IN THE EMPLOYMENT TRIBUNAL Claim No: 1500469/2011

BURY ST EDMUNDS BETWEEN NARINDER KAPUR

Claimant

and

CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST

Respondent

STATEMENT OF CLAIMANT

Index to Statement

A. My Background – Page 1-3, paras 1-11

B. ‘Whistleblowing’ Disclosures,

Unqualified Psychology staff endangering patients – Page 4-10, paras 12-50

C. ‘Whistleblowing’ Disclosures,

Bullying and Harassment – Pages 11-20, paras 51-88

D. ‘Whistleblowing’ Concerns,

Staffing, Working Conditions and Resources – Page 20, para 89

E. Attempts at Grievance Resolution and Mediation – Pages 21-31, paras 90-129

F. Dismissal Hearing, 2010 Pages 32-52, paras 130-198

G. Appeal Hearing, 2011 – Pages 53-58, paras 199-223

H. Facts coming to light after the appeal hearing – Pages 59-61, paras 224-233

I. Financial Matters – Pages 62-68, paras 234-267

J. The impact of my dismissal – Pages 69-73, paras 268-285

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I, Narinder Kapur, of 29 Rushout Avenue, Harrow, Middlesex, HA3 0AS, make this statement in support of my claim to the employment tribunal for unfair dismissal and protected disclosures, and will state as follows.

A. My Background 1. I was born in New Delhi, India. When my family settled in N Ireland in the early

1950s, I was only a few years old, and I found myself exposed to a different language from that of my infant years. This may have played a part in a developmental stammer I had at that time, which included rapid speech, and for which I received speech therapy. To some extent, a slight dysfluency and related gaze limitations when I speak with others have remained with me for most of my life. I appreciate that others may sometimes misinterpret this as uncertainty or lack of interest in my part, but I have tried my best to rectify this limitation.

2. I attended Queen’s University Belfast, and qualified with a first class honours degree and later PhD in Psychology. I gained experience and training at the Royal Victoria Hospital Belfast, where I carried out research into the effects of missile injuries of the brain, then in the Boston University School of Medicine, and later in a number of London teaching hospitals, including the Maudsley Hospital, Northwick Park Hospital, and St George’s Hospital. I became a fellow of the British Psychological Society in 2007, and was made President of the British Neuropsychological Society in 2008. Other aspects of my background are provided in my cv (P2120-2138), and in a book I wrote, The Irish Raj (2a / CP1-2, book on display).

3. I was senior neuropsychologist and Head of Neuropsychology at the Wessex Neurological Centre, Southampton General Hospital from 1980 to 2003. I enjoyed my time in Southampton – I had excellent relationships with clinical, academic and managerial staff. I wrote my first book during my time there (Memory Disorders in Clinical Practice – 3a / CP3-5, book on display), and also a second book (Injured Brains of Medical Minds: Views from Within – 3b / CP6-8, book on display).

4. In 1994, I was made honorary senior lecturer and in 1997 honorary Professor of Neuropsychology at the University of Southampton. I took a leading part in aspects of the running of the Wessex Neurological Centre, and I was made vice-chair of its local League of Friends, a charity formed to help patients and ex-patients of the centre, and active in raising funds for wards and departments.

5. I got on very well with managers and clinical directors when I was in Southampton – I helped to write the business plan for a new epilepsy service and I set up that service in collaboration with senior colleagues in neurology, neurosurgery, neuroradiology and neurophysiology. I regularly taught nurses on the local neuroscience nursing course, and appeared on local radio to offer my expertise in the area of memory. I collaborated with a range of colleagues on academic issues and interesting clinical cases, and this is seen in the number of joint publications I produced during my time in Southampton. I also regularly won awards from the Chief Executive as part of the Suggestion Scheme that was running at Southampton General Hospital during my

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time there. One of the managers in fact met up with me, and subsequently wrote an article in the hospital newsletter to highlight how I had won more awards in this scheme than any other employee.

6. While in Southampton, I wrote my first booklets for patients (e.g. the Wessex Memory Manual which later became the Cambridge Memory Manual) and I produced my first sets of clinical guidelines for junior staff (‘Smart Papers’). I regularly took on trainee clinical psychologists who successfully completed placements with me. I supervised a number of doctoral theses and projects conducted by trainees in clinical psychology. I initiated and provided significant support for a project to write a book on the history of the Wessex Neurological Centre, and this involved collaborating with a wide range of colleagues (6a / CP9-10, book on display). I also organized several cricket matches between the neurologists and the neurosurgeons.

7. As part of my application for the Head of Neuropsychology in Cambridge, I was specifically asked by the Director of Neurosciences John Pickard to prepare a talk to be given at interview in which I should set out my plans for the service, and put these in the context of a ‘regional services framework’ for Neuropsychology. I spent considerable time preparing this talk, having discussed it and shown a draft to senior colleagues in Southampton. At my interview, I read out this statement (P372-4), and answered questions relating to it and to other matters.

8. When I applied for the post, I knew that there had been a relatively high turn-over of Neuropsychology post-holders at Addenbrooke’s, with some discontent amongst past holders of my post (P594, P1387). In fact, John Pickard had been quite open about the problems I might face, and he did rather surprisingly refer to my application for the post as my taking up ‘a poisoned chalice’. I thought that he was just being frank about the major problems that my predecessors had encountered, and I simply regarded that as a challenge that I had to face. Barbara Wilson, a Neuropsychology colleague whom I had known for a number of years, since she has also worked in Southampton, also pointed out to me that some of my predecessors at Addenbrooke’s had encountered problems working there.

9. After being offered the Cambridge post, my wife and I decided that for family reasons I would work in Cambridge but retain my Southampton base. We knew that there would be major financial implications for such an arrangement. I would have significant travel costs, and also have to maintain two residences. I therefore had a relatively protracted period of discussion, primarily with John Pickard and Kathy Haynes, regarding my terms and conditions.

10. Since I myself had been a national assessor for NHS posts in Neuropsychology, I was aware of the retention and recruitment premium that could be offered to staff. I therefore asked for this premium as part of the package that I requested (P361). I had a key telephone conversation with John Pickard around March 2003. He did not say I might but that I would get the premium. I distinctly remember him adding - ‘You can trust me, you know I am a man of my word’. In view of the importance of the premium to my decision to take the role, I documented this conversation in an email

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(P378). I knew that the email had to be tactful, but I wanted for my own records to note the fact that I had this key conversation with John Pickard in relation to the Recruitment & Retention premium. I took on good faith this promise I had received as well as others– e.g. being given a full-time personal secretary – John Pickard had verbally promised me that this would occur, and John Hodges told me that he strongly supported such a promise (P376).

11. As detailed in my job description, both the one when I applied for my post (11a / CP603-4) and the one that was later updated as part of the NHS Agenda for Change regrading exercise (P150-154), the key components of my job at Addenbrooke’s Hospital in Cambridge were – to provide a clinical Neuropsychology service to Neuroscience consultants, Neurorehabilitation consultants and other consultants at Addenbrooke’s; to take part in multidisciplinary clinical meetings; to carry out teaching; to supervise trainee clinical psychologists on placement; to appoint, supervise and provide Continuing Professional Development (CPD) to junior staff; to develop and enhance the Neuropsychology service; to manage the Neuropsychology department, including budgets, IT & test equipment orders, staff recruitment, etc; to generate income for the department; to carry out research and introduce innovations in clinical practice; and to provide a lead to public engagement that involved educating patients, their families, patient organizations, the media, etc.

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B. ‘Whistleblowing’ Disclosures – Unqualified Psychology staff endangering patients

12. From the early days of my employment at Addenbrooke’s, I realised that the Hospital had a practice of significant use of unqualified staff in Neuroscience outpatient clinics. Unqualified psychologists who did not have a professional qualification in clinical psychology and who were not appropriately registered with a regulatory body, were carrying out neuropsychological assessments – administering standardised tests, making judgements of cognitive impairment, and making recommendations for treatment. This was an unusual and troubling issue. I had not encountered this practice in my previous post in Southampton, and my colleague Dr Veronica Bradley had not seen it in her setting at the Hurstwood Park Neurosciences Centre in West Sussex. The detailed reasons for my worries are set out below – paragraph 18.

13. It may help the tribunal to give some important clinical background at this stage. A 'qualified' clinical psychologist is someone with an approved undergraduate degree in Psychology who has also undergone a recognized period of post-graduate professional training on an accredited course in clinical psychology. Having such a post-graduate qualification ensures that the individual has the knowledge, skills and experience to carry out work to a high standard, and to deal with complex issues that might arise in a clinical setting. Clinical psychology training courses are currently jointly approved by the British Psychological Society and the Health Professions Council. In order to be registered as a clinical psychologist with the Health Professions Council (HPC), such a qualification is required. The Health Professions Council was set up in 2002, following an Act of Parliament, and a draft Order laid before Parliament in March 2009 enabled the legislation to encompass Psychologists. The HPC opened its register to clinical psychologists on July 1, 2009, and this gave a legal framework to the practice of psychologists. Prior to that date, regulation was carried out by the British Psychological Society in conjunction with its Division of Clinical Psychology and its Division of Neuropsychology.

14. In order to work as a clinical Neuropsychologist, further specialised training and experience is strongly recommended, and may soon become mandatory. Those who have such training and experience can join a ‘specialist register of neuropsychologists’ that has been established by the British Psychological Society (14a / CP11-84). Thus, in order to work as a consultant Neuropsychologist (Band 8d), it takes around 8-10 years of formal training, with a further period of around 10-12 years specialised clinical experience.

15. In the case of the unqualified psychologists in Neuroscience clinics, neither

Dr Edginton, nor the two unqualified psychologists before her – Dr Catherine Loveday and Dr Jo Iddon – even had post-graduate clinical psychology qualifications, and none of them was registered with the Health Professions Council at the time that they were carrying out assessments in Neuroscience clinics. After Dr Iddon left Addenbrooke's, she did subsequently gain a post-graduate qualification in clinical psychology, something I strongly advised her to do.

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16. It was claimed that the supervision of unqualified psychologists’ work by Professor Barbara Sahakian, Professor of Neuropsychology at Cambridge University, was sufficient cover and the work thus did not endanger patients. However, Professor Sahakian had not been in active clinical practice for many years, and she herself only became registered with the Health Professions Council in November 2011. She is not listed on the specialist register of Neuropsychologists (14a / CP11-84). The clinic where patients were seen was next to my office on R3 Neurosciences (16a / CP-85), and I myself had never in fact seen Professor Sahakian even once set foot in R3 Neurosciences.

17. John Pickard claimed around the time of the appeal hearing in early 2011 that the

clinics ‘are R & D clinics’ (P1542C), implying that the assessments had a research rather than a clinical function – but the assessments in question used standardised rather than research tests, and there was nothing in the patients’ notes or in any ethics or research forms to indicate that this was purely research project activity. Standardised tests are ones with established norms and procedures, and are used for clinical purposes; research tests are specifically designed to answer a particular research question.

18. My concerns were that the neuropsychological assessments were likely to be harmful to patient care for at least eight reasons –

a. The right tests might not be given. b. Tests might not be appropriately administered. c. Patients might be asked the wrong questions in clinical interview. d. Patients would not know that the person whom they were seeing did not

have a clinical qualification. e. Inappropriate recommendations for management or treatment might be

given. f. Reports might be badly written. g. There would be no liaison with the Neuropsychology Department to

ensure proper coordination of care – the Department had many resources that could have been helpful to staff who were seeing patients in Neuroscience outpatient clinics. I would have happily provided supervision and support to staff carrying out assessments.

h. Given the absence of liaison with the Neuropsychology Department, there could be interference in testing if the patient was administered cognitive tests in the Department shortly after being tested in Neuroscience outpatient clinics; there is a large and complex literature on practice effects in neuropsychological testing, and qualified neuropsychologists are aware of the possible impact of these effects on the validity of the results obtained in an assessment.

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19. The first time I formally raised these concerns was in January 2004, at a meeting I had with Kathy Haynes, John Pickard and John Hodges, where a range of issues were discussed. I disclosed concerns over the use of unqualified staff in neuroscience clinics. The set of notes that were subsequently prepared as a record of that meeting (P388a,b) were not approved by me, and used terminology such as ‘imprimatur’ which I would not have approved, and which I certainly did not utter at the meeting. (John Pickard was later allowed to comment on the reliability of the minutes (P389), but this opportunity was not provided to me).

20. My concerns about unqualified psychologists did not appear to be taken seriously by those who had been present at the January 2004 meeting. For example, John Pickard characterised my concerns as trying to engage in ‘turf games’ (P399), or he made inappropriate remarks such as - ‘I have repeatedly tried to warn Narinder that Cambridge does not like moaners who keep on repeating the same points whilst failing to act on the advice proffered’ (P630, paragraph 7). I pointed out to John Pickard that I was primarily interested in the welfare of patients (P398). I also considered that in the case of unqualified staff the Trust was putting itself in a risky position legally, should an adverse event occur. This was endangering the health of individuals for which it had a common law duty of care, and if an adverse event occurred, then the individual might have recourse to legal action against the Trust in view of the fact that unqualified staff were involved.

21. On February 12, 2004, I made a suggestion to John Pickard that I support and supervise unqualified psychology staff who were servicing his hydrocephalus clinic (P400), but this proposal was never taken up. Patients in that clinic were being considered for major neurosurgical intervention, and if a decision to offer or decline surgery was made on the basis of a faulty neuropsychological assessment, then this would have significant implications for the health and safety of the patient, especially since that neurosurgical procedure can be associated with significant complications.

22. John Pickard and Peter Hutchinson used unqualified Psychology staff to service their hydrocephalus and traumatic brain injury clinics respectively. Patients who were being assessed for suitability for deep brain stimulation had also on at least three occasions, around 2008 (P1332), been administered standardised tests by an unqualified Psychologist.

23. The employment of unqualified staff was not in the best interests of patients or my Department and it also went against the recommendations of my professional body, the British Psychological Society (23a / CP86-89, paragraph 7-n). It was in addition important that such work was supervised by someone who was in active clinical practice and regularly running NHS clinics. On a few occasions, I had been unable to find a record of test scores or reports prepared by the unqualified psychologist in question. Just as it would have been inappropriate for me to employ an unqualified neurosurgeon who provided a clinical service independently of the Neurosurgery Department, it was inappropriate for a neurosurgeon to employ an unqualified

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Psychologist to provide a clinical service, particularly where this was also done independently of the Neuropsychology Department.

24. I disclosed information about the issue on unqualified staff in my grievance letter of October 12, 2005 that was addressed to Angela Huxham, Director of Human Resources (P601, paragraph 9).

25. I raised the same issue in my letter of January 19, 2006 to Richard Sunley, Director of Operations (P672, line 15).

26. I next raised the issue in a further letter to Richard Sunley of July 4, 2006 (P782, paragraph 9).

27. At the Stage 4 Grievance Hearing on October 4, 2006, the issue of unqualified staff and patient safety was part of my Statement of Case (P818, paragraph 9). During the hearing itself, I again raised this issue (P846, lines 13-16).

28. My colleague, Professor Barbara Wilson, a senior and very experienced neuropsychologist, who had been employed by the Medical Research Council in Cambridge as a senior scientist, and had worked at Addenbrooke’s as an honorary neuropsychologist, also raised her concerns on this issue at the same 2006 hearing (P250, line 7, lines 13-15).

29. On July 23, 2009, I disclosed further concerns about the employment of unqualified Psychologists to my line manager, Juliet Walters (P1103).

30. In an email dated September 22, 2009, from Mrs Kathy Haynes, neurosciences manager, to Dr Phil Buttery, consultant neurologist to the Deep Brain Stimulation Service, she acknowledged the point I was making – ‘The issue is also not helped by the fact that Trudi isn’t actually a qualified clinical psychologist’ (P1122).

31. In an email to Juliet Walters on July 23, 2009 (P2435), I again raised the issue of unqualified psychologists working in Neuroscience clinics, but the Trust still did not appear to take any action in response to my concerns.

32. On October 27, 2009, I sent an email to Juliet Walters expressing concern about the use of unqualified staff in Neuroscience clinics (P1144).

33. On November 16 2009, I again expressed my concerns on this matter in a letter to Juliet Walters (P1160).

34. On October 7, 2010 I sent an email to Juliet Walters expressing my concern on the same issue, which had come to a head in the light of a patient I had seen in one of my clinics (P1316) – this important episode is detailed below. This was just the sort of incident I had been repeatedly warning the Trust about.

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35. On October 8, 2010, Peter Hutchinson, consultant neurosurgeon, admitted to Kathy Haynes, neurosciences manager, that the unqualified psychologist ‘performs screening neuropsychological assessments’ (P1318).

36. In a document written by Kathy Haynes, and dated October 19, 2010, there is an admission that neuropsychological assessments carried out by the unqualified Psychologist, Trudi Edginton in the Deep Brain Stimulation Service, were ‘far more clinical than academic’, and that three had already been carried out (P1332). In the case of the Traumatic Brain Injury Clinic, Mrs Haynes states – ‘Trudi identifies patients who require cognitive rehabilitation or onward referral to a clinical neuropsychologist’.

37. Two points need to made – firstly, the identification of such patients requires knowledge, skill and experience, since a clinical judgement has to be made, and this can only come from someone who is properly qualified; secondly, I do not recall the Neuropsychology Department receiving a single referral from Trudi Edginton, or from a consultant who indicated that a referral to the Neuropsychology Department was on the basis of an assessment carried out by Trudi Edginton. This contrasted markedly from what had been normal practice in my previous post in Southampton. This practice in Cambridge could result in inappropriate onward referral of patients, or failure to make onward referral of suitable patients.

38. John Pickard tried to make a similar point around the time of the appeal hearing in March 2011 (P1542C), claiming that unqualified Psychology staff ‘profile and signpost patients on to appropriate assessment and treatment’. He also seemed to think that unqualified Psychology staff can appropriately identify those patients who need particular diagnostic investigations or treatment. However, in order to accurately ‘profile’ and ‘signpost’ patients, a degree of knowledge, skill and expertise is required.

39. On October 22, 2010, I indicated to Juliet Walters that in the case notes of a patient being considered for deep brain stimulation I myself had seen a formal Neuropsychology Report that had been prepared by Trudi Edginton (P1336).

40. Professor Robin Morris, Professor of Neuropsychology at Kings College Neurosciences Centre, when he came to carry out a review of the Neuropsychology service in 2004, did agree with me that the employment of unqualified staff in Neuroscience clinics was unsatisfactory, and that – even if it was purely research – (which it wasn’t) it would be important that all Neuropsychology research projects carried out at Addenbrooke’s involve close consultation with the Neuropsychology Department (P438).

41. The issue of unqualified staff remained a ‘live’ issue up to the time of my dismissal, since – apart from the Deep Brain Stimulation Neuropsychology Service – I had not been provided with any evidence that the practice had stopped in respect of the Traumatic Brain Injury Clinic (later called the Neurotrauma Clinic) or the

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Hydrocephalus Clinic. By the continued practice of having assessments carried out by unqualified Psychologists, I found myself effectively excluded from providing a service to the clinics, and I regarded this exclusion as a form of ‘passive bullying’.

Serious Clinical Incident

42. In August 2010, a serious adverse clinical event happened which confirmed my worst fears, fears that I had repeatedly expressed over the previous seven years about the use of unqualified Psychology staff in outpatient clinics (It is quite possible that other adverse events had occurred, but did not come to my attention). I saw a patient in my clinic who had been referred by a neurorehabilitation consultant. It was clear that he had only sustained a minor head injury, but from my consultation it became clear that he had been led to believe that his head injury was a major one, that he had suffered cognitive impairment as a result and that he needed specialised treatment, including cognitive rehabilitation. When the matter was investigated further, I found out that he had in fact been given a cognitive assessment in the Traumatic Brain Injury Clinic by an unqualified, non-HPC registered psychologist, Trudi Edginton, who had written a report which specifically indicated that the patient had cognitive impairment and should be referred for cognitive rehabilitation (P1358-1366). The problem with this advice is that it falsely gives the patient the impression that he has sustained a major brain injury, that he has significant cognitive problems as a result, and that he requires active treatment for those problems. I had to spend a great deal of time with the patient and with his mother, both of whom were clearly in some distress, and I tried to rectify this situation.

43. I subsequently raised the matter with my line manager at the time, Juliet Walters (P1316). In the correspondence that ensued (P1317-1321; P1496), Juliet Walters did not appear to take account of my opinion as Consultant Neuropsychologist (P1336-7) but preferred to listen solely to the opinion of a Consultant Neurosurgeon (P1388-9).

44. In my letter of December 3, 2010 (P1496) to Juliet Walters, I pointed out the ways in which the issue fell within the province of our new regulatory body, The Health Professions Council. The employment of Trudi Edginton in such a manner also did not respect guidelines on neuropsychological assessment from The British Psychological Society (23a / CP86-89, see para 18).

45. I found this quite disturbing, all the more so because there is clear published evidence (44a / CP90-100) that has been gathered by Neuropsychologists about the dangers inherent in clinical judgements that are conveyed to patients in neuropsychological settings. This is such a major topic in the area of the management of brain injury patients that a number of papers have been published, and the clinical issue has its own term, Diagnosis Threat. Thus, there are many ways to achieve a low score on a cognitive test, and a low score does not

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necessarily mean that the patient is brain damaged. If a patient has achieved a low score and is then told professionally or in a clinic setting that this demonstrates brain injury, this can be very harmful. The recent literature on the phenomenon of ‘diagnosis threat’ shows that information given to patients with regards to brain injury may have significant effects on the symptoms that patients experience and report, or on their test performance.

46. I subsequently found out that in October 2010 Kathy Haynes and John Pickard had sought advice from a senior Neuropsychologist in Oxford, Katherine Carpenter, on the use of unqualified staff in the area of Deep Brain Stimulation, and this expert in fact agreed with my concerns (P1320), noting ‘I’m afraid this is probably correct’.

47. In a reference to a previous unqualified psychologist, Jo Iddon, who had worked in Neuroscience clinics, Katherine Carpenter also made the significant comment (P1320) – ‘Jo Iddon saw the light and went off and got qualified’. This clearly implies that the Psychologist realised that what she was doing was wrong (‘saw the light’), and that she should not have been working in this capacity.

