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Robbie Powell: Time for Truth, Justice and Accountability

In this article, Sharon Hartles examines Robbie Powell’s Injustice and in doing so unveils Will and Diane’s (Robbie Powell’s parents) relentless pursuit for truth, justice and accountability. Sharon Hartles is a member of the Open University’s Harm and Evidence Research Collaborative.

Robert Darren Powell, a much loved member of a close family, was just 10-years old when he died on the 17th April 1990. Every parent’s worst nightmare, the tragic loss of a child, became Will and Diane Powell’s lived reality. Their acutely distressing grief, was exacerbated because they quickly learned that Robbie’s death was preventable. Little did they know back in 1990 that their pursuit for truth, justice and accountability would span across three decades, cost them in-excess of £300,000 in compensation, and unveil medical negligence, cover-ups and bureaucratic failure.

 

As stated in the Canary, according to Will, the investigation into Robbie’s death has led to cover ups involving: medical professionals, the NHS, the police, the Crown Prosecution Service, the Welsh Office, the Independent Police Complaints Commission, the General Medical Council and other public bodies. A comprehensive database of evidence supporting these allegations has been catalogued on Robbie’s Law Trust.

 

In 1989, Robbie was a healthy 10-year-old school boy with his whole life ahead of him. However, on the 5th December 1989 (four months before Robbie’s death) he was admitted to Morriston Hospital, Swansea, as an emergency, by ambulance, by Dr Elwyn Hughes (one of seven General Practitioners at the Ystradgynlais Health Centre, where Robbie and his family were patients). Robbie had suffered from stomach pain, vomiting and weight loss caused by dehydration. Robbie had been an inpatient for four days and had been critically ill, but he improved and was discharged. The Powells had been informed that Robbie’s pain and vomiting was the result of gastroenteritis caused by a throat infection. They had no reason to doubt the diagnosis from the professionals.

 

Unbeknown to Will and Diane, the senior consultant paediatrician at the hospital, Dr William Forbes, suspected that Robbie was suffering from Addison's disease, which is a rare disorder of the adrenal glands that sit on top of the kidneys. Although Addison’s disease is a serious health condition, it is treatable. Despite that, it invariably results in death without treatment.

 

  • An adrenocorticotropin hormone test (ACTH test) that could have confirmed the diagnosis was ordered, but it was never carried out. This was the first of nine alleged missed opportunities to diagnose Robbie and save his life.

 

  • The hospital informed Ystradgynlais Health Centre of the suspicion of Addison’s Disease and the need for the ACTH test.

 

In the event of Robbie falling ill again, the GPs were instructed to refer him back to hospital immediately. Yet in January 1990, Dr Forbes had a second opportunity to diagnose Robbie and to inform the Powells that he suspected Robbie had Addison’s disease. Despite the fact that Robbie went back to Morriston Hospital for a check-up, the ACTH test to check for Addison’s Disease was not carried out. Furthermore, no other tests were carried out that would have confirmed the diagnosis.

Extract taken from a Professor of Endocrinology - Expert Medical Report provided to Dyfed-Powys Police (9th April 1996)

Letter from a Professor of Endocrinology to Dyfed-Powys Police (17th April 1996)

For a couple of months Robbie was fine, but this all changed at the beginning of April 1990 when Robbie’s health began to deteriorate. Will took Robbie to Ystradgynlais Health Centre on the 2nd April 1990, where Robbie had a consultation with Dr Elwyn Hughes. This was the same GP that admitted Robbie to hospital as an emergency on the 5th December 1989. Dr Hughes did not read Robbie’s notes and was therefore unaware that Robbie had been suspected of having Addison’s Disease.

 

A few days later, Robbie was sent home from school unwell on the 5th April and taken back to the surgery on 6th April 1990 and seen by Dr Nicola Flower, but she found nothing wrong and did not make a diagnosis, despite Robbie’s available GP medical records regarding the suspicion of Addison's disease. However, Dr Flower did not read the medical notes.

