Donald Fraser V. The State Hospitals Board For Scotland
| Jurisdiction | Scotland |
| Judge | Lord Carloway |
| Date | 11 July 2000 |
| Court | Court of Session |
| Published date | 11 July 2000 |
| OUTER HOUSE, COURT OF SESSION | |
|
| OPINION OF LORD CARLOWAY in the cause DONALD FRASER Pursuer; against THE STATE HOSPITALS BOARD FOR SCOTLAND Defenders: ________________ |
Pursuer: J. R. Campbell, Q.C., R. J. MacLeod; Ketchen & Stevens, W.S.
Defenders: Macdonald, Q.C., Brodie; The Scottish Health Service Central Legal Office
11 July 2000
- MERITS
- EVENTS
(a)Background
[1]For many years the pursuer's life was intimately involved with the State Hospital, Carstairs. The Hospital holds persons convicted of criminal offences by the courts or otherwise ordered to be detained by legal process. Many of these persons are violent and the nurses have to cope with that aspect of their work. Because of the extreme danger to the public posed by an escape of a patient, the over-riding priority is one of security. That danger had been exposed in 1975 when two patients had escaped and murdered a nurse, a policeman and a member of the public.
[2]The pursuer's father had worked at the Hospital from 1951. The pursuer started work as a staff nurse in January 1974, having completed a period of training at Shotts. In January 1976 he was promoted at a very young age to charge nurse, grade G. He was the youngest person in Britain to have been promoted to that position at that time. For the next eighteen years he continued to work as a grade G charge nurse. His work spanned several management regimes. His personal file (Pro. 7/8) revealed no problems with his work.
[3]A glowing appraisal for 1989/90 noted:
"Mr. Fraser's combination of experience and clinical expertise enables him to fulfil the nursing requirements of his patients to a high standard.....Mr. Fraser develops and trains staff working with him very effectively. He provides an excellent role model in his own approach to updating his professional knowledge.....Mr. Fraser plans, organises and controls his staff ably and efficiently. He delegates appropriately and recognises the strengths and weaknesses of his staff. He analyses problems intelligently and this combined with his experience enables him to reach sound decisions.....His written reporting is of an extremely high standard and sets an example to all.....Mr. Fraser enjoys positive relationships with his patients. He is respected by senior and junior colleagues.....Mr. Fraser is clearly the leader of his team.....Mr. Fraser has made the difficult transition to multi-disciplinary working very well.....He undoubtedly has the abilities for a middle management post at senior nurse level. He may wish to pursue this direction in his career."
[4]He did not reach middle management level. Nevertheless, he continued to obtain good reports. The appraisal for 1993/94 recorded (Pro. 7/8 p.99):
"He maintains accurately all necessary staff and patient records, his work is characterised by methodical and meticulous attention to detail.....Donnie's experience and sound clinical knowledge enables him to form accurate assessments and judgments.....His reports are accurate and concise both in written and oral form".
This appraisal, completed by the ward manager in October 1994 continued (p. 100) :
".....He displays a firm but fair approach to all patients....Donnie's strength is his excellent organisational and communications skills. His administrative work is methodical and meticulous."
[5]Latterly the pursuer was the grade G team leader in charge of a shift on Tay Ward, which had re-opened at the turn of the year 1993-94. The pursuer's view of himself was as a bit of a dinosaur or one of the old guard in a environment changing from primarily containment to a more liberal regime.
[6]A report from Dr. Ian Tierney (Pro. 6/13) who saw the pursuer at the end of 1996 recorded accurately the pursuer's general views as follows:
"He remembers that when he started working at Carstairs it was a particularly grim place but for a number of years prior to the early nineties the regime had become more enlightened without placing the staff at risk. However, in the early 1990s there were management changes which Mr. Fraser felt were dangerously liberal in that the physical structure of the wards and management of wards in terms of reduced searches, greater unearned privileges etc. made the management of wards a far more risky and difficult procedure. He had had increasing difficulty running his ward as a safe place for staff and patients with the increasing demand from management for auditing of all aspects of ward management in an increasingly lax atmosphere. He felt that the criminals on the ward ran the place and that his hands were tied and he had no backing from management.
