NHS Injury Benefit Scheme (PO-10363)

Ombudsman’s Determination

Outcome

Dr R’s complaint is upheld and to put matters right NHS BSA shall within 7 days of the date of this Determination pay Dr R £500 for distress and inconvenience caused and within 28 days reconsider Dr R’s application for a Permanent Injury Benefit (PIB).

My reasons for reaching this decision are explained in more detail below.

Complaint summary

Dr R’s complaint is that he has been incorrectly refused a PIB.

Among other things, Gordons Partnership (who are representing Dr R) say:

• Dr R’s complaint is primarily in respect of his stage two internal dispute resolution (IDR) appeal.
• NHS BSA have never addressed the significance of the Coroner’s inquest and its possible contribution to Dr R’s mental health incapacity.
• NHS BSA were wrong to narrow Dr R’s eligibility for a PIB to the period only of the rescue. Consideration should be given for the entire period he was working as a GP after the accident.
• NHS BSA should not have discarded Dr Bickerton’s opinion that Dr R’s major depressive disorder was related to his GP work.
• NHS BSA are wrong to say that there is a lack of corroborative evidence about any injury while Dr R was working as GP after the accident. They have ignored other witness statements (including that of Dr R’s wife), the letters with the Partners and the independent evidence of Dr Bickerton.
• Under the rules of natural justice NHS BSA should not ignore Dr R’s testimony just because he is the applicant.
• The Scheme medical adviser’s instruction to Dr Bickerton on attribution was erroneous and was relevant to his consideration of the “attribution” of Dr R’s mental illness.
• NHS BSA should not ignore the contents of Dr Bickerton’s letter of 18 November 2014, after correctly establishing that it contradicted his June 2014 report.
• There seems little doubt that Dr R’s rescue attempt damaged him mentally and that this developed into a serious and sustained bout of mental illness while he worked as a GP such that it forced him to retire.