48. In an email dated May 18, 2010, Geraldine Owen, Head of Clinical Psychology in the neighbouring Mental Health Trust, also supported my concerns (P1258).

49. Even a senior Trust officer, Karen Clarke, who was present at both mediation hearings, expressed concern on this matter in an email to Juliet Walters on November 1, 2010 – ‘The area I feel a little uncomfortable about is the issue he [Narinder Kapur] keeps raising about non-qualified’ (P1349). In addition, the medical director Dr Jag Ahluwalia was copied into some of the relevant correspondence (e.g. P1336, P1342, P1343), so serious was the matter being considered.

50. The last occasion that I formally raised my concerns was at the appeal hearing on March 23, 2011. When I pointed out to John Pickard (P1633) that the unqualified Psychologist ‘made clinical judgments and put them in writing’, he replied that she ‘may have written on a piece of paper but it didn’t go anywhere’. In fact, it went to the most important place it could have gone to, into the patient’s medical notes.

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C. ‘Whistleblowing’ Disclosures – Bullying and Harassment

51. I was surprised to see in staff surveys carried out in 2008 and 2009 that bullying was in fact quite prevalent at Addenbrooke’s (50a / CP101-106). The first significant episode of bullying and harassment that I experienced at Addenbrooke’s took place in early 2004. By ‘bullying’, I mean attempting to directly or indirectly coerce someone into a course of action. I regard exclusion as a form of ‘passive bullying’, something that had also come to my attention in an article I read in one of my professional journals (P1475-78). By ‘harassment’, I mean behaviour that is likely to cause alarm or distress.

52. Around 9am on Tuesday February 10, 2004, in the neurosciences library after the Neurosciences Directorate meeting had taken place, I had a meeting with Kathy Haynes and John Pickard to discuss matters relating to Neuropsychology. I indicated my plans to set up an East Anglia Neuropsychology Forum meeting, as I had outlined at my job interview. John Pickard asked me whether I was going to invite his academic colleague Barbara Sahakian (Professor of Neuropsychology) to the meeting. I explained to him that, since this was the first such meeting I was setting up, I had decided to ask Barbara Wilson and Keith Jenkins (senior neuropsychologist at St Andrew’s Hospital, Northampton) to join with me in co-organizing the meeting. I told him that I would therefore be consulting with them about who the attendees should be, both in terms of their background (non-psychologists, etc.) and in terms of their geographical location.

53. John Pickard refused to accept my answer, and asked me again, this time more vehemently if I was going to invite Barbara Sahakian – I recall him saying ‘I am going to put on my legal hat – are you or are you not going to invite Barbara Sahakian?’ I took these words to mean that he was being very serious, that I was to imagine we were in a legal setting, and that he was going to press me for a ‘Yes’ or ‘No’ answer. It was clear to me that John Pickard was trying to bully me into a response that he wanted, but I could not give in to this bullying. I therefore repeated the same answer as before, that at this point in time I simply could not say one way or the other as I had to consult the two others who agreed to help me organize the meeting. I realised that because of Barbara Sahakian’s involvement in the ‘supervision’ of unqualified staff in neurosciences clinics, John Pickard was very sensitive to her position vis-à-vis qualified clinical psychologists, and to her being seen to be excluded in any way. (In view of my own academic background, I myself would have been in favour of individuals such as Barbara Sahakian attending the meeting, but it was possible that one or other of my co-organizers might have wanted the meeting limited to those in active clinical practice.)

54. At that point, John Pickard screamed and shouted at me, and said numerous disparaging things about me, criticising my behaviour and interactions with others. It was such a bolt out of the blue that I did not note details of his specific remarks. Although it seemed to go on for an eternity, it probably did not last more than 2-4 minutes. He ended his explosive outburst by exclaiming, ‘I’m off to theatre’, and

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stormed out of the room. I remember thinking – ‘God help the patients you are going to operate on!’ I was speechless throughout the outburst, and although I could have retaliated in kind, I am not the sort of person to seek a confrontation, and from my professional experience I know that the best thing to do in that situation is simply to let the person finish their rant.

55. Kathy Haynes and I were then left alone in the room. There was a stunned silence,

as we both knew we had just witnessed something quite extraordinary and extremely unpleasant. Kathy Haynes on a later occasion, around the time of the Stage 3 hearing in December 2005, remarked that she thought John Pickard was so out of control that he was going to have a heart attack. After the stunned silence, I fully expected Kathy Haynes to offer some regret for his conduct, or to try and comfort me in some way as my manager. But after 30 seconds or so, she simply started talking about other items, as if nothing had happened. I was dismayed that Kathy Haynes did not say anything at all to comfort or support me.

56. I was so distressed by this event that I immediately recounted it to John Hodges, Consultant Neurologist, at my regular meeting with him that happened to take place shortly afterwards. Professor Hodges was equally taken aback at what had occurred. I realised, and John Hodges probably also realised, that I had a full clinic that morning, and that it was important that I was not distressed or upset during my clinic, both for the benefit of patients and those junior staff who may be sitting in with me. He therefore tried to comfort me by making light of the situation – he joked, ‘Perhaps John Pickard is sleeping with Barbara Sahakian!’

57. I also recounted the episode to Professor Barbara Wilson at my subsequent regular meeting with her, and she was shocked at such an outburst. Although I later received an apology from Kathy Haynes in respect of this episode (P652), to date I have not yet had any apology from John Pickard, who has adamantly refused to apologise (P787) and on a number of subsequent occasions claimed amnesia for the event (P629, paragraph 5; P652; P659).

58. This whole incident was of concern to me. However, I did not allow the event to get in the way of my meeting up with managers or senior doctors, or in trying to get strategic developments off the ground. The next day, I therefore did agree to meet up with John Pickard over lunch. I did not mention his outburst, but I waited, expecting him to offer an apology. He did not do so, and the only thing I received was a tangential email about my not starting ‘turf games’, to which I replied that I was not interested in such ‘turf’ activities, and that they had never even crossed my mind (P398).

59. I was also upset that in the following months, when asked to indicate what had happened, Kathy Haynes produced an account (P641) that was quite at variance with actual reality. In essence, she said that I had been repeatedly asking the same questions, that I refused to listen, that I did not comprehend issues and that I

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‘appeared to demonstrate a total lack of insight at how hospital services were organized and financed’.

60. I could not believe that a senior manager would try to spin an event in this way. Presumably she did this to try to protect John Pickard. I am nevertheless pleased that on a later occasion, she seemed to retract her account, and agree with my version of what had actually taken place (P656). This was a matter of ongoing concern. Here you had two senior individuals in the Trust, with major authority and responsibilities, who were denying that a significant adverse event had occurred or were distorting their account of the event. A simple apology and acceptance of the event, so that we could all move on, would have been the normal reaction to such matters, and one which would rebuild rapport between these two individuals and me.

61. While the episode in February 2004 was the most significant of the explosive outbursts from John Pickard that I personally witnessed, there were two other similar but less dramatic episodes which I should report, and I note them here even though they took place at different time periods.

62. Firstly, several months after I started working at Addenbrooke’s, in the second half of 2003, John Pickard invited me at very short notice to go with him to a meeting in East Anglia relating to head injury services, where there would be several talks. I happily agreed to drop what I was doing and to go, and we went together in his car. During the journey, the issue arose about what he termed ‘academic clinics’ in neurosciences, and presumably he meant clinics that are run by those with primarily academic appointments. When I raised the possibility that in one or two respects they may not compare favourably with some NHS clinics, such as in their use of unqualified staff, he had an explosive outburst and completely lost his temper with me. I was so worried that I thought he might lose control of the car, and I recall pointing out to him that his side of the car had an air bag, but mine did not! This outburst was less dramatic than the episode which occurred on February 10, 2004, but it nonetheless shocked me that John Pickard would suddenly lose his temper over what I considered to be a genuine and reasonable expression of concern. I strongly disagree with John Pickard’s version of this event (P628, paragraph 3) that I ‘launched into an invective’, or ‘was scathing’. I was simply pointing out the pros and cons of various clinics, and he was clearly very sensitive about this, and in particular the use of unqualified Psychology staff.

63. Secondly, at the Neurosciences Division meeting held on Tuesday October 5, 2010, John Pickard – who chaired the meeting – was clearly getting agitated and angry over an issue, which related to resources for neurosciences. This anger was evident to all concerned, and in fact Juliet Walters herself made a joke that she would not like to be the patient he was next going to operate on when he left the meeting. Although others, strangely, regarded this episode as a matter of amusement, as a professionally qualified clinical psychologist I could see similarities between this episode and the two other episodes recounted above and thought that someone with responsibility should take the matter more seriously.

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64. I regularly attended meetings of John Pickard’s coma research group. I particularly

enjoyed these meetings, since they were an attempt to understand comatose patients from a multidisciplinary perspective. I was disappointed therefore when the meetings stopped occurring, even though John Pickard promised that they would resume. I later learned from a couple of members of that group, Dr Martin Monti and Dr Adrian Owen, that John Pickard had a major explosive outburst at one of the meetings of this research group.

65. In spite of the way John Pickard had behaved towards me, I tried to be as accommodating and as flexible as possible towards him, to listen to his concerns, and to take account of his sensitivities, especially in relation to Barbara Sahakian and the use of unqualified staff. I therefore, with the agreement of my co-organizers, did two things – firstly, I invited him to give the opening address to the inaugural meeting of the East Anglia Neuropsychology Forum that took place at Addenbrooke’s Hospital on May 10, 2004; secondly, even though we had a tight programme for the meeting, I gave his close colleague Professor Barbara Sahakian the opportunity to present her research on automated neuropsychological testing. All of Professor Pickard’s research group, including students of Barbara Sahakian, were also welcome to come to the meeting, which I made sure was free of charge, with refreshments and snacks provided. Although this was not the reason for the invitations, I thought that by inviting John Pickard to the meeting, and by also arranging for his close colleague Barbara Sahakian to speak, he might appreciate this and even offer to meet some of the costs of the meeting, since I knew he had access to a number of Trust funds and academic funds. Sadly such an offer was never forthcoming.

66. What I regarded as another example of bullying and harassment took place at a meeting with John Pickard and Professor Hodges on July 1, 2005. This meeting was key in the development of the situation which culminated in my dismissal in December 2010. I was called to the meeting at only a few hours notice, and without being told what the purpose of it would be. I was so upset and disturbed by the meeting that I made my own detailed notes of the meeting shortly afterwards (P1678).

67. I regarded the meeting on July 1, 2005 to have three intimidating features that amounted to bullying. (a) It was confrontational, in that two consultants were closely and forcefully questioning me. (b) It did not take place in a neutral setting, but in John Pickard’s office. (c) I did not have anyone from my own profession nor any union official present at the meeting. John Pickard was very much the lead in the meeting, and John Hodges was there more as support for him. John Pickard started the meeting by asking about my state of mental health – his words were ‘Are you suffering from depression?’ I found this most surprising and unhelpful and told him I was feeling fine. I then outlined some concerns about the support given to the Neuropsychology service.

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68. John Pickard then suggested that allegations had been made against me. I repeatedly asked for the specific nature of the allegations against me, and for the identity of any complainants, to be explicitly stated. John Pickard repeatedly refused to provide me with this information, pleading confidentiality. I was misleadingly told by John Pickard that two members of my Department had made complaints about me, when in fact I later learned that only one non-Department member had made written allegations. That person (Mrs Libby Hutchinson) was not a member of my Department. John Pickard also did not declare a conflict of interest, namely that the husband of the complainant (Mrs Libby Hutchinson) was his close colleague and senior lecturer in Neurosurgery (Mr Peter Hutchinson).

69. John Pickard kept insisting that I should consider “choosing the health option”, namely admitting that I was suffering from a mental disorder, something I found particularly upsetting. I was disappointed that two long-standing colleagues, each with an outstanding academic reputation, had uncritically accepted at face value allegations from one or two individuals, and then appeared to dismiss out of hand the statements that I made in response to the alleged comments.

70. I was also shocked and perplexed by some of the allegations at this meeting, in particular those relating to my presumed state of mental health, especially as none of these had been raised by Professor Hodges or Kathy Haynes at my appraisal meeting on February 1, 2005. In addition, for around two years I had worked closely with a senior consultant psychiatrist, Professor German Berrios, and he had never once expressed to me any concern about my mental health. John Pickard nonetheless repeated those highly upsetting allegations in a document he wrote in December 2005 (P630, paragraph 9), claiming that I needed ‘professional help’. I regard the choice presented to me by John Pickard on July 1 2005 as representing a form of ‘mental torture’ – he was pressurising me to agree to his repeated insinuation that I was suffering from a mental disorder, and ‘take the easy way out’. I clearly recall remonstrating and saying that I could not be dishonest to myself, and that I would take the other option, (despite the risks of my standing up to John Pickard). I was placed under strong psychological pressure to make a ‘false confession’, and until that moment had never before experienced the potential of such pressured situations to try and extract a ‘false confession’ from an individual.

71. I was naturally upset that John Pickard several months later put defamatory and misleading comments about me in writing – e.g. that I was ‘economical with the truth’ (P629, paragraph 6), that in Southampton I was head of ‘a selective, partly academic service cocooned within a Neurosciences Unit’ (P628, paragraph 2). I was particularly disappointed as I had invited him and his wife to my house for a farewell dinner when he left Southampton for Cambridge in 1990, and I had specifically mentioned him in the Acknowledgements of two of my books, Memory Disorders in Clinical Practice (3a / CP3-5) and The Paradoxical Brain (70a / CP107-9).

72. I found it particularly distressing that in the course of the meeting on July 1, 2005 a demeaning strategy was used against me – I was told that I either accepted a clinical

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diagnosis of obsessionality and depression, and agreed to be treated via Occupational Health for this, or that the matter would be referred to Human Resources (P516). I considered this a seriously inappropriate way to deal with an issue of this nature.

73. John Pickard was suggesting I would face the prospect of investigatory proceedings following such allegations about me. I was also worried that such investigatory proceedings could conceivably result in a contract of employment being terminated. I considered that the behaviour by John Pickard and John Hodges went against the principles of Good Medical Practice as outlined by the General Medical Council, and in particular Clause 46 of those principles (72a / CP110), which indicates that colleagues should be treated fairly and with respect. Professor Hodges subsequently expressed regret at elements of the meeting, indicating that I must have felt that he not been supportive (P549). I think that was an understatement. To spring such allegations on someone, and to try and force the person down a route with threats if he did not follow that route, was not reasonable management.

74. I subsequently received a copy of Libby Hutchinson’s letter of complaint (P501), and also was finally given the names of the two individuals (Annette Farrant, a junior psychologist in my team, and Sarah Nicol, a part-time locum secretary) on whom Libby Hutchinson and John Pickard had apparently relied for their allegations. However, neither Annette Farrant or Sarah Nicol had been prepared to put any allegations in writing.

75. Annette Farrant had sadly turned out to be an unsatisfactory employee through her demands to do less work yet have Psychology Assistant support of her own and through her decision to go part-time. She was struggling to manage. She then went to see John Pickard to make allegations about me. Neither John Pickard nor Annette Farrant came to me to discuss those specific concerns or to get my point of view. I made specific and detailed rebuttals to those allegations (74a / CP111, 74b / CP112-113). None of the three individuals who made allegations responded to my rebuttals in writing or denied the points of fact that I had outlined in my rebuttals. Normally when someone makes serious, written allegations, as did Libby Hutchinson, it is the obligation of management to investigate these fully, and to respond in writing to both the person who has made the allegations and to the target of the allegations.

76. If the allegations prove to be unfounded, then appropriate measures would often be taken in respect of the individual who made them, including requests for an apology or other disciplinary action. In the case of Libby Hutchinson, to my knowledge, management did not even formally reply to her, but rather preferred to quietly drop the whole matter, since she had simply got her facts completely wrong. Further, I understood from speaking to a trainee clinical psychologist who worked in the same office at the time that Annette Farrant and Sarah Nicol encouraged each other to make verbal complaints about me, yet they were not willing to put any complaints in writing. I naturally was upset and hurt about how all this was managed. I was also upset when, apparently on the basis of what he had heard from these individuals,

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around this time John Pickard remarked to Barbara Wilson that he thought I was ‘a bully’ to my staff. It seemed to be a case of double-standards – minor things that I was alleged to have done wrong were magnified out of all proportion, but when he bullied and threatened me, something that was witnessed and documented, it was all brushed under the carpet. Further, when someone else – in this instance a person in management (Libby Hutchinson) who was the wife of a very close colleague and friend of John Pickard – did something that was wrong, it was also allowed to pass and hushed up.

77. On a number of occasions, I sent email messages to John Pickard, but he tended not to respond to these emails. When I raised this matter with him at the end of the meeting with him and Professor Hodges on July 1, 2005, he tried to laugh this off, comparing himself to the Regius Professor of Medicine in Cambridge University, and claiming that the Regius Professor only answered half of his emails. I regarded John Pickard’s response as rather dismissive and insensitive. Around this time, I relayed my frustration to Professor Alastair Compston, academic head of clinical neurosciences and former Divisional Director (76a / CP114, 76b / CP115).

78. When, subsequent to this meeting, I sent John Pickard and Professor Hodges identical emails on September 1, 2005 (P568), while Professor Hodges responded to the email, John Pickard never responded to the one that I sent him, in spite of the specific concerns that I expressed at the meeting on July 1, 2005.

79. On September 16, 2005, Kathy Haynes rang my colleague Dr Veronica Bradley, without my knowledge or consent. In that conversation, she made a number of critical comments relating to my case (P595-6). She also apparently suggested (to my great shock) that I suffered from Asperger’s Syndrome – I was later to discover that Kathy Haynes had carried out research into this and had even discussed this with someone in Human Resources (P545-548). When, shortly afterwards, Dr Bradley notified me of this conversation, I found this attempt to label me with a psychiatric diagnosis both distressing and highly offensive, as well as being well outside Kathy Haynes’ knowledge and experience. Kathy Haynes had no right to reach such amateur and indeed wild conclusions, and then articulate these and even discuss them with HR. Had there been any concerns over my health (however unjustified, presumptuous and indeed distressing), the only proper route was to involve Occupational Health. I believe that this was more about putting me in my place and retaliating to someone who had stood up to Professor Pickard and had not been willing to turn a blind eye to the use of untrained staff.

80. As can be seen from my interactions with colleagues, we work in a tight-knit community and have links with many colleagues who practice in different Trusts and institutions. These comments from Kathy Haynes could therefore have easily had an impact on my professional reputation, particularly if repeated to other sources. I also discovered that my staff were being interviewed and asking questions by managers such as Mrs Sandra Craft about my private practice (P1262), something I considered insensitive and quite inappropriate.

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Exclusion – Evelyn Trust Grant Application

81. Over this period, I continued to be excluded and marginalised further in a number of ways. In 2006, I found that I was excluded from the steering group that held discussions about developing the Cambridge Clinical Neuroscience Service (P773). Between 2006 and 2007, I also found that I was excluded from discussions around a new community Neuropsychology rehabilitation service for Cambridge patients that was to be closely linked to Addenbrooke's Hospital. This was a grant application to the Evelyn Trust (80a / CP116-195), a grant-giving body based near Cambridge. Peter Hutchinson, consultant neurosurgeon, was the lead applicant, and John Pickard was second lead for the grant, representing the University of Cambridge and Addenbrooke’s Hospital. Kathy Haynes was also listed as one of the applicants. This application was submitted jointly with the Oliver Zangwill Centre for Neuropsychological Rehabilitation and Headway, a local head injury charity. A number of the patients who used that service would also have been patients that had passed through my department, and so it was illogical not to involve me in the planning of such a service in any way. Such involvement had in fact been recommended by Professor Robin Morris in his review of the Neuropsychology service (P438).

82. In addition, in view of the success of my Memory Aids Clinic, I had considerable knowledge, skills and expertise which I could have used to help plan and implement the service outlined in the Evelyn Trust grant application. I was therefore disappointed and puzzled that neither John Pickard, Peter Hutchinson nor Kathy Haynes had consulted or involved me in any way in the application. I was upset by such exclusion, which I also did not think was in the best interests of patient care. I of course had regular contact with members of the Oliver Zangwill Centre around this time – e.g. I had regular meetings with Fergus Gracey, a neuropsychologist who was then based at the Oliver Zangwill Centre. I also knew Barbara Wilson, who had founded the Centre and who was its Director of Research.

83. I realised that Oliver Zangwill staff were based in Ely, and to some extent would have regarded my Memory Aids Clinic in Cambridge as a ‘competitor’ for the grant that was being sought. It therefore would have made much more sense that those individuals who were working in the same building as me in Cambridge – Peter Hutchinson, John Pickard and Kathy Haynes – would have asked for my advice, support and involvement, which I would have readily given. After the grant had been awarded to Peter Hutchinson and his fellow applicants, I did not let myself feel aggrieved – when clinic staff were subsequently appointed to that programme of research, I contacted the two individuals in question, a rehabilitation consultant and a neuropsychologist. We had an amicable meeting where I showed them the resources I had in my Memory Aids Clinic, offered them all the support and resources that I could provide, and promised that my support would be free of charge.

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Exclusion - Memory Aids Clinic

84. There was also evidence of my being excluded from proper bidding processes for new service developments. In early December, 2004, the Multiple Sclerosis (MS) Society carried out a site visit of my Memory Aids Clinic (83a / CP196), which I myself had resourced without any material NHS funding, and they subsequently decided (P456) to offer £60,000 in pump-priming funding for a post of MS Neuropsychologist. This post would help provide a much-needed cognitive rehabilitation service to patients with multiple sclerosis, as well as provide support to specialist MS nurses. I appreciated that there a number of hurdles to be crossed before this offer of funding could be translated into a substantive post – from my experience in putting together an epilepsy business plan in Southampton and my experience in grant applications, I was aware that there were a number of stages to go through. What I simply wanted was a ‘fair crack of the whip’, and for the funding offer to at least be presented to the Investment Board. Although I committed a great deal of time and effort to securing this funding, the proposal was never formally taken to the Addenbrooke’s Investment Board which was operating at the time, in spite of clear indications by individuals such as Kathy Haynes (P506) that it would be done so, and in spite of my specific request that it at least be given a chance of being considered by the Board (P507).