Extract taken from Dr Flower’s statement (20th July 1990) in response to Will Powell’s formal NHS complaint

 

On the 10th April Robbie was vomiting, had obvious weight loss and was lethargic so on the 11th April 1990 he was taken back to the surgery. On this occasion Robbie was examined by Dr Michael Williams, but he could not find anything wrong. Unlike Dr Hughes and Dr Flower, Dr Williams had read Robbie’s notes. Yet, he did not communicate Robbie’s suspected Addison’s Disease or the need for the ACTH test to the Powells.  

Extract taken from Dr Williams’ statement (20th July 1990) in response to Will Powell’s formal NHS complaint

 

Dr Williams informed Will and Diane that he would refer Robbie immediately back to Dr Forbes at Morriston Hospital. It would later come to light that in an attempt to deceptively cover up medical negligence, Dr Williams and a secretary typed a referral letter after Robbie' death and intentionally backdated this referral letter to the 12th April 1990, the day after the consultation.

Statement from Mrs Sims (Medical Secretary at Ystradgynlais Health Centre, Swansea) (5th

December 1990)

By the 15th April 1990, Robbie was so weak that he had to be carried in and out of the Casualty Department of the Ystradgynlais Community Hospital (local hospital) by his father and was examined by Dr Paul Boladz, (a senior partner at the Ystradgynlais Health Centre). He did not access Robbie’s notes and thought Robbie had glandular fever, which is a viral illness. Dr Boladz prescribed a penicillin based medication that is contrary to the treatment for a viral illness. He gave the Powells forms for Robbie to have blood tests on the 17th April 1990 at the Health Centre.  

Extract taken from Will Powell’s formal NHS complaint (30th May 1990)

Extract taken from Dr Boladz’s statement (20th July 1990) in response to Will Powell’s formal NHS complaint

Overnight Robbie’s condition had worsened so on the 16th April 1990, Dr Keith Hughes, another senior partner (not to be confused with Dr Elwyn Hughes), visited Robbie at home following a request for a home visit by the Powells. He wanted to do a blood sugar test on Robbie, but the test equipment he had in this car was out of date. Dr Hughes decided not to send Robbie to hospital because his condition, according to him, was not serious. Dr Hughes hadn't accessed Robbie's GP medical records before the visit and cancelled the blood test arranged by Dr Boladz for the following day to the 18th April, by which time Robbie would be dead. 


Extract taken from Will Powell’s formal NHS complaint (30th May 1990)

 

The Powells had been reassured by five doctors, on five different occasions, over a two-week period (2nd April – 15th April 1990) that Robbie was not seriously ill. Will and Diane couldn’t have known Robbie was hours from death. However, Dr Elwyn Hughes, Dr Nicola Flower, Dr Paul Boladz and Dr Keith Hughes had not read Robbie’s notes and were not aware that if Robbie became ill he needed to be transferred to hospital as a matter of urgency. It came to light subsequently that Dr Boladz had received, signed and filed the letter from Dr William Forbes referring to adrenal insufficiency with the request for hospital admission if Robbie again became unwell.

On the 17th April 1990, at about 3-00pm, Robbie fainted and collapsed at home while his mother assisted him to the bathroom. Following an emergency phone call Dr Flower visited and diagnosed a throat infection that had gone to Robbie’s chest and refused pleas from the Powells to admit Robbie to hospital. Dr Flower prescribed another penicillin medication that was contrary to the suggested diagnosis of Glandular Fever. Robbie had dilated pupils and blue lips. Dr Flower claimed Robbie had fainted because he had been in bed all week.

The Powells telephoned Ward 7 at Morriston Hospital for help but were advised to believe in their GP but to call her out again if they were still worried. At 5.30pm, after another frantic call from Robbie’s parents, Dr Flower returned and agreed, allegedly after a heated argument, to refer Robbie to hospital but refused the Powells' request to admit Robbie by ambulance. Will and Diane took Robbie to Morriston Hospital, which was 12 miles away, by car.

Extract taken from Will Powell’s formal NHS complaint to the Family Practitioners Committee received on the 30th May 1990.

