Last June, six senior NHS professionals, including myself, met Jeremy Hunt to relate our personal histories and petition him for a public inquiry into whistleblower victimisation. We had all suffered extreme retaliation after raising serious concerns about patient care. Five of us had been dismissed. A week later Jeremy Hunt, health secretary, commissioned Sir Robert Francis toconduct a review into creating an open and honest reporting culture in the NHS. For Francis this is unfinished business from his earlier inquiries at Mid Staffordshire Foundation Trust , as he told us with some passion at our first meeting. At Mid Staffs he found it necessary to have clandestine meetings with staff after guaranteeing their anonymity. “People were just scared,” he told us.
The scope of the review was unsatisfactory. Historic cases would not be reopened or adjudicated. The review team was small and the timescale too short, we thought, to cope with the submissions we anticipated. We may have been naïve but decided to trust Francis that this could at least be a step to a full public inquiry. He reassured us that this had definitely not been ruled out.
This new review is a frank admission once again that all is not well in the NHS. Variable, substandard and sometimes abysmal care is still all too common. In hospitals where frontline staff attempt to address this they are often met with a wall of silence and hostility by management. This was our own experience. In a recent major speech, Hunt, with alarming recognition, wished out loud that some NHS chief executives would behave a little less like Stalin and model themselves more on Ghandi, the great soul of tolerance and compassion.
Last February, speaking to the Health Select Committee, Francis was clear that the current victimisation must stop. “We now have unanimity among those who are leaders of the government and everywhere else that supressing whistleblowers is absolutely wrong. Any chief executive, any board that is found guilty of that should be sacked.”
We have come a long way since Sir David Nicholson told the Mid Staffs public inquiry that whistleblowing (and bullying) was not a significant problem in the NHS. That is the attitude of denial that has allowed this culture to fester and hold back staff engagement in safer patient care.
The Freedom to speak up review has two main parts. The qualitative review has received about 600 submissions mostly from individuals. Many of these tell stories of highly competent professionals who, putting patient interests beyond their own, have felt the full force of managerial blame come down on them. The quantitative review involving a volunteered phone survey of the experiences, good or bad, of staff raising concerns has attracted 17,500 submissions. At a recent seminar we were told these recorded largely negative experiences and that managers rather than colleagues were the main source of victimisation.