BY RIGHTS, 52-year-old Ian Perkin should be enjoying life at the pinnacle of an impressive career. But when he highlights his achievements — “30 years as an accountant in public sector finance, 16 in the health service, in charge of 200 people and one of the biggest budgets in the NHS” — it is with the stunned disbelief of a man picking over the bones of his life.
Until October 2001, that life was running on rails. True, his wife, Janice, had health problems after being struck by a motorbike, his youngest son Toby, 9, suffers from asthma, and his elderly father and mother were both in and out of hospital. But two of his four children had flown the nest and he and Janice were looking forward to redecorating their home in Worcester Park, southwest London. What he did not know was that he was about to become a victim of his success and, he believes, of the terrible pressures of the “targets culture” gripping the NHS.
As the executive director responsible, among other things, for information and reporting at St George’s Healthcare NHS Trust, southwest London, he realised he had a hot potato on his hands when a junior staff member claimed that she had been told to report incorrect figures for cancelled operations. Within a year, he had been hauled before an internal disciplinary hearing. Despite an unblemished 16-year career in the NHS that had featured only praise and promotion, he was suddenly accused of rubbing people up the wrong way and of not being a team player. After a hearing chaired by his own chairman which stuttered over five days between September and November 2002, he was denounced by three of his four executive board colleagues and, on December 2, 2002, sacked.
His crime, as far as he could see, was that he had blown the whistle on the falsification of data for cancelled operations. What happened to him when he did has ramifications not only for other whistleblowers but for the Government’s insistence that such people are essential for the self-monitoring of the NHS, and that they must be protected at all costs.
In October 2001, Kelly Goulding, an information analyst at the trust, told her section head that a senior manager had instructed her to enter “zero” for the number of cancelled operations in a certain week, when she believed that there had been 28. In a statement, Goulding said: “I mentioned that we usually have at least five cancelled operations and it would seem odd suddenly to have no cancellations.” She was told “that the cancelled operations figures were something that we were being closely monitored on at the moment, and that I should enter zero”.
The report travelled up the chain to the head of information and then on to Perkin’s desk. As director of finance since 1990, he had proved to be such a safe pair of hands that, as No 3 to the chairman and the chief executive, the responsibilities of procurement, and information and computing, had been added to his portfolio.
Low figures for cancelled operations were a big issue for any hospital hoping to achieve a three-star rating — and the Health Secretary at that time, Alan Milburn, had made it clear that only three-star trusts would be considered for elite Foundation status. That a system criticised for pitting hospital against hospital for funding incentives is fundamentally flawed and not in the best interests of patient care has now been tacitly recognised by the Government. The Times disclosed yesterday that John Reid, Milburn’s successor, is to launch a consultation paper questioning the use of performance targets.
But back in 2001, at the height of the pressure-cooker targets environment, Perkin was aware that submitting false figures to the Department of Health was a disciplinary offence which could cost him his job. He investigated and found similar discrepancies, which he raised with other board members, initially in an e-mail to Ian Hamilton, the chief executive, on October 12, 2001. The response from his senior colleagues, he says, took him by surprise. “It was, ‘ How can we trust you as a board member if you are not going to back us against junior members of staff?’ ”
But it was only on November 14, when he was called in see the chairman of the trust, Catherine McLoughlin, that he began to feel uneasy. At the tribunal into his eventual sacking, he claimed that he had met her to discuss the cancelled operations. She agreed that the meeting had taken place but denied that they had discussed the issue. At the tribunal, however, the trust accepted that “the raising of the matter in 2001 was a ‘protected disclosure’ . . .” — or, in other words, a genuine case of whistleblowing as defined by the Public Interest Disclosure Act. Under the Act, workers are protected from dismissal for blowing the whistle on wrongdoing.
The trust denied that Perkin had been sacked over the disclosure. Ian Hamilton told the tribunal that Perkin had been sacked for his “management style”. He had received comments from inside and outside the trust “which raised serious questions about his attitude and approach and ability to form effective working partnerships”. Perkin was regarded, said Hamilton, as “a scorecard keeper” with a “can’t do” attitude.
But although Hamilton told the tribunal that several people had complained about Perkin, not a single written complaint was submitted in evidence and only one external witness appeared in person: a retired finance director at another health authority. Although Melvyn Esterman gave evidence at length about disputed financial forecasts, there was never any question, even in the trust’s submission, that Perkin was anything other than an entirely efficient financial manager. The tribunal’s focus, however, fell on his suggestion that Perkin “seemed to cause tension when he was present” in meetings and that he was “prickly” to deal with. It boiled down to what Hamilton was saying: that Perkin didn’t get on with people.
“I was delivering a very unpalatable message and that’s why I wasn’t getting on with senior colleagues,” says Perkin. “I was in a unique position because I wasn’t looking for career advancement. People can find the truth unpalatable, particularly in an institution like the NHS, where people are worried about the retribution that falls on them if they fail to meet targets.”
But Hamilton and Esterman’s words appeared to carry more weight with the tribunal than those of Dominic Sharp, an accountant who had worked in the finance department at St George’s for ten years and who served as acting financial director after Perkin was suspended. “Ian maintained a consistently honest and open style of management,” he said in evidence. “He was always approachable and supportive . . . I understand some senior members of the trust have expressed criticism of the finance department and Ian’s leadership . . . no senior members expressed any such criticism in my presence.”
