Kim Holt: Daniel Pelka's story is a sadly familiar one

On 2 August 2013 the mother and stepfather of Daniel Pelka were sentenced to 30 years for the cruelty and murder of the child.

‘All deaths in child protection are preventable; this is the primary purpose of our child protection system’

Nothing distresses society more than the realisation that once again a child slipped through the net − that any assertions that we are able to robustly protect children in every case are “wishful thinking”.

I was saddened to note once again a senior official suggest that because it was the parents that killed the child this absolves the authorities from any responsibility. That may not have been the intended meaning, but it was the mistake that Sharon Shoesmith made in 2007, with regards to Peter Connelly’s death, in her early statements about that tragedy.

All deaths in child protection are preventable; this is the primary purpose of our child protection system. If we think otherwise we shouldn’t be working in it.

Erased from history

I spent four years on special leave having raised a grievance against what I believed to be a bullying management style in Haringey. My grievance was upheld.

Strangely, despite my complaint being upheld no formal investigation into the team dysfunction took place, HR influenced the chair of the panel to insert various derogatory statements about me and the result was a fudge. Team dysfunction was not addressed and I went on sick leave soon afterwards.

‘I do not recollect any mention of the importance of an open supportive culture in any of the official statements’

The key issues highlighted in the Sibert report several years later in relation to failings over Peter Connelly’s death were lack of a named doctor in post, lack of nursing support for the child protection clinic, and inadequate numbers of paediatricians

At the time of the various inquiries, such as the initial serious case review in 2008, the Sibert report, the 2009 Care Quality Commission inquiry and NHS London’s 2009 investigation, my existence had been virtually erased from the departmental history.

Defence mechanisms

I had not been permitted in 2007 to return to my post after a period of depression, brought on by the workload and hostility against me. While we tried to negotiate my return the response was repeated offers of money to leave, with the famous gagging clauses attached.

I spent four years on special leave, and during this time I studied at the Tavistock Institute, went on secondments and also spent some very useful time working voluntarily with the charity Kids Company.

‘When I speak with other healthcare professionals from around the country, none of them seem to be very surprised by what happened in Haringey’

I signed up for a masters degree in complex care and child protection in 2007 to try and learn more about the complexities of our work and make sense of what was happening to me. There I learned about organisational defence mechanisms, group dynamics and the power of the unconscious in shaping our behaviour, as well as the roles of leaders and followers.

I realised my leadership abilities and I understood that it was due to an attempt to provide some clinical leadership in Haringey that I had been subjected to a concerted attack and repeated attempts to discredit and isolate me. That is the risk of standing up to be counted in hostile environments. Attempting to facilitate a culture change is no easy or quick task.

My sadness over Daniel Pelka’s death is that the case is so reminiscent of Peter Connelly’s. Did we really learn about the cultural issues that were pervasive in Haringey? I do not recollect any mention of the importance of an open supportive culture in any of the official statements made since the tragedy; it was all about frontline staff and how they had failed and needed retraining.

Oppressive cultures

If we look back at who bore the onslaught alongside Sharon Shoesmith, it was a number of social workers, the GP and the locum paediatrician. No health service managers were held to account or even remotely criticised.

Are oppressive cultures more widespread than we dare to think?

‘No longer can we allow the victimisation of whistleblowers to leave children unsafe

When I speak with other healthcare professionals from around the country, none of them seem to be very surprised by what happened in Haringey. They recognise similarities in relation to resources and staffing that we described, and none seem to think Haringey was so out of the ordinary. There is definitely a resonance with how raising concerns can be dangerous.

Since returning to my post, now under a new employer, I note improved communication between clinicians and managers and more willingness to hear from the frontline. I have raised concerns and the response has been more positive and constructive.

It’s even more important now to raise concerns than ever before, and in my view there needs to be training and support to managers and boards in how to respond. Health professionals are key players in the protection of children − no longer can we allow the victimisation of whistleblowers to leave children unsafe.

Dr Kim Holt is a consultant paediatrician in London, designated doctor for children in care at Whittington Health Trust and the founder of Patients First