.....He maintains that his relationship with management was difficult anyway because he couldn't work with the management team that was in place. He had applied for the ward manager's job and then withdrawn his application when he realised that his management style was incompatible with theirs."
[7]During the course of 1995, the defenders had embarked upon a re-grading of the nursing staff. Only a limited number of grade G posts were to remain. Interviews with the pursuer in relation to re-grading were carried out in December 1995 and he seemed resigned to the fact that he would not be retaining his grade G status but would become a grade E albeit with a protected salary for five years. This is what happened eventually on 14th January 1996 (Pro. 7/4).
[8]Although I am sure that the pursuer remained capable of performing adequately as a team leader during 1994, by the end of that year at the latest, he had become disillusioned with the management. In turn, given that attitude to management, he must have had serious concerns about his own future at the Hospital. Sooner or later these concerns were bound to have some effect on his work.
[9]In due course, the events about which this case is concerned occurred. In various reports (infra) these events were said to have left the pursuer with feelings of anger amounting to rage, vitriolic hatred of the management and frustration. I formed the impression that, at the time of these events and at the proof, the pursuer was of the view that he knew how to run a ward better than his management did. I do not think that he was correct in this. It was clear that during his evidence he still felt a great deal of anger and bitterness about the actions of the management. This did have a material effect on his evidence which was at times so exaggerated or biased as to be unacceptable. For that reason, as will become clear, I rejected his evidence on several points especially when it was either not supported or was contradicted by either documents or other testimony which I did find reliable. I seldom disbelieved the pursuer but often found his evidence unreliable.
(b) The Hierarchy, Tay Ward and the Christmas Party
[10]A shift in a ward comprised the team leader and four others. The others would include two qualified nurses of grade D or E. There were three shifts per twenty-four hours. The pursuer usually worked the first day shift from 7 a.m. to 2.30 p.m. whereas Alexander (Sandy) Jackson was the team leader on the following shift. Each ward had an overall manager who was the immediate superior of the team leaders. The ward manager usually worked from 9 a.m. to 5 p.m. His position was much more administrative than operational. The team leader was, in practical terms, in charge of what happened on the ward. Above the ward manager and supervising the nursing staff generally was the Nursing Services Manager. At the material time, acting in that post was Stephen Milloy. In charge of security generally was the Director of Security, Archibald Finlayson. In overall charge of the Hospital was the general manager, Dick Manson.
[11]There were a variety of different wards at Carstairs. Tay Ward was a mixed sex ward with perhaps twenty male and ten female patients. There were different types of patients on the ward ranging from those with learning difficulties through to those with psychopathic personalities. The ward was all on one level. Each patient was accommodated in a separate room leading off a corridor. Running at right angles to the corridor there was a hallway off which lay the ward office and sundry communal areas (Pro. 7/12). The communal areas could be sealed off and each bedroom could also be locked. There was a vestibule near the outside entrance to the ward. In the vestibule area were lockers where the patients could store personal items which were surplus to their daily requirements.
[12]In December 1994 there was a Christmas party in Tay Ward. The pursuer was not on duty at the time but had been earlier in the day. He was to learn of the incidents at the party when he returned to work on the next day. Sandy Jackson was on duty at the time of the party. At the party, which started at about 5 p.m., staff noticed after a while that three patients were behaving in a loud and uninhibited way. They were found to be under the influence of alcohol. The ward manager, Barbara Wilson, who had only taken over a few weeks before, decided that the three patients should be returned to their rooms. This was achieved with two but the third, a celebrated patient called Noel Ruddle, struck a member of staff and had to be restrained and kept in a "safe" room. Drink is not permitted in the wards and a breach of that rule is regarded as a serious matter.
(c) The Ward Search
[13]The day after the episode, a ward search was carried out together with intensive questioning of the patients. This commenced before the pursuer's return to duty. Certain items were found in Mr. Ruddle's room. He had been in Tay Ward only for four or five months. He was a particularly dangerous patient whose background as a dealer in illegal drugs had included homicide using a Kalashnikov rifle and aiming the gun at a policeman. This was in late 1991 and he had been in the hospital since about then. He had originally been diagnosed as schizophrenic but this...
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