 

On arrival, at around 7.00pm, he was admitted moribund (at the point of death) with adrenal crisis, the staff immediately called the crash team as Robbie took his last conscious breath in the presence of his father. Despite their best efforts, Robbie died as the staff at Morriston Hospital tried in vain to revive him. It would later come to light that Robbie died from Addison's disease, which caused the severe dehydration that led to a severe drop in his blood pressure. As a consequence, Robbie had two heart attacks and the second attack was fatal.


Extract taken from Dr Flower’s statement (20th July 1990) in response to Will Powell’s formal NHS complaint

 

Within days of Robbie’s death, Will began to suspect that the doctors who had been charged with Robbie’s care had been negligent and were guilty of wrongdoing. Subsequently, Will complained to the Family Practitioners Committee in Powys. This action set in motion a pursuit for justice for Robbie, which to date, has consumed 31 years of the Powells' lives.

 

When Will eventually received copies of Robbie's GP and Morriston Hospital medical records, in November 1990, he discovered that the notes sent from Dr Forbes regarding his suspicion of Addison’s disease (which had also been witnessed by Reverend Thomas) had gone missing out of Robbie’s notes.  Moreover, new material including a back dated referral letter and torn open envelope addressed to the Appointments Officer Morriston Hospital from Dr Michael Williams (which was never sent) had been added. Yet, the 5 GPs had claimed in a July 1990 combined statement that Robbie had been referred to Dr Forbes.

 

In 1990 a Committee of the Local Health Service in Swansea, where the case had been referred, took just one afternoon to clear doctors Elwyn Hughes, Michael Williams, Paul Boladz and Keith Hughes of any negligence and dishonesty. Moreover this seemed to be supported by the fact that the Swansea Coroner had registered Robbie’s death as ‘natural causes’ on his death certificate and that the Powells’ request for an inquest had been refused. However, Dr Nicola Flower was found to be in breach of her terms and conditions of service, and was given the minimal reprimand which was to conform to her terms and conditions of service in future.

Extract - The medical opinion of a Professor of Endocrinology with regards to four of the General Practitioners. Taken from Operation Radiance: Death of Robert Powell (Report for the Crown Prosecution Service) (24th October 2002)

 

The Powells appealed the decision of the Committee to the Welsh Office and were granted a hearing, which went on for 5 days in 1992. Yet, while Robbie's original GP medical records were in the possession of the Welsh Office, additional documents had been added to the file. As a consequence of the Chairman's refusal to investigate this maladministration, (attempt to pervert the course of justice) the Powells' legal team, with their agreement, withdrew from the proceedings before it was concluded. The Powells had to pay £34,000 in costs for their legal representation, and the Welsh Office claimed that it was a gesture of good will that the Powells did not have to pay the GPs' legal costs. Following the Parliamentary Ombudsman’s Report on 31st March 1999, the Welsh Office agreed to pay the Powells’ legal costs for the appeal and also pay the Powells £500 compensation.

Extract from DCI Poole’s Operation Radiance: A Review of the Death of Robert Darren Powell (30th November 2000)

Extract taken from the Summary page of the Parliamentary Ombudsman’s Report dated 31st March 1999

 

As the Powells’ constituency MP (1992 – 1997) Jonathan Evans requested that the then Secretary of State for Wales John Redwood authorise a full public inquiry for the purpose of getting at the facts surrounding Robbie’s case. On the 8th May 1994, Redwood confirmed that he would set up a non-statutory inquiry into Robbie’s case. However, it didn’t go ahead because the GPs refused to participate.

Extract taken from a letter to Jonathan Evans MP from the Rt Hon John Redwood MP, (the then Secretary of State for Wales ) (8th May 1994)

Extract taken from a letter to Will Powell from Julia Annand, Health Services Division (12th December 1994)

 

It was established that the response from Redwood to a parliamentary question on 19th June 1995 was untrue. As a result, the Parliamentary Ombudsman agreed to set up an independent investigation into this matter and the alleged maladministration at the Welsh Office in 1992. Yet when Jonathan Evans MP, made a formal complaint about the maladministration at the Welsh Office in 1993 (regarding the 1992 Welsh Office appeal) the Parliamentary Ombudsman informed him that it was outside of his jurisdiction to investigate.

