Scathing criticism of health chiefs in Dr Ranson’s employment tribunal

By Siobhan Fletcher   |   Reporter   |
Tuesday 17th May 2022 5:53 am
@siobhanfletcher
[email protected]
Share
Dr Rosalind Ranson (Isle of Man Newspapers )

Subscribe newsletter

Subscribe to our email and get updates right in your inbox.

An employment tribunal has unanimously ruled in favour of Dr Rosalind Ranson following her unfair dismissal from the Department of Health and Social Care.

The explosive decision states that Dr Ranson, ‘having made protected disclosures, was automatically unfairly dismissed and suffered detriments in consequence’.

It also states that he former medical director was unfairly dismissed ‘irrespective of the protected disclosures’.

At the close of the tribunal, there were some 6,000 documents in evidence, including extensive witness statements, plus a further 1,000 pages of transcripts and lengthy legal submissions.

The final report is 202 pages long.

The ruling states that Dr Ranson was subject to what the tribunal considers ‘a pattern of disgraceful behaviour – similar to the satirical manner of making an employee feel not wanted’.

For example, in December 2020, her personal assistant had been moved away from her office without warning or consent, and on arrival at Noble’s in early January 2021, Dr Ranson discovered that she had now lost her own office.

Her belongings had been removed and put in store. She had been re-housed in a junior manager’s office with a broken chair, no computer screen and no telephone. Her nameplate no longer appeared on the door.

Before this incident, back in September, Dr Ranson had a particularly dismissive experience with Dr Ewart.

On Friday, September 5, 2020, Dr Ranson had phoned Dr Ewart but with no response.

She needed to make contact and so then sent a text message at 9.49pm asking a question regarding ‘testing pathways’.

The text messages belatedly entered into in evidence – only when in the witness-box did Dr Ewart produce an exchange of text messages held on her phone – were as follows:

Dr Ranson: ‘Hello Henrietta has CT got a pathway for the scenario we have? I wanted to check because presumably the transport contact should be included in the CT given we don’t know when he became positive as he is asymptomatic. KR-R.’ (The tribunal interpreted this as abbreviation for Kind Regards – Rosalind).

Dr Ewart: ‘I’ve no idea what you are talking about or who you are.’

Dr Ranson: ‘It’s Rosalind Ranson.’

Oliver Segal QC, representing Dr Ranson then asked how Dr Ewart replied.

Dr Ewart said: ‘I did not reply. At that point I blocked her number from my phone.’

The tribunal stated that Dr Ewart’s ‘indignant, proud and defiant tone was astonishing’.

In the report, they said: ‘The panel members could not understand why the response to a question about a Covid-19 situation during the evening warranted such rudeness to a fellow doctor who needed help.

‘It was also extraordinary that Dr Ewart testified that when this message arrived, she professed or had pretended not to know who it was from.

‘Then, when she was told, her reaction was so immediately hostile.’

Dr Ranson alleged she was routinely ignored when attempting to advise on the government’s response to the Covid-19 pandemic – allegations which have been proven true via this ruling.

Many of her criticisms were levelled at former DHSC chief executive Kathryn Magson, and the director of public health, Dr Henrietta Ewart.

Indeed, much of Dr Ranson’s advice was not passed on to the Council of Ministers (CoMin).

A command structure was created in early March 2020 by Miss Magson, which was designed to ensure that the Council of Ministers was not overburdened with data and opinions.

The chain was from Bronze through Silver to Gold and ultimately to the Council of Ministers.

Dr Ranson sat on both Bronze and Silver. Matters decided in Bronze then went to Silver.

Agenda items of merit were then passed to Gold, on which Miss Magson and Dr Ewart sat.

At this time, Dr Ranson had also established two medical groups – the Senior Medical Leadership Team (SMLT) and the Clinical Advisory Group (CAG).

MISHANDLING OF THE PANDEMIC

On the basis of the tribunal’s findings, a case could easily be made to argue that the events which occurred early in the pandemic, such as those at Abbotswood, could have been avoided, had Dr Ranson’s advice been heeded.