85. I was originally under the clear impression that the bid had been taken to the Investment Board. In view of the adverse events and instances that had occurred, I became concerned that I had been misled. Since this issue was brought up again at my dismissal hearing, I decided around the time of that hearing to check this out with one of the senior managers. I had known a senior manager, Lawrence Ashelford, for some time. We had got on well together – e.g. we had liaised closely on setting up the epilepsy business plan in Cambridge, he had presented me with my award at the Staff Suggestion Scheme award ceremony (196a,b / CP340-1) which had also been attended by the chief executive, Dr Gareth Goodier, and the Trust chair, Lady Mary Archer. I therefore trusted him and believed that he trusted me. I asked him to formally check the minutes of Investment Board meetings around that time. He came back to me with the reply (P1511) that my MS Society funding offer was in fact never even taken to the Investment Board. I was quite shocked when I learned this – I had placed full trust in management to do their bit, and I believed Trust management when they indicated that they would take my offer of funding to the board (P506, P687). John Pickard initially praised me for my success in obtaining this grant offer (P457), but at the dismissal hearing he misleadingly implied that the offer had been considered by the Investment Board (P1463). The fact that the offer of funding was never even taken to the Investment Board was very disappointing, and its effect was to marginalise me and exclude me from opportunities to develop my service.

86. Attempts were also made to exclude me from any publicity relating to my Memory Aids Clinic. In the summer of 2005, I entered my Memory Aids Clinic in a national competition called the Medical Futures Innovation Awards. I was successful in being short-listed for that competition from a total of 1200 candidates. Short-listed

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candidates were invited to deliver a presentation to a distinguished panel of judges at the Royal College of Psychiatrists in London. I made it through to the finals award event that was held on November 3, 2005 in London at a ceremony that was opened by the Health Minister at the time, Lord Warner. My Memory Aids Clinic won runners-up prize in that competition. I was particularly pleased for the junior staff who had supported the work, and I personally paid for them to have a dinner table at the awards ceremony.

87. I was therefore dismayed and surprised that some individuals in Addenbrooke’s management, such as Kathy Haynes and Angela Huxham, (P231) felt that I should be excluded from any publicity being given by the Trust to my award. I found all of this to be quite puzzling. They made the conscious decision not to have a press release to the local media or even just have an item on the Addenbrooke’s website, things that would normally happen if an employee is successful in a national competition and thus enhances the reputation of the Trust.

88. Around that time, I had met up with Mary Archer, Chair of Addenbrooke’s NHS Trust, who told me that she warmly supported my Memory Aids Clinic work (an article about it had appeared in the Addenbrooke’s Newsletter, and I presume that this is how she heard about it). I therefore found it strange that at the most senior management level in the Trust there was strong support for my clinic, but at the level of neurosciences management there was active discouragement. This was telling.

D. ‘Whistleblowing’ Concerns – Staffing, Working Conditions and Resources

89. In accordance with the over-riding objective of the hearing to address key issues relating to the health and safety of patients and bullying matters, and so as not to use up valuable time of the tribunal on important but less critical matters, I have on reflection decided to put to one side as a protected disclosure the issue of facilities for trainee clinical psychologists, and related issues such as working conditions and resources.

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Attempts at Grievance Resolution and Mediation

90. In the summer and autumn of 2005, I held three meetings with management, on August 8, 2005 (P553-8), on September 8, 2005 and on October 19, 2005. Around this time, I lodged a formal grievance in respect of the way I had been treated (P598-603). This is not a step I took lightly. Never in my previous 25 years in the NHS did I ever take out a grievance or even contemplate taking such action. I had always enjoyed excellent relationships with managers, consultants and other staff.

91. At the meetings, as I recall, were Kathy Haynes, Denise Hollinger, Veronica Bradley, Ian Maidlow (Union Rep) and me. Veronica Bradley was not allowed to attend the meeting in October. I regarded these meetings as quite hostile, with the allegation being repeated that I suffered from ‘an underlying health problem’. Far from hearing my concerns, they largely consisted of criticisms about me. For Veronica Bradley, this was her first face-to-face introduction to how managers operated at Addenbrooke’s, and I recall her afterwards being particularly shocked at the hostility that was shown towards me. As part of a suggested resolution, and as requested by management, I submitted a document (P614) which offered constructive proposals for a way forward. In that document, I alluded to the use of unqualified staff in Neuroscience clinics (section 4), since I considered that this contributed to a fragmentation of the Neuropsychology Service.

Stage 3 Grievance

92. A Stage 3 Grievance hearing took place on 21 December 2005 and was attended by Ian Maidlow, Richard Sunley, Karen Clarke, Kathy Haynes, Ms Christine Baron (from Human Resources, as note-taker) and myself. At this hearing, I was allowed to air my grievances, and I recall it was at this hearing that Kathy Haynes made two important concessions – she accepted that my version of John Pickard’s explosive outburst in February 2004 was the correct one, rather than the one that she had previously conveyed, and she herself admitted that John Pickard’s behaviour on that occasion was so alarming and so extreme that she feared he might have a heart attack. Kathy Haynes herself later (P852) used the term ‘explosion’ to describe the outburst by Professor Pickard.

93. My union official at the time, Ian Maidlow, and I were subsequently asked by Richard Sunley (Director of Operations) to attend a meeting that was held in April 2006, one where just Richard Sunley and Karen Clarke would be present. This had followed on from the earlier Stage 3 Grievance hearing in December 2005, which Richard Sunley had chaired. I readily agreed to this meeting (P728) – the meeting was heralded as one where some sort of compromise could be agreed. The fact that neurosciences management were not invited to the meeting was, I thought, significant and I went into this meeting with high hopes of agreeing a solution to my grievances. The meeting was a full and frank one, and I felt that I received a sympathetic hearing.

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94. There were two key points made by Richard Sunley which I regarded as highly significant. He himself said that since Child Neuropsychology at Addenbrooke’s was successfully managed by the neighbouring Mental Health Trust, with a Service Level Agreement (SLA) in place, my suggestion that Adult Neuropsychology should be similarly managed made a lot of sense. He and Karen Clarke reminded me that I would then be a paid employee of that Mental Health Trust, and only an honorary employee at Addenbrooke’s, and I indicated that I was aware and happy with such an arrangement. I had been accustomed to such a management arrangement in my previous post in Southampton. He indicated that there would need to be formal consultation before such a move could be implemented, but I received the clear impression that this was just a formality and that the new management arrangements would soon be put in place. This would appear to be confirmed by the handwritten notes of the meeting (P749-59; P760). In view of Richard Sunley’s seniority, I thought that this change in management arrangements would be prudent, practical, appropriate for patients, and that it would happen.

95. I realised, however, that if such a management transfer was implemented by Richard Sunley it might displease John Pickard and Kathy Haynes, since they would no longer have ‘control’ of me, of the Neuropsychology Department or my budget. I therefore specifically indicated to Richard Sunley that I was quite happy for the suggestion of an SLA to be seen to come from him rather than from me, since this might be more tactful and more diplomatic. At the meeting in April 2006, Richard Sunley also expressed sympathy with my request for a Recruitment and Retention supplement, using words along the lines of - ‘I appreciate that you were promised a Recruitment and Retention supplement’. He promised to look into this, and again I got the impression that the supplement would be favourably considered.

96. I really did think that the meeting in April 2006 was the end of the whole affair, and that my stresses and strains were at an end. I clearly recall after the meeting standing with my union official, Ian Maidlow, in the foyer of Addenbrooke’s Hospital, shaking hands with him, thanking him for his support over the past two years, and expressing relief that this was now all over, and that I could concentrate on what I enjoyed doing most, looking after patients. Ian Maidlow was also optimistic that we had reached a constructive solution and that the affair was now settled.

97. In the subsequent weeks, I had several interactions with Karen Clarke, where she asked me to provide documentation relating to the Recruitment and Retention premium, since it operated via Department of Health guidelines in 2003. I readily provided her with all of this information. Sadly, some months later, I received a letter from Richard Sunley (P170-171), where he declined my request for a Recruitment and Retention premium. I was both disappointed and puzzled at what I considered to be his ‘about turn’. I can only surmise that he may have been put under some pressure by others not to agree this premium, though I did appreciate the time and effort that he accorded to the matter.

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98. At the meeting in April 2006, Mr Sunley indicated that he would appoint a project officer to deal with the formalities involved in considering a transfer of the management of my service to the Mental Health Trust. I was rather surprised therefore when in subsequent correspondence it seemed that this person would in fact be carrying out a major review of Neuropsychology services. This seemed to be going in a different direction from what had been agreed at the April 2006 meeting. I nevertheless did not wish to create a fuss, and in particular I did not wish to do anything to delay any review taking place. The review was carried out by Bob Ellis, a senior manager in the Trust.

99. I happily met up with him, and gave him all the information he requested. The subsequent review and report took an extraordinarily long time to be written and circulated, and the report itself was not made available to me till over two years later, May 2008, even though I had chased this up periodically (P800). I was never given satisfactory reasons for this protracted delay. The report recommended a radical overhaul of the management of Neuropsychology Services, together with significant investment in resources (P2418) – ‘The history of this service would seem to indicate that only through a radical change of management, as well as a degree of additional investment, will the potential provided by its locality be fully realised and the challenges referred to above acknowledged and met’. Neither of these two measures has ever happened, and really summarised the key issues that my Department faced.

100. The original offer by Richard Sunley to favourably consider a transfer of the management of my service to the Mental Health Trust seemed to have got hijacked and I obviously felt let down. Looking back at all of the time and money which has been spent by all-concerned over the past few years on legal, mediation and other expenses, money that the Trust could have spent on patient care and improving my service, and money that I could have spent on my family and in my charitable activities - this expenditure could all have been avoided if the earlier suggestion of a Service Level Agreement, that Richard Sunley himself supported in April 2006, and which I now know Karen Clarke also supported (P863), had been implemented without delay.

Stage 4 Grievance

101. On October 17 2006, a Stage 4 grievance hearing was convened in response to my letter of July 4, 2006 (P781-84). At this hearing, the Trust brought witnesses, and I too was allowed to bring witnesses. My Statement of Case for the hearing specifically referenced the use of unqualified staff, as well resources and working conditions, together with instances of bullying and harassment (P815-819). The notes of this hearing are at P844-854 – I specifically reference unqualified staff at P850, as well as indirectly referencing bullying, also at P850. In my suggested resolutions, I again proposed that neuropsychological activities in Neuroscience clinics at Addenbrooke’s should be under the remit of the Neuropsychology

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Department to ensure good clinical governance. The outcome of this hearing (P855-56) was sympathetic to the concerns that I had raised, but sadly no specific steps were put in place to address issues relating to management of the Neuropsychology Service, my concerns regarding the use of unqualified staff, my exclusion from key service activities and developments, and shortages in staffing and resources (P857-8) compared to other comparable centres (P1699).

2008 Mediation

102. In the spring of 2008, I suggested mediation as a way forward to resolving grievances, and this was only reluctantly agreed to by management. Trust management eventually entered into mediation. On my side was my solicitor, Sarah King from PJH Law, my colleague Dr Veronica Bradley, Consultant Neuropsychologist. Representing the Trust were Richard Sunley and Karen Clarke. The mediator was Fiona Colquhoun from the Centre for Effective Dispute Resolution. The mediation meeting took place in July 2008. The outcome was that a Mediation Agreement and a Working Arrangements agreement were drawn up. The Trust agreed to issue a statement to key individuals noting regret for the way that I had been left to feel and acknowledging that it could have handled matters differently.

103. In clear breach of the mediation agreement, the agreed circular from the Trust to key individuals was not in fact issued, and it was only when I happened to ask about it 1-2 years later at a meeting with Karen Clarke (P1053) that a much delayed, and probably by then ineffective, circular was issued. Although Karen Clarke did offer her apologies, I nevertheless felt upset that a key part of the Mediation Agreement had not been adhered to, and it did dent my confidence as to whether other parts of the agreement would be properly implemented.

104. As part of the mediation, an document entitled "Working Arrangements" was drawn up to agree commitments, activity levels and resources in respect of my service (P1004-5). One of the Trust management’s requests of me that was encapsulated in the Working Arrangements document was that ‘Memory Aids patients’ should constitute no more than 10% of the patients seen. This request reflected a degree of misunderstanding on the part of Trust management in that, although some patients were referred specifically to the Memory Aids clinic, the vast majority were patients who were referred more generally for assessment and rehabilitative input; the need for any memory aids, if it arose, emerged during the consultation. Nevertheless, I attended to this request. If I did include memory aids input during a routine outpatient consultation, it usually took up less than 10% of normal contact time. The number of patients seen solely for memory aids intervention was quite small, no more than 12 a year.

105. In late summer, 2008, I met up with my new manager, Tom Bennett, who had been named in the Mediation Agreement, and who took over the line management role from Kathy Haynes. Although I had not been consulted about this change over, and

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had only found out about it in a passing comment at the Mediation meeting, I welcomed Tom Bennett to my Department. We set up regular meetings. I recall at the first meeting we had a general chat about Southampton, since he had spent some time there, and I thought our relationship got off to a good start and continued to thrive. As for all managers, I invited him to come to any of my monthly Department staff meetings, and to sit in on any of my clinics.

106. I was delighted therefore when he agreed to attend one of my Department meetings – I hold these as a working lunch in the Addenbrooke’s post-graduate centre. I treat my staff to lunch, and at the same time we go over an agenda of items, usually to do with Department level of activity, resources, etc. Any concerns that staff have can also be brought up at this meeting. Tom Bennett came to one of the Department meetings, and joined in on these discussions. At one of our 1:1 meetings, I told Tom about the fact that I was making booklets for patients (which I gave to them free of charge), and that it would really be helpful if the Neuropsychology Department had a booklet maker. This would save time in preparing booklets, and would result in a better finished product. He readily agreed to this request. Another issue that came up at our meeting was payment by a Trust outside Cambridge for a patient I had seen privately. There had been some misunderstandings between me and that Trust, and Tom gave helpful advice in resolving those misunderstandings.

107. I therefore was pleased about these new management arrangements. I found Tom easy to get on with, and I think that he found me easy to get on with. I purposely did not involve Tom in any discussions about the Mediation agreement, or an exit package, since I considered that this was something that Karen Clarke, who was at the Mediation meeting, was dealing with, and I regarded Tom’s input as primarily relating to the day-to-day clinical service in my Department. There had been lots of ‘politics’ in the events of previous years, and I simply did not wish to involve Tom in such matters.

108. In December 2008, I realised that the Trust was unwilling or unable to comply with its side of the Working Arrangements. My disclosures with regards to the use of unqualified staff were still being ignored by management. I had still not been given adequate space for both my junior staff and me to see patients 1-to-1. There was only one testing room for the whole Neuropsychology Department, so only one patient could be seen at any one time. It was claimed by John Pickard in December 2005 (P629) that I could have carried out neuropsychological investigations in my own office. This shows a lack of insight into what is involved in carrying out neuropsychological investigations. It also shows a disregard for that aspect of the review of the Neuropsychology service carried out by Professor Robin Morris, where he specifically commented on the issue of space (P444). My own office is quite small (16a / CP85), and for health and safety reasons could not be used for seeing patients, even ambulatory patients, never mind those in a wheel-chair (Trust health and safety staff did in fact visit to survey my office in a summer period and stated that in terms of temperature alone it was unsuitable for seeing patients). As

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per our professional guidelines (P1734, paragraph 5) ‘the Clinical Neuropsychologist will require a dedicated area for conducting assessments and rehabilitation so that appropriate access to testing and rehabilitation materials is optimized. Issues that need to be kept in mind include noise, lighting, temperature, health and safety considerations should patients have a seizure, etc’.

109. I felt badly let down and it was for this reason that at my suggestion I held some informal meetings with Karen Clarke about a possible departure but these did not come to anything, and I did not pursue that option, especially in view of the fact that at my age and seniority it would be very difficult for me to get a similar post elsewhere. Part of me also felt that while many of my predecessors had just given up and left in response to difficulties and frustrations with management, as a matter of principle and in the interests of patient care I should stand firm and try to improve the situation rather than just pack my bags and leave.

Juliet Walters and 2010 Mediation

110. When Juliet Walters came into post in early 2009, I was not consulted about the fact that she was to take over from Tom Bennett as my line manager. She was more senior than Tom Bennett, and had the same role as Richard Sunley. Richard Sunley had never been my line manager, and so I thought it odd that such a senior person would now be my line manager. I found this change in management puzzling and upsetting, especially as I had been developing an excellent relationship with Tom Bennett.

111. I regarded this as being excluded from a strategic decision that affected the Neuropsychology Department, and in breach of the Working Arrangements agreement. Clause 11 of the agreement indicated that I would ‘be properly consulted by the Clinical Services Director and Neurosciences management on developments relating to Neuropsychology’ (P2393).

112. I nevertheless readily met up with Juliet Walters. I welcomed her to the hospital and to my service. I invited her to sit in on any of my clinics, to Department meetings, to meetings of the East Anglia Neuropsychology Forum, etc. and I highlighted my desire to forgive and forget the past. I was therefore disappointed that Juliet Walters never attended any of the Neuropsychology Forum meetings, nor any of the Department meetings, but she did take up the offer to sit in on one of my clinics.

113. My paper on clinical excellence (On the Pursuit of Clinical Excellence) had just been published at the time, and I gave her a copy (P2148). I hoped that she might use the paper as the basis of my appraisals and professional development, and any improvements for the service that she felt were needed. I also thought that she might find the paper helpful in her dealings with other staff. So I was disappointed that she did not even acknowledge or give thanks to receiving the paper. This was surprising in view of the fact that I later won an award for that article.

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114. I was nevertheless pleased when Juliet Walters accepted my invitation to sit in on one of my clinics in October 2009. I recall that shortly before that clinic I had just come back from attending a meeting of the Memory Disorders Research Society in Chicago, and I was recovering from a bad dose of the flu I had picked up in the States. I was in two minds whether to cancel the session we had arranged, but I felt that she was probably making an extra effort to sit in on my clinic, and that for my part I should make an extra effort to make sure that the session went ahead, even though I myself might be performing slightly ‘under par’. Juliet Walters was able to see at first hand what I did during a clinical interview and neuropsychological testing, and how I could help a patient both with counselling and with assistive technology such as memory aids. I went out of my way to explain my clinic and the clinical case to her, to make her welcome by offering her tea and biscuits, and to give reasons why I engaged in various activities in the clinic. I also pointed out some of the limitations in our resources that she could see at first-hand, such as our having only one treatment-testing room, and I hoped that she would therefore take steps to try and improve this situation. The patient we saw in fact had both diagnostic and rehabilitation needs, and I was thus able to show Juliet both sides of my clinical practice. I was therefore both puzzled and upset when I later found out during the disclosure exercise that shortly after attending my clinic she appeared to disparage it in an email to John Pickard and Kathy Haynes (P1140), especially as she had not raised any concerns with me at the time of the clinic. Even if her concerns were in her view justified, I would have expected that someone who was relatively new both to the Trust and to the profession of clinical Neuropsychology would be more cautious about coming to conclusions after just one clinic attendance.

115. Juliet Walters intimated to me during discussions at one of my early meetings with her that I should consider moving elsewhere, and she gave her own example of having moved down from northern England because she did not like the job she was in. It was clear to me that she favoured me leaving, which troubled me, but I tried not to take it personally, and accepted that she had a viewpoint that she was entitled to. During my conversations with Juliet Walters it was also clear that she was quite sensitive to my saying anything critical about John Pickard or mentioning his past bullying behaviour.

116. What was more concerning to me was that when I told her that one of my colleagues (Dr Georgina Browne) was unhappy with her working conditions, she stated that if my junior colleague did not like her working conditions she should move elsewhere. I was quite taken aback by the bluntness of this remark. When in an email of March 12, 2009 I expressed unhappiness to Juliet Walters about one of the remarks, she denied having made it (P2428). For me, this was doubly upsetting – that such remarks should have been made in the first place, and that Juliet Walters should then be willing to deny having made the remarks. For me, it did not portend well for the future, since I regard honesty as a key principle in any

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relationship, but I nevertheless readily agreed to future regular 1:1 meetings with her.

117. In other ways, I unfortunately found Juliet Walters to be on occasions difficult to work with. On one occasion, when we were meant to have a meeting first thing in the morning, the meeting was clearly diarised to be in her office, but for some reason she went to my office. I waited at her office for around 5-10 minutes, and then returned to my own office, thinking that there might have been a simple misunderstanding and that she might be there waiting for me. When I reached the ground floor of my unit, she was coming out of the lift. It is hard to forget the look on her face. She was obviously extremely angry. We duly went to my office on the first floor, and she started to have what I can only call a ‘rant and rave’ at me, making what I considered to be unfounded and unfair criticisms of me, implying that I was deliberately being obstructive and unhelpful. I was quite taken aback by this. I appreciated that she obviously got flustered by having to wait for me, and while I considered the mix-up may have been a genuine misunderstanding, she had jumped to the conclusion that I was deliberately trying to avoid meeting her. I did not respond to any of her provocative and angry comments, but I regarded the incident as quite distressing and unbecoming in a senior manager.

118. At one of our early meetings, Juliet Walters indicated that she wanted to set up “a review of the Neuropsychology Service”. I told her that there had already been around four reviews of the service, two from external assessors (P430-P445; P446-P452), one from Bob Ellis (P2409-25) and also a detailed review of clinical psychology services that I had carried out at the request of senior consultant colleagues in the Psychological Medicine Group which I regularly attended and where I also liaised with senior managers (P950-954;117a / CP197-99). There had also been a review of Neuropsychology input to a planned epilepsy service. All of these five reviews had taken up considerable time and resources, with interviews of key stakeholders, data from comparable teaching hospitals, etc. and I questioned as to whether there was need for yet another review. She dismissed my concerns immediately and decided to go ahead with a review, stating that it was her intention to set up a ‘strategy review group’. Although I was troubled by this, I nevertheless indicated that I would work with her in setting up the review group.

