Former head of Baby P clinic had warned of staffing crisis

A senior doctor today told how he had repeatedly warned about failings at the child protection clinic which missed the injuries that killed Baby P.

Professor Sundara Lingam told the Standard that he had written a series of letters raising the alarm over problems at the clinic in St Ann’s Hospital in Haringey when he was director of community child health.

Professor Sundara Lingam was in charge of the facility from 1991 to 2002 and said he had become concerned in 1998 at the state of the resources he was expected to work with and had written repeatedly to managers.

In a letter published in today’s Standard, he said: “I was the only consultant in my department, responsible for a population of children four times the recommended size.

“There was consistent understaffing in secretarial and administrative roles, with the result that records and correspondence were not being handled properly.”

At the time the clinic was run entirely by the NHS in Haringey. It later became partly run by Great Ormond Street Hospital, which was responsible for providing doctors, and is now entirely its responsibility.

The clinic’s performance was heavily criticised by the Care Quality Commission this week in its report into the death of the toddler at the hands of his mother and stepfather in 2007. The Standard has revealed that a year before Baby P died, four doctors at the clinic in St Ann’s Hospital wrote to managers from Haringey Primary Care Trust and Great Ormond Street Hospital to warn about the “very high risk” of a child protection failures.

They said there was “no child protection follow-up” for vulnerable patients and complained that managers “trivialised” their concerns.

Dr Sethu Wariyar, one of the four, said that managers from Great Ormond Street and Haringey Primary Care Trust, which jointly ran the clinic, ignored the letter. “The managers completely buried it and refused to bring the problems out,” he said. “At one stage we were literally told to shut up.”

Two of the consultants subsequently left the clinic and the other two suffered health problems, one of whom has since returned to work.

Their warnings were apparently not acted on and by the time Baby P came to the clinic, in August 2007 — four months after social services had requested a follow-up appointment — care was provided by two temporary locums, one of whom missed the fact that he had a broken back. Two days later, Baby P died.

Professor Sundara Lingam adds to the criticisms today.

“Even when senior managers were replaced after Great Ormond Street took over the running of Haringey Teaching Hospitals it appeared to make no impact on middle management personnel and attitudes,” he wrote.

“Without radical restructuring these places will be kept dependent on locum staff and their management weaknesses will remain intact.”

Great Ormond Street Hospital has acknowledged that a failure to see Baby P at the clinic promptly was “unacceptable”.

The trust said in a statement: “We’re truly sorry Peter suffered and died. Looking after vulnerable children is the most important thing we do.

“The trust welcomes the finding by the Care Quality Commission of the substantial work done on child protection since the death. Everyone agrees that what is important is building the strongest possible system of child protection to prevent future tragedies.”