Whistleblower says safeguarding loophole needs to be plugged

Martin Shipton

An advocate for vulnerable people who claims she was sacked for raising concerns about the way clients were treated says a gap in the law that can make safeguarding impossible to enforce needs to be plugged.

Debbie Thompson, who lives near Denbigh, was employed by a charity called CADMHAS that provides independent mental health advocacy (IMHA) services across north and mid Wales.

She is taking the charity and its director Elfed Williams to an employment tribunal alleging unfair dismissal. The tribunal has already ruled that two disclosures she made about a case she had concerns about amounted to acts of whistleblowing.

Ms Thompson, who is a qualified counsellor and previously worked for Citizens Advice, said: “I have serious safeguarding concerns regarding the charities that provide IMHA services in Wales. As someone who has worked directly within this system, I believe these issues warrant urgent attention.

Monopoly

“I question the true independence of these services. The charity I worked for was funded by the NHS and held a near monopoly on contracts across north and mid Wales. This financial dependency raises significant concerns about the impartiality and effectiveness of their advocacy.

“During my time at CADMHAS, I witnessed numerous troubling practices. For instance, a ward manager regularly blocked tribunal applications by disposing of them, stating that he didn’t want to risk patients being discharged and potentially committing crimes that would attract media scrutiny. When I reported this to the director of CADMHAS, I was instructed to work around the staff on this ward rather than addressing the issue, effectively colluding with wrongdoing and neglecting patient protection. Shockingly, it was made clear to me in writing that ‘safeguarding’ does not override the patient’s explicit permission, even in cases of obvious harm.

“I also observed advocates colluding with health professionals, compromising their duty to support patients impartially. When I blew the whistle on these practices, I was suspended and subsequently dismissed on unfounded charges.

“The core issue lies in a grey area within the Mental Health Act, as advocacy services remain unregulated. Despite signing a document at the start of my employment committing to the Social Services and Well-being Act, which outlines clear safeguarding steps for vulnerable adults, these protocols were routinely ignored.

“There is an updated Mental Health Act currently in development. I believe it is crucial to address and close this safeguarding loophole to ensure true protection for those in need.”

Safeguarding

The case that led to Ms Thompson’s dismissal involved the safeguarding of two brothers, both in their 80s and both suffering from dementia, who had lived together for most of their lives. She believed it was in their best interests to continue living together, but because they had expressed the view that they should live apart, they were split up and put in different care homes.”

Ms Thompson said: “I was open to discuss the matter, but as someone with a safeguarding responsibility I had no legal right to object to their separation.

“In my view CADMHAS’ policy on safeguarding is troubling. Suppose a patient sectioned under the Mental Health Act alerts an advocate to a safeguarding concern. In that case, the advocate can only raise an alert if they have explicit permission from the patient, according to company policy. This is extraordinarily worrying, as these patients are highly vulnerable, having had their liberty taken away against their will, not as criminals, but as vulnerable individuals who may be a danger to themselves or others.

“The idea of providing an independent advocate as a safeguard seems to have been tagged onto the Mental Health Act. When the code of practice states that ‘an advocate is the patient’s voice,’ some charities funded by the NHS or local authorities take this literally. If the patient says they are too afraid to complain, they take them at their word and do not safeguard them.

“This policy raises serious questions about the funding arrangement for advocacy services. These services are funded by the very entities that advocates are supposed to challenge – health professionals and social services – when they deviate from mental health law. It’s a bit like being asked to bite the hand that feeds you.

“Thankfully, the days when communities colluded to fool themselves that bad things don’t happen behind closed doors are behind us. The notion that safeguarding is everyone’s responsibility is now widely accepted. So why would a charity avoid ruffling any feathers with their funders? Could it be the competition for contracts? In recent years, funding for advocacy has been spread out to different charities covering north Wales. Cadmhas picked up almost all of the contracts, giving them a monopoly majority.

“My battle with CADMHAS highlights the tension between safeguarding vulnerable individuals and the operational pressures on charities reliant on government funding. This case underscores the urgent need to review safeguarding policies, and the law itself, to ensure they genuinely protect those most in need.”

Troubling

Ms Thompson went on to list a number of incidents she regards as troubling that she had observed during her time working for CADMHAS.

She said: “Patients who have been sectioned faced active obstruction from ward management and staff in exercising their legal right to apply for a tribunal to consider their discharge. This blatant disregard for due process and human rights is a grave injustice that must be addressed.

“One doctor routinely strips new admissions of all medications without consultation, ignoring the severe withdrawal symptoms that can follow. This practice endangers patients and raises serious ethical and medical concerns.

“Patients who are noisy or disruptive are heavily drugged, rendering them nearly incapable of speaking. This approach to patient care silences those who need their voices heard the most, suppressing their ability to communicate and advocate for themselves.

“A particularly harrowing case involved a client who gave birth via Caesarean section in the morning and faced a tribunal in the afternoon, only to lose. Her newborn was kept in the main hospital while she was sent back to the mental health ward. The following day, she was notified that Social Services was applying for a ward of court. This brutal sequence of events highlights the cruel treatment of a new mother.

“One of my clients was violently attacked by another patient deemed highly dangerous and supposed to be under one-on-one supervision. To ensure my client’s safety, staff resorted to locking him in his room. In another incident, the same aggressive patient entered another client’s room, and when she sought help, staff laughed at her distress.

“These incidents are not isolated but part of a disturbing pattern of neglect and abuse. The public deserves to know how vulnerable individuals are being treated behind closed doors. As it is company policy of the charity CADMHAS not to offer safeguarding protection unless explicitly directed by the patients, their needs went unheard.”

Whistleblowing

CADMHAS director Elfed Williams said: “The pre-tribunal hearing was listed in March to hear her claim of whistleblowing with a full tribunal hearing listed for four days between June 17 and 20 to hear her claim for unfair dismissal. As the whole four days were eventually taken up by the presentation of evidence the judge had no choice but to earmark a further day later on in the year to take final submissions and has therefore earmarked October 21 to hear final submissions and give a final decision regarding her claim. This claim is therefore ongoing.

“Having read the information you have provided it is premature for us to be making a statement.

“I would like to make it clear that CADMHAS refutes the claims made by Debbie Thompson and evidence has been provided to the tribunal and we are entirely satisfied there has been no wrongdoing on our part.

“In regard to Debbie Thompson’s claim that disputes our independence as an organisation, CADMHAS follows an advocacy code of practice as set out by the National Development Team of Inclusion (NDTi) and every three years we have to submit copious evidence as well as a site visit by an NDTi assessor where we have to demonstrate that we follow the code of practice and that we operate independently from any funding body be that the NHS or local authority. Only after going through this stringent assessment are we then awarded an advocacy quality mark.”