NHS England is facing calls to introduce an independent second opinion whenever it moves to dismiss a healthcare professional, following renewed scrutiny of staff welfare and whistleblower protections.
The proposal, known as “Amin’s rule”, has been put forward by Dr Narinder Kapur in memory of Amin Abdullah, a nurse who took his own life in 2016 after being unfairly dismissed. Dr Kapur argues the change would close a serious gap in how the NHS handles disciplinary decisions that can have devastating consequences for staff.
Dr Kapur, 76, a consultant neuropsychologist and visiting professor at University College London, was dismissed by Addenbrooke’s Hospital in Cambridge in 2010 after raising concerns about staff shortages and unqualified employees working without proper supervision. An employment tribunal later ruled that he had been unfairly dismissed, after he spent around £300,000 pursuing the case using proceeds from the sale of his home and his NHS pension.
He has since held discussions with senior NHS figures, including NHS England chief executive Jim Mackey, in an effort to prevent similar cases.
Dr Kapur said, “If they had a second external opinion when Abdullah had his kangaroo court or when I had my kangaroo court, that external person would almost certainly not have approved his unfair dismissal or my unfair dismissal.”
He added, “If staff wellbeing is affected then patient care is going to be affected. If you’re a whistleblower you’re going to get in trouble in the NHS, if you’ve got coloured skin you’re probably going to get in trouble.”
Evidence shows people of colour working in the NHS are more likely to face disciplinary action than white colleagues, while doctors from minority ethnic backgrounds are also more likely to fear negative consequences when raising patient safety concerns.
Mr Abdullah had been suspended from Charing Cross Hospital after signing a petition supporting a colleague who faced a patient complaint, and later writing a letter describing the patient as a “professional complainer against NHS staff”.
An independent inquiry in 2018, which Dr Kapur helped initiate, concluded that Mr Abdullah “should have known that signing the petition was not appropriate”. However, it noted that none of the other 18 staff who signed the petition were disciplined and ruled that the 41-year-old had been “treated unfairly” by Imperial College Healthcare NHS Trust.
Dr Kapur, who is a member of Justice for Doctors, is also calling for wider reforms. These include extending the “maintaining high professional standards” framework, which currently applies to doctors and dentists, to cover all healthcare professionals.
He has further proposed splitting the Care Quality Commission into two separate bodies, one focused on patient care and the other on staff treatment. “You need to have external scrutiny of trusts and also private healthcare bodies as to how they treat staff, especially whistleblowers and BME staff,” he said.
Dr Kapur is also urging the NHS to limit its use of the “some other substantial reason” dismissal mechanism, which allows staff to be sacked for reasons outside conduct or capability. Between April 2010 and September 2018, the NHS dismissed 10,604 staff using this route, often citing a breakdown in working relationships.
“If I can do things to make sure that what happened to me and Abdullah won’t happen to people in the future, I will do until there are meaningful improvements,” he said.
A spokesperson for NHS England said it was working with the Department of Health and Social Care to strengthen protections for whistleblowers. They added, “It is completely unacceptable for any member of staff to feel silenced or unable to speak up about issues affecting them or their patients. We’d urge anyone who has concerns to contact the Freedom to Speak Up guardian in their organisation, to help ensure the NHS learns from mistakes so we can provide the best possible care for patients.”