Letter from Sir William Reid, the then Parliamentary and Health Service Ombudsman (11th November 1993)

Letter from William Hague, the then Secretary of State for Wales to Jonathan Evans MP (16th October 1995)

Letter from Jonathan Evans MP to William Hague, the then Secretary of State for Wales (30th October 1995)

 

On the 4th March 1994, Will took his concerns to his local police. Between 1994 and 1996, Dyfed-Powys Police, supported by the Crown Prosecution Service (CPS) in Wales, investigated Robbie's death. On the 7th May 1996, the investigation finished with the CPS deciding it could not find any evidence of crimes committed by the General Practitioners at Ystradgynlais Health Centre, Swansea.

Dyfed-Powys Police Headquarters – Responsible for policing half of Wales

 

In 1998, Will Powell filed a complaint against the then Deputy Chief Constable of Dyfed-Powys Police (Keith Turner) regarding the perceived inadequacies of the criminal investigation which they had conducted between 1994 and 1996. Although a second criminal investigation commenced on the 18th January 1999, just like the first it failed to adequately investigate Robbie's death and the post death cover up. Will then filed a complaint against the Chief Constable of Dyfed-Powys Police in December 1999. Unknown to Will until some years later, the two formal complaints he made were not recorded and therefore avoided investigation. Will’s justification regarding the inadequacies of the two criminal investigations was confirmed when Dyfed-Powys Police was found to be ‘institutionally incompetent’ in 2003 by Avon and Somerset Constabulary.

This document was prepared for a meeting with the Powells which took place on the 18th March 2003 regarding the conclusion of the Operation Reboant Investigation

 

It was also established in 1998 that the GPs under investigation were retained by Dyfed-Powys Police as Police Surgeons, a clear conflict of interest which was not disclosed.

Letter from the then Deputy Chief Constable Keith Turner to Will Powell confirming the GPs under investigation were retained as Police Surgeons (17th June 1998)

 

As a result of the failures into these investigations, Will secured a meeting with Mr Clough, the then, Deputy Chief Constable of Dyfed-Powys Police. In turn this led to the appointment of Detective Chief Inspector (DCI) Poole from West Midlands Police. The second investigation agreed on the 18th January 1999 was halted on the 6th September 2000. DCI Robert Poole was appointed to proceed with Robbie’s case. On the 7th September 2000, Operation Radiance (The Robert Powell Enquiry) commenced and this review concluded on the 30th November 2000. In March 2002, DCI Poole submitted his investigation report entitled 'Operation Radiance' to the Crown Prosecution Service (CPS) in York. His report was based on the same documents provided by Will and his solicitor to Dyfed-Powys Police in March 1994.

 

Operation Radiance put forward 35 suggested criminal charges against five GPs and their medical secretary (Dr Elwyn Hughes, Dr Nicola Flower, Dr Michael Williams, Dr Paul Boladz, Dr Keith Hughes and Mrs Linda Sims, Medical Secretary at Ystradgynlais Health Centre, Swansea). Charges included:

 

  • gross negligence manslaughter
  • forgery
  • attempting to pervert the course of justice
  • conspiracy to pervert the course of justice

 

Given the 35 charges set out by the late DCI Poole, it is astonishing that even though the Crown Prosecution Service in London agreed that there was sufficient evidence to prosecute two GPs (Dr Michael Williams, Dr Nicola Flower) and their Medical Secretary (Mrs Linda Sims) for forgery and perverting the course of justice, none were prosecuted. The reasons the CPS decided not to prosecute included:

 

  • The passage of time, which was caused by a decade of cover ups between 1990 and the appointment of DCI Poole in 2000.
  • Dyfed-Powys Police had provided the GPs with a letter of immunity. (NB the gift of immunity is not with the police but with the Director of Public Prosecution and the Attorney General).
  • The available evidence had been initially ignored by the police and the CPS, between 1994 and 2000, for a variety of reasons. 

