Section 10: Removal of Professional Allegiance : The "closing of the ranks syndrome"

10.1 Patients have come to the conclusion that this is the main cause of their dis-empowerment. This "closing of the ranks" is a euphemism for collusion and is often referred to as "the old boy/girl network". It is understood, from the medical profession and from other sources, that this is often used as a pseudonym for corrupt freemasonry.

10.2 The Bristol Babies' Scandal raised the subject of freemasonry which appears to have been rife at the BRI with the hospital having 44"its own Masonic Lodge". 45A newspaper article on Bristol entitled "Probe into hospital Masonic links" alleged that: " the brotherhood's activities led to poor scrutiny of under-performing staff. Frank Dobson, who was aware of these claims was said to be threatening tough action if the Inquiry supports them. It could mean ordering all surgeons and senior hospital administrators to declare membership of the society". Chris Mullin, Chairman of the Commons Home Affairs Committee, endorsing the views of Frank Dobson said that :"it would be right for the Inquiry to ask about the involvement of masons in the tragedy and then to decide whether their membership was relevant to what happened. He believes that any involvement of free masons should be made public." 

10.3 46The fact that the BRI paediatric cardio-thoracic surgical department was known within the hospital as the "killing fields" since 1988, suggests that "the total closing of ranks" prevented the exposure of the poor mortality rates. This continued for almost a decade until the concerns raised by Dr. Stephen Bolsin were at last given credence.

10.4 In a Channel 4 News item broadcast shortly after the opening of the BRI Inquiry, it was suggested that merit awards were linked to Masonic privileges. 47Masons "of which there are a large number in medicine…were bound by codes of loyalty and secrecy". Freemasonry requires members to look favourably on the activities of other masons but such "brotherly allegiance" is incompatible with the professional regulatory body, the GMC, which demands that: "the safety of the patient must come first at all times". It is likely this "clubbing" is preventing the mechanism within the health care system from functioning properly in the interest of the patient. 48The fear of the "old boy/girl " network has a profound effect on potential whistle-blowing doctors who fear their careers will suffer if they break ranks. This ill treatment of whistle blowers is yet another barrier to improving standards and protecting and empowering the patients.

10.5 49Patient concerns and awareness of the effect of the "oldboy/girl network" was highlighted in evidence put forward by witnesses giving oral evidence to the Health Select Committee: "they acted like a closed shop - the 'old boy network' and it still goes on. Why has it been going on all these years and why have they not been honest….?" 50The Health Select Committee is so concerned about allegations of freemasonry within the GMC that, in its recent Inquiry into the Shipman affair, the Committee will be questionings the GMC about allegations brought by former GMC members of links with freemasonry.

10.6 The fear of upsetting the "old boy network" is well illustrated in a 51letter sent to SIN by an anonymous concerned health professional. This letter appeared in "Hospital Doctor" and advised all potential whistle-blowing locums not to break ranks. Although the hospital locum is well placed to make comparative assessment practices within different hospitals and departments, this letter advised them not to let their conscience get the upper hand by exposing incompetence and malpractice because:

"… the slightest hint of criticism or disapproval will lead to you being labelled a troublemaker and being blacklisted in the hospital and amongst the old boy network…..Don't do it mate! Don't do a Dr. Bolsin and blow the whistle on your colleagues, not unless you want to go down under to Aussie land".
The GMC Guide to Good Medical Practice implicitly instructs all doctors that it their duty to protect patients when it is believed that a colleague's health, conduct or performance is a threat to patients. Indeed those health professionals who do not blow the whistle are in breach of these guidelines. 

10.7 51bIt is quite unacceptable that such conscientious doctors should have their integrity besmirched by scurrilous suggestions from the Trusts that they are 'trouble-makers' and 'incapable of working as a team member'; and that they should be suspended immediately from their posts, at considerable public expense. It would appear that one whistle blowing Radiologist was recently charged with the transgression of taking an 'unofficial audit' , the data of which was eventually confirmed by an NHS audit. It is remembered that the last well known person to take a similar audit was Dr. Stephen Bolsin. Would anyone now dare to suggest he should not have done this? 

10.8 Our members have great solidarity with all professional whistle-blowers because patients who whistle-blow about sub-standard care are treated to the same abuse. Patients' complaints are subjected to the same pseudo-investigations by Trusts and Regional Offices; like the doctors, the full facts and evidence are never addressed; like the doctors, patients are subjected to shameful character assassinations. Health professionals have their careers put in jeopardy, patients have their on-going health care compromised. If standards are to be improved in the NHS, then whistle blowing on poor medical practice, whether by health profession or patient, is not only essential but should be actively encouraged. Hence, victimisation of all whistle blowers doctors and patients alike should be stopped immediately. SIN believes that statutory measures currently available for the protection of whistle blowers should be enforced and sanctions taken against any manager who fails to give protection. Blacklisting of patients by G.P's and consultants should be a statutory offence.

10.9 The problems caused by 'closing of the ranks syndrome’ by turning a 'blind eye' has been recently exposed by the deplorable abuse of the elderly in several high profile articles in 52March and 53April this year in the Sunday Times. Clearly such treatment of the elderly is a breach of Article 2 of the Human Rights Act 1998: "Everyone's right to life shall be protected by law. No one shall be deprived of his life intentionally…"

10.10 It is very disturbing to read in an ACHCEW advisory document entitled: "Implications of the Human Rights Act 1998 for Patients and CHCs", which specifically refers to this Article, the following statement that " policies and practices which have an adverse affect on certain sections of the community, for example practices involving starvation and dehydration of the elderly, and a do not resuscitate policy for the over eighties, refusal to provide specific life saving treatment for the elderly…." obviously contravenes Article 2. Is the inference to be drawn from this that the CHC, the officially paid "watchdog" was aware of this aforementioned abuse of the elderly before it became public knowledge? If so, why was the exposure of this scandal left to undercover journalists and the efforts of the victims and their relatives?

10.11 If such obvious sub-standard care is blatantly metered out regularly to wards full of the most vulnerable elderly and goes unreported by those employed by the D.o.H., then what possible hope is there for the hidden, isolated iatrogenic patient to have their concerns addressed? Clearly, this state of affairs is wholly unacceptable for the damaged patient and those caring health professionals who are afraid to speak out because of the lack of management and colleague support. Whilst team training and effort is all well and good, the team can only be as good as the team leader and at the end of the day, individual responsibility is a moral obligation.