Bad Arguments and the Future of Intensive Care Services at the Leicester General Hospital

Last Friday, the Leicester, Leicestershire and Rutland joint health scrutiny committee met and should be commended for supporting a motion which stated, that “in the interests of openness and transparency, the committee recommend that the Clinical Commissioning Groups and the University Hospitals of Leicester undertake public consultation before continuing with the proposals.”

The vote was passed by seven votes to six, with most of those opposed to holding a consultation coming from Tory county councillors. However, as reported in the Leicester Mercury, one lone city Labour member, Councillor Dr Lynn Moore, used this opportunity to side with the hospital bosses and was quoted in the paper as saying:

“There’s a moral imperative to put patient needs above what should have been done legally and what’s got to be done legally. My opinion is to go ahead without public consultation because of the cost and the delays.”

But a full review of the baffling speech that Dr Moore delivered to the health scrutiny committee sheds light on why Dr. Moore, a child psychologist by profession, chose to side with the hospital bosses rather than with campaigners.

To begin with, Moore is happy to accept that the bosses at the University Hospitals of Leicester (UHL) were wrong in not already having carried out a public consultation, noting how UHL chief executive Jonathan Adler “has already said and admitted that you are in an unfortunate position, it is a really bad that you are where you are, and things obviously didn’t go politically right etc.”

She then drew attention to the good work of the health campaigners, including Dr. Sally Ruane, who had just explained to the committee the many good reasons, legal and otherwise, why the public should be consulted on the future of their hospital services. Moore acknowledged that Dr Ruane had made “some excellent legal arguments” about “what should have been done and wasn’t done,” before going on to warn the UHL bosses that “your card has been marked”.

Yet despite offering-up this warning and highlighting the errors that had been made by the UHL bosses, Moore then attempted to convince the scrutiny committee that they should now let the bosses off the hook by not calling for a public consultation. Here she specifically referred to game promoted by a psychologist named Eric Berne which is known as “Now I’ve got you, you son of a bitch.”

This game describes a scenario whereby an “aggressor (usually unconscious) identifies their victim, sets up a trap and springs it as a form of getting even or gaining perceived power.

Moore therefore deliberately introduced the idea of this game – without explaining anything about it – precisely so she could disparage the arguments made by Dr Sally Ruane and other health campaigners from Save Our NHS Leicestershire and the pro-consultation opinions held by her fellow Labour councillors.

Bizarrely Dr Moore was suggesting that those in favour of consulting the public were somehow the ones in the wrong and it was they who were trying to get one over on the UHL bosses. Obviously, the exact opposite is the case: the UHL bosses had been found to be negligent and were being politely asked to remedy their mistake by now doing the correct thing by organising a public consultation on the future of intensive care services (ICU) at the Leicester General Hospital.

In her own words Dr Moore therefore stated:

“There is a well-known game in psychology so forgive me because I am a psychologist — god I have forgotten his name — but ‘Now I’ve got you’ — excuse me it’s going to be bad language – ‘you son of a bitch.’ Now I don’t know if anybody knows about that game, but its citing all the legal arguments and putting all the weight on those. I feel as a member of the public, and I can acknowledge those legal arguments, but speaking as a member of the public, speaking as someone who is getting to a pretty ripe old age who might be in need of ICU etc. etc., it is almost a moral imperative to put patients interests above what should have been done legally and what’s got to be done legally in the future. So, I am glad to hear that you [the UHL bosses] apologise because that was going to be one of my questions, ‘will you apologise?’ But you are saying you have, so that is good. ‘Will you say you will undertake a full consultation?’ I think you have said that you are going to do that.”

Here on the issue of a full consultation, Dr Moore is not referring to a consultation on the future of the intensive care services, but instead is referring to another proposal that at some point in the future UHL will be consulting on their as yet undisclosed finalised business case for removing acute service provision from the General Hospital. This leads Dr Moore to conclude:

“So at the moment my position is, rather than argue for a public consultation, and I know it is up to the public to go for a judicial review and try to get that decision made, but my personal position as a councillor and as a member of the public is that I am okay with you going ahead without a public consultation because of the cost of it and the delay in getting those services up and running, because in my world, the interests of patients have got to take an absolute premium over anything else.”

Unfortunately Moore misses the point that having a public consultation is the only genuine way that the interests of patients can be truly catered for in a democratic and accountable fashion. After all, the entire the point of having a public consultation is to ensure that patient concerns can be flagged-up (not simply ignored) and then acted upon in a timely fashion in order to improve health outcomes for everyone.

And let there be no doubt, that organising a public consultation is probably the best way to avoid the type of unforeseen problems (some of which were highlighted in Dr Sally Ruane’s contribution to the scrutiny committee) that would prevent the need for any members of the public to ever seek to launch a judicial review of UHL’s plans. The public would of course prefer not to ever have to go for a judicial review that Dr. Moore refers to, which is why the public would prefer consultation not imposition!

UHL consultation graphic

Transcript of Dr. Lynn Moore’s contribution:

“In a sense the questions that I was going to ask last time, have been pre-empted by the current documents. So, is it okay for me just to comment rather than ask questions? …

“Well I mean I think Jonathan has already said and admitted that you are in an unfortunate position, it is a really bad that you are where you are, and things obviously didn’t go politically right etc.

“It is difficult for me because I am not a lawyer. I am a councillor and I am also a member of the public. I read the paper with great interest, I had lots of questions about it, but they are more for the future and the exercise that is going to be happening when you get the money to do the development that you are going to propose and do the consultation on that.

“The clinical case to me was made beforehand and was certainly made in this paper that the services would be safer, they were going to be staffing issues resolved, and you are going to create a really good training model by moving the beds to the Royal.

“We’ve had legal advice, I know, from our legal advisors, and you can take a legal position and I think Sally presented some excellent legal arguments, very very clear and I could follow them, so thank you for that. What should have been done and wasn’t done, and I think that you have presented a very very good model for what should govern the forthcoming project and accompanying consultation. In a sense, to be in common parlance, your card has been marked and you need to be aware of that and move forward.

“There is a well-known game in psychology so forgive me because I am a psychologist, god I have forgotten his name, but ‘Now I’ve got you’ — excuse me it’s going to be bad language – ‘you son of a bitch.’ Now I don’t know if anybody knows about that game, but its citing all the legal arguments and putting all the weight on those.

“I feel as a member of the public, and I can acknowledge those legal arguments, but speaking as a member of the public, speaking as someone who is getting to a pretty ripe old age who might be in need of ICU etc. etc., it is almost a moral imperative to put patients interests above what should have been done legally and what’s got to be done legally in the future.

“So, I am glad to hear that you apologise because that was going to be one of my questions, ‘will you apologise?’ But you are saying you have, so that is good. ‘Will you say you will undertake a full consultation?’ I think you have said that you are going to do that.

“So at the moment my position is, rather than argue for a public consultation, and I know it is up to the public to go for a judicial review and try to get that decision made, my personal position as a councillor and as a member of the public is that I am okay with you going ahead without a public consultation because of the cost of it and the delay in getting those services up and running, because in my world, the interests of patients have got to take an absolute premium over anything else.”

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s