The tribunal agreed with Dr Ranson, that Miss Magson had ‘suppressed or had failed to pass on material evidence relating to the health and welfare of the island’.

This prevented it from being considered by the Council of Ministers.

For example, just after midnight, on March 16, 2020, Dr Ranson sent a PowerPoint presentation to Miss Magson for use at the Council of Ministers in the morning.

However, unknown to Dr Ranson (until the tribunal itself), Miss Magson had not used the presentation. Former Health Minister, David Ashford MHK confirmed this in his evidence.

Had the Council of Ministers meeting had the opportunity to be aware of this advice they would have read that the Senior Medical Leadership Team’s view was that: ‘The tipping of the balance – to delay – means that we have an impending major clinical emergency that could overwhelm our health and social care services.’

Dr Ranson further reiterated that if the SMLT advice had been followed, ‘there would have been fewer cases which may well have been contained – thus resulting in fewer or perhaps no deaths and certainly a shortened period of lockdown’.

The tribunal stresses throughout its report that it is not looking at the government’s wider response to coronavirus.

An official review of the Manx government’s handling of the Covid-19 pandemic is due to start soon, the results of which will be published by the end of 2023.

The main focus of the tribunal was instead Dr Ranson’s allegation that she was unfairly dismissed from her job.

BACKGROUND

In 2019, Dr Ranson applied to be appointed medical director and was successful.

She joined the Department of Health and Social Care on January 27, 2020, having been a doctor in the UK since 1988 ‘with an unblemished record’. She was on a limited-term agreement (LTA) of two years.

However, when she started her employment in January 2020, she had good cause to believe that she would be transferring as medical director from the DHSC into Manx Care on April 1, 2021.

As advertised, the role was open-ended and not limited to a two-year term. The job was described as being permanent full time with an operational medical director role.

She was therefore all set to aid the department during its upcoming transition to Manx Care.

In her February 2021 presentation, Dr Ranson had an aim to have a well-governed medical workforce fit for purpose and fit to practise in order to deliver high-quality safe care.

She summarised the challenge on arrival in January 2020 as follows:

*A disillusioned, fragmented medical workforce.

*Reports of bullying were rife.

*A lack of medical management.

*A medical leadership structure that was unworkable, resulting in a sense that those in leadership positions were absolved from any sense of responsibility or accountability.

*A culture of not reporting concerns and a culture of not investigating concern.

On Dr Ranson’s arrival, she also discovered that ‘relationships between the medical staff were fractured, as were relationships between them and executive administrators’.

She ‘discovered allegations of medical incompetence, cover-ups of medical mistakes and an overarching unhealthy work environment’.

According to the tribunal report, ‘some startling examples of potential medical neglect and incompetence were evidenced in the documentation before the tribunal’.

Dr Ranson ultimtely lodged a complaint against the department on April 16, 2021.

Her case was that she had been expected to transfer to Manx Care.

Instead it was alleged she had been left with an empty shell role with the DHSC, compared with that of operational medical director as she had been employed since commencement. The tribunal stated it was ‘satisfied that had there been no pandemic, Dr Ranson had the correct credentials, vision and determination to make the changes that she had identified.

‘She set about repairing relationships with the doctors and substantially succeeded although not every person could or would be satisfied.

‘Suffice to say, there was ample persuasive evidence that she secured the general respect of the doctors for whom she was responsible.

‘The tribunal considered that it was a loss to Manx Care that someone of Dr Ranson’s ability ended up unemployed from January 26, 2022.’

Dr Ranson was informed by Miss Magson on December 8, 2020, she was not transferring to Manx Care and the staff who worked underneath her were informed of this.

Then, from January until March 2021, the tribunal declared that she ‘endured a series of demeaning actions taken against her’ which ‘led to confusion and speculation about what was happening to her’.

As a result, Dr Ranson received a number of warm and supportive unsolicited letters of support, which are quoted in the report.

WHISTLE-BLOWING

Dr Ranson was sidelined by the DHSC largely due to her alleged disclosures.

These disclosures are outlined within the document released by the tribunal.

In one alleged protected disclosure, Dr Ranson spoke to then-Education Minister Dr Alex Allinson MHK directly.