119. I intimated to Juliet Walters that it was in the best interests of patient care that the ‘strategy review group’ that she formed in respect of Neuropsychology Services should have both a regularly-referring neurosciences consultant, such as someone from the Memory Clinic or the neurorehabilitation service, and also a senior practising neuropsychologist other than myself. For the latter, I suggested my colleague Professor Barbara Wilson who had worked at Addenbrooke’s for many years, who knew my Department and my service well, who had set up the Oliver Zangwill Rehabilitation Centre, and whose opinions were highly respected both nationally and internationally. This proposal was not taken on board. Juliet Walters seemed to have her own fixed views on how to proceed, and did not seem to appreciate my concerns about what was in the best interests of patient care,

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professional regulations, etc. This was in breach of the letter and the spirit of the Working Arrangements agreement.

120. I recall in several emails making specific representations to Juliet Walters (P1140-44) about the importance of having these two individuals (Barbara Wilson and a regularly-referring consultant) in the group. She decided, after consultation with John Pickard, the individuals who would be in the group. I repeatedly pointed out to her the value of having proper professional representation in the group, and she repeatedly refused to accept these suggestions. She made vague offers of possibly having other individuals in the group at a later stage, but I knew that involving someone at a later stage of a process was quite ineffective, since they would have no first-hand knowledge as to what had previously been discussed at earlier meetings, and might feel aggrieved or insulted that they had not been included earlier. In later statements, both Juliet Walters (P1452) and John Pickard (P1463) appeared to back-track on the reasoning behind their refusal to allow the request for Barbara Wilson to be allowed to join the group.

121. Juliet Walters later claimed that, since Barbara Wilson did not at that time have an honorary contract with Addenbrooke’s Trust, she could not be in the group. I explained to Juliet Walters that Barbara had always held an honorary contract, that it had temporarily lapsed following her retirement from her post with the Medical Research Council, and that we were in the process of renewing her contract. Delays in the renewal of her contract had in fact come about because neuroscience management had mislaid honorary contract forms that I had sent them (P945; P955).

122. Despite my remonstrations, Juliet Walters insisted that she would not allow my two requests for representation in her strategy review group. As a last resort, since she did not appear to understand the reasons why I wanted these individuals present, and at a loss to know what to do, I asked my solicitor to write to the Trust indicating the background of those individuals whom Juliet Walters insisted should be present in the group. I appreciate that this letter could have been worded more diplomatically, and that it has been interpreted by Trust management as my appearing to show lack of trust in management, but I was clear on one key point – for my part, I did not refuse to attend the meetings because of certain individuals (e.g. Barbara Sahakian) whom John Pickard and others insisted were present. I would have readily attended meetings with them present, even though I could have raised the technical objection that Barbara Sahakian was not at that time registered with the Health Professions Council, was not in active clinical practice, and had supported the use of unqualified Psychology staff in Neurosciences clinics. It was Juliet Walters who was adamant that Barbara Wilson and a regularly-referring consultant would not attend the meetings, and it was this that led to my decision. I nevertheless left the door open for my attending group meetings, after appropriate consultation and agreement (P1144).

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123. I went out of my way to maintain good working relationships with many of those who took part in the strategy review group meetings. Thus, in the case of Barbara Sahakian, I attended a lecture on neuroscience by her at the Royal Institution in London, and also a lecture by her on leadership at Addenbrooke’s Hospital. I took the view that local colleagues should be present to indirectly offer support when someone gives a lecture, and after the lecture at the Royal Institution, Professor Sahakian in fact thanked me for attending. I also jointly authored a paper that was written on a rare patient with whom Barbara Sahakian and I were involved (122a / CP201). I wrote to Barbara Sahakian, offering to meet up with her to discuss the Neuropsychology Service at Addenbrooke’s (P1161), but sadly she did not even respond to my letter. In the case of Peter Hutchinson, I offered him joint authorship on a paper that Barbara Wilson and I wrote on a single case (122b / CP200), even though Mr Hutchinson’s contribution was relatively minor. He and I successfully liaised on that publication.

124. I realised that I had to take a principled stand on the issue of the constitution of the strategy review, because of what was in the best interests of patient care. I also wished Neuropsychology to be treated with more respect. It was something of a dilemma for me, as I realised that I would once again be excluded from something I wished to engage in. I knew that my stated inability to attend those meetings would not be taken favourably by Juliet Walters, but it was not a decision I took lightly, as my natural instinct is to engage with others. For such critical decisions, I do consult senior colleagues, and in this case I consulted Geraldine Owen, Head of Clinical Psychology in the neighbouring mental health Trust. As part of my clinical governance and appraisal arrangements, I had regular meetings with her, and when this issue was discussed, Geraldine Owen supported the stance that I took. She agreed with me that Juliet Walters was being unreasonable, and Geraldine Owen also made the explicit decision not to attend any of the strategy review group meetings.

125. In spite of my decision not to attend the meetings that Juliet Walters unilaterally organised, I regarded it as my prime duty to continue to engage in dialogue with Trust management at a senior level in any ways that would improve my clinical service to patients. Thus, around the time of the strategy review group meetings, when Lawrence Ashelford asked to meet up with me, I readily agreed. He was a senior manager whom Juliet Walters had asked to carry out yet another service review, which related to her strategy review. I had interacted with Lawrence in the past. He was a senior manager in the Trust, with responsibility for strategic developments. We had got on very well, and we both respected each other’s views. I clearly recall having a friendly chat with Lawrence about psychological aspects of management, since he was attending some related courses. Lawrence and I met up for an extended meeting on matters relating to the Neuropsychology Service, and I provided him with all the documentation that I had which would help him in his review. On a later occasion, one of his junior staff also asked to meet up with me,

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and I also readily agreed to this, meeting up with her, and also providing her with documents (P1341).

126. Around this time, Juliet Walters insisted that she wished to escalate our earlier 1:1 meetings to ones where Karen Clarke was present. I knew that this meant a more formal flavour to the meetings, and that issues relating to the Mediation Agreement would be brought up, since Karen Clarke had attended that meeting and was one of the ‘caretakers’ of the Working Arrangements document. Karen Clarke would also be familiar with employment law and rights. I had in the past had quite a distressing experience with a 2:1 meeting – the one in July 2005 with John Pickard and John Hodges. I therefore asked that my lawyer, Sarah King, accompany me to such a meeting, since Sarah had also been present at the Mediation Meeting, and would be familiar with employment law and rights. This was agreed to.

127. There would of course be costs in Sarah attending, and since Addenbrooke’s had paid my legal costs in full at the 2008 mediation, I thought it would be reasonable that they pay her costs for attendance (not of course any other advisory costs which I continued to pay in full), especially if there were to be many such meetings, with a likely additional cost to me of many thousands of pounds if there were to be half a dozen or so such meetings. If it had definitely been down as a one-off meeting of the four of us, I would have been prepared to pay one day’s costs, but I could not afford to commit to major, open-ended expenditure. I appreciate that the Trust could also not commit public funds to open-ended expenditure, and in retrospect we should jointly have pursued other options, such as perhaps having a meeting by video link via Skype or similar technology, which would have been less costly. I had used the video conferencing facilities at Addenbrooke’s before for clinical case discussions, so that could have been a practical possibility, but unfortunately none of us thought of it at the time. We failed to reach agreement on this matter, but it is important to note (P1290) that I continued to offer 1:1 meetings with Juliet Walters and Karen Clarke at any time and in any place. This is an offer that neither of them took up.

128. In the light of not being able to agree on matters within the Working Arrangements document, I therefore suggested that the matter be referred back to mediation. Trust management were again reluctant to take part in such mediation, but eventually agreed to it taking place.

129. Mediation took place on 6th October 2010. As at the mediation meeting in 2008, there were representatives from both sides. The mediator was Kate Lawson, an employment lawyer. Regrettably, no agreement was reached as a result of this mediation meeting.

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F. (i) Dismissal Hearing & (ii) Evidence to Rebut

(i) Dismissal Hearing

130. It was a major shock to me when I received a letter from Juliet Walters (P1338) effectively indicating that she was putting in place steps to effect my dismissal. I had in the intervening weeks been carrying out my work as usual; this included ensuring that the strategic development of the Deep Brain Stimulation Service was proceeding smoothly.

131. I immediately circulated my consultant colleagues, asking if they would provide statements of support – I realised that they would find themselves in a difficult position, not knowing details of my case, not wishing to upset managers, not wishing to upset someone as senior as John Pickard, etc., but I was nevertheless pleased that many of my consultant colleagues readily provided statements of support. In my email to consultant colleagues (P1512), I recounted the story of Mahatma Gandhi who had been unjustly ejected from a train in South Africa onto the station platform, and then used that event as a metaphorical platform to resolve to put right the injustice that he and others in South Africa had suffered. I also at that time copied my letter of protest to the chief executive, Dr Gareth Goodier, and to the chair of the Trust, Mary Archer, with whom I had in fact had good relations and whom I had met on a number of occasions, but they did not respond. I knew that they also would find themselves in a difficult position, and I was therefore not surprised that they did not intervene.

132. I also could not understand the threat of dismissal in the context of my job description, and everything I had done to meet the specific requirements of that job description. As I was to outline in my Statement of Case for the dismissal hearing, I had gone out of my way to carry out what was required of me to the highest standards (P1586-7). I also could not understand why something that I and a number of my colleagues had simply regarded as a personality clash between Juliet Walters and me could be elevated in such a disproportionate way.

133. My dismissal hearing was scheduled for December 1, 2010. A few days before the hearing, the two panel members, Richard Howe and Oonagh Monkhouse, asked to visit my Department. I agreed to this, and they also sat down with me for about 15 minutes, asking me about my service. Oonagh Monkhouse was quite friendly with me, and we talked about our shared experience working in N Ireland. By contrast, I found Richard Howe rather formal - he made relatively little eye contact with me, and he did not appear to wish to readily engage in ‘small-talk’. I was also somewhat puzzled and surprised by some of the questions that Richard Howe asked me (e.g. about the nature of the referrals I received). It was clear from his questions that he had little grasp of what was involved in providing and managing a clinical service, never mind a complex, specialised clinical service such as Neuropsychology. Since I knew that he was by far the more senior of the two individuals, I was therefore somewhat apprehensive in advance of the hearing

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134. The dismissal hearing itself took place over the whole day of December 1, 2010. My Statement of Case and Appendices are at P1884-2372. This was naturally a new experience for me, and I found the whole day very stressful. The events of the day took up so much of my attention and concentration, and for me were so tense, that I did not feel like eating or drinking during the day.

135. On quite a few occasions, Oonagh Monkhouse or Richard Howe stopped me from making particular points or asking particular questions, stating that they regarded these as outside the remit of the hearing. I naturally had to accept their judgment on this. In retrospect, I would have much preferred if the hearing had been set over two days, and if there had been enforced breaks at regular intervals.

136. It became clear to me during and towards the end of the hearing that the panel were not being objective or open-minded but were going to try and decide against me. I was given the clear impression that failures and lapses by management were being ignored or downplayed, whereas any lapses on my part were magnified and pursued in great depth. Thus, Richard Howe appeared to take seriously and spent some time discussing with John Pickard a suggestion that I should resign, and then take up a part-time temporary post at the Oliver Zangwill Centre. This appeared to be a half-baked idea that I was later to learn had not even been discussed with anyone at the Oliver Zangwill Centre. By contrast, Richard Howe hardly spent any time considering the detailed options which I had put forward as alternatives to dismissal (P2566-67), such as my being managed by another individual or a service level agreement with the Mental Health Trust. I was never provided with any specific evidence to suggest that they were formally considered as options. I was told that some options were not affordable, but formal costings were never presented to me. My understanding is that the Trust has an overall budget of around £550 million, and on legal expenses and claims alone spends hundreds of thousands of pounds every year. I appreciate that every Trust has cost considerations and priorities, but there was a lack of fairness in how my options to dismissal were handled.

137. During the hearing, Mr Howe appeared not to question any statements made by John Pickard or challenge some of his rather derogatory or inaccurate comments. Thus, there was no challenge from Richard Howe when John Pickard implied (P1449) that he sent many patient referrals to me, when I in fact rarely received any referrals from him; when the bullying episode in February 2004 and John Pickard’s explosive outburst were raised (P1451), he again tried to paint a picture which put me in the wrong: ‘have been very provoked by NK at the time. Doesn’t understand reverse psychology. NK guilty of harassing me – repeatedly asking for resources’; thus, although John Pickard no longer claimed amnesia for the event, he was putting a complexion to the episode that Kathy Haynes had initially put but later retracted. There was no challenge from Richard Howe when John Pickard downplayed the importance and the role of the Health Professions Council and implied that it might soon not have any important regulatory role (P1461), when John Pickard claimed that he had just undergone 360-degree feedback and no one had made any complaint about his temperament (P1450), or when he denied

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(P1463) that Barbara Wilson had been excluded from the strategy review group. There is no question (as I understand it) of the Health Professions Council being disbanded and it remains a major and important professional regulatory body, and in the case of 360-degree feedback, one would wish to know the format of the feedback form, to whom it was sent, how many returned the forms, etc. For example, Heads of Department in Neurosciences would normally be expected to receive such forms, but I certainly did not receive a 360-degree feedback form in respect of John Pickard.

138. At the dismissal hearing, I referred Richard Howe and John Pickard to the important document on commissioning Neuropsychology Services that had been drawn up by the Division of Neuropsychology of the British Psychological Society, and its key recommendation (P1735, paragraph 8) that ‘The question of who manages Clinical Neuropsychologists may be critical. Managers should have experience and training in the management of psychology services’. John Pickard misleadingly interpreted that as referring to my management of junior staff (P1461), and Richard Howe simply accepted his word rather than mine. I was dismayed at this, since it went to the heart of one of my alternatives to dismissal – that my service could be managed by the neighbouring Mental Health Trust, and where I myself would then be managed by someone who had experience and training in the management of psychology services, just what my professional body recommended. One of my key managers, Kathy Haynes, had in fact in earlier years admitted (P565) – ‘I am conscious that I do not have expertise in this area of service’; ‘Neuropsychology is one area where I have particularly little knowledge about how it works’ (P389).

139. In the case of derisory comments, not all of which were recorded, John Pickard for example called Barbara Wilson’s appraisal of me ‘Micky Mouse’ (later at the dismissal hearing, he described her as ‘old school’); he suggested to the panel that I was ‘not [an] easy person to collaborate with – panel can see that’ (P1462). He called my former colleague Dr Illis ‘always cross - colourful character’ (P1463) and he later at the appeal hearing claimed to be ‘looking after’ Dr Illis as a junior when they were both in Southampton, something I found both bemusing and rather odd since Dr Illis was by far more senior and more experienced than John Pickard. I recall all of these comments since they were inappropriate and unbecoming in someone as senior as John Pickard.

140. The issue of appraisals was raised at my dismissal hearing. At my appraisal meeting on February 1, 2005, which was convened and organized by Kathy Haynes, no colleague from my profession was invited to be present. The only other person present was John Hodges, a consultant neurologist. I considered this to be unsatisfactory, because neither Kathy Haynes nor John Hodges had relevant qualifications, skills or experience relating to Neuropsychology, nor were they familiar with the professional standards set by my regulatory body at that time, The British Psychological Society. I did indicate my dissatisfaction to Professor Hodges after the meeting, and that a clinical psychologist should have been present.

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141. On a number of occasions since my appointment, where Kathy Haynes disagreed with the department’s policies and procedures, to my knowledge she never took up the option of consulting the two other local experts in clinical psychology (who were on my appointment panel), Professor Barbara Wilson or Mrs Geraldine Owen. In the case of later appraisals, I took advice from Geraldine Owen, who agreed with me that Barbara Wilson was the best person to carry out my appraisals. As well as being a very senior neuropsychologist with extensive knowledge, skills and experience, she had worked at Addenbrooke’s for many years, having held a full honorary contract there, and was familiar with the running of my clinical service and related Neuroscience departments. I subsequently followed all relevant procedures and diligently completed my annual appraisals with Barbara Wilson and submitted them to HR. On no occasions were these appraisals questioned at the time.

142. As a non-clinician, it was also clear that Richard Howe was misinterpreting or not accurately following some of the evidence provided by experts. Thus, for example, when my colleague Graham Lennox, Consultant Neurologist, gave evidence he indicated that it was ‘obligatory’ for him to attend neurology department meetings. I could see from Richard Howe’s response to this that he was confusing Department meetings with Division meetings, and had misinterpreted what Graham Lennox had said. When it came to the issue of unqualified Psychology staff being employed in Neuroscience clinics, Richard Howe also did not seem to grasp what was involved at the level of clinical governance, and he simply dismissed my disclosures as a ‘difference of professional opinion’. This was not accurate or a serious effort at understanding and grappling with the important patient care issues involved.

143. At the end of the hearing, Mr Howe seemed to give a clear implicit indication to my union official – by his glance and by they way he concluded the meeting – to get me to agree to some form of ‘exit package’. I did not see that as indicative of a proper and fair decision making process.

144. During the hearing, I was particularly upset at two events. Firstly, when I asked Juliet Walters to read and comment on the heartfelt statement of support from my junior staff (P2606), she responded – ‘Subordinates, what more would you expect’. I was so shocked by this response that in the following few days I sent an email to my union official to confirm that I had heard it correctly (P1482). That comment from her seemed to sum up her attitude towards me, my staff and my service. Secondly, when John Pickard gave evidence, I asked him specifically about the conversation we had in the spring of 2003, prior to my taking up my post, and when we specifically discussed a Recruitment & Retention premium. At the hearing, I asked him – “Do you not recall saying in respect of your promise of that premium, ‘You can trust me, I am a man of my word?’”, and he denied making that remark. I found it upsetting that someone could deny something that they had said, especially someone as senior as him, and someone whom I had known for many years as a colleague.

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145. During the hearing, I found it strange that when Juliet Walters was being evasive, with remarks such as ‘I cannot comment’ (P1456, P1458), this was not once challenged by Richard Howe or by Oonagh Monkouse. I also found it surprising that they did not appear to give any weight to her own admission that, if John Pickard had any concerns about me, he should have taken the initiative and held 1:1 meetings with me, something that he never did. When John Pickard was evasive or did not answer questions directly, this was also ignored. Thus, for example, he alleged that I never put a paper to the Neurosciences Division Board ‘setting out a strategic vision’. When I asked him if he had ever asked me to prepare a paper and if I had ever refused, he simply responded, ‘Leaders lead’ (P1461). The paper I presented at my job interview (P372-4) had in fact set out my strategic vision, but this seemed to have been forgotten about.

146. At the December 1, 2010 hearing, I was also stopped (P1463, bottom of page) by Richard Howe and by Oonagh Monkhouse from challenging John Pickard on the explosive outbursts that he had displayed, which amounted to bullying behaviour, and which were a major cause of the situation at hand. I was effectively not allowed to make this point as it related to John Pickard. This was unfair and prevented me from advancing a key part of my case.

147. At the end of the hearing, another episode took place which suggested that the hearing was biased. Towards the end of the hearing, I was understandably both hungry and exhausted. I realised by then that I would likely lose the case. I genuinely thought that if I was conciliatory and flexible that I might keep my job, so I made some conciliatory statements about being prepared to give up the management side of my job. Around this time, Richard Howe asked me to retract what I had stated about John Pickard’s explosive outbursts. He also demanded that I retract my gagging allegation against Juliet Walters. I mistakenly thought that this was part of a genuine negotiation - if I agreed to this, then they would let me keep my job. When Richard Howe, Juliet Walters and Oonagh Monkhouse saw me considering conceding these two points, I got the impression that they thought it was 'a free for all', and Juliet Walters then asked me to apologise for something else, I suddenly realised what was going on and stood firm and said I would not apologise for anything more.

148. Richard Howe had repeatedly suggested that he was fair and impartial, that he would not make a decision till after the hearing, and here he was along with Oonagh Monkhouse and Juliet trying to force me to admit that I was wrong. John Pickard had in previous years said a number of unfounded things about my mental health, and Richard Howe never asked him to apologise to me. Juliet Walters had said inappropriate things about my staff (‘if Georgina does not like it here, she can move on'), and he did not ask Juliet Walters to apologise. So the idea of the panel being impartial and Richard Howe not taking sides was in my eyes proving by this stage to be far from reality.

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149. It was only in the following weeks that I realised I had given in at the end of the dismissal hearing while under duress. I later in fact withdrew my form of retraction in relation to gagging, and in respect of John Pickard’s explosive outbursts, I indicated that I stood by every single word of the evidence relating to them, but that I agreed that a technical diagnosis of Intermittent Explosive Disorder could not be made on the basis of the available evidence.

150. When I received the minutes of the hearing, I was concerned that a number of the events outlined above were not accurately represented in the minutes. In his dismissal letter of December 15, 2010 (P1504), Richard Howe stated that the notes ‘were made to assist us with noting the key points made at the meeting and are not intended as a full record of the hearing’ – Two examples of significant omissions are the statement by John Pickard above about his stating to me ‘I am a man of my word’ and a derogatory remark by him about the appraisal document carefully prepared by Professor Barbara Wilson, calling it ‘Micky Mouse’. I subsequently found it strange that my appeal hearing had a dedicated note-taker, but that the dismissal hearing did not have a dedicated note taker. I also found it strange that the appeal hearing had three individuals on the panel, two who were clinically qualified, but that the dismissal hearing only had two individuals, neither of whom was clinically qualified.

151. After the dismissal hearing, I met up with my external colleague Dr Veronica Bradley, who had come to Cambridge for the hearing. I also expressed to her my clear impression, from the way the hearing was conducted, that I would be dismissed. I recall that the night of December 1, 2010 was one of the few nights in my life when I did not get any sleep at all, so upset was I with the day’s events and with the certainty that the Trust would fire me from my job.

152. On Sunday December 5, 2010 I had my annual Xmas lunch with a former Southampton colleague, Dr Lee Illis, who had been consultant neurologist in the Wessex Neurological Centre. At the meeting, he told me of an extraordinary phone call that he had recently received from John Pickard, in which John Pickard had clearly tried to influence him in his opinion about me, making derogatory remarks about me (calling me ‘extremely dysfunctional’) and stating that the Trust had been trying to terminate my contract for some time. I was flabbergasted by this and the concerted campaign against me now made sense.

