‘We are talking about impact on vulnerable children’

Policy & Resources vice-president Gavin St Pier has been blamed for contributing to the departure of not just one but three paediatricians.

Dr Sandie Bohin announced last week that she was bringing forward her retirement plans after a code of conduct investigation found that Deputy St Pier had bullied her and tried to discredit her professional and personal reputation.

The Medical Specialist Group has now linked his actions to the resignation of two other consultants from its paediatric department – Dr Clare Betteridge, who left last year, and Dr Claudia Rettberg, who resigned recently.

‘From discussions with them, it has certainly played a part,’ said MSG chairman Dr Steve Evans, in an interview with the Guernsey Press.

‘I think the pressure the paediatric department has been put under by the length of time this criticism has been going on for has had an impact on their working environment and has played a part in them leaving the island.’

Unprecedented dispute

The MSG and the local branch of the British Medical Association, the doctors’ union, has also accused Deputy St Pier variously of spreading false allegations, damaging safeguarding services for children and precipitating a recruitment crisis. Deputy St Pier has claimed essentially that the medical establishment has turned on him for vocally representing families who have suffered from poor clinical practices, a culture of defensiveness and an unwillingness to learn from mistakes.

Doctors and deputies have clashed before. In two terms as a deputy, the late Mike Hadley regularly provoked criticism from inside parts of the health service which he alleged were unsafe and complacent. Twenty years earlier, the BMA led opposition to a Social Insurance Authority scheme which would have insured patients against escalating primary care costs.

But the current feud, which is what it clearly has become, is unprecedented in its duration and intensity. It will reach the States Assembly again this week when deputies debate a recommendation from their standards commissioner, Dr Melissa McCullough, to suspend Deputy St Pier for 25 days, reduced from 30 days on appeal.

The previous Assembly reprimanded him for criticising Dr Bohin’s leadership of safeguarding services, having earlier cleared him of abusing parliamentary privilege. Since then, voters have had their say, returning him to the States at June’s general election with the seventh-highest number of votes among the 82 candidates.

This weekend, he was finalising a vigorous defence, including potentially using parliamentary privilege to reveal more about dozens of complainants he is now representing. He has claimed it would ‘undermine democracy’ if he was suspended over the brief phone call at the centre of the latest case, during which he said he merely confirmed information to a national journalist which she had already obtained from other sources.

The BMA has called on the Assembly to suspend him, which is not surprising, but so too has the MSG, an intervention which would have seemed unthinkable a few years ago.

‘Five or 10 years ago, if you had said that one of our paediatricians was going to be subjected to a lengthy campaign of harassment, with aspersions being cast on her professional standing and her capability as a doctor, I would probably have said to you that I couldn’t see that happening,’ said Dr Evans.

‘What we are asking is for deputies to support the evidence and findings of an independent commissioner and an independent appeal. It’s not as if we’re standing outside the States with a placard. There has been an independent process that has made some recommendations, and we are expecting and hoping that the politicians will follow through with it.

‘If the independent findings were rejected, I think it would seriously impact on public confidence in both the States and the paediatric department. We have to consider the broader implications. We are potentially talking about impact on vulnerable children in the island. If, before somebody makes a referral with safeguarding concerns, they have to consider if they are going to be subjected to political interference and harassment, and even if that puts a doubt in the mind, that’s a bad thing for Guernsey.’

Different types of complaint

Dr Evans was concerned about how the MSG would recruit two replacement paediatricians in the next few months.

‘One of the first things people are going to see in a Google search is that there has been a political campaign against the safeguarding team in Guernsey, in particular focused on Dr Bohin, which is significantly misleading. I can’t see how that wouldn’t have an impact on recruitment,’ he said.

Deputy St Pier has claimed that nearly 30 families have approached him with serious complaints about local medical or safeguarding services, mostly in the area of paediatrics, many connected to Dr Bohin. This has angered the MSG because only a much small number of cases have been pursued through formal complaints procedures. Dr Evans makes a simple and persuasive case: the other complaints have not been examined and, therefore, should not be used as evidence against Dr Bohin and her colleagues. Doctors are not infallible and patients are not always objective. It would be impossible to find a doctor in Guernsey, or indeed anywhere, without critics or complainants, but that does not establish fault, much less malpractice.