The pleaded disclosure states that on April 25, 2020, she spoke to Minister Allinson by telephone and told him that she reasonably believed that Miss Magson had failed to pass on crucial information to the Council of Ministers.

‘The information that Miss Magson had failed to pass on concerned the impending medical emergency.

‘She was obliged to pass on that information because it was clearly in the public interest to do so and if she did not, then ministers and others would be making critical decisions in the absence of key information.

‘Dr Ranson told the minister that this had placed people at risk and it was in the public interest for her to do so.’

Dr Ranson had wanted her concern about lack of access raised with then Health Minister David Ashford, and Dr Allinson agreed to suggest to the Health Minister that he should receive information directly from her, among others.

The tribunal stated it was ‘satisfied that Miss Magson would have been displeased had Dr Ranson gone direct to Minister Ashford on the March (or any) issues’.

Equally, the tribunal was satisfied ‘that Minister Ashford did not want or expect to hear directly from Dr Ranson (or from anyone other than through the command structure)’.

WITNESS CREDIBILITY

Then Health Minister Daivd Ashford, among others, was called to testify at the tribunal as a witness for the DHSC.

Whilst the tribunal ‘never had cause to distrust the evidence of Dr Ranson’ as ‘she presented throughout as truthful’, they said Mr Ashford’s evidence ‘reflect[ed] his best recollections’, but said it was ‘not always consistent or easy to support’.

The tribunal declared that ‘because of Miss Magson’s determination to apply the rigid command structure, the tribunal considered [Mr Ashford] to have been over-reliant on Miss Magson for his information’.

They added: ‘In consequence, he may have been misinformed.’

Mr Segal summarised Mr Ashford’s evidence as ‘practised and diplomatic seemingly guided by the principle of deniability of anything potentially inconvenient unless/until objective evidence was available to the contrary.’

More damning was the tribunal’s opinion of Miss Magson.

Whilst Mr Segal submitted that she was ‘both a liar and vindictive’, the tribunal said: ‘The tribunal had no problem in general with relying on the veracity of Dr Ranson’s evidence – in sharp but unfortunate contrast to the evidence of Miss Magson.’

RULING

Ultimately, the tribunal ‘was satisfied that the nature of Dr Ranson’s role was diminishing from December 2020 and was then so changed from April 1, 2021, as to amount to a fundamental breach and repudiation of her contract of employment, a conclusion consistent with the approach in ‘Hogg v Dover College’.

Dr Ranson was therefore unfairly dismissed from her role of medical director on March 31, 2021, having been employed for more than a 12-month period.

Dr Ranson’s dismissal ‘was the consequence of having made certain protected disclosures’.

Because of these proven disclosures, she had suffered a significant number of identified detriments and especially, as such a detriment, had been prevented from transferring to Manx Care on April 1 2021.

In response to the ruling, the British Medical Association has released a statement in support of Dr Ranson.

It said: ‘The hearing, which began in January of this year, heard how Dr Rosalind Ranson was unfairly dismissed from her role as Medical Director on the Isle of Man after she had urged the Manx Government to depart from Public Health England advice in the early stages of the pandemic in 2020 – which eventually it did.

‘However, Dr Ranson was victimised and dismissed after she raised a number of serious concerns, which included whether the chief executive [Kathryn Magson], who was not medically qualified, was passing on her advice to Ministers.

‘Dr Ranson had also raised serious concerns about patient safety and governance matters.

‘The employment tribunal hearing, which began in January of this year, heard how Dr Ranson was marginalised, bullied and unfairly dismissed from her role as medical director on the island.

‘Dr Ranson became the medical director in January 2020, moving to the Isle of Man to oversee a reorganisation of health services and subsequently to provide expert medical advice and guidance on how the health system should respond to the pandemic.

‘However in March 2020 it became apparent that Dr Ranson and her team’s expert advice was not being heeded.

‘The island’s pandemic strategy of following Public Health England was rejected by the island’s doctors.

‘Dr Ranson’s role was to get their voices heard.