153. The next day, I sent an email to Dr Illis, and I asked him to put down in writing the content of the conversation, while it was fresh in his mind (P1485). In fact, shortly after the telephone conversation with John Pickard had occurred, Dr Illis - who has extensive experience in medicolegal settings - had dictated notes of the conversation, since he realised that it was a highly significant event and might be of material consequence in any legal proceedings. I also considered John Pickard’s phone call to Lee Illis to be a breach of confidence.

154. Tuesday December 7, 2010, 4pm was the date that the dismissal panel had set for telling me the results of the dismissal hearing.

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155. The dismissal outcome meeting was probably the most distressing meeting of my life. I was told that not only was my employment to be terminated, but that it was to be terminated with immediate effect. How could they dismiss me because of problems that I had with one manager, when I had liaised well other senior managers; how could they say that this alleged breakdown was affecting the business of the Trust when I was providing my clinical service to an ‘exemplary level’, the words used by Richard Howe himself (P1591); and how could they have ignored or belittled every alternative to dismissal that I had put forward?

156. I considered that the decision was not fair, was not just, and was grossly disproportional to any allegations of transgression. Although I had prepared myself for dismissal, I knew that in the case of my patients and staff there was a full programme of activities over the coming months, and I had assumed that I would be given at least a few months to wind down my work, remove items from my office, etc. Instead, I was told that I was not allowed to return to my office from that day onwards.

157. At the beginning of the hearing, I told Richard Howe and Oonagh Monkhouse of the development that had taken place the previous week in terms of the call that John Pickard made to Lee Illis. It was clear that they had already made up their minds, and that they were not going to change their decision. I also made a statement of the impact of the previous few months on my life, and the attempts I had made to manage to cope with this.

158. I found it difficult to believe that I would be instantly dismissed – I thought that if the Trust were to remove me I would still be given several months to see outpatients who had been booked to see me, deal with ongoing interactions with staff, sort out teaching and research commitments, ensure that new strategic service developments that I had put in place – such as the Deep Brain Stimulation Neuropsychology Service – would continue to run smoothly, etc. I was therefore completely shocked to be told that Tuesday, December 7 would be my last day at work after over 30 years of dedicated NHS service, and that I could only come back to work on an agreed day to remove my personal belongings under supervision.

159. I was given no reason for such an instant dismissal. How could I do any harm in staying on for a few months, and terminating my work in a planned and organized way? I was being treated like someone who would do harm to the Trust by staying on for a day longer, such as implanting a computer virus or setting fire to the buildings. In effect, I felt that I was being treated like a ‘terrorist’, although I appreciate that they probably did not regard me as a terrorist. As a professional person who prides himself on having the utmost integrity, I would never do anything to jeopardise patient care or to cause harm.

160. In spite of my protests, I was not given a single explanation then or until now for why I was subject to instant dismissal. I was also banned from having any professional contact with my staff after the day of my dismissal, something that I could not understand and which both my staff and I found distressing. Oonagh

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Monkhouse did kindly ask me if I would be alone that evening of December 7, so she did seem to realise that it would be a distressing time for me.

161. I also found it distressing that when on December 7 I recounted to Richard Howe and Oonagh Monkhouse how I had found courage and inspiration to deal with the distress of dismissal by thinking of a close consultant neurologist colleague who had recently died of a terminal illness in his 50s, Richard Howe made the rather insensitive remark that if only I had behaved differently I could have avoided that distress, whereas my late colleague did not have any option to avoid distress. I realise that Richard Howe may not have purposely meant any harm by the remark, but in that setting I found his comment both hurtful and insensitive. Although at the appeal hearing, Richard Howe tried to justify the basis for his remark, I pointed out to him that – by his reasoning – if others in the Trust had behaved differently, then the distress that I suffered could also have been avoided.

162. After the hearing, around 5pm, I returned to my office. My junior colleague, Dr Georgina Browne, who was away from work at the time, immediately came back to my office and comforted me, which I really appreciated. Ironically, while she was comforting me, my consultant colleague Dr Jerry Brown came to my office asking me if I would see one of his inpatients over the next few days. When I told him what had happened, he was very sympathetic and supportive. I then rang my wife in Southampton. She made the decision to come up that evening to Cambridge. The following day I returned to what was then my home in Southampton.

163. I was quite astonished to discover that the next day or thereabout, a senior manager came to see my junior colleague, Dr Georgina Browne, and told her that she had with immediate effect being upgraded from Band 8a to Band 8b. This was puzzling and inappropriate for several reasons – there was a due process for upgrading a post, with a detailed case having to be made and the proposal put to a panel, but this seemed to have been bypassed; there were major cost implications; Georgina had only recently, with my active support, being upgraded from Band 7 to Band 8a, and this second upgrading flouted the normal rule of three years in a band before upgrading, which I always told staff was in the best interests of patients and also of themselves. All this seemed an irregular thing to do, and it additionally appeared to go against everything that the Trust had said to me about a shortage of funds for the Department.

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(ii) Evidence to Rebut Conclusions in Dismissal Letter

164. Richard Howe wrote to me in a letter dated December 15, 2010 giving reasons for dismissal. He did not appear to have been guided by the over-riding principle of fairness, to have carried out all reasonable investigations in order to substantiate his decision, to have consulted with experts in those areas that were outside his expertise and experience, nor to have given due weight to the concept of proportionality. Apart from the single site visit he made to my Department, I could find no evidence in his letter of any of these four key considerations being kept to the fore.

165. Mr Howe explicitly chose not to consider my dismissal in the context of events in earlier years (P1500). This meant I could not have a fair hearing. It was clear that I had been raising a number of concerns about the use of unqualified staff and patient safety, and about bullying and harassment (as well as resources/working conditions) for a number of years, dating back to 2004. I considered that the Trust had a common law duty to act with skill and care, and that it was not doing so. It was also clear that Trust management had been actively considering from at least July 2005, if not earlier, how best to facilitate the termination of my employment in the Trust (P545). In an email from Kathy Haynes to Denise Hollinger on July 19, 2005, Kathy Haynes noted – ‘The priority has to be to persuade NK to be assessed and get a confirmed [psychiatric] diagnosis. There might then be a remote chance of negotiating some academic post/funding for a period to take him to retirement, or indeed allow him to retire early from his NHS job on the grounds of ill health’. Similar sentiments were expressed in comment made by John Pickard to Lee Illis in 2010 that the Trust had been trying to terminate my contract for some time (P1485). The downgrading of my post in 2006 from Band 8d to Band 8c, which I overturned on appeal (P220), can also be seen in this light, especially if no other Band 8d post in the Trust had been similarly downgraded. There was therefore evidence that the process of my raising concerns, and the process of attempts to engineer my departure from the Trust, had historic roots that should have been given due weight. By ignoring all of these issues and the fact that I appeared to be singled out by the Trust, the process could not be a fair one.

166. Under the subheading ‘My assessment and conclusion’ (P1501), Richard Howe reached a number of conclusions that were not supported by the evidence which was presented at the dismissal hearing.

167. In paragraph 2 of that section, Mr Howe concludes ‘that working relationships have irretrievably broken down between you and the senior managers in neurosciences’. This implies that there were a significant number of senior managers within neurosciences with whom I had a breakdown in relationships. The organisational structure for Neurosciences (P1616) shows me reporting to Juliet Walters. Whilst I accept the relationship with Juliet was not as good as it had been with other managers, I do not agree that it had ‘irretrievably broken down’. I was still willing to meet up with her on a 1:1 basis (P1290), and I had readily provided her with

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information and documents relating to Neuropsychology as a profession and my service in particular. I also readily met up with the person she had asked to spearhead the strategy review, Lawrence Ashelford, and with his staff (P1341). So far as our relationship occasionally had strains I believed, for the reasons explained in detail above, that she was mainly the cause of these.

168. Of the other key senior individuals noted in that structure, I had dealings with a few of those, including Professor Compston, Dr C Allen, Kathy Haynes, and Judith Shaw. My working relationships with all of these individuals was good. I liaised with Professor Compston and his neurology colleague, Dr Alasdair Coles, around the time of the interest expressed by the MS Society in making a site visit to my Memory Aids Clinic and possibly investing in the Neuropsychology service (P453-4). Professor Compston was pleased with the clinical service that I provided to his patients (P2233). I sent him an email of congratulations on a prize that he was awarded (167a / CP202-3). I specifically mentioned him in the Acknowledgements of my book, The Paradoxical Brain (70a / CP107-9), about which he also expressed kind words (167b / CP204).

169. Dr Allen wrote a complimentary letter to me about the quality of my service (168a / CP209) in the first few years of my working at Addenbrooke’s, and referred quite a few private patients to me. When he approached me to give some work experience and supervision to his daughter, who was a Psychology graduate and who was keen to get onto a Clinical Psychology training course, I went out of my way to accommodate his request, even though we were short staffed at the time (168b / CP205). I gave her a number of 1:1 teaching sessions, and lots of advice about how best to get onto a course. I gave her a very supportive reference when she made her application. I am pleased that within a year of having a placement with me she was successful in getting onto a course.

170. In the case of Kathy Haynes, as outlined elsewhere in this document (paragraph 182) I held a number of meetings with her to successfully set up and implement the Deep Brain Stimulation Neuropsychology Service. In the latter half of 2009, Kathy Haynes approached me to indicate that one of the non-executive members of Addenbrooke’s Board had come to her inquiring about employment for his daughter, Rebecca Kenny, a qualified clinical psychologist. Kathy wanted me to employ Rebecca for several sessions. I liaised with Kathy in setting up a job interview, etc. – I organized the interview panel, and invited John Pickard to join Kathy Haynes and me on the panel. Kathy Haynes once indicated to me that her mother was suffering from Alzheimer’s Disease and that her father had difficulty in coping with this. She wanted to buy items for her father from the Memory Aids resource centre. I insisted that I would never charge her or any other staff member for items, and that she was welcome to take any literature or aids free of charge (169a / CP206-7).

171. In the case of Judith Shaw, who worked in Neurosciences management, she was my first in the line of call when a new member of staff was appointed, or when a

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staff member left, so I had many management-related dealings with her. We both got on very well with each other.

172. The implication in Mr Howe’s conclusion, that there was an irretrievable breakdown with a large number of senior managers in neurosciences, is therefore seriously incorrect, and misleadingly generalises from a few problems with one senior manager, namely Juliet Walters.

173. In paragraph two of the subheading ‘My assessment and conclusion’, Mr Howe states that ‘Trust management have acted reasonably in trying to, and have made every effort to, implement the Working Arrangements document’. However, that document (P1004) indicated that Neuropsychology staff would be ‘provided with reasonable space to conduct their consultations……to ensure that full 1:1 consultations can take place’. There were never any steps taken to ensure that this clause of the document was implemented, since only one testing-treatment room was available, and this meant that my junior clinical psychology colleague and I could not see patients concurrently. This had a significant impact on patient throughput.

174. Furthermore, during questioning at the dismissal hearing, Juliet Walters herself accepted that if John Pickard had concerns about me or my performance he should have specifically arranged to meet me and to discuss them with me and discuss those concerns (P1456). This is something that he did not do.

175. At the dismissal hearing, no evidence was presented to support the conclusion reached by Richard Howe regarding the Working Arrangements agreement, in spite of the fact that I had pointed out the continued failure by the Trust to provide adequate space, in breach of the Working Arrangements agreement (P1457). There had also been a failure by the Trust to distribute an agreed circular after the Agreement was signed, and this only took place after I reminded Karen Clarke (P1053).

176. In the case of the Working Arrangements document, at the dismissal hearing the Neurosciences Divisional Director, John Pickard, in fact confessed to never having seen a copy of the document (P1450). This gives a clear message as to how seriously the document was taken by the Trust, and in particular by Neurosciences management. If that was their approach to the mediation agreement we reached it is hardly a surprise that the relationship became more difficult as a result.

177. In paragraph 3, Mr Howe states that there was no ‘evidence that further interventions would have a chance of success’. I am not sure what he meant by the term ‘intervention’, but in terms of a viable way forward I provided clear evidence (176a / CP208), which constituted Part 9 of Bundle A at the hearing, that Child Neuropsychology was being successfully managed by a service level agreement with the neighbouring Mental Health Trust. This was not properly investigated and was an obvious and easy solution.

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178. Mr Howe also states in paragraph 3 that my evidence had ‘confirmed that you had no trust in the senior management of the Neurosciences Division’. In paragraph 14, Mr Howe repeats this conclusion. However, as I have pointed out in paragraphs 168-171, I had good relationships, with mutual trust, in respect of a number of key individuals in Neurosciences management. Where some issues of loss of trust had emerged, these were largely due to breach of promises by management, breach of the mediation agreement, unreasonable accusations, or instances of active or passive bullying.

179. In a large organization such as Addenbrooke’s, there were numerous relationships that I successfully forged, with a high level of trust and confidence. Many of these were at senior management and strategic service-development levels.

• Neuroscience Consultants. Many consultants gave their support when they found I faced the prospect of dismissal (178a-1 / CP210-220). Over the years of my time at Addenbrooke’s, consultant neurologists in particular had expressed gratitude for the excellent clinical service I provided (178a2-5 / CP221-4), and for my teaching contributions (178a5-6 / CP224-5). In terms of strategic and management roles, I had management-level meetings with Dr Phil Buttery, consultant neurologist, to set up the Deep Brain Neuropsychology Stimulation Service (178a7 / CP226), and I had management-level meetings with Dr Mark Manford to develop the epilepsy business plan (178a8 / CP227).

• Neurorehabilitation Consultants. They expressed appreciation and support at the time of my dismissal (178b1-2 / CP228-230). In terms of strategic and management roles, I held a management-level meeting with Dr Stephen Kirker (Neurorehabilitation consultant) and Sue Jestice (head of complex case management at NHS Cambridgeshire) to explore ways in which we could develop the Neuropsychology component of the Neurorehabilitation service (178b3 / CP231).

• Consultant Psychiatrists. I worked closely with one consultant psychiatrist in a multi-disciplinary team setting, Dr Fiona Thompson, and she readily gave me her support when she found out about my dismissal (178c1 / CP232). As well as seeing their clinical referrals, I regularly liaised with senior consultant psychiatrists on management issues via my membership of the Psychological Medicine Group. I prepared a detailed report on Health Psychology Services for that group (P950-954, 178c2 / CP233), which they had asked me to carry out. I readily agreed to take on this senior management role, which my colleagues thought I was uniquely qualified to do, even though it involved quite a lot of time and effort on my part. I had additional management-level interactions with members of the group in a wide range of ways (178c3-4 / CP234-237).

• Consultants in General Medicine. I had a particularly warm and friendly relationship with Professor Tim Cox who ran the Lysosomal Clinic, a highly specialised clinic for patients with rare, genetic metabolic disorders. Professor Cox greatly valued my input (178d1 / CP238-9), as did his colleague Dr Patrick Deegan (178d2 / CP240). We had put in place strategic plans to secure funding for enhanced Neuropsychology input to his clinic, and I agreed to supervise and support any new staff who were appointed as a result of the plans being successful (178d3 / CP241-2).

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I also had a close relationship with Dr Chris Carne, consultant in genitourinary medicine. He did not send any patients to my service, but he was keen to develop health psychology input to his service. Since I was the most senior clinical psychologist at Addenbrooke’s, he turned to me for advice and support. I did quite a bit of reading and background research in preparation for the management-level meetings we held together (178d4 / CP243-5). We were able to successfully set up Psychology input to his service by encouraging a lecturer in Psychology to take up some honorary sessions. I met up with this person, and I helped put in place appropriate clinical governance arrangements, after further discussions, this time with my colleague, Geraldine Owen in the Mental Health Trust. Chris Carne was really appreciative of my input, and he readily agreed to be a witness in support at my dismissal hearing (178d-5 / CP246).

• Consultants in Surgery, including those in Transplant Medicine. I had seen several patients for the renal transplant team, and I discussed with one of the transplant surgery consultants, Professor Andrew Bradley, how best to submit a bid for more Psychology input to his service (178e-1 / CP247-8).

• Consultants in Occupational Health. I would receive referrals of quite complex and delicate cases where senior or junior members of Addenbrooke’s staff might have work concerns due to an ongoing neurological or neuropsychiatric condition. In view of my own expertise in this field, having written a book on a related topic (3b / CP6-8), I probably received more Occupational Health referrals than other neuropsychologists, and some of my reports might involve liaison with professional regulatory bodies.

• Junior doctors in Neuroscience and other specialities. I frequently gave informal and formal supervision and teaching to junior doctors in neurosciences. I also met up with a paediatric neurologist, Dr Nicholas Smith, (178f1 / CP249-50) in Professor Cox’s team on a number of occasions, and we successfully wrote a joint paper on a case that Professor Cox’s team and I had seen (122a / CP201).

• Both senior managers and their junior colleagues. I have detailed elsewhere how I had numerous, successful, management-level interactions with senior management staff such as Tom Bennett (paragraphs 104-106), Lawrence Ashelford (paragraph 196), Kathy Haynes (paragraph 181), and their junior colleagues. I also liaised on a number of occasions with a senior manager, Mrs Brenda Hennessy, Director of Patient Experience and Public Engagement (178g1 / CP251). She would organize senior staff briefings and lectures, often at lunchtime or in the evenings, and I would try and make it a point of attending these. When in September 2007 the Trust had an open day as part of its public engagement policy, which Brenda Hennessy organised, I readily agreed to prepare and man a stand which displayed items such as our patient self-help booklets and Memory Aids Clinic (178g2 / CP252).

• Specialist nurses. I often had to liaise at various levels with specialist nurses, especially from the Multiple Sclerosis (MS) service and from the epilepsy service. In the case of the latter service, I had management-level interactions with regards to the epilepsy business plan. Talks that I gave to local branches of the MS society, where patients and their families were often present, were often arranged via the MS nurses (178h1-3 / CP253-55). The MS nurses kindly wrote a letter of support around the time leading up to my dismissal (178h4 / CP256).

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• Nurses working in inpatient wards. I had a management-level meeting with one of the senior Neuroscience ward nurses, and helped her put together a case for more Clinical Psychology input to the inpatient Neuroscience wards. This was in the context of an episode where more adequate Neuropsychology resources might have helped to prevent a serious clinical incident (178i1 / CP257-8).

• Social workers. Social workers were a regular part of the neurorehabilitation team, and I would regularly meet up with them at the weekly multidisciplinary neurorehabilitation meetings. When case conference were held in the general medical wards for a case where I was involved, I would attend those meetings, and this would also involve interaction with social workers. It was usually through social workers that I linked in with the local branch of the brain injury charity, Headway, and I attended management-level meetings on brain injury services that included the chief executive of the local Cambridge branch of Headway.

• Secretaries in other departments. I invariably had to liaise with other secretaries in Neurosciences, and it was essential to have good working relationships with them. We worked well together, and there were never any issues raised.

• Staff in IT. There would often be times when I would have to liaise with IT staff – e.g. when a new member of staff arrived, when ordering new computing equipment, repair of computing equipment, etc. IT staff and I had excellent working relationships. I did once have strategic, management-level interactions, when I explored the use of tablet PCs as clinical decision aids in outpatient clinics, but that project did not progress due to hardware limitations at the time.

• Staff in Addenbrooke’s Charitable Trust. Since I had an account with the Addenbrooke’s Charitable Trust, I had to liaise with staff there, and we got on well.

• Estates staff. I would often have interactions with estates staff with regards to facilities within my Department. These interactions were always cordial and efficient.

• Patients. I went out of my way to provide the highest quality service I could to patients, and this is reflected in the numerous letters and cards I received over the years from patients and their families (178j1-23 / CP259-80).

• Neuropsychology Staff. I had excellent relationships with my junior staff over the years. When they learned about the possibility of my dismissal, my junior staff wrote a letter of unstinting appreciation and support, a letter to which I had no input whatsoever (P2606). In previous times, they had also written in my support (P643, 178k1 / CP281). When any of my staff moved on to other posts, I asked them to complete a feedback form (178k2 / CP282-4), and I continued to provide them with support and references (178k3 / CP285).

• Clinical Psychology colleagues in other departments at Addenbrooke’s. The paediatric psychologists and those in palliative care were the main psychology colleagues that I met with at Addenbrooke’s. For one of the appointments in palliative care, I agreed to be on the interview panel and I recall having a number of management interactions with the key consultant in charge of the department. I liaised well with these other psychologists, and in my last years at Addenbrooke’s we began to have regular meetings to discuss issues and to

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effectively have an informal Clinical Psychology Department that covered the whole of Addenbrooke’s.

• Clinical Psychology colleagues in other parts of East Anglia. I often provided advice and support to clinical psychologists in East Anglia, since I was regarded as the Neuropsychology expert for East Anglia, and I would be asked for advice on a whole range of issues – clinical, teaching, management, etc. I had particularly close links with the Oliver Zangwill Centre in Ely, and I provided regular support to Oliver Zangwill staff (178l1-2 / CP286-88). The East Anglia Neuropsychology Forum that I set up was a focus point for networking as well as teaching, and delegates at every level appreciated the value of the forum (178l3-10 / CP289-96).

• Trainee Clinical Psychologists and Graduates. I took trainees on placement on a regular basis, as long as staffing and resources allowed. I had good working relationships not only with trainees, but also with their course placement supervisors. I supervised and assessed doctoral theses by trainees. They valued the good working relationships that I had with them (178m1-4 / CP297-300). Graduate Psychologists who spent time in the Department also appreciated the support and guidance that I gave them (178m5-7 / CP301-3).

• Occupational Therapists. I would work with Occupational therapists primarily via the neurorehabilitation team. I readily gave them items from my Memory Aids resource centre.

• Physiotherapists. I would work with Physiotherapists primarily via the neurorehabilitation team. I did carry out some strategic development work with them, mainly in relation to devices such as the Nintendo Wii, a computer-based game with an interactive, movement component. There had been some evidence that other rehabilitation centres in the world were finding the device useful for motor rehabilitation, and so I myself bought one which I then allowed the physiotherapists to borrow and use.

• Speech and Language Therapists. I would work with Speech and Language primarily via the neurorehabilitation team. We worked closely on a number of cases, and they valued some of the resources I made available to them from my Memory Aids resource centre.

• Staff in public relations. Staff in the public relations department asked for my cooperation in writing an article for the Hospital Newsletter on my Memory Aids Clinic, and I agreed to this (178n-1 / CP304, 178n-2 / CP305). I liaised with them when someone from the media visited my department, to carry out interviews with me in the area of memory disorders – as well as East Anglia TV, I featured on a BBC Radio 4 Science Programme and a programme on the BBC World Service. I regarded this work as an important part of my public engagement role, something that the Trust promoted.

