NHS England is facing calls to introduce a mandatory independent second opinion whenever it moves to dismiss a healthcare professional, a proposal named in memory of a nurse who died by suicide after losing his job.
The Push for 'Amin's Rule'
Dr Narinder Kapur, a prominent NHS whistleblower, is championing the change, which he has termed 'Amin's rule'. The name honours Amin Abdullah, a nurse who set himself on fire in 2016 after being unfairly dismissed from his post at Charing Cross Hospital.
Kapur, a 76-year-old consultant neuropsychologist and visiting professor at University College London, argues the measure is vital to close a gap in staff welfare protections. He was himself dismissed by Addenbrooke's Hospital in Cambridge in 2010 after raising safety concerns, a decision later ruled as unfair by an employment tribunal.
A Personal and Systemic Battle
'If they had a second external opinion when Abdullah had his kangaroo court or when I had my kangaroo court, that external person would almost certainly not have approved his unfair dismissal or my unfair dismissal,' Kapur stated. He spent £300,000 from the sale of his house and his NHS pension to win his tribunal case.
He has held recent discussions with senior NHS officials, including chief executive Jim Mackey, to advocate for systemic reform. Kapur directly links staff welfare to patient safety, highlighting particular risks for whistleblowers and ethnic minority staff. 'If staff wellbeing is affected then patient care is going to be affected,' he said.
Broader Protections and Disparities
Kapur's campaign extends beyond the call for a second opinion. He is also advocating for several other key changes to protect NHS staff:
- Extending the 'Maintaining High Professional Standards' framework—currently for doctors and dentists—to cover all healthcare professionals.
- Splitting the Care Quality Commission (CQC) into two separate bodies, one to oversee patient care and another to scrutinise how trusts treat staff, especially whistleblowers and those from Black and Minority Ethnic (BME) backgrounds.
- Reducing the NHS's use of the 'some other substantial reason' (SOSR) legal mechanism for dismissal. Data shows the NHS used SOSR to dismiss 10,604 staff between April 2010 and September 2018, often citing a breakdown in working relationships.
These calls are underscored by stark disparities. People of colour working in the NHS face disciplinary action at higher rates than white staff, and ethnic minority doctors are more likely to fear repercussions for raising safety concerns.
The Case of Amin Abdullah
Amin Abdullah's case remains a poignant example. He was suspended and later dismissed after signing a petition supporting a colleague and describing a patient as a 'professional complainer'. A subsequent independent inquiry in 2018, which Kapur helped secure, found that while Abdullah should not have signed the petition, none of the other 18 signatories were disciplined. The inquiry concluded the 41-year-old had been 'treated unfairly' by the Imperial College Healthcare NHS Trust.
'If I can do things to make sure that what happened to me and Abdullah won't happen to people in the future, I will do until there are meaningful improvements,' Kapur affirmed.
NHS England's Response
In response, an NHS England spokesperson stated it was working with the Department of Health and Social Care to strengthen whistleblower protections. 'It is completely unacceptable for any member of staff to feel silenced or unable to speak up about issues affecting them or their patients,' they said, directing staff to internal 'Freedom to Speak Up' guardians.
If you are affected by the issues raised, support is available. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or by email. Other international helplines can be found at befrienders.org.