‘After some delay the government followed Dr Ranson’s medical advice and implemented the recommendations around quarantine and controls at the port.

‘When the island’s new healthcare service, Manx Care, was created in April 2021, Dr Ranson fully expected to transfer to it as medical director.

‘Instead, she was moved sideways into what the judgment called ‘an empty shell role’ still within the Department of Health and Social Care.

‘The tribunal concluded that because Dr Ranson had “blown the whistle”,’speaking out about her concerns, she was first sidelined and eventually, unfairly dismissed.

‘It also considered the praise of Dr Ranson by her colleagues acknowledging she was held in high esteem and found that the chief executive’s criticisms of Dr Ranson were ‘ludicrous and unjustifiable’.’

Dr Ranson added: ‘The past two years have seen the highest but also the lowest parts of my career.

‘The highest because eventually the Manx government and healthcare leaders did heed my advice and the team I led and Covid-19 was, for most of 2020, eradicated on the island, allowing the public to live a life free of restrictions.

‘However, if my advice had been heeded earlier, more lives would have been saved.

‘As a doctor, my duty is to put patients and public first and this was made almost impossible by the campaign that was waged to make my work life untenable, to undermine my credibility and professionalism and finally force me out of a role I had been so looking forward to making a success.

‘Standing up as a whistleblower is extremely difficult, even when you know it’s the right thing to do.

‘There were times when it felt a very lonely place to be as efforts to make my work life as unbearable as possible gathered momentum and I can wholeheartedly understand why many doctors, in similar positions, may feel they simply cannot fight for justice.

‘But I knew what I had to say was right and I was doing it in the interests of the patients and wider public on the island.

‘The tribunal’s decision isn’t just a victory for me, it is also a victory for the principle of whistleblowing and for doctors having the freedom and independence to speak the truth.’

DISCLOSURE CONCERNS

As we reported at the close of the tribunal, the disclosure of documents from the department was critiqued multiple times throughout it.

It was first revealed that additional documents were disclosed by the DHSC’s lawyers only in the days before former DHSC chief executive Ms Magson was due to give evidence.

In response to this, Dr Ranson’s representative Mr Segal said that in 29 years doing his job it was the closest he had come to saying a respondent has not complied with disclosure.

On Tuesday, February 1, proceedings were again delayed when the DHSC disclosed more documents overnight. Mr Segal doubled down on his criticism of the DHSC as a result, arguing the delayed release of the documents amounted to an ‘ambush’ for Dr Ranson.

The critiques regarding the disclosure of documents is also highlighted in the ruling, which declares a ‘serious miscarriage of justice’ was narrowly avoided.

The document states: ‘Ensuring a fair hearing, whether in this tribunal or in the High Court depends on the integrity of the disclosure process.

‘It is the duty of opposing litigants each to disclose to the other those documents that are material to the issues whether helpful or a hindrance to their own case.

‘But for the persistence of Dr Ranson in refusing to accept the integrity of the respondent’s disclosure in October 2021, under what is called standard disclosure, there might have been a serious miscarriage of justice because so many documents were not produced until she took advantage of the process known as Data Subject Access Request (DSAR).

‘Yet even that process failed to reveal all documents that should have been before this tribunal.’

The tribunal has announced it will hold a special disclosure hearing to investigate ‘a number of troubling issues’.

At least these following issues will be investigated:

*Alleged ‘concoction’ of material documents

*Selective non-disclosure of documents

*Late (and extremely late) disclosure of material documents

*Unavailability through inadvertent destruction of material documents

*What documents may never have been produced and why / how?

The tribunal described the disclosure issues as ‘prejudice to Dr Ranson’ and particularly damned the ‘very belated drip-feeding of documentation even after she had given her evidence’.

There are also allegations that some of the documents submitted may have been ‘concocted’.

For instance, one typed note of a meeting identified Dr Ranson as an attendee.

Not only had she not attended, but at the date of the meeting, Dr Ranson had not even been employed by the DHSC.

Evidence may also have been destroyed.

Indeed, the report states: ‘It seemed clear to the panel members there must have been many more communications relevant to Dr Ranson’s case than ever surfaced.’