We – Families for Culture Change – believe that the current code of conduct complaint faced by Gavin St Pier is the latest example of a process being weaponised and a smear campaign being mounted against someone challenging medical and health services locally.
We can attest to being on the receiving end of this behaviour during the darkest and most terrifying times of our lives, when our children were at their most unwell. We would never wish our experiences on any family. This is why, over a number of years, we independently approached Deputy St Pier to advocate for us, bring our experiences to light and press for much-needed cultural change. Only after years of resistance did Deputy St Pier use parliamentary privilege to name Sandie Bohin, the doctor who was at the centre of so many of our harrowing experiences.
We can evidence complaints stretching back more than a decade. Our concerns have led to three independent investigations being commissioned by the island’s Medical Director/Responsible Officer. One of these was conducted by the Island Child Protection Committee, one by an independent UK safeguarding consultancy, and one by the Royal College of Paediatrics and Child Health.
Significant findings have arisen from these investigations. The Medical Specialist Group and Dr Bohin like to state that no complaint has been upheld about her, but this is demonstrably untrue.
- In 2016, she and her MSG colleagues offered an ‘unequivocal apology’ for actions taken by them towards one of our families. For these actions, and breaking confidentiality, the MSG was sanctioned by the Data Protection Authority, their actions being described as ‘neither fair nor lawful’. Dr Bohin also lost some of the child’s records, resulting in the authority outlining that her actions were not compliant with data protection law.
- In 2021, another report looked into the cases of more families who had been referred to safeguarding services. Their crime? To seek second opinions or alternative treatments for their very sick children. None of the families was found to have caused any harm to their children and the accusations were all dismissed. At the heart of these safeguarding accusations was the then named doctor for safeguarding, Dr Bohin.
The report found there was ‘bias against families who were inclined to seek second opinions and alternative approaches’. It highlighted that ‘challenges from healthcare professionals involved language and behaviour which served to alienate families’. The report also highlighted the ‘fundamental breakdown in trust between health professionals and families’ and how it must have had ‘consequences for the children in terms of appropriateness of treatment and oversight’.
The report set out how parents – our families – ‘always wanted help and support, but instead of feeling supported and understood they have instead felt suspicion, accusation and blame from professionals’. The report found that ‘the system has become adversarial, which of course also means that it might not be child-centred’.
As parents of sick children, some of whom were gravely ill, we were dealing not only with the weight of their conditions, we were also under fire from the very practitioners who were supposed to help us get our children better. Merely as a result of pressing for the appropriate care our children required, the system locally turned against us, and various processes were weaponised against us.
- The 2024 report was instigated by a complaint from the parents of a very young child with a congenital diagnosis.
When the child began showing clear signs of being unwell post-surgery, off-island investigations were cancelled by Dr Bohin when they should not have been. When the child’s parents pointed out notes in the care plan which contradicted Dr Bohin’s opinions, their behaviour was labelled negatively in writing. These negative labels soon found their way around the office of the MSG and to UK doctors. The parents were distressed to find that a smear campaign had been mounted against them.
In the case of this child, Dr Bohin said: ‘My opinion is that the ongoing [symptom] is not significant’. But when the parents took the child to a private hospital in the UK, the symptom was found to be far from insignificant. Indeed, the small child was in need of major surgery.
This report found that Dr Bohin had discharged the child too early from tertiary (off- island) services. It reported that symptoms should have been ‘more fully assessed’ due to the potential for ‘more complex causation’ and that there should have been ‘earlier discussion with the tertiary service to explore whether further investigations should be performed’. It also found that Dr Bohin’s style of written communication was ‘abrupt’ and ‘lacking empathy’. It was recommended that Dr Bohin should be asked to discuss her communication style at her next appraisal and that, as part of that appraisal, 360-degree feedback should be obtained, including from staff at all levels and patients or their representatives. She was also advised to consider personal development opportunities to help her improve her style of written communication.
Contradicting the repeated claims made by Dr Bohin and the MSG that investigations have not been upheld, three elements of the 2024 complaint were upheld or partly upheld, one of which asked the following: ‘Did the clinical team listen to the concerns of X’s parents and did they communicate in an appropriate manner?’.
Considering how similar the feedback was in 2016, 2021 and 2024, can it be said that Dr Bohin or the MSG have learned any lessons from these investigations? How much more are the taxpayers of Guernsey going to pay for investigations which reach similar conclusions but appear to change little or nothing? Now the taxpayer is footing the bill for the latest Code of Conduct debacle. The cost, already high financially and emotionally, continues to mount.
All we have ever sought is better care for Guernsey’s children. Twenty-four recommendations were made as a result of the 2024 Royal College report. It remains to be seen whether any of these have been implemented. One of the earlier reports resulted in families driving forward a project with Health & Social Care to deliver a code of practice for medics when presented with complex or perplexing conditions. However, this work seems to have stalled, with no update offered by HSC about its progress, despite requests from the families.
As families, we approached Deputy St Pier as an elected representative with the power to highlight this issue. We did so of our own volition and out of desperation. We also spoke with a journalist from The Guardian to tell our stories, and we have spoken with other media. Every fact we have ever given to any journalist has been evidenced. We would never make an allegation without evidence. We don’t need to. We have medical records stretching back years and countless examples to back up everything we have ever said about Dr Bohin not reporting events reliably and about her judgements, approach and reactions when challenged.
