save Lewisham Hospital Campaign, as well as campaigns in the past at Whipps Cross, are good examples. This was certainly very much the case in my campaign. It was a fight for what is just and by relying on a collective this outcome was possible.

WW: Could you sum up the significance of the victory to the fight to get organised and turn things around?

What I found is that there is a strength of common values amongst people of different walks of life and opinions. There is a very, very strong sense that what happened to me was totally unjust, reflects the experience of many others, and that we must take a stand on it and these values of the people who are committed to the health service and the right to health care should be cherished. What happened to me and the support I have had reflected and strengthened people’s beliefs in these values and since I have been back so many staff have come up to me made it clear just how important my case has been to them saying that it reflected everything that went wrong, which was the general devastation of the staff, their de-stabilisation, de-valuing of the contribution that they had made, not listening. What happened to me was a symptom and an expression of what happened to everybody and the whole hospital, and similarly people felt the fact that I succeeded has become a vital step in beginning to try and turn things around. In this way it shows people can be empowered and organised to fight to defend their health service and speak out for what they need to safeguard its future.

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