• Medical Photography staff. I often liaised with medical photography staff for teaching, and when I held meetings of the East Anglia Neuropsychology Forum. In my early years at Addenbrooke’s, I had video conferences on complex cases with my Neuropsychology colleague Dr Veronica Bradley, and this involved liaison with senior staff in the Medical Photography department.

• The Chief Executive. I recall going to one of the first informal evening meetings that the chief executive, Gareth Goodier, held when he joined Addenbrooke’s in

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2006. By that time, I had already met Lady Mary Archer, chair of the Addenbrooke’s Trust board, and she introduced me to him. Gareth Goodier and I had occasional email interactions over the years (178o-1 / CP306-10), and I would make it a point of going to hear him speak when he occasionally held a lunch-time meeting for all staff.

• Chair of the Trust Board. I also had excellent working relationships with Lady Mary Archer, Chair of the Trust Board, in relation to her idea to set up Addenbrooke’s Abroad, a charity to help health care in overseas developing countries (178p-1 / CP311-14). She was keen to have my advice and input, in view of my knowledge and experience of health care in developing countries, and we had a meeting that lasted 1-2 hours. We kept in touch on that matter over the years. I also later met up with senior staff in Addenbrooke’s Abroad (e.g. Evelyn Brealey, Addenbrooke’s Abroad project manager, in October 2008), and provided whatever advice and support that I could (178p2 / CP315-6). When in later years I won a prize in the Addenbrooke’s Staff Suggestion Scheme, I donated my prize money to Addenbrooke’s Abroad (178p3 / CP317). Mary Archer and I had a positive and cordial working relationship. After I had been dismissed, I emailed her in 2011 with my best wishes in view of the cancer surgery that she had, which had been featured in a number of newspapers, and I updated her on my new book and the hospital in India that would receive royalties from the book’s sales. She kindly responded to that email, and also updated me on Addenbrooke’s Abroad (178p4 / CP318-9).

• Academic colleagues in partner organizations such as the Cambridge University and the Medical Research Council (MRC). I had a number of strategic, management-level meetings with university and MRC colleagues on issues such as setting up joint posts (178q1 / CP320). I was pleased at the support they gave me around the time of my dismissal (P2557, P2578, 178q2 / CP321-2).

I had excellent working relationships with individuals from all of the above sectors. Many in fact commented on how easy-going, flexible, generous and accommodating I was to work with. This is exemplified by the many expressions of appreciation I have received over the years. This evidence was presented to Richard Howe at the dismissal hearing, but appears to have been ignored or considered irrelevant.

180. Mr Howe further states in paragraph 3 that ‘it was not possible for you to fulfil the leadership role of the Department’. As I have documented (P1586-7), the few difficulties that I had with Juliet Walters did not prevent me from fulfilling leaderships and other roles in my job description. This was pointed out to Mr Howe at the hearing (P1463), though unfortunately the hearing notes just refer to ‘listed improvements’, without referring in detail to what I said.

181. Regardless of how Kathy Haynes had treated me in the past, I was prepared to ‘forgive and forget’, and I did not let this get in the way of our working relationships. I had previously pointed out to Kathy Haynes that the use of unqualified staff in areas such as deep brain stimulation work was unsatisfactory and could potentially put the Trust at risk, and I was pleased that she was now prepared to stop that practice (P1156), and to engage with the Neuropsychology Department to provide the

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service. This was a similar situation to that of the Traumatic Brain Injury (TBI) clinic, but in this service, unlike the TBI service, the Trust seemed to eventually agree that such use of unqualified staff could be harmful to patient care, and it was stopped.

182. I did a lot of preparatory work for my meetings with Kathy Haynes (181a / CP323), since deep brain stimulation work was a highly specialised service. I needed to carry out a detailed review of the literature and also consult other colleagues in my field. Thus, I had lengthy discussions with colleagues in centres such as Oxford and the Kings College Neurosciences Centre, London who had been doing such work for a number of years. I drew up a proforma for the neuropsychological aspects of the service, and I made sure that we had the right neuropsychological tests and other resources in place for the service to be delivered. I arranged supervision and support meetings with the junior clinical psychologist who was to carry out the testing. I made preparations for the Assistant Psychologist post that I was promised by Kathy Haynes as part of that service development. All this involved additional time and work on my part and was not part of my agreed job description. I nevertheless tried to be as flexible and as accommodating as possible in getting the Deep Brain Stimulation Neuropsychology Service off the ground.

183. As part of his reasonable investigation of all the facts relevant to the dismissal decision, in view of Kathy Haynes key and strategic management-level interactions with me such as those described above, I expected Mr Howe to call Kathy Haynes to be a witness, to give evidence and to answer questions at the dismissal hearing, but he did not do so.

184. In spite of the treatment from Juliet Walters and John Pickard and the breaches of the Mediation Agreement, I regularly met up with senior management to discuss and implement strategic developments in my service. Thus, as indicated above, in 2010 I met up with Lawrence Ashelford and his colleagues on a number of occasions. In the spring of 2010, I had several meetings with Kathy Haynes and with a senior consultant to set up the Deep Brain Stimulation Neuropsychology Service (P1177; P1183; P1204-5). I also attended Trust meetings on patient safety, and I recall going out of my way (despite other pressing commitments) to go along to one such meeting on March 17, 2010 that was called by the medical director, Dr Jag Ahluwalia (who later chaired my appeal panel hearing). In his lecture, Dr Ahluwalia was quite critical of some of the care at Addenbrooke’s, in fact comparing it to what had recently been in the media in relation to Mid-Staffordshire Trust. I admired his frank and forthright views, and I sent him an email the following day, also attaching a copy of my article, On the Pursuit of Clinical Excellence. He thanked me for this article, and expressed the hope that we might work together to improve patient care at Addenbrooke’s (P1218).

185. In paragraph 4 of the section ‘My assessment and conclusion’, Mr Howe concludes that I was not excluded from decision-making relating to Neuropsychology. At the dismissal hearing, I gave at least two examples of instances where I had been excluded, one instance related to the Evelyn Trust grant application for developing

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Neuropsychology services for Cambridge patients, and the other instance related to the employment of unqualified staff (P1406). This evidence appears to have been ignored or not given proper consideration by Mr Howe.

186. In paragraph 5, Mr Howe appears to fully accept John Pickard’s statements at face value, with no probing, regarding partnership arrangements between research and service provision, and responding in a ‘flexible and innovative way to new initiatives’. Richard Howe did not press John Pickard to give details of those initiatives, and did not press John Pickard to provide any evidence of my alleged failure to respond to them. By contrast, I provided clear examples (P1586-7) that I had developed links with a number of academic partners, including the Medical Research Council and University. I had also been innovative in the Memory Aids Clinic I had developed, winning an award for that particular innovation, and in my collaborations with Microsoft on their novel memory aid which I helped to develop – SenseCam, a portable automatic camera worn round the neck.

187. In paragraph 6, Mr Howe states that he agreed with the view expressed by John Pickard that in the case of the Evelyn Trust grant application he ‘did not consider it to be a Neuropsychology endeavour’. This is a very surprising statement, and perhaps again reflects Mr Howe’s background as a non-clinician. A cursory reading of the grant application shows at least 21 separate references to Neuropsychology in the body of the application (80a / CP116-195). Mr Howe should have taken on board that application, which confirms this fact.

188. In paragraph 8 of that section of his letter, Mr Howe states that I could have ‘considered changing the timings of the Memory Clinic’ in order to make it easier for me to attend the Division board meetings. However, I did point out at the hearing (P1438, P1456, P1460) that the clinics were multidisciplinary, involving other senior clinicians, and that I was not in a position to make changes to their timing. I also indicated, although it is not specifically recorded, that I was happy to be flexible if the days of the Divisional board meetings were alternated, but he seemed to ignore this evidence on my part.

189. In paragraph 9, Mr Howe talks of ‘refusal to hold further one-to-one meetings with Juliet Walters’. However, specific evidence was presented at the hearing to indicate my willingness to attend further one-to-one meetings with her (P2456), but he seemed to ignore this flexibility on my part, without offering any explanation.

190. In paragraph 9, Mr Howe claims that the purpose of Karen Clarke’s attendance at any meeting between Juliet Walters and me was to ‘facilitate these meetings’. The evidence suggests that this was not the purpose (189a / CP324), but rather that Juliet Walters wished for Karen Clarke to be there as an observer to support her stance at the meetings and back her up later if necessary. The fact that this email was copied to the Trust’s lawyer is a vindication of my concern that the meetings were in fact taking on a legal and more serious flavour. In addition, since Karen Clarke had been a key player in earlier mediations, and knew the relevance of the

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mediations for employment law, I considered it only fair that if Karen Clarke was present I too would have some such formal support.

191. In paragraph 10, Mr Howe indicated that I assumed my views would not be listened to at strategy review group meetings, and that in the case of Barbara Wilson’s attendance Juliet Walters was open to discussing the composition of the group further at a first meeting. However, the relevant email evidence that was available to Mr Howe shows this to be a misleading conclusion. In the case of the strategy review group meetings, my concerns were for what was in the best interests of patient care, and it made sense to include consultants who regularly referred me patients, such as Dr Jerry Brown or Dr Peter Nestor, both senior consultant neurologists and my close colleagues in the multidisciplinary Memory Clinic, rather than someone such as Mr Peter Hutchinson, a consultant neurosurgeon, who hardly ever referred any patients to me (P2443). In the case of reference to an initial meeting with a small number of group members, which might be modified at a later stage to include others, the relevant email (P2477) from Juliet Walters in fact includes Barbara Wilson in that initial group, something that I would have been quite happy to go along with, but this was a decision that Juliet Walters later reversed, deciding to exclude Barbara Wilson.

192. In paragraph 13 of that section of his letter, Mr Howe states that he had considered my concerns regarding the use of unqualified Psychology staff in Neuroscience clinics and that he accepted John Pickard’s reassurance that the relevant practice was ‘safe and appropriate’. As someone without expertise or experience in Neuropsychology, and not even a clinician, I would have expected Mr Howe to carry out all reasonable investigations, and to consult relevant experts in my field before coming to this conclusion. The fact that John Pickard and Kathy Haynes themselves considered that this consultation with an expert was an appropriate thing to do (P1320) supports my reservation regarding the basis of Mr Howe’s conclusion. The further fact that at the dismissal hearing John Pickard did not disclose this evidence from a relevant expert (P1320), which in fact supported my whistleblowing claims with regards to clinical practice, is a matter of real concern. If Juliet Walters also knew about this evidence and chose not to disclose it at the hearing, this is again a matter of serious concern.

193. In paragraph 15, Mr Howe appears to give cursory consideration to alternatives to my dismissal. He provided no evidence to indicate that he had carried out reasonable investigations to fairly and systematically evaluate alternatives to my dismissal. For example, he referred to ‘significant sums’, with no figures or costings to support the use of this phrase. There is no evidence that he approached possible organizations who could have operated a service level agreement, such as the Cambridge and Peterborough Mental Health Trust or the Cambridgeshire Community Services NHS Trust. There is no evidence that he approached relevant commissioning departments within Cambridge University NHS Foundation Trust. In addition, I could not see how an informed and balanced appraisal of alternatives could be reached by simply consulting Juliet Walters and John Pickard, as Mr Howe

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appears to have done - both of them actively supported my dismissal, and had largely contributed to my strained relationship with them.

194. The alternatives to my dismissal (P2566-7) had been carefully thought out by me, and included a change of line manager, a relatively simple solution. If the Trust felt that I had some problems with Juliet Walters, regardless of who was to blame, it could simply have asked another senior manager to take over that role. For around six months prior to Juliet Walters joining Addenbrooke’s, I had been successfully managed by Tom Bennett. As he indicated at my dismissal hearing, we got on well together (P1457). When at the appeal hearing I asked Richard Howe to give me specific examples of any difficulties I had in my relationships with Tom Bennett, he could not give any (P1599). When I also pressed Juliet Walters on this, she gave an evasive response – ‘I cannot comment’ (P1631). In the same sentence she alluded to my contacting Karen Clarke – that was do with items following on from the mediation. Since Tom Bennett was not party to the mediation, I did not consider it appropriate to involve him.

195. A further senior manager with whom I had excellent relationships was Lawrence Ashelford, Assistant Director of Planning in the Trust. We had linked up closely a number of years before on the epilepsy business plan, having a number of meetings, both 1:1 and also with other members of the epilepsy business planning group. He had spoken warmly of my suggestions in the Addenbrooke’s Suggestion Scheme, and presented me with an award (196a / CP340;196b / CP341). I had also readily met up with him with regards to the strategy review that Juliet Walters had asked him to undertake. I recall at one of our 1:1 meetings having an interesting side-chat about the Tavistock Clinic (a psychotherapy clinic) since it seemed that he had attended a course on management run by that clinic. I naturally could give my perspectives as a trained clinical psychologist, so I thought we had a number of things in common in terms of philosophical approaches. When he sent one of his junior colleagues, Louise Leggott, to meet up with me on the strategy review, Louise and I got on very well (P1330). At the dismissal hearing, Lawrence agreed that we had got on well (P1467), that we had met five times in total, on three occasions regarding the video telemetry component of the epilepsy business plan, and twice in relation to the strategy review he was carrying out for Neuropsychology. I was always delighted to meet up with him (P1946), and I welcomed his addition to the strategy review group when Juliet Walters first raised the idea (P1107). Lawrence sent me a kind email when he found out I had been dismissed (P2605). When at the appeal hearing I asked Richard Howe to give me specific examples of any difficulties I had in my relationships with Lawrence Ashelford, he could not give any (P1599). I therefore do not understand why the Trust could not have simply asked Lawrence Ashelford to take over Juliet Walter’s management role.

196. There was also published evidence (193a / CP325-39) to support one of the options – that my service could be successfully managed by a body such as the neighbouring Mental Health Trust as part of a service level agreement.

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197. A related option would have been an extension of one that that John Pickard and Trust management themselves raised – namely that my service was managed by the Oliver Zangwill Centre as part of a service level agreement (SLA). The manager of that Centre, Dr Andrew Bateman, indicated that he would definitely consider such a proposal, and when Barbara Wilson, who founded the Centre, was asked for her views at the appeal hearing, she said that the Oliver Zangwill Centre would be delighted to be associated with me on a formal basis. Briefly, such an SLA option, under which I had in fact worked for most of my time in Southampton, would have involved transfer of the management of my service to the Mental Health Trust or to the Oliver Zangwill Centre. My staff and I would be formal employees of either of those two organizations, and would be managed by appropriate individuals in the organization. There would be an SLA that would specify items such as numbers of patients to be seen, how soon they would be seen, types of service provided, etc. A budget for this service would be agreed. The SLA would normally be reviewed every year for any minor amendments. In practice, both my staff and I would work as usual at Addenbrooke’s, and our day-to-day routines would not be very different. An SLA would have in fact been beneficial to Addenbrooke’s in a number of ways – it could have saved Addenbrooke’s money since test materials could be shared; it meant that the management of individuals such as myself would be by those with knowledge and experience in managing clinical psychologists; and it would have allowed for greater sharing of skills and expertise between Addenbrooke’s and the SLA provider. Moving to an SLA would have meant some inconvenience for me, and it would probably have reduced my chances of being upgraded to Band 9 (since there already was a Band 9 in post in the Mental Health Trust), but I was prepared to make these sacrifices in the interests of patient care and in the interests of moving forward with an amicable solution.

198. A Service Level Agreement would not have involved major structural reorganisation on the part of the Trust. As Richard Sunley, former Operations Director at Addenbrooke’s, himself pointed out (P749-59; P760), Child Neuropsychology was already managed by an SLA with the neighbouring Mental Health Trust, so adding on Adult Neuropsychology to that existing SLA would have been relatively straightforward. In addition, psychiatric services at Addenbrooke’s had for many years been provided on the basis of an SLA, and so the operational requirements for such a framework were already well established. So there was a clear precedent for this too.

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G. (i) Appeal Hearing & (ii) Evidence to Rebut

(i) Appeal Hearing

199. On 24th December 2010, I completed the prescribed form making a request to appeal against dismissal. I was invited to an appeal hearing on 17th February 2011. The members of the panel were Dr Jag Ahluwalia, Medical Director; Mrs Brenda Hennessy; Professor Pat Troop. In attendance as Appeal Secretary was Mrs Judy Wallace. I was accompanied by my union official, Mr Mark Robinson.

200. The Trust decided it needed to hear evidence from John Pickard, who was unavailable on the proposed date. The hearing reconvened on 23rd March 2011, since John Pickard could not make the earlier hearing. I called Dr Lee Illis, Dr Veronica Bradley and Professor Barbara Wilson to be witnesses at the hearing in February.

201. The documents I presented at the hearing are at P2553-2623, and P1621-1625.

202. I clearly recall at the appeal hearing, which took place in the Addenbrooke’s board room, that my colleague Professor Barbara Wilson was particularly upset at not being allowed to say the things that she had planned to say, and that she complained about the fact that there were no neuropsychologists on the panel. This is a memory that will stay with me for ever – to see my close colleague reduced to tears by what she saw as the unfair constitution of the panel and the unfairness of the reasons for my dismissal.

203. The panel had explicit powers, as laid out in its procedures, to consult experts in my field. Since my professional body, The British Psychological Society, has a dedicated Faculty of Managers of clinical psychology services, such individuals could have provided expert advice on key management and associated relationship issues as they related to the delivery of a clinical Neuropsychology service. I regarded as double standards the fact that a few months earlier Kathy Haynes and John Pickard had consulted (P1320) the Senior Neuropsychologist in Oxford about Addenbrooke’s use of unqualified psychology staff, not sharing this information with me at the time, and yet the appeal panel refused to consult experts in my field about any issues relating to my dismissal. Such experts could have included some or all of those three clinical psychologists on my interview panel, or the two senior neuropsychologists who had carried out an external review of my service. They could have suggested alternative management arrangements, and given specific advice on the viability of alternatives to dismissal, utilising their considerable management experience of similar working arrangements in other NHS Trusts.

204. During the hearing, it was clear that one or more members of the panel may have had extensive interactions with key members of management who supported my dismissal, something that I naturally could not have foreseen before the hearings. This was manifest, for example, in the panel chair’s (Dr Ahluwalia) particularly friendly remarks to Juliet Walters after she finished giving evidence on March 23, something along the lines about how much he had missed her when she was on

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leave. I was somewhat surprised by this remark, especially since no similar remarks were made to any of my witnesses.

205. The panel chair, Dr Ahluwalia, repeatedly stated that the purpose of the appeal hearing was to review the process of the dismissal hearing, and specifically not to review old evidence. He did not hesitate to stop me or my witnesses when we accidentally erred from this direction, but he himself broke the rule when he chose – e.g. in his detailed questioning of me on February 17, 2011 in relation to email evidence that was presented at the dismissal hearing on December 1, 2010. I also found it strange that he appeared to accept statements from management without questioning any unsatisfactory reply – thus, when Oonagh Monkhouse was asked about whether she had explored the possibility of a service level agreement as an alternative to my dismissal, she responded ‘This was not a decision for us to make’ (P1596). Her response appeared to be an admission that a key matter that should have been considered by the dismissal panel was not given due consideration. But Dr Ahluwalia did not question this at all.

206. On occasions (P1631), Dr Ahluwalia intervened to stop me from pressing Juliet Walters for a clear response, and to stop me from making the important point that I had enjoyed excellent relationships with her predecessor, Tom Bennett.

207. During the hearing, when I asked Dr Ahluwalia about my request for external expert advisors in my field to be consulted, he simply turned to the Appeal Secretary, asked her if there was a formal requirement to involve such experts, to which she replied ‘No’, and he then moved on to the next matter. When inaccurate generalisations were made by management, they were not questioned by the panel – e.g. when (P1598), Oonagh Monkhouse claimed that I refused to attend any 1:1 meetings or to attend any Division Meetings, both of which were clearly not the case, since I had numerous 1:1 meeting with managers at every level and I did attend some Division meetings; or when Oonagh Monkhouse claimed (P1611) that with regards to the issue of the employment of unqualified staff ‘we had no evidence of this at the (dismissal) hearing’, whereas it was a key issue that was discussed, and where I in fact challenged John Pickard as to how he would feel if I employed an unqualified neurosurgeon in my clinic, which he refused to answer directly (P1462). All of this convinced me that my appeal had not received a fair hearing. Exculpatory evidence was elided and ignored, whilst any potentially unhelpful evidence was seized upon and explored in great depth.

208. After Dr Illis had presented evidence at the hearing on the afternoon of Wednesday March 23, an episode occurred which shocked and distressed me. At the very end of his evidence, Dr Illis indicated that he considered what had happened to me at Addenbrooke’s was appalling, and that it reminded him of the abuse of Psychiatry in the Soviet Union in the 1950s. The panel asked for a break immediately after Dr Illis gave evidence. I took that opportunity to go the gentleman’s toilet. While I was washing my hands in the toilet, I noticed someone bursting into the toilet, doubled over and in hysterical giggles. For a moment, I thought the person was in

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distress, but then I realised that he was in hysterical fits of giggles. It soon became apparent that the person was Richard Howe, who had been at the appeal hearing as a management representative. When he realised I was present in the toilet, he immediately stood upright. There was a stunned silence for a few seconds, since we both realised that this was highly embarrassing (it reminded me of the stunned silence after John Pickard’s explosive outburst in February 2004). After that silence, Richard Howe proceeded to ask me how long I had known Dr Illis, so it seemed clear to me that Dr Illis had been on his mind. I answered him, and then walked out of the toilet. I can only surmise that by his hysterical giggles he was laughing at Dr Illis’ sincere testimony, without knowing I was there. I considered Richard Howe’s reactions to be wholly inappropriate. His behaviour gave the impression that the whole process was a sham, and that all along there had only been one pre-determined outcome.

