Sacking of surgeon “contrary to law, unjust, and based on irrelevant considerations"

Monday 04 July 2016

Jersey’s hospital administration and senior politicians, including Chief Minister Ian Gorst have all been heavily criticised for their involvement with the sacking of a top surgeon.

A States board tasked with investigating the case has issued a damning indictment of the decision to fire father-of-four Dr Amar Alwitry, saying the decision was “contrary to law, unjust, and based on irrelevant considerations and misunderstandings.”

But the 146-page States of Jersey Complaints Board report says what was most alarming was “No-one involved on the side of the States, from the senior personnel at the hospital, the HR Directorate, the then Solicitor General and senior members of his staff, the then Minister of Health and Social Security or the SEB (States Employment Board) perceived that there might even be a risk that the decision making process might be flawed.”

The stinging criticisms held within the report received a response from the States Employment Board today, which read: “The States Employment Board (SEB) was grateful to receive the detailed findings of the Complaints Board. While the Complaints Board’s observations are noted, SEB expresses significant disappointment in relation to a number of aspects of the report. SEB will now reflect further on the content.

“Legal proceedings may follow the publication of the Complaints Board’s findings and it would therefore be inappropriate for SEB to make any further comment at this stage.”

Dr Alwitry – who was born in the Island but later moved to England to advance his career – had been offered a post at the General Hospital as a consultant in ophthalmology and was due to start work on December 1, 2012, but just a week before taking up the job was told his contract had been terminated.

The board said: “What appears to have happened is that the senior clinical team formed the view that Dr Alwitry was raising spurious concerns [over patient safety] to achieve a certain agenda and they regarded him as a “troublemaker” and a “disaster” whose behaviour was “atrocious” because he persisted in raising the matter.” They then ganged up to get his appointment cancelled. The report even notes one of the medical directors said “we should sack this bloke before he gets here.”

The board added: “A culture has developed at the hospital where senior clinicians and managers felt it was appropriate to make decisions in an informal way that ensured no records were kept of their consideration, no proper process followed, and there was no possibility of independent scrutiny, or right of appeal/review.”

The board described this as a “serious institutional failing” and says “[The management] failed in their duties to such an extent that, at the very least, they should undergo extensive re-training before being allowed to make decisions on employment (or, indeed, other important matters relating to management of the hospital, other than clinical issues) in the future.”

Dr Alwitry refused to operate on a Friday morning because there was no junior cover at the hospital over the weekend and he was worried about patient safety – a view backed by other experts in the field, but simply dismissed by staff at Jersey General Hospital. He also angered the hospital authorities for refusing to work for free on a Saturday because it was not in his contract.

The complaints board concluded: “A small group of people had decided that Dr Alwitry would not fit with their preferred style of management – ie to expect others to simply do as they were told - and were determined to oust him."

Advice from the Law Officers’ Department seemed to indicate the hospital would only have to pay Dr Alwitry three months’ wages if they acted swiftly. But the hospital authorities were still worried, and in a letter one of them wrote: “The real risk is that he was born and brought up in Jersey – first generation rather than old Jersey blood – but he and his father (a retired JGH consultant) claim to be well connected to the politicians and media here and in fact he has used this as a threat already.”

When Dr Alwitry discovered his contract was being terminated, he e-mailed the hospital, saying: “Both Claudia (my wife) and I are now out of work as we’ve both resigned from our jobs so obviously I will be getting a lawyer and will have to take action against the hospital. We have four small children under seven so this is a nightmare…  I still want to come and work with you all. It’s been my dream from the start. Could I be officially reprimanded, or put on probation for a while? Not quite sure what for but I’d be happy with anything that sorts out this unpleasantness.”

Following the fall-out the then Solicitor General was asked to conduct a review, but the board say he was conflicted as he was being asked to comment on advice that his juniors had given. The board said: “We have to record our frank astonishment that [he concluded] Dr Alwitry was not raising legitimate concerns and was only motivated by a desire to ‘keep his weekends clear so he could return to the United Kingdom for family reasons’ or that Dr Alwitry ‘was not looking to put in place suitable Saturday cover.’”

Politicians appear to have been compliant and rubber stamped the hospital’s decisions. The board said: “It is a perfectly reasonable impression that there is rather too cosy a relationship between the politicians responsible for the hospital and the senior officers at the hospital who were eager to protect their own.”

The report notes: “While decisions made on the subjective and potentially ill-informed views of senior officials may have been the way that public authorities were run in the 19^th Century, they are most certainly not appropriate in the 21^st Century.”

As to what should be done to put matters right, the board recommend the following. "The best alternative that the board is able to recommend is that the Chief Minister and the Minister for Health and Social Services give Dr Alwitry an absolute and unqualified acknowledgement that the termination of his contract was unlawful and contrary to natural justice. This acknowledgement should be given without a thought to the consequences that may flow from it. The SEB and the Department of Health and Social Services have brought that on themselves."