In the wake of my investigation into Eddie Daly's dismissal, which seems to suggest that staff welfare plays a very distant second to other priorities upheld by LAS senior management, Jason Killens, LAS Director of Operations and chair of the disciplinary hearing which brought the axe down on Eddie Daly's career, has made claims that 'there are things which he cannot discuss which informed [his] decision'. This is a claim he made to me when I spoke with him earlier this month and one which he has since made elsewhere.
I contacted Eddie Daly about this, concerned that there was something of which I hadn't been made aware. Eddie was also confused and concerned about it, with the implication of Jason Killens' claims being that there was some dark secret that 'only 4 people know about'. Eddie confirmed to me that he knew of no such secret and to his knowledge everything was in the open.
When I met with Jason Killens to discuss his part in the Eddie Daly case, Jason had referred to documentation that had been sent to Eddie Daly as a result of the hearing which Mr Killens said detailed everything that informed his decision. Indeed, any information that had an impact on the decision should and would have been included in this documentation. My understanding was that those documents would be the source of any previously unreleased insight.
I joked to Eddie that even if he'd been caught eating babies on shift, by Mr Killens' logic it would not have been 'central to the allegations' and could not be considered (a poor taste joke I accept, but it seems that inappropriate humour is one of the 'facts' which 'informed' Mr Killens' decision - more on this shortly). In any case, if a fact wasn't mentioned in the official documentation, then it couldn't be one of the factors which Mr Killens feels gives weight to his decision.
In order to get to the bottom of this potential smokescreen, I have been given permission by Eddie to publish the documents in full, which should save Mr Killens the trouble of dealing with potential obstructions from Human Resources and the LAS legal team in his effort to defend his decision. The following links for the Outcome Letter and the Supporting Narrative detail this information in its entirety.
What Does Mr Killens Know?
Having worked my way through these documents numerous times, it seems to me that the essence of Mr Killens decision comes down to the simple fact that he didn't believe Eddie's health was a factor. According to the supporting narrative, Eddie Daly did not bring up health concerns as a reason for his refusal of the call for several weeks. Points 25 and 26 state:
'25. I noted that the recording of the conversations between Mr Daly and EOC made no mention of illness being the reason for refusing the emergency call and that this was also not a feature of the conversation on the balcony with [redacted] nor had Mr Daly made mention in the four weeks between the incident and the meeting of 23 June of the refusal to a DSO or AOM being caused by illness'.
'26. Illness was only introduced as a reason for refusal on 26 June after suspension had taken place'.
Eddie explained that his reluctance to discuss his struggles was due to embarrassment and the fact that he had been hiding his health problems as he continued to work. This seems plausible, but playing Devil's advocate, it could also be the desperate attempt of a man trying to save his career at any cost after making one poor decision while heavily fatigued after 11 hours of relentless emergency work.
Jason Killens' supports his assertion that Eddie's ill health defence was constructed after the fact by referring to Mr Daly's demeanour as heard on the tapes of the conversation between him and EOC on the night of the 29th May 2013. Jason Killens writes, 'I noted that Mr Daly was laughing and joking through the tape recorded conversations, that he did not say he was unwell and did not appear unable to continue his shift as a result of illness'.
It seems a bit of a leap to make broad assumptions about someone's state of physical or mental health based on their capacity to find humour in frustrating situations, especially in this line of work. Perhaps, with 'hear and treat' skills like this, Mr Killens' ability to rule out all forms of illness by analysing laughter patterns should be included in the 111 algorithm.
Further, Mr Killens felt that the Area Controller's account of meeting Eddie after his return to station was also clinical evidence of Eddie's well-being. Counter to this, Eddie's ongoing problems with PTSD and subsequent diagnosis of diverticular disease do not get considered in the documentation.
On reflection, perhaps relying on the Killens method of assessment and diagnosis will aid ambulance response times and utilisation in the future; telling the patient a joke over the phone and performing a brief visual assessment whilst smoking a cigarette would certainly take a lot of pressure off clinical staff.
Further mention of Eddie's comments in the telephone conversation with EOC are made and include the statements 'I am not accepting it and I think it is dangerous' and 'you can make us patients too because right now I am tired', but these were not examined in terms of any kind of risk assessment made by a respected clinician. Instead they are used simply as evidence that Eddie Daly was not ill. Jason Killens interpretation of the the entire episode never really moves beyond the three allegations:
1. You failed to respond to emergency call CAD 707 of 29 May 2013.
2. By your actions you failed to act in the best interests of the patient.
3. You failed to exercise appropriate leadership behaviours as a Team Leader.
Jason Killens found all of these allegations proven based on the facts he was presented, underlined by point 38 of the Supporting Narrative:
'38. Having considered all 3 allegations and the fact that I have found, on balance, that they are proven I have carefully considered the aggravating and mitigating features of this case before deciding what action is reasonable and appropriate in the circumstances. I must now state that I do not accept Mr Daly's case that his reason for not accepting the call was that he was too unwell to do so but did not state this. Mr Daly's demeanour on the tape and the number of opportunities to state he was unwell if that was the case, do not for me make this a credible argument'.
