Francis NHS whistleblower report: a new begining?

New review is a frank admission that all is not well in the NHS and that substandard care is still commonplace

Robert Francis
Robert Francis: ‘We now have unanimity among those who are leaders … that supressing whistleblowers is absolutely wrong.’ Photograph: Martin Godwin

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.

Without a judicial examination of historic cases including the failure of the Department of Health, trust boards, unions, regulators, Royal Colleges, and others to support whistleblowers the truth will never be known. The whistleblowers have lost their careers. Their families have been damaged, in some cases beyond repair. Their health has suffered and personal finances often lie in tatters. The perpetrators will never be held accountable for their behaviour. Worst of all patient harm will go unaddressed and the vital lessons of this tragic history will go unlearned. Hunt and Francis understand this better than most. The report and the way it is implemented will tell us if they have found the political will to translate their understanding into decisive action, or if life under Stalin is to continue as normal.

4 thoughts on “Francis NHS whistleblower report: a new begining?

  1. I reiterate ALL whistleblowers should be considered and a register kept this is not for the select few I have been in senior positions for over 45 years and no-one know more than me about bullying cover ups safety issues etc

  2. This lot doesn’t need or want whistle blowers no matter whot oh theyl make the right noises but will sweep it under the carpet allowing these boards to sack the culprits but untill you has doctors stand up has one body you see its the only way telling the public that the tories lied lied lied about keeping the nhs safe sadly to late has doctors you must all stick together and show that the nhs is still alive and kicking that selling it off will be the biggest mistake ever whistles blowers will not be tolerated in thier new yanky hospitals run by the yanks policies given out by unum for their stay in their overpriced understaffed hospitals yet I hope all doctors would stand and be counted has going the tory way willnot be in the interest of anyone but the bean counters jeff3

  3. There were/are whistleblowers in Morecambe Bay but their fate has been no different to the fate of whistleblowers throughout the UK. The report of Dr Bill Kirkup’s investigation into what went wrong in Morecambe Bay will soon be produced but take note that none of the interviews were held in public, the summaries of them are as illuminating as a one watt bulb and the investigations terms of reference were as broad as a bootlace tie.

  4. Dr Drew is absolutely right but why so few comments on this excellent blog?, Where are Julie Bailey, James Titcombe, Kim Holt and Kay Sheldon for example?
    Another question Sharmila and her readers might want to ponder is why was Sir Robert Francis and Bill Kirkup disinterested in evidence of persistent financial irregularities involving the movers and shakers in Morecambe Bay?

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