'the Nhs At Its Worst', Ex-ombudsman Tells Inquiry

A erstwhile wellness ombudsman has condemned intelligence wellness services for their handling of 2 susceptible young men who died successful their care.

Sir Rob Behrens, who was parliamentary and wellness work ombudsman (PHSO) from 2017 to 2024, said astatine nan Lampard Inquiry, which is examining nan deaths of much than 2,000 group nether intelligence wellness services successful Essex complete a 24-year period.

Sir Rob said it was "a disgrace" really Essex Partnership University NHS Foundation Trust (EPUT) had grounded successful its attraction of 20-year-old Matthew Leahy, who died successful 2012, and a 20-year-old man referred to arsenic Mr R, who died successful 2008.

"This was nan National Health Service astatine its worst and needed calling out," Sir Rob said.

Sir Rob referred successful his enquiry quality to respective reports made during his tenure, including "Missed Opportunities", which looked into nan circumstances surrounding nan deaths of Mr Leahy and Mr R.

Mr Leahy was recovered unresponsive astatine nan Linden Centre successful Chelmsford. He reported being raped location conscionable days earlier he died.

Sir Rob told nan enquiry nan PHSO identified "19 instances of maladministration" successful Mr Leahy's lawsuit by North Essex Partnership University NHS Foundation Trust - a predecessor to EPUT - including that his attraction scheme was falsified.

The erstwhile ombudsman said location had been "a near-complete nonaccomplishment of nan activity of this trust, surely earlier it was merged" pinch South Essex Partnership Trust to go EPUT.

"This was an indictment of nan wellness service," he added.

Sir Rob paid tribute to Matthew's mother, Melanie Leahy, who campaigned for much than a decade for a nationalist inquiry, calling her "an exemplary complainant".

"She was very good prepared for each meeting, she was courteous but assertive. She knew what she wanted retired of an investigation.

"Given nan calamity that she'd been through, it was a singular publication to nationalist life that she performed complete galore years," Sir Rob said.

He besides said that nan measurement immoderate doctors said astir Mr R was "staggering".

Mr R was recovered unresponsive successful nan Linden Centre successful December 2008 and died afterwards. Sir Rob Behrens recovered he had been grounded aggregate times by those treating him.

"Some clinicians were interviewed aft he died, and they had a very patronising attack to him" he told nan inquiry.

"In their view, [Mr R] didn't person intelligence wellness problems astatine all, and he had been admitted because he wanted location to unrecorded because he was homeless. That is staggering."

In a study called "Broken Trust", published successful 2023, Sir Rob referenced location were much than a twelve different wellness and attraction regulators playing important roles successful diligent safety.

"Political leaders person created a confusing landscapes of organisations, often successful knee-jerk guidance to diligent information situation points," nan study said.

Sir Rob agreed pinch a proposal put to him by Nicholas Griffin KC, main counsel to nan inquiry, that immoderate incidents "fall done nan gaps" owed to nan complexity of nan complaints process and truthful are not investigated.

"There are a batch of group who simply don't cognize wherever to go," Sir Rob said.

"At nan moment, I person nary assurance that group spot nan strategy because they don't cognize wherever to spell erstwhile they want to make a complaint."

Sir Rob said that Essex was "not exceptional" and nan issues he had discovered location could beryllium seen successful different places arsenic well.

"The absence of leadership… not communicating efficaciously pinch patients, nan information issues astir ligature points… and nan absence of training and improvement - these are still issues which nan NHS has to reside generally, not conscionable successful Essex," he said.

The erstwhile ombudsman besides told nan enquiry that he was prevented from investigating a important number of deaths due to a "serious limitation" successful his office's powers.

Sir Rob Behrens explained nan ombudsman could only analyse pursuing a complaint, but that for understandable reasons of bereavement aliases trauma, galore families successful Essex did not kick pursuing nan deaths of loved ones.

Sir Rob said if nan ombudsman had nan powerfulness to return its ain inaugural past "the solution of these tragic issues could person been speeded up very dramatically".

EPUT main executive Paul Scott has apologised for deaths nether his trust's care.

He said: "As nan enquiry progresses, location will beryllium galore accounts of group who were overmuch loved and missed complete nan past 24 years and I want to opportunity really sorry I americium for their loss."

The Lampard Inquiry will perceive grounds crossed respective sessions until July 2026, pinch Baroness Lampard's study apt to beryllium published successful 2027.