 

Beyond the suggested criminal charges, DCI Poole's investigation also led to a disciplinary inquiry into Will's allegations of misconduct against Dyfed-Powys Police officers with regards to their criminal investigations between 1994 and 2000. The inquiry, codenamed ‘Operation Reboant’ was carried out by Avon and Somerset Constabulary. As a result of this inquiry, Dyfed-Powys Police was found to have been 'institutionally incompetent'.

 

Despite the inquiry findings, as Dyfed-Powys Police was neither a person nor a corporate body for prosecution purposes, prosecution for misconduct in public office would not apply. Although three senior officers were issued with disciplinary notices as a consequence of DCI Poole’s review dated 30th November 2000, no police officer has been held accountable. Two of the police officers who were served with disciplinary notices were permitted to retire. Subsequently these officers did not participate in the inquiry which was set up to investigate their alleged misconduct.

Letter from Barry Taylor, the then Assistant Chief Constable of Dyfed-Powys Police, regarding the issuing of disciplinary notices on (two of the three) Senior Officers who were involved in the two inadequate criminal investigations between 1994 – 2000 (21st May 2001) 

 

During this same time frame the Powells secured a Fiat (Court Order) from the Attorney General in 2000. This led to an inquest which took place in 2004 for twenty days over a period of three months. The verdict determined that Robbie’s death was not a result of ‘natural causes’ alone as registered on his death certificate; instead Robbie’s death was a result of ‘natural causes aggravated by neglect’.

 

In 2003 the Director of Public Prosecutions appointed Mr John Bell of CPS Essex; Ms Terrina Narbett, a CPS employee; and Ms Clare Reggiori, an ‘independent Barrister’, to investigate the Powells' serious complaints against the CPS. The CPS were exonerated by the investigation. However, when Will challenged the content of the report, which he believed was a further whitewash and cover up, the then Director of Public Prosecutions wrote to Will on the 28th August 2003 informing him that unless any fresh issues were raised, anyfurther correspondence would be filed without response.

Letter from the former Director of Public Prosecutions, Sir David Calvert-Smith QC (28th August 2003)

 

A breakthrough presented itself, when Jonathan Evans MP (1992 – 1997) secured a debate in Parliament on the 12th March 2013. Evans challenged the important considerations of the passage of time and the earlier CPS decisions as excuses not to take a prosecution forward. Furthermore, in a Sky News interview the former Director of Public Prosecutions, Sir Kier Starmer, (now the leader of the Labour Party) explained that prosecutions can take place decades after the crimes were committed if it could be proven that there had been a cover up of the facts.     

 

A further breakthrough happened in February 2014, when the then Director of Public Prosecutions, Alison Saunders, instructed the Crown Prosecution Service to press ahead with historical cases, noting a long gap in the time taken to report the crime should not rule out a potential prosecution. Alison Saunders stated: ‘we will consider cases in the same way be they 30 days or 30 years old’.

 

Following the 2013 adjournment debate a meeting took place between Will and Karen Harrold of the Crown Prosecution Service in May 2014. As a consequence of this meeting, on the 9th October 2014, in a letter to Will, Alison Saunders (the then Director of Pubic Prosecutions, who was the most senior public prosecutor in England and Wales and head of the Crown Prosecution Service) agreed that there would be an independent legal review into the decisions made by the Crown Prosecution Service in 2003.

Letter from Alison Saunders, Director of Public Prosecutions to Will Powell (9th October 2014)

 

It has now been almost 7 years since Alison Saunders made this agreement, yet to date, the outcome of the legal review has not been brought to a conclusion. Will has been informed in writing that when the legal review has been concluded, the Director of Public Prosecutions will then revisit his complaints against the Crown Prosecution Service, which he alleges were covered up in 2003.