209. I had previously been given the choice as to whether I wished to hear the appeal decision in person, or whether I would like it in writing. I wished it to be in person. I was called to attend a decision hearing at Addenbrooke’s Hospital on April 13, 2011. Present at that meeting were Dr Ahluwalia, Mrs Wallace, Mr Robinson and myself. Even though I was advised by my union official that my chances of being successful were very low in view of the internal nature of the dismissal and appeal procedures, I was nevertheless shocked and distressed by the decision. I sincerely thought they would reconsider and explore the alternatives I had put forward. Dr Ahluwalia read out a prepared letter, which he also handed to me. No other statements of substance were made at that meeting.

(ii) Evidence to Rebut Conclusions in Appeal Letter

210. Dr Ahluwalia wrote to me in a letter dated April 13, 2011 (P1659-64) giving reasons for rejecting my appeal. I had hoped that he would have been guided by the over-riding principles of fairness, that he would have carried out all reasonable investigations before reaching his decision, that he would have consulted with experts in those areas that were outside his expertise and experience, and that he would have given due weight to the concept of proportionality. Sadly, apart from a single reference on page 1 of his letter to proportionality, I could find no evidence of these four key considerations being kept to the fore. Dr Ahluwalia’s letter was shorter than that of Mr Howe, and so my own comments are more limited.

211. On April 19, 2011, I wrote to Dr Ahluwalia (P1666-7) in response to his letter of rejection of my appeal. I outlined in clear terms my dissatisfaction, and that of my witnesses, with the constitution of the appeal panel, the way the hearings were conducted, and in particular a number of factual inaccuracies in his letter.

212. Four key factual inaccuracies were – (a) He stated on page 1 of his letter that the appeal panel was ‘wholly uninvolved in the dismissal process and had no prior knowledge to the details of your case’. Yet he knew that as medical director he had been specifically copied in by both Juliet Walters and myself to correspondence

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relating to my ‘public disclosure’ concerns around the use of non-qualified, non-HPC registered psychologists in Neuroscience outpatient clinics. I had also previously expressed my concerns to him about the Neuropsychology service for epilepsy patients (P281) - (b) He stated on page 3 of his letter that ‘neither you nor your representative presented any evidence to suggest that the notes taken by Oonagh Monkhouse had caused you a problem or detriment’. I referred him to paragraph B (6) of my Statement of Case, where I in fact made detailed and specific reference to such concerns. (c) He stated on page 3 of his letter that I ‘did not attend Divisional meetings’, but the Trust’s own records show that I did in fact attend some Divisional meetings, and more than some other individuals – e.g. the former neurosciences divisional director, Professor Alastair Compston, hardly ever attended any Divisional meetings or even sent apologies for non-attendance, yet he had not been singled out and criticised. (d) Dr Ahluwalia stated on page 3 of his letter that the Working Arrangements agreement was ‘legally binding’, but no statement within that document indicated that it was legally binding. Further, the Trust had not followed it and/or the Mediation Agreement in a number of respects.

213. I would like to briefly document here the concerns noted above that I had raised with Dr Ahluwalia with regards to the absence of a dedicated Neuropsychology service for epilepsy patients. In March 2009, I saw a patient in my clinic whose case reinforced my concerns. Limitations in staffing for epilepsy patients had been pointed out by Professor Robin Morris in his review of the Neuropsychology service (P437). The patient, who had suffered from epilepsy, was complaining bitterly that he had memory and word finding difficulties after brain surgery, and that he had not been forewarned prior to surgery that they could occur. His surgery had taken place the previous year. When I investigated his case further, I found out that he did not in fact have any proper pre-operative neuropsychological assessment, an important investigation that gives an indication of the risks of brain surgery in this type of patient. I also realised that if I had carried out such an assessment, in the light of other factors in his case I would not have recommended surgery, or at the very least pointed out the major risks in terms of adverse side-effects on his cognitive functioning. I had built up experience with these types of cases in my previous post in Southampton, and I had in fact specially prepared guidelines to help Neuropsychology staff when seeing such patients (P2365) As far back as November 2004, both consultants and managers in neurosciences had been aware of the importance of adhering to best practice guidelines on epilepsy, such as those produced by the National Institute of Clinical Excellence - NICE (210g / CP348).

214. Around March 2009, I also had a number of discussions and email correspondence with managers and Dr Ahluwalia to try and expedite an epilepsy neuropsychology post (P1071-73). I additionally brought this up at a meeting of the Neurosciences Division, and asked John Pickard as director if he would try and expedite an appointment. I immediately relayed my concerns that arose from this clinical case to Juliet Walters (P2430), also indicating that the Trust might find itself adversely reviewed by regulatory bodies. So serious did I regard this matter that I also copied

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into my email Karen Clarke, Kathy Haynes, Gareth Goodier (the chief executive) and Jag Ahluwalia (medical director). No action was taken in respect of our staffing resources, nor were there any changes made to procedures or guidelines as a result of my raising this concern. It is worth noting that around this period of time Lady Mary Archer, chair of the Trust, visited the National Hospital for Neurology and Neurosurgery in London, saw at first hand the comprehensive epilepsy surgery service that is offered there, which includes a very well resourced dedicated epilepsy Neuropsychology team, and expressed the wish that such a comprehensive service was also available at Addenbrooke’s.

215. Dr Ahluwalia replied on May 9, 2011 (P1670-71) to my misgivings about the appeal hearing. That letter did acknowledge three of four factual inaccuracies in his letter of April 13, 2011, but ignored the fourth factual error. By the middle of May 2011, I had not yet not received transcripts of the February or March appeal hearings, something that I had been promised, and I therefore wrote another letter to Dr Ahluwalia (P1672) on May 17, 2011 pointing out these omissions to him. Dr Ahluwalia did then reply on May 24, 2011 (P1675) and apologised for the delay in my receiving the transcripts, but he did not address any other points. When I read through the transcripts, I noted further factual errors, as well as a large number of minor and major typos (a few of which changed the sense of the passage in question). I felt obliged to point these out to Dr Ahluwalia, since he was chair of the appeal panel, and I indicated these to him on June 27, 2011 (P1676-77). I did not receive any response to that letter.

216. On page 2 of his letter, Dr Ahluwalia noted that Mr Howe was experienced in ‘leading, planning and delivering complex services’, but in view of Mr Howe’s engineering background these were presumably all non-clinical services, whereas the Neuropsychology service was a complex, highly specialised clinical service.

217. On page 3 of his letter, Dr Ahluwalia made what I considered to be a biased judgment, namely that my remarks about John Pickard were ‘derogatory and defamatory’. I had simply pointed out the explosive outbursts by John Pickard, which have been witnessed and well documented. Dr Ahluwalia chose to ignore both the outbursts and the bullying that lay behind them.

218. On page 3 of his letter, Dr Ahluwalia noted the absence of evidence that I wished the dismissal proceedings to extend to a second day, but he ignored the evidence I presented (P1594) that I was actually never asked or made aware of the fact that the proceedings could have been extended for another day. A second hearing of the Appeal panel had been specially convened for the benefit of John Pickard. If I had been told orally, or provided with documentation to show that I could have asked for a further meeting of the Dismissal panel to accommodate the attendance of Barbara Wilson, I would certainly have availed myself of that opportunity. I had never experienced such hearings before, and I in fact had earlier indicated my willingness to attend a further day, should that have been required (P2666).

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219. On page 4 of his letter, Dr Ahluwalia stated that he had considered my concerns regarding the use of unqualified Psychology staff in Neuroscience clinics and that he accepted John Pickard’s reassurance that the relevant practice was ‘safe and appropriate’. As someone without any qualifications or experience in Neuropsychology, I would have expected Dr Ahluwalia to carry out reasonable investigations, and to consult relevant experts in my field before coming to this conclusion. The fact that John Pickard and Kathy Haynes themselves considered that this consultation was an appropriate thing to do (P1320) supports my reservation regarding the basis of Dr Ahluwalia’s conclusion. The further fact that at the appeal hearing John Pickard did not disclose this evidence from a relevant expert, which in fact supported my whistleblowing claims with regards to clinical practice, is a matter of serious concern. If Juliet Walters also knew about this evidence and chose not to disclose it, this is again a matter of serious concern.

220. On page 4 of his letter, Dr Ahluwalia alleged that on my part there was a ’refusal to engage with key stakeholders’. I consider that he was under an obligation to specify the specific stakeholders in question. In this context, ‘stakeholders’ would have been those consultants who used my clinical service. As I repeatedly pointed out, I fully engaged with all those clinicians who referred patients to me, and there is no evidence that I refused to meet up with any such stakeholder. By contrast, I went out of my way to engage with key stakeholders such as Memory Clinic consultants and neurorehabilitation consultants, one of whom (Dr Stephen Kirker) was a witness at my dismissal hearing.

221. On page 4 of his letter, Dr Ahluwalia appeared to accept the view stated by Oonagh Monkouse that my successful interactions with senior managers, which I outlined in detail at the appeal hearing, could simply be labelled as ‘collaborations with colleagues’. The label that she attached was quite misleading. I know what is involved in collaborations with colleagues, e.g. on clinical cases, writing papers, etc. and I have always listed those separately. Dr Ahluwalia did not question this phrasing by Oonagh Monkhouse.

222. On page 4 of his letter, Dr Ahluwalia alleged that I had ‘no trust in senior management of the Neurosciences Division and that it was not possible for you to fulfil the leadership role of Head of Neuropsychology’. These were essentially the same criticisms as those made by Richard Howe, and I have dealt with them in paragraphs 168-171 and paragraph 180 respectively. Further, Dr Ahluwalia failed to engage with the issue of how the state of affairs had come about by way of management’s actions.

223. On page 4 of his letter, Dr Ahluwalia states that my service could no longer ‘be run and developed in line with the Trust’s requirements’. When I attended the lecture that Dr Ahluwalia himself delivered as medical director (P1218), it seemed that Trust requirements for a clinical service primarily related to the principles of excellence in care, patient safety, and patient experience. There is no evidence that I had not excelled in all of these requirements.

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H. Facts coming to light after the appeal hearing

224. As part of my preparations for the Employment Tribunal hearing, my legal team sought and obtained a number of disclosures. I found a number of these disclosures quite distressing.

225. I have been upset to find out that some individuals at Addenbrooke’s could say things about me without even trying to ascertain the authenticity and veracity of their statements, and without firstly checking with me and asking for my comments. Some comments were just factually wrong, some were half-truths or gross distortions, and some by their choice of words contained subtle innuendos about my character, my mental state or my integrity. In some cases, the views and attitudes of some of my close clinical colleagues were hijacked from the word go by these repeatedly stated remarks, and by the campaign against me. I felt a real sense of hurt and injustice when I read these documents. I will later give some specific examples.

226. Key evidence had been withheld from me at appeal and dismissal hearings, and it seems such evidence was also withheld from the respective panels – I found out that the Trust had consulted a senior neuropsychologist in Oxford (P1320) about the use of unqualified, non HPC-registered Psychology staff in neuroscience clinics, and that this neuropsychologist had agreed with the position that I had taken. Yet the Trust continued to deny that my disclosures had any substance.

227. Kathy Haynes wrote to this neuropsychologist and made a somewhat derisory comment, implying that my staff were much happier without me (P1532). I found tis astonishing. This flew in the face of the sincere and heartfelt statement that they wrote in my support (P2606), and by coincidence around the time that I read this letter from Kathy Haynes I received an unexpected birthday card in September 2011 from my former members of staff, something that I really appreciated (P1883).

228. There is a disclosure (P545) in which Kathy Haynes specifically stated that she had ‘doctored’ a statement made by someone she had interviewed, Sarah Nicol. I was distressed that some of the statements that Kathy Haynes claimed had been made by witnesses contained highly personal remarks against me, that there seemed to be no indication that the witnesses agreed with Kathy Haynes’ record of what they had said, and there was no indication that they had in fact given permission for their alleged words to be written down and used in a legal setting.

229. In a document written by Kathy Haynes (P505), derogatory things were said about me and conclusions were drawn about my behaviour, without any input from me. Furthermore, it is clear in this document that Kathy Haynes recognized that one interpretation of her behaviour towards me was that she was ‘bullying’ me. In a second document (P564-5), a Neuropsychology colleague and a member of the interview panel for my job (Katherine Carpenter) was provided with misleading and biased information about me – e.g. Kathy Haynes stated that ‘all my staff had left’, and implied that they were unhappy with me, whereas around that time two staff members in fact wrote very complimentary statements in my support (P643; P677).

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In a third document (P597), Kathy Haynes actively sought evidence from clinical colleagues that she hoped would be negative about me.

230. In a fourth document (P545), apparently written by Kathy Haynes, derogatory remarks are made about me, and the issue of my being persuaded to leave Addenbrooke’s is raised. There is a fifth example. In the spirit of reconciliation and forgiveness, I had sent a sincere email of thanks and good wishes to Kathy Haynes when I found out that she would be moving to another post and would no longer be my neurosciences manager. I did not receive any reply to this, but on disclosure I later found an email that she sent to Karen Clarke, forwarding my own email, and simply adding a series of over 20 exclamation marks (P1002). I was puzzled by this and regarded it as somewhat demeaning. In a sixth document, Kathy Haynes made a rather derogatory remark about a patient of mine and her husband, calling them a ‘bizarre couple’ (P512e), when she had never even met them. In the same document, she reproduced a four-letter word that had allegedly been used to insult me (P512b). In a seventh document (P232), Kathy Haynes implied to senior managers that I nominated myself for a prize, accused me of making ‘misguided statements’, and presented a jaundiced and factually incorrect account of the aids I gave to patients. This was all quite misleading – e.g. I entered my Memory Aids Clinic in an award competition in the usual way. I did not profit financially, and in fact there were significant expenses that I incurred in creating an A1 poster for the awards day, and in taking along my junior staff to the awards dinner. The Trust’s reputation was enhanced by my being short-listed and winning a runners-up prize at an event where media and press were present to see how an innovative clinical service at Addenbrooke’s was helping patients.

231. Perhaps most distressing and shocking of all, and something which I still find difficult to fathom, was a discovery I made on Monday afternoon of October 17, 2011 when I was reading through a set of disclosures from the Trust at my solicitor’s offices. I came across an item titled ‘Investigation notes – Narinder Kapur’ (P510-12). It became apparent that it referred to the fact that there had been surreptitious forced entry to my office by Addenbrooke’s management on a day when I was away in Ireland giving a paper at a Neuropsychology conference in July 2005. Presumably a master key had been used to enter my office. My office was searched. Computing equipment appears to have been removed from my office. The hard disk on one of my computers was hacked and cloned, and both the private and work-related contents of the hard disk were examined in detail, including confidential material relating to patients. In addition, it appears that some of my email communications had been secretly intercepted or monitored (228a / CP349). All of this was done without my knowledge or consent, and was a breach of the duty of trust owed to me by my managers. I was never made aware that such surreptitious and secretive monitoring could occur at my place of work – I was not made aware at staff induction/mandatory training days that I always attended, in my interactions with managers, or in any documents that were specifically provided to me (out of the many hundreds of policy and procedure documents in existence). I

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could simply never have even imagined such action taking place behind my back. It sustains my belief that I was fully entitled to call into question the impartiality of a few of my managers, and my belief that they may have transgressed the Protection from Harassment Act and other statutes in their dealings with me.

232. The reasons given by management for their conduct relating to this event have been spurious, inconsistent and misleading (e.g. alleged concern about my seeing private patients, when this was in fact formally agreed with management as a means of generating income for the Trust when I started in my post in 2003 – P228). I appreciate that my office and my computer were the property of the Trust, to which they have a right of access if they so request, but the way in which they went about this was wholly disproportionate and inappropriate. I also considered that the trust which patients have in consultants had been compromised by the arbitrary viewing by other staff of confidential material relating to their care, with some of the staff who viewed the material not even being clinically qualified. I recall still being in shock that evening after I discovered this disclosure, and having disturbed sleep the following night, on account of what I had discovered, and I still get disturbed sleep when I think about this, and any other surreptitious or secretive monitoring that may have taken place over the years, or may in fact still be taking place. Part of me felt that I was being ‘stalked’. A few days later, I narrated what I had found to a number of colleagues, and they were just as shocked and as incredulous as I was.

My understanding is that this action may have flouted both legal statutes and regulatory guidelines, such as -

a. The Data Protection Act b. The Regulation of Investigatory Powers Act c. Employment Practice Guidelines from the Information Commissioner on

Secretive Monitoring d. Guidance from the Office of Surveillance Commissioners e. Article 8 of the European Human Rights Act

233. This alarming episode happened during the tenure of John Pickard as Clinical Services Director for Neurosciences. It is inconceivable that as Director of Neurosciences at Addenbrooke’s John Pickard did not know about the event (and if he did not know about it, one would wish to know why not), and it is important to know if he authorised it, if he condoned it, or if he was involved in a cover-up to conceal its existence. It should be noted that the incident only recently came to light after considerable efforts on my part. So far, at the time of writing this statement, the Trust has persistently refused to answer specific queries on the issue.

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I. Financial Matters

234. I was distressed when I found out that after my dismissal management had gone to considerable lengths (P348-9) to try to find evidence of financial impropriety on my part (‘digging for dirt’). I felt the same sense of shock and outrage as when I had found out about the surreptitious forced entry to my office and the hacking / cloning of my computer.

235. In the months following my dismissal, management alleged to have found evidence of financial wrong-doings on my part while I was working at Addenbrooke’s. It suggested to me that they knew their case against me was weak, so they were desperate to try and find something more credible. They had never come to me with any queries or requests for clarification on financial matters either during my employment or after my employment. They spoke to my former staff and also to my colleagues, and this must have been both embarrassing and possibly upsetting for those individuals. It is important for me to set the record straight on this matter, especially since Kathy Haynes has on the one hand implied that I am guilty of fraud by talking about ‘fraud teams’ being involved, while at the same time she herself had admitted in personal correspondence about me that ‘I am not suggesting there has been fraud / false accounting’ (P348). In addition, the Trust’s own ET3 statement admits ‘there is no suggestion that the claimant tried to enrich himself through these actions’ (P34). I have found management’s allegations very hurtful, especially as I had gone out of my way, often at great personal expense, to provide resources for patients and for my staff, resources which Addenbrooke’s management often refused to provide, and in numerous other ways I have had the highest standards of financial integrity, often at significant personal cost to me. It is therefore important that I provide a full set of relevant facts.

236. Shortly after I took up post at Addenbrooke’s in July 2003, I met up with Andrew Bateman to see how in general there could be fruitful and productive relationships between the Oliver Zangwill Centre and the Neuropsychology Department at Addenbrooke’s, and in particular how I could use my knowledge and expertise to help the Oliver Zangwill (OZ) service. One of those meetings was attended by Geraldine Owen, the most senior clinical psychologist in Cambridge, and who was on my job interview panel. Amongst the initiatives we agreed was that I would provide Continuing Professional Development (CPD) and support sessions to OZ staff, and in particular to Dr Fergus Gracey, then a clinical psychologist at the Oliver Zangwill Centre. Initially, we agreed that I would be paid for these sessions. However, I myself suggested after the first 1-2 sessions that I would be happy to provide these sessions pro bono. To help cement this arrangement, I was invited to be honorary consultant to the Oliver Zangwill Centre. To facilitate collaboration between the Neuropsychology Department at Addenbrooke’s and the Oliver Zangwill Centre, we set up an arrangement whereby I paid in funds to the Oliver Zangwill Centre and these monies were handled through their research and development account. This meant that I was able to efficiently deposit income from, say, teaching/lecturing and then to expend funds for relevant NHS activities such as

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purchase of memory aids, some of which were imported from USA. I always kept a record of my expenditure (233a,b,c / CP350-465). Such deposits and expenditure were checked by Andrew Bateman or by his senior management colleague (Michelle Young). This administrative support was provided in return for supervision and other support that I was providing to the Oliver Zangwill Centre.

237. I had encountered a lot of red tape and frustrations in trying to purchase items through Addenbrooke’s for my Memory Aids Clinic, and Addenbrooke’s management had eventually told me that they would not fund that clinic. This clinic was a development which the Oliver Zangwill Centre strongly supported. I could at that time have taken my Memory Aids Clinic into the private sector as a personal profit-making enterprise, but I decided instead to retain it within the NHS, so that NHS staff and patients would benefit. I offered to provide resources in the Memory Aids Clinic free of charge to the Oliver Zangwill Centre, and we readily and happily agreed for me to use Oliver Zangwill administrative facility to support the Memory Aids Clinic, especially as I was using this facility to help provide memory aids to NHS patients at Addenbrooke’s and to Oliver Zangwill patients. I also used their research and development account to hold meetings such as the East Anglia Neuropsychology Forum and a memory disorders workshop, and I agreed for Oliver Zangwill staff to attend such meetings free of charge, and for the Oliver Zangwill Centre to have displays at such meetings. Since the Oliver Zangwill Centre was part of the Cambridge Community Services Trust, it naturally followed that payments were made in the name of ‘Cambridge Community Services’. Andrew Bateman and Michelle Young were in a position to document and scrutinise all my deposits and expenditures during this period. Receipts were all retained and it was above board. I did not personally profit in any way.

238. The Memory Aids Clinic and close links with the Oliver Zangwill Centre (OZ) enabled a number of productive collaborations to occur, including joint projects with Microsoft’s European Research Laboratory in Cambridge, which included grant income for the Oliver Zangwill Centre. A number of high quality publications have emanated from that collaboration, enhancing the reputation of both the Oliver Zangwill Centre and Addenbrooke’s Trust. The collaboration with Microsoft was one that I specifically initiated in 2003 when I came to Cambridge. Other benefits that have emanated from the close links I forged between the Oliver Zangwill Centre and the Neuropsychology Department at Addenbrooke’s have included - sharing of frameworks for clinical governance and clinical excellence, as outlined in my article On The Pursuit of Clinical Excellence that I made available pre-publication to OZ staff; providing memory aids, patient booklets and ‘Smart Paper’ clinical guidelines to OZ staff; my visiting the Oliver Zangwill Centre, seeing the work of the whole team, and providing a peer review of the goal planning process and of the facilities; the writing of joint papers, such as my guest chapter in Barbara Wilson’s recent book on memory rehabilitation; recruitment of patients for research trials at the OZ; OZ staff and visitors to OZ spending a day at the Memory Clinics within the Addenbrooke’s Neuropsychology Department.