In its statement backing Deputy St Pier’s suspension, the MSG said it was aware of only eight complaints involving Dr Bohin over the past four years, and that none had been upheld. In her code of conduct report, Dr McCullough went further, saying that independent reviews had consistently found no wrongdoing related to clinical judgement or actions.

These emphatic assertions have astonished some of the families represented by Deputy St Pier. They point to a 2024 report into the case of a child diagnosed with insignificant symptoms following an incomplete assessment who was then found to require major surgery when the parents insisted on a second opinion at a private hospital in the UK, and a 2021 report into safeguarding which found bias against families who requested second opinions. Neither of these reports has been published.

‘I’m not able to discuss complaints in detail,’ said Dr Evans. ‘People forget that, as doctors, we are bound by a strict code of confidentiality. There is nothing to stop patients coming to you or their deputies to say this or that happened, but I have to be very circumspect about what I can reveal about individual cases because I could quite easily lay myself open to a breach of confidentiality.’

Dr Evans is perhaps entitled to think that this line of questioning is unfair. I am not bound by his conditions of confidentiality, and he does not know which sections of the unpublished 2021 and 2024 reports have been shared or with whom. One has to speak as one finds, and in all my dealings with Dr Evans, previously as a deputy and now as a journalist, I have always found him to be open, measured and constructive. However, it was the MSG which forcefully asserted that no complaints had been upheld, and it was reasonable to ask how that could be reconciled with the independent reports.

‘Those reports were meant to be confidential. They have obviously been shared. But I don’t know whether the whole report is being shared or just excerpts of it and, depending on the information you release, you can change things by presenting them out of context. I’m not saying that has been done.

But this is about the code of conduct and the fact there has been an independent investigation into Deputy St Pier’s behaviour, it has been found wanting, and he has appealed to someone else who is independent and that appeal has not been upheld.’

Why the MSG has spoken out

Deputy St Pier sent a briefing note to States members and the media the weekend before last, as a prelude to his defence in the Assembly. He may also have been pre-empting a rumoured guillotine motion at Wednesday’s meeting. A similar attempt to curtail the previous code of conduct debate was heavily defeated. Former P&R president Peter Ferbrache summed up the mood on that occasion, saying: ‘I have heard directly from some members of the public that they believe this will be swept under the carpet and the States will look after its own and it’s important that there is a hearing and some discussion.’

Dr Evans invited interviews following coverage of Deputy St Pier’s briefing note. ‘It would be unfair if one party in a debate was able to present information and the other party wasn’t,’ he said.

It’s understandable that the MSG would want to defend one of its consultants. Social media commentary indicates there are plenty of local families pleased it has. Every doctor inevitably has friends and supporters as well as critics. Every doctor must also have wondered how their record would fare under a similar microscope of scrutiny. As our interview nears its end, it occurs to me that Dr Evans has argued his colleague’s case as well as he could, given the hand he has been dealt. He said he had not lobbied deputies privately ahead of the suspension debate.

Finally, I wanted to ask Dr Evans about a recent radio interview – for which even the word unprecedented feels inadequate – in which Dr Bohin appeared to be trying almost to goad P&R president Lindsay de Sausmarez into voting to suspend her vice-president, saying ‘nothing would surprise’ her in a discussion about how Deputy de Sausmarez might act, and referring to her criticism of misbehaviour among senior politicians in the previous Assembly.

‘I don’t think Sandie was trying to drive the vote one way or the other and I don’t think she made a specific comment about Deputy de Sausmarez – I think it was about the States in general,’ he said.

‘We need to wait and see how the deputies vote and whether they are going to support the independent findings or not. If they don’t, it calls into question the usefulness of having an independent commissioner and the appeals process because they both found that there were serious breaches of the code of conduct.’