 

In a letter dated the 10th November 2020, Rob Behrens CBE, Parliamentary and Health Service Ombudsman and Nick Bennett, Public Service Ombudsman for Wales, continue to pledge their full support for a public inquiry into the circumstances and aftermath surrounding Robbie’s death. Furthermore, Behrens and Bennett determine an extraordinarily strong need for a public enquiry given the lessons which can be learned and the range of unsatisfactory circumstances and flawed investigations. They set out the case for a public inquiry, including:  

 

  • The original handling of the case with the extreme reluctance of clinicians to give an account of what happened;
  • Successive investigations by a number of public bodies, all inadequate in some way, failing to lead to closure and resulting in serious allegations that crucial documents were tampered with at the time and raising doubts about the effectiveness of the duty of candour;
  • Very serious and evidenced allegations of police corruptions and conflicts of interest in investigating wrongdoing;
  • The file residing with the Crown Prosecution Service since 1994 with no decision being made about action to be taken, if any, following a legal review that was agreed in October 2014;
  • The structural advantage of a Welsh-based case being jointly overseen by United Kingdom processes through a period when devolution has significantly altered powers and responsibilities. (The Welsh inquiry could only look at devolved aspects of the case such as health matters).

 

Even with the support of Behrens and Bennett, the Welsh and English Health Ministers have refused to set up a public inquiry into Robbie’s case.

 

In regards to the legal review, Will recently received an update from the Crown Prosecution Service, apologising for yet more delays meaning that the Powells have now waited 6 years and 10 months for this review into Robbie’s injustice which Alison Saunders agreed to on the 9th October 2014.

Correspondence received from John Law, Senior Specialist Prosecutor Special Crime and Counter Terrorism Division Crown Prosecution Service (30th June 2021)

Will Powell’s response to John Law’s correspondence (30th June 2021)

 

It is Will and Diane’s hope that their own personal pursuit for truth, justice and accountability for Robbie will come to an end and they will be given the public inquiry their injustice warrants. Beyond this the Powells do not want another family to be put through the heartache of unnecessarily losing a child due to medical negligence or to suffer the trauma that has been caused by an alleged 31-year systemic cover-up by the state.  

 

To ensure this is the case, in 1996 Will and Diane sacrificed an estimated £300,000 in compensation and instead went on to expose the absence of a Legal Duty of Candour.  The Care Quality Commission (The independent regulator of health and social care in England), states ‘The tragic case of Robbie Powell and the perseverance of his parents through the UK courts and then the European Court of Human Rights (ECHR) exposed the absence of this legal duty’ or alternatively ‘a doctor’s right to lie’.

Extract taken from ECHR’s Ruling in the case of Robbie Powell (4th May 2000)

Robbie’s campaign Poster: Robbie’s Law

 

In November 2014, the Government finally introduced a Legal Duty of Candour. However, the current legal duty of candour which is policed by the Care Quality Commission applies to NHS organisations and not individuals. So as the law now stands there is still no individual legal duty of candour for healthcare professionals.

 

For Will and Diane their heartbreak was exacerbated again in June 2019, when they found their middle son Ian (41 years) deceased in his flat. They believe that Ian became alcohol dependent as a consequence of Robbie’s death and how the cover-ups destroyed his family life.  

 

The Powell’s 31 year fight for accountability is testimony to their sheer tenacity, in some cases, in the face of incomprehension, demeaning and patronising comments from public bodies. Every step of the way they have fought back against indifference and incompetence. Moreover, Will’s determination and resilience has led to an ordinary, Scottish/Welsh father shaking the British establishment to the core.

 

At the heart of this remarkable pursuit for justice for Robbie, is a 31 year old promise that Will made to Robbie, as he stood over Robbie’s death bed he pledged I will find out what went wrong. The Powells are motivated by raising the profile of Robbie’s negligent death and by exposing the multitude of cover ups resulting primarily as a consequence of medical dishonesty.

 

No longer should Robbie’s death be covered up by the State with no course of redress. It is time to bring this 31 year injustice to an end and give the Powells the justice they so rightly deserve. Reconciliation of the past is long overdue.

 

If you would like to find out more about Robbie’s injustice or keep up to date with how this is unfolding, please visit:

 

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