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239. As a result of the repeated enquiries by Kathy Haynes, I understand that a senior financial officer from the Community Services Trust did visit the Oliver Zangwill Centre, inspected the relevant account, examined relevant deposits and expenditure, and was entirely happy that everything was satisfactory and above board. It was all clearly documented, with receipts retained, etc.

240. In respect of the clinical case where funding issues have been raised by Addenbrooke’s management, since the patient was seen in my Addenbrooke’s Memory Aids Clinic, and since I was funding the Memory Aids Clinic from the account at the Oliver Zangwill Centre, it was quite natural and reasonable for me to ask the referring agency to make a payment to Cambridge Community Services. (This payment was in fact never made, since I left Addenbrooke’s around this time and I cancelled the invoice in question, thus providing memory aids to the patient at my own personal expense).

241. Many Addenbrooke’s staff have joint appointments with other external organisations, such as with the University of Cambridge, the Medical Research Council, the Wellcome Trust, Cancer Research UK, etc. and this invariably results in their having more than one account, with funds in one organization being used to support activities in another organization – this is not only supported but actively encouraged by management in both organizations. Why was I being singled out for such exhaustive inquiries? For example, one of my colleagues, Dr Jerry Brown, consultant neurologist, held a personal account with his former secretary to service the Cambridge Dementia Course, sponsored in part by pharmaceutical companies, and to my knowledge this arrangement had never been questioned. Many hospital staff have Addenbrooke’s Charitable Trust accounts that they use for teaching and research – staff in that Charitable Trust never questioned any of my purchases, yet Kathy Haynes has now questioned my propriety with respect to purchases. I was never provided with any documentation by managers that would give guidance or help to show that any of the above fiscal arrangements, or the fiscal arrangements that I had set in place with the Oliver Zangwill Centre, was inappropriate or fell outside the Trust’s financial management systems.

242. Since 2003, when I started to see private patients at Addenbrooke’s hospital, I have always paid the consulting room fees that I have been charged (thus generating income for Cambridge University Hospitals NHS Foundation Trust). There has not been a single instance where I have defaulted on such payments (239a-c / CP594-6).

243. I was distressed by the criticisms of me, and in particular the liberal use of the term ‘fraud’ in management correspondence (P345, P347). The term ‘fraud’ implies illegal financial activity for personal gain. I had gone out of my way, often after a lot of time, effort, personal inconvenience and financial self-sacrifice, to help patients, staff and students. While I generally avoid publicity for my financial generosity, it is important for me to itemise some of this generosity to highlight my own philosophy

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of putting ‘principles before pounds’, and of viewing it as an important responsibility to use part of one’s income to help others in need.

244. I have used much of my private patient income to support the work of my Department – e.g. buy memory aids for patients, buy items for the Neuropsychology Department. For example, through NHS purchasing I ordered a test item (The Recognition Memory Test) in September 2003, and the item had still not arrived by July 2005. I therefore ordered and paid for it in August 2005 using my personal credit card, and it arrived a few days later (241a / CP466).

245. I could have followed the examples of other consultants and set up my private practice at a local private hospital, but I chose to use the facilities at Addenbrooke’s, since my employer would directly benefit from income that I generated. Where possible, I tried to ensure that I did not see ‘extra-contractual referrals’ as private patients, but instead put that money directly towards funds for my clinical service, teaching and research.

246. I funded from my own pocket the external reviews that were carried out of the Neuropsychology service in 2004, with fees, hotel and travel costs coming to around £1000. This review was initially opposed by John Pickard (P388a,b), even though I had promised it in my job interview statement - when I later pointed this out to him, he replied ‘I thought you were only bullshitting’.

247. In the case of the Cambridge Memory Manual (P2281) l that I wrote (which was a further edition of the Wessex Memory Manual that I had written when working in Southampton), and in the case of the other ten patient booklets I have written (PP2325), I could easily have set up a company to sell these privately as a personal source of income. Instead, I chose to sell them to generate income for my Department, thus saving the Trust expenditure. Since the time of my departure from Addenbrooke’s, I now use income from such sales to support the work of Unicef, even though I incur costs in printing the booklets.

248. I have always given out memory aids free of charge to patients. In the case of the purchase of memory aids, this has usually been with my own credit card. I invariably have to pay import duty and significant carriage costs when I have purchased memory aids from the USA. When I am in USA on a conference, I often purchase memory aids there, again at my own expense. Dr Andrew Bateman set up the account described above at the Oliver Zangwill Centre, and I was able to pay generated income into that account, and for some memory aids I was able to get reimbursement for my own expenditure. However, in a number of instances, this reimbursement was for various reasons not possible, and I simply had to incur this as a personal cost (245a-b / CP467-70).

249. In the case of private patients, it also occasionally happens that the patient’s insurance company declines payment to me of services rendered (e.g. the patient may not have realised that my assessment is not covered in their policy, they may have reached their limit for outpatient fees incurred, etc). In such instances, in addition to consulting room costs, I have often had to incur costs relating to memory

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aids that I may have given to the private patient. In such instances, I have never asked the patient for payment and have seen them pro bono.

250. I have always donated my book royalties to charity, usually a health care charity in India. This was a principled decision I first made when I wrote my first book in 1988 (Memory Disorders in Clinical Practice), and I have applied it to all subsequent books. The health care organization that has primarily benefited has been the Arpana Hospital Complex in northern India, near New Delhi (247a / CP471-4). My brother, who is a General Practitioner in N Ireland, has provided clinical and financial support to that hospital over the years, and he encouraged me to select this hospital as the primary recipient of my book royalties (247b / CP475). Other health care bodies that have benefited from my book royalties include the Gwalior Children’s Hospital near Delhi, and the local health centre in the town in N Ireland (Ballycastle) where my family settled when we arrived from India in the early 1950s (247c / CP476).

251. In 2009, I made a personal donation of £3000.00 to the British Neuropsychological Society in memory of my late mother and father. This donation was made in order to support the work of the society, to ensure high quality meetings by attracting international speakers, etc. (248ab / CP477-8). All of my efforts and achievements while President of the British Neuropsychological Society were greatly appreciated by my colleagues in the society (248cde / CP479-481).

252. I personally took the initiative to persuade the British Neuropsychological Society and the Division of Neuropsychology of the British Psychological Society to set up a Neuropsychology International Fellowship scheme to support and promote Neuropsychology in developing countries. The first two fellows in 2011 happened to be both from India. The maximum amount of the fellowship award is £750. I realised that in the case of the two fellows from India there would be major additional expenditure which meant that this amount would be insufficient for all of their expenses – both visiting fellows stayed in the UK for around six weeks, attending courses and conferences, visiting Neuropsychology Departments, etc, I therefore promised that I would personally meet all of their costs over and above the £750 award. This amount came to £400 for one fellow, and £600 for the other fellow (249a,b / CP482-3). One of the fellows, HM Nithya, wished to attend the Cambridge Dementia Course in December 2011, and I personally paid her fee for that course (£275) (249c-2 / CP484).

253. In the case of an Indian neuropsychologist, Mrs Jawala Narayanan from Bangalore, who had been attending the Glasgow Neuropsychology Course in 2010, I waived her fees to attend the Cambridge Memory Disorders Workshop that I organized and which took place in September 2010. She also subsequently attended a meeting of the International Neuropsychological Society that was held in New Zealand in July 2011. I was impressed by her enthusiasm to learn about Neuropsychology and to impart her knowledge, experience and skills to other clinical psychologists in India. I therefore undertook to pay any expenses she incurred for which she did not get

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reimbursement from an Indian grant body that did part-fund her conference attendance (Ratan Tata Trust). This amount which I paid her came to £385 (250a / CP485).

254. Another Indian neuroscientist based in Bangalore was attending a conference in Madrid in 2011, and I paid for some of the expenses she incurred (around £500) in attending the meeting (250a / CP485). I also made a donation to the Dementia Care Centre where she worked (around £200) when I visited Bangalore in November 2011 (251a / CP486-9).

255. I was invited to give a talk at the first Indian National Neuropsychology Conference that was held in Bangalore in November 2011. Even though the organizers had no funds to pay my travel costs, I decided to meet those costs myself and to attend the meeting, so that I could help promote my discipline in India (252a / CP490). While at the meeting in Bangalore, I gave a free Neuropsychology workshop to over 40 delegates, and I also helped on the occasion of the meeting to set up the Neuropsychology Society of India. Since I myself had helped set up the British Neuropsychological Society in the 1980s, I was happy to give advice and share expertise to help set up a similar society in India.

256. The World Federation of Neurology organises annual meetings in India to promote Cognitive Neurology and Neuropsychology there. For the meeting in Calcutta that was held in January 2012, I set up a bursary scheme in memory of my late father (Dwarka Nath Kapur bursary). This was to a total value of 40,000 Rupees, around £500, with an allowance for bursaries to cover travel and accommodation costs of delegates (253a / CP491-2).

257. I have recently written a booklet, The Cambridge Happiness Manual, which is intended to convey to members of the public the fruits of research into the Psychology of well-being. Most of the sales income from this booklet is intended to go to the work of Unicef in India. I have been impressed by the wonderful work carried out by Unicef in India, and in particular their nutrition rehabilitation centres. Even though the booklet has cost me several thousands of pounds to produce, since I have used the services of two graphic artists and have had a number of print runs of early versions, I have been prepared to meet this expense to support the work that Unicef is carrying out in my mother country.

258. Around the summer of 2011, I was elected a Rotarian, since I found that their principles and ideal were in such close harmony with my own. I have already engaged in Rotary charitable activities, such as street collections. I am currently exploring ways in which the Rotary organization can market and distribute the Cambridge Happiness Manual, retaining some proceeds for their own charity work, with the remainder going to Unicef. I have agreed to fully fund the first print run of around 5000 booklets on behalf of Rotary.

259. I have held regular Department meetings since I came to Addenbrooke’s in 2003. I have had these as working lunches with my staff. I have always insisted on paying for the meal in full. When a member of staff leaves, I have always paid for the meal

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when we have taken staff out, and I have also always personally paid in full for the present that is given to the departing member of staff. Likewise, on occasions such as the annual Department Xmas meal, I have always taken my staff to a high quality restaurant in Cambridge, and personally paid for the meal in full (256a,b / CP493-4).

260. I usually held East Anglia Neuropsychology Forum meetings every year. At those meetings, for which I never changed attendance to delegates, I would often have expenses such as refreshments (drinks and Indian snacks), paying helpers on the day, etc. I would pay for these expenses from my own pocket.

261. When asked to give talks to patient organisations, I usually waive my fee for such talks – e.g. for a talk I gave to Headway (head injury charity) in September 2011 (258a / CP495).

262. At the regular, weekly Memory Clinic multi-disciplinary meetings at Addenbrooke’s Hospital, attended by neurologists, neuropsychologists, a psychiatrist, etc., I personally provided beverages for all staff, again paying this at my own expense.

263. I organized the annual Memory Clinic Review meetings at Addenbrooke’s Hospital, and for those meetings I also personally paid for refreshments (beverages and Indian snacks).

264. I have donated items to the Ward (R3 Neurosciences) where my Department is based – e.g. I bought a microwave oven for use in the staff kitchen. I also arranged for a donation to the R3 Neurosciences Ward Fund. In the case of my staff, I have always tried to ensure that, in spite of NHS cutbacks, they had comforts to make their work environment enjoyable – towards that end, I bought a fridge and cordless phones for each of the three offices used by Neuropsychology staff, etc. (261a / CP496-7).

265. Every Xmas, my Department would send cards and give chocolates / biscuits to the wards and secretarial / admin staff with whom we liaised over the past year. I would put this down as coming from my staff and me, but would always pay for the purchases myself.

266. When I was President of the British Neuropsychological Society, during a meeting of the society I personally paid the costs of dining speakers and senior colleagues for a special meal in a London restaurant (263a / CP498-9).

267. Although the visiting Professor post that I currently hold at University College London is honorary, I feel privileged and proud to be associated with such a prestigious university, and I am touched by the appreciation and gratitude for my work that colleagues and students have shown to me. I have always made a point of contributing some of my private practice income towards the setting where I work, and to this end I made a donation of £500 to my host Department at University College, for them to use in any ways they wished to support post-graduate students on the course on which I teach, such as a student hardship fund (264a / CP500).

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J. The impact of my dismissal

268. It is difficult to explain in a few paragraphs what I have been through, and its adverse effects. I would however like to end this witness statement by making a brief impact statement, so as to try and describe some of the effects that my dismissal, and the manner of my dismissal, have had on me and on those who are nearest and dearest to me.

a. Impact on my family – I am the sole bread-winner in my family; my wife is a part-qualified teacher who only very occasionally is able to find work. I have three children, aged 26, 23 and 20 years, none of whom are married, and all three are to a varying extent financially dependent on me. There is a degree of loss of esteem that results from being instantly dismissed, and this naturally affected my status within my family. Since the only place I stood a chance of generating adequate private practice income was London, I had to move my family residence from Southampton to London, with all of the upheaval that this caused my wife and my children. My son, who was aged 18 at the time of my dismissal, declined to come with us to London, preferring to stay with his friends in Southampton. We therefore had to find and partly subsidise a flat for him in Southampton, and we visit him regularly. This has therefore been a worrying time for me and my wife, with our family being dislocated in this way, quite apart from the time and expense involved in travelling between London and Southampton.

b. Impact on me – Being dismissed from a job that I loved, being abruptly taken away from colleagues and staff who admired my work and needed my support, and being no longer able to help patients who valued my care, is one of the most demoralising and soul-destroying things that can happen to anyone. In such a situation, what could I or should I say to my patients and to my colleagues in UK and abroad? From the practical point of view, at short notice I had to clear out my office and arrange for the removal of thousands of items, some that I had collected over 30 years in the NHS. Although the Trust provided a removals firm to help me, this consumed a huge amount of time and stress, and also significant expense on my part. I had already arranged, as I did every year, to treat all my staff to a Christmas meal in a city restaurant, and I went ahead with this meal in Cambridge, even though the circumstances were anything but happy.

269. I had to think of the excellent national and international reputation that I had built up, and which I had to protect from distorted information and misinformation that might still emanate from Addenbrooke’s. One of my academic colleagues told me in early 2011 that he had been speaking to another academic colleague in San Diego, who seemed to somehow know about my recent dismissal from Addenbrooke’s. I have had to seek out jobs and possible sources of income, knowing full well that at my age and at my level of seniority I would be very unlikely to get any reliable source of income. I had to draw my pension and lump sum, something that I had not planned to do for a number of years. Most of the lump sum that I had planned to spend on

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my children and on comforts in retirement has now had to be used for other things, including legal expenses. I have even had to discuss with my wife the possibility of having to sell our house and live in rented accommodation. I had to think of health insurance if I were to fall ill, since I could not rely on the generous sickness benefits that are associated with NHS employment. I had to find income for attending conferences and courses, something that an employer usually pays for.

270. Since the date of my dismissal in December 2010, I have made a number of attempts to mitigate the financial and other losses that I have suffered as a result of my unfair dismissal. This has not been easy, especially in the current financial and employment climate, and in view of my age and seniority, but I have explored every possible avenue to generate income to sustain my family and myself, and also to sustain the work-related charitable work I have carried out over the years.

271. I realised that I was very unlikely to obtain a post in the NHS similar to the one that I held in Cambridge, and therefore private practice was my only realistic option. I also realised that the only place that I would have any chance of generating sufficient private patient income would be London. I therefore sold my house in Southampton, and moved to a lower specification one in London. That house needed major refurbishment, which itself was costly. I had to arrange for the building of a dedicated workshop in my back garden to house my Neuropsychology books, memory aids, teaching materials, etc. I also had to take over the living room of the house and use it as my general office.

272. I have applied for and successfully gained consulting rights in two local private hospitals and one local private health care centre – these are the Clementine Churchill Hospital, Harrow, Middlesex (P1883o); the Spire Hospital, Bushey, Herts (P1883n); the Harrow Health Centre, Harrow, Middlesex (P1883b). In view of the competition in London from centres such as Harley Street, where Neuropsychology centres have recently been established, it has proved much more difficult than I anticipated to generate referrals and to set up a successful private practice in London.

273. I have regularly checked NHS job websites, such as ‘NHS Jobs’, and I have also registered with employment agencies. There are very few suitable jobs that have arisen in 2011 in my speciality and at my level of seniority. In addition, the enormous amount of time taken up in preparing for the Employment Tribunal hearing has limited the number of hours I could work in any post. Even finding honorary clinical work has proved to be difficult (P1883g, P1883h).

274. I have applied for and successfully gained an honorary visiting chair at University College London. I have always enjoyed teaching and supervising students and junior staff, and when I was in Cambridge I received praise from students and colleagues for the excellence of my teaching. The visiting chair at University College London enables me to continue this work, and also provides me with invaluable resources such as access to library and other facilities (P1883i).

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275. When in Cambridge, I had set up an award-winning Memory Aids Clinic, which patients and clinical colleagues greatly appreciated. I have therefore sought to set up a similar clinic, and have been able to gain backing for this from a private rehabilitation centre in Kent, the Raphael Medical Centre. They have agreed to pay me temporary consultancy fees to help set up such a clinic, recruit and train staff, etc. (P1883a, P1883e).

276. Apart from the major expenses I have incurred, as outlined in my Schedule of Loss, I had to spend a huge amount of time preparing my employment tribunal case, and also seeking advice and support. This naturally reduced the time I could spend with my family or dealing with other matters such as trying to find work. I was surprised to find how closely my experience at Addenbrooke’s overlapped with that of other NHS whistleblowers (273a, b / CP501-2a-h; 273c / CP597-601), and I took some comfort in the fact that I was not alone, and that any lessons learned from my case might bring about changes that might help whistleblowers in the future raise concerns without fear of the consequences.

277. Fortunately, although I am not religious, I have deep-seated principles that have sustained me over the years, these being based on the principles of truth and compassion inculcated in me by my father and also espoused by Mahatma Gandhi. It was in Gandhi’s memory that I dedicated my last book, The Paradoxical Brain (70a / CP107-9). It was Gandhi’s principles that I documented in a chapter on morality in medicine (P2162). It was Gandhi’s values that I promoted in the booklet on well-being that I have produced for the general public (274b / CP602). While I have generally been able to retain good physical and mental health, at times I naturally have been anxious about the impact of my dismissal on my wife and my family, and I have on occasions suffered both disturbed sleep and also a number of mostly minor ailments, including facial skin rash (acne rosacea) and gastrointestinal symptoms, which did require invasive investigations (274c,d / CP503-4), with fortunately no malignant abnormality being found.

278. As indicated above, my instant dismissal meant that patients who were due to be seen by me in the following weeks and months had to have their appointments with me cancelled, and more junior staff had to take on these cases. One patient, a senior member of the legal profession, was in the middle of a treatment programme with me, and that programme had to be abandoned – his condition was quite complex and specialised, I had built up a strong rapport with the patient and his wife, and his case was therefore not one that could have been handled by my junior staff.

279. I had introduced a number of innovations into diagnosis and treatment in my department, and I personally have regularly updated these procedures. Thus, I produced ‘Smart Paper’ clinical guidelines (P2359-70), a memory manual (P2281) and around ten other therapy booklets for patients (P2325). Every 1-2 months, based on new evidence in the literature, I personally updated most of these items for the benefit of the clinical service in my Department. I knew that leaving

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Addenbrooke’s would mean that I could no longer provide updates and that this would mean a reduction in the excellence of care to patients. I offered to provide continued support from a distance to the clinical psychologist working in the deep brain stimulation service, but this was vetoed by management, even though the consultant neurologist in charge, Dr Phil Buttery, was keen on the idea and thanked me for making this offer (P1497).

280. As senior consultant I regularly gave advice to my junior staff on complex cases, and I knew that they would no longer have any on-site consultant support. I also knew that the practice of using unqualified staff in Neuroscience Clinics continued to be a live issue up till the time of my dismissal, and that this factor together with staff shortages had contributed to serious clinical incidents that had occurred, so I remained worried for the health and safety of patients. My remaining junior staff would have been excluded from those clinics where unqualified Psychology staff were still practising, and so would have been subject to this form of ‘passive bullying’.

281. Since I was the only senior neuropsychologist in my Department who could take on trainee clinical psychologists for supervision, I knew that this partnership that we had with training schemes, such as with the University of East Anglia, would lapse. I had set up a Memory Aids Clinic and resource centre, which I had largely funded myself, and I knew that consultants and patients would no longer be able to benefit from this resource, which they all highly valued. I organized and ran regular meetings of the East Anglia Neuropsychology Forum, which were greatly appreciated by staff and students alike throughout East Anglia, and I knew that these would also have to lapse.

282. I occasionally gave lectures to junior doctors, and since there was no other consultant neuropsychologist in post, this teaching would no longer take place. I was involved in a major research project with the MRC Cognition and Brain Sciences Unit in Cambridge, which had ethical approval and was going well, and I knew that this project would probably have to be abandoned, and that colleagues in the project would be distressed and very disappointed with this situation.

283. I had generated income for my department, and had bought a number of items for staff and for the ward to which I was attached, and I knew that this source of income would no longer be there. The husband of one of my Southampton patients had been so grateful for the support and treatment that I gave to his wife over the years that he had arranged in his will for a major part of his estate to be donated to my Memory Aids Clinic research and development work – this money would have come to Addenbrooke’s had I stayed there, and I therefore had to make alternative arrangements for another centre outside Cambridge to potentially benefit from this generosity.

284. I would like to end my statement by saying how much I had enjoyed working at Addenbrooke’s - in spite of what I have suffered at the hands of a few individuals - and also how much I am grateful for the admiration and support that I received from

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my junior staff, from my consultant colleagues, from a number of managers and senior figures at Addenbrooke’s, and especially from my patients and their families. I am saddened that a few individuals at Addenbrooke’s behaved in the ways that they did. I appreciate that in some cases they may simply have been misled by others, or just lacked the knowledge, skills and experience to deal with a discipline outside their sphere of expertise, and I would nevertheless be happy to interact with them professionally in the future.

285. I feel fortunate to have maintained good physical and mental health over this period, to have been able to remain true to my principles, and to have been privileged to help so many patients and staff during my time at Addenbrooke’s.

Statement of Truth I believe the contents of this statement to be true Narinder Kapur……………………………………… Date …………………