The woman in charge of Maidstone and Tunbridge Wells NHS Trust during deadly hospital superbug outbreaks has broken her silence.

Rose Gibb was chief executive of the Maidstone and Tunbridge Wells NHS Trust.

She, and the trust, hit the headlines in October when a damning Healthcare Commission report blamed sloppy hygiene and lack of nurses for fuelling C-diff outbreaks contributing to the deaths of 90 people, between 2004 and 2006.

Miss Gibb has always maintained a silence, until now.

BBC1’s Panorama special How Safe is Your Hospital? was broadcast on Sunday, fronted by journalist Sally Magnusson.

Present and former Maidstone and Tunbridge Wells NHS Trust staff were interviewed.

Miss Gibb, who left her job just before the report was published, is now suing the trust for a £250,000 payoff.

Only a small part of a letter she sent to Panorama was broadcast, but the full content has now been released.

In the letter, she said the board inherited a range of problems, as she took charge.

She said: “Performance was reviewed and I responded as my knowledge and understanding increased, or as the situation altered.

“The C-diff issue shows this as the incidence fell dramatically from April 2006, once I understood its implications and causes.

“As chief executive I was approachable. Staff met me regularly and raised issues with ease because they knew I would respond as appropriate.”

She says she did not leave her post willingly, adding: “I believed I should stay and account to the public and was prepared to address the difficult issues which included clinical practice. I did so on many occasions to safeguard patients.”

Speaking after the programme was broadcast, Jon Restell, chief executive of her union, Managers In Partnership, said: “Rose may have been sacked if she stayed, but it was the NHS’s choice to avoid a disciplinary process and offer a payout.”

Jackie Stewart spoke to Panorama about losing her mother Mary Hirst in 2006. She told the Kent Messenger: “It is easy for her to apologise now, but I never saw her when I was trying to raise issues about my mother’s care. She always sent someone else.”

Nursing staff told Panorama how they tried to deal with issues themselves because of a lack of response from former management.

While looking at C-diff nationally, Panorama also filmed improvements that had taken place at the trust, since the outbreaks.

New chief executive Glenn Douglas said in a statement issued on Wednesday : “The programme showed that our hospitals are very different and better places than two to three years ago.

“The isolation ward where Panorama filmed has now been moved to a smaller ward, because we now have fewer cases.”

Latest figures show the trust has seen a 35 per cent reduction in C-diff cases this year than in 2006 to 2007.

The full text of the letter reads:

BBC News

Panorama

Current Affairs

17th April, 2008.

Panorama Programme, 27th April, 2008.

Thank you for your letter for 11th April 2008. As previously advised for legal reasons I have refrained from participating in the programme. However for the BBC to continue to see the issue of infection control and Clostridium Difficile as purely a Maidstone and Tunbridge Wells issue is inaccurate and misleading, the evidence over the past 12-18 months shows this is a national issue, causing significant numbers of deaths in the NHS.

The Board of MTW inherited an organisation with a huge range of long standing problems affecting patient care. These could not be addressed in one year and were prioritised into a range of patient specific and strategic objectives outlined in the boards’ annual corporate objectives (a publicly available document). These were all pursued vigorously. The trust was heavily performance managed and individuals subjected to tremendous pressure on behalf of the Department of Health, by the Strategic Health Authority on the attainment of government targets and priorities, which are not optional for trusts. Interestingly in the local SHA prior to the summer of 2006 Clostridium Difficile was not part of this agenda and was still not of primary importance on these agendas in September 2007.

I focused on patient specific issues and addressed these through staffing, practise, policy, organisational and major strategic changes. There are many examples of this from changes to maternity and medical services, recruitment of medical staff, renewal of equipment and environmental improvements through to infection control. Performance was reviewed and I responded as my knowledge and understanding increased or as the situation altered. The Clostridium Difficile issue shows this as the incidence fell dramatically from April 2006, once I understood its implications and causes.

I can confirm that as CEO I was approachable. Staff met me regularly in open forums or as individuals and raised issues with ease because they knew I would respond as appropriate. I was determined and focused on patients and had a developmental approach to staff as seen by a substantial organisational programme of change covering managerial, clinical and medical staff, which included directors, managers and front line clinical leaders.

I was prepared for and on behalf of the board and in the interests of the public to address the difficult issues which included clinical practice and did so on many occasions in order to safeguard patients. For example when clinical staff continued to demonstrate poor compliance despite involvement and good medical leadership I made difficult decisions to remove antibiotics from shelves to enforce the new antibiotic policy. I stopped medical staff performing procedures when they could not demonstrate best practice or outcomes etc. These decisions are never easy and do not result in popularity even when done in the interest of patients.

I did not leave my post as CEO willingly. I believed I should stay and account to the public, which is why I stayed after the April 2006 outbreak and continued to take action to improve infection control at the hospitals. The death of any patient if avoidable is always tragic and I offer my sincere apologies and condolences to those who may have suffered such losses in the NHS and in particular Maidstone and Tunbridge Wells NHS Trust.

Yours sincerely.

Rose Marie Gibb