This seems tantamount to calling Eddie a liar.
It's interesting to note that, on the second allegation, Mr Killens identified that 'From the tape, it is also clear that Mr Daly was informed that there was no other resource available and that there was "no possibility of any vehicles coming up". Mr Daly was also aware that the call had been held "for some time" '(Supporting Narrative point 32) which is clearly a failure of service for which Mr Killens himself is ultimately responsible as Director of Operations, but shows no remorse or recognition for the fact that these very failings contributed to the conditions which led to the incident. Eddie Daly's circumstances, his fatigue and ill health arose as a direct result of LAS's failure to provide reasonable working conditions for their staff. Mr Killens, not Mr Daly, should be answerable for this.
The Blade Should Cut Both Ways
Further, Jason Killens felt that there was no other course of action aside from dismissal for gross misconduct:
'I believe that these proven allegations cannot be rectified through remedial training, education or a sanction designed to change behaviour as clear and unequivocal refusal of an emergency is clearly a matter of gross miss conduct [sic]. "Avoidance of, or non response to calls, or not activing once a call has been accepted" are all listed in the Disciplinary as issues that fall into potential gross misconduct.'
However, evidence was brought up (and dismissed) at Eddie Daly's appeal hearing that a paramedic officer who refused a 999 call received far more lenient punitive action, which suggests that there is in fact a choice to explore other conduct pathways when those in charge so choose. A choice that Mr Killens chose to ignore.
So in summary, it seems that the hearing was never going to move beyond the fact that refusing an emergency call was a matter of gross misconduct and any mitigating circumstances were always going to be considered irrelevant. It boils down to the fact that Jason Killens did not believe Eddie Daly and was not prepared to seek a more positive or supportive resolution.
Throughout the hearing documentation, it is clear that it is Jason Killens who decides who and what is and isn't credible. This gives me a great sense of unease as Jason Killens is a man who is ultimately responsible for the physical and psychological meatgrinder which is the UK's worst-performing and most brutally over-utilised ambulance service. If anything isn't credible, it's the judgement of a man who cannot see that his own failings are ruining the health and lives of his own staff.
An Appeal to Jason Killens
I make this appeal directly to Mr Killens:
As a senior executive officer, if you hold any hope of preserving your work force's ability to withstand the ongoing challenges of delivering the world-class pre-hospital care you aim to provide, then there needs to be a change in the approach to the welfare of staff.
The case of Eddie Daly seems evidence enough of a blinkered and remorseless system which does not effectively take into account the human impact of ambulance work. Prevention is better than cure and no amount of LINC or TRiM is going to repair damage already done by pushing your staff beyond reasonable limits. Your claim that the majority of paramedics are leaving LAS for career advancement reasons doesn't ring true, it carefully sidesteps the issue of grassroots discontent. You told me that the days of working on the front line for an entire career are long gone, but this should not be because you have planned around that by exhausting your crews, dismissing them when they break or driving them away and then just draughting in some new ones.
First and foremost, you are a healthcare professional and although you primarily work making high-level decisions, you still have a duty of care to your staff. If they cannot function, your service cannot function and your strategies will fail. I appreciate that you are attempting to alleviate the pressures by improving utilisation figures and targets, but if your handling of the Eddie Daly case is anything to go by, you have lost your compassion and your grasp of how individuals respond to the dire circumstances which are part of their everyday work. You are no longer able to see that your people are as fragile as the patients you serve.
You could have made different choices with regard to Eddie Daly, but you didn't because you claim to have had no choice. However, just as you chose not believe Eddie, I choose not believe you. I think you had to make the call you did because to do otherwise would have shone too much light on your own failings. I urge you to undertake some reflective practise of your own and remember why you signed up to work in healthcare in the first place, before you needlessly destroy any more careers.
Perhaps you are just a product of the system, a system which your choices have shown to be deeply flawed. But you are now at the top of that system so you are in a position to change it for the better. And by better, I don't just mean more efficient and leaner, but more inclusive and sustainable. Look after your staff, look out for your staff, treat them as you would your patients when you were still new.
They deserve better. Eddie deserved better.
[This is just my interpretation of the available information. Please feel free to review the Outcome Letter and Supporting Narrative documents yourself to find the facts which Mr Killens says 'informed' his decision. At the very least, their publication means that he can no longer claim to have exclusive knowledge of facts which he feels give him more insight than everyone else.]