It was our group of families who lodged a complaint with the General Medical Council. It has not yet been resolved and investigations are ongoing. We told The Guardian of our GMC complaint. We have spoken to other media about it too. We are not ashamed of speaking to the media, but we would likely not have chosen to do so if our concerns had been listened to and learnings applied.
We have spent nearly a decade trying to get our voices heard to no avail. We have followed complaint and appeal procedures, only to see them used against us. Our voices were suppressed or silenced. Therefore, we decided that it was time to speak up to the only outlet left available to us – the media. We wish we could publicly attach our names to our complaints, but we are forced to remain anonymous due to the fear that our children will not be safe in the paediatric system. That is the sad reality we face. Dr Bohin’s current pursuit of Deputy St Pier, through yet another code of conduct complaint, is merely the latest evidence of the lack of safety in the system for people who speak out.
The BMA’s recent comment evidences the adversarial approach patients often encounter when those in the medical industry are challenged. The union came out publicly with what sounded very much like a threat to politicians, the GEP headline reporting, “Suspend St Pier or risk destabilising the medical profession”. We suggest that, instead of threatening politicians, the union which represents local doctors should seek to listen to, and understand, patient concerns. Only then will patient safety be improved and poor practices eradicated.
Believe us when we say that the last thing any parent of a sick child wants is to come into conflict with their child’s medical team or spend precious energy writing letters of complaint. It is utterly terrifying to speak up. It is traumatizing to be subjected to medical gaslighting. It is abhorrent to watch your child suffer, knowing that their suffering could be alleviated by the correct medical assistance. It is not good enough that we have had to remove our children from the system locally to seek out essential treatment.
With the lengthy, evidenced and detailed background we are able to offer into Dr Bohin’s practice, we find it utterly baffling that the standards commissioner who investigated the latest code of conduct complaint, Dr Melissa McCullough, could take Dr Bohin’s account of events wholesale without even thinking to query their accuracy with us. Surely, before propagating Dr Bohin’s allegations of a confidentiality breach, Dr McCullough should have asked the families involved if we believed this to be the case? For the record, we refute any notion that our data has been compromised by Deputy St Pier, and we hope that Dr Bohin has not compromised our data while pursuing her complaint.
Dr Bohin seems to be suggesting that we were incited to make complaints by Deputy St Pier. This is yet another insult to add to the list of those she has committed to writing in our children’s medical records. If Dr McCullough genuinely believed that we were a flock of sheep, blindly following Deputy St Pier, why didn’t she interview us? Had she done so, she would have found a group of educated, professional and loving parents still traumatised by their experiences while caring for children who live with the negative impact of Dr Bohin’s actions.
Dr McCullogh was well aware of our existence as a group of families, as we wrote to her back in November 2023 to complain about the behaviour of the then Chief Minister, Peter Ferbrache, during the Privileges Panel debate. Peter Ferbrache revealed during the debate in October 2023 that, directly contravening the confidentiality of the panel’s discussions and outcome, he had met with Dr Bohin before the debate to gain her side of the story, whilst not affording us – the families affected – the same luxury. We told Dr McCullough of the upset the debate had caused us. We quote directly from the letter: At no point [in the debate] was it mentioned that there were real families with real children at the centre of this debate, which had sadly become a political football. Why were we – the families – not consulted, nay even mentioned by Deputy Ferbrache as stakeholders with a valuable voice in this process alongside that of Dr Bohin? Where was our invitation to give evidence to the island’s Chief Minister over a cosy cup of coffee?
Later in the letter, we outlined:
Rather than seeking evidence to back up these revelations or questioning the motives behind the person reporting these revelations, Deputy Ferbrache instead took this fourth-hand gossip and relayed it as the truth to States members and the listening public.
So, Dr McCullough knew that our accounts disputed the accounts of Sandie Bohin. She knew we existed. She had our names and even our home addresses. Yet, she still did not seek to speak to us to collect evidence in this latest episode of an ongoing saga that has overshadowed our lives for more than three years. (We attach our letter of 2023 to Dr McCullough, and her reply, for your information.)
Dr McCullough claims she followed an ‘investigative’ process. How can she claim to have done so if she has not sought to reconcile Bohin’s version of events with the families at the heart of the allegations, who have reams of admissible evidence? This begs the question, is the Code of Conduct process fit for purpose? Does it stand up to scrutiny? States members need to ask themselves if this decision should be thrown out on process alone. Furthermore, this code of conduct finding and recommendation should be concerning for every islander. If elected representatives are no longer allowed to bring individual cases into the light, where does that leave free speech? Where does it leave the role of elected representatives? This could be about any matter – health, policing, housing, education – the list goes on. The message Dr McCullogh has put forward is clear – speak out and face condemnation.
This ruling is much bigger than Deputy St Pier, Dr Bohin or any of us as families. This ruling fundamentally strikes at the heart of democracy and raises questions about the role of our elected individuals in representing the voice of our community. They have an essential role as advocates for their constituents. It is tragic and alarming that this role is now being threatened by those prepared to weaponise process to protect their own low standards and poor behaviour.
Families for Culture Change
Families for Culture Change is a group representing the parents at the centre of the learning report into local safeguarding failures, together with other parents who have experienced significant clinical failings in the treatment of their children, and healthcare professionals who have raised concerns about the delivery of paediatric care in Guernsey.