The Dilemma of a Whistle-Blower

CRASH attended an event for NHS whistle-blowers at the Office of the National Guardian on 20th January. 

WARNING: this page contains a graphic image.

 

 

 

We went to the event already inspired by stories of whistle-blowers and the detriment they suffer. Many of their stories are already in the public domain (some on this blog) but an element of confidentiality, appertaining to those who attended the event, must be honoured. We came away in awe of their courage for which they have paid a huge price.

There were significant reservations expressed in advance of the event about the Office of the National Guardian. Read more on Dr Minh Alexander’s blog and twitter feed. 

These are just a few personal opinions and perceptions arising from the event.

 

Negatives and problems

 

• Your scribe perceived an air of paranoia¹ in the room, which is entirely justified. The National Guardian has a mountain to climb to gain trust.
• The current line of accountability for the Guardian does not inspire confidence. Her office should be entirely independent of any NHS-related organisation (including the Secretary of State). The National Audit Office next door would make a good home. It has it’s own hotline – 020 7798 7999 – for concerns about public spending and conduct: unsurprisingly, it is rarely (if ever) publicised within the NHS.
• Some of those attending the earlier event (largely made up of representatives from health trusts, regulators etc.) are not ‘fit for purpose’ in the context of their own organisations’ treatment of whistle-blowers. 
• There should have been one event for all stakeholders – or the views of the whistle-blowers should have been heard first: the whistle-blowers felt ‘ghettoised’.
• There was no confidence in the Care Quality Commission protecting whistle-blowers.
• Does the National Guardian have sufficient resources to be effective or does she face the same problem the National Data Guardian found on taking up her post? 
• The National Guardian should not use ‘weasel words’/NHS jargon to soften the meaning of reports. For example, ‘challenges‘ should not be used as an alternative to ‘problems‘ and ‘learning opportunities’ should not be used instead of ‘mistakes’. ‘Mistakes‘ should be qualified on a grade of severity.
• The ‘problems and mistakes’ appear more serious in the mental health sector.

Analogies on NHS jargon:

Climbing Mount Everest is a challenge: falling into a crevasse on descent is not a ‘challenge‘ – it is a serious, life-threatening ‘mistake‘ and a ‘problem‘.

Shredding/amending a suicide patient’s notes before an inquest is not a ‘learning opportunity’ – it is a ‘mistake‘ (or as one Trust Chairman said, “A cock-up“) of such severity that it might constitute the criminal offence of perverting the course of justice.

Similarly, it is a ‘challenge‘ for NHS staff to have the courage to whistle-blow but it is often a ‘problem‘ for them once they have done so.

 

Positives (not many yet).

 

 

• There is good practice: at least one delegate was present who had not lost his job.
• It is an opportunity to make a difference for those who have already ‘come out’ as whistle-blowers – albeit that it must be treated with due scepticism and, by those who have not ‘come out’, with considerable caution.
• The Guardian, Dr Henrietta Hughes and her officials appeared empathetic and receptive to ideas – only time will tell.

Conclusion:

Whistle-blowers may find some of this contentious (but are welcome to add comments). However, I suggest Dr Hughes should at least given an opportunity by whistle-blowers, especially those who have already ‘come out’, to prove her doubters wrong.

Dr Hughes has requested advice and guidance on the following by 20th February 2017:

• The criteria to select cases for review.
• What [are] the greatest challenges of reviewing cases and how to meet those challenges [I know, but we warned you].

Send your suggestions to Dr Hughes by email here or by post to National Guardian’s Office, 151, Buckingham Palace Road, London, SW1W 9SZ. In addition to whistle-blowers, she wants to hear from anyone with an interest in the NHS, including patients and bereaved families. Names of whistle-blowers, who are fearful of speaking up, can be withheld.   

To paraphrase that great man and orator, Martin Luther King:

“Let us not wallow in valley of despair, I say to you today my friend. And so, even though we face the difficulties of today and tomorrow, I still have a dream.

I have a dream that one day even the [NHS], a [body] sweltering with the heat of injustice, sweltering with the heat of oppression, will be transformed into an oasis of freedom and justice.”

2022 NHS Whistle-blower

2017 NHS Whistle-blower

 

       We should dream too.

 

 

 

 

¹ In the common (not medical) understanding of the word.