Response to Francis Report

After much publicity and media coverage Sir Robert Francis was commissioned a review into NHS whistleblowing

After three month delays Francis report into whistleblowing was finally published on 11 February 2015.  There were numerous media coverage of the publication of the report.

What about the coverage after published report? Here are some of them:

Russia Times

Daily Mail

ITN News

Independent on Sunday

The Telegraph

 

So what did NHS whistleblowers and their supporters think?

Eileen Chubb 

Gary Walker 

Anon –    “Although yesterday’s report will probably help me, I have spent time with some wonderfully kind professional and dedicated, doctors nurses and health professionals in the review who won’t receive the help they badly need because they have already lost jobs, homes and had their lives destroyed.  In essence, how can I feel happy today? I feel like a survivor in a plane crash”
 
I am very upset guys. I wish it was me and not you!
It’s not right!
 
 
Minh Alexander:
I think the Speak Up review helps to advance understanding of what happens to NHS whistleblowers, but it does not reveal the full picture. I found it disappointing overall, as do a number of other whistleblowers.
The review was inherently and substantially flawed by the terms of reference, and the avoidance of any examination of whistleblowers’ concerns. The patient harm, including deaths, related to whistleblower suppression has hardly been referred to in the report.
 
There has been no acknowledgment of the gravity of what has been repeatedly covered up in many cases. It is therefore not valid for Robert Francis to argue the proportionality of his proposed measures. The matter has simply not been weighed in the balance in a way that gives the report authority.
 
My reading of the report is that Robert Francis has repeatedly pulled his punches throughout. The report consists largely of expectations. These types of expectations have existed for years. The last major NHS guidance on whistleblowing was published in 2010 ( http://www.pcaw.org.uk/files/SpeakupNHS.pdf ) .
 
The whole point is that the NHS has so far failed to  deliver in the face of such guidance. NHS organisations, assisted by highly paid lawyers, are endlessly creative and determined in creating and misusing loopholes against whistleblowers.  Without a different approach, strong enough proposals and enforcement of accountability, they will continue to play the system. I doubt that Robert Francis measures will prevent recidivism by the worst employers.
Robert Francis emphasised ignorance as a factor in NHS organisations failures to respond appropriately to whistleblowers. I think this somewhat misses the point, as much of the victimisation is carefully calculated, orchestrated and sanctioned at the top level of organisations. It is not a matter of educating hapless employers to do better, but recognising that these are immensely toxic organisations, which need a very firm hand.
 
Robert Francis’ description of what “good looks like” does not reflect reality. The notion that you can have a whistleblowing process in which no one gets blamed is unfeasible (page 91). Disclosures about misconduct and reckless endangerment of patients are hot potatoes, which is partly why there is sometimes extraordinary defensiveness by organisations. Airbrushing this very real tension out of the picture does not help resolution.
 
I was particularly disappointed by Robert Francis’s decision not to recommend any provision for independent investigation of whistleblower’s concerns. In the most serious cases, where there are attempts to cover up, I would have thought that independent investigation is essential.
 
Even the Government recognised this 5 years ago, when Mr Lansley spoke in Parliament of plans to consider an independent authority for NHS whistleblowers to turn to if employers were unresponsive. ( http://www.publications.parliament.uk/pa/cm201011/cmhansrd/cm100609/debtext/100609-0004.htm ).
 
RF’s argument that it is appropriate to leave investigations in the hands of employers seems inconsistent with his views that complaints from patients about serious incidents should be independently investigated.
 
It is also inconsistent with general NHS policies, which mandate the external review of particularly serious incidents, and which recognise that it is important to eliminate conflicts of interest in these situations. I fear Robert Francis’ decision not to afford whistleblowers the protection of independent investigation will allow employers to continue with their well known techniques of undermining concerns, and discrediting whistleblowers.
 
There is also a relative absence of hard data in the report about the activities of the various organisations that submitted to the review. The review methodology stated at the outset that these organisations would be asked to provide the numbers and types of concerns that they handle. We must conclude that this data was either not provided, or that the review has failed to transparently disclose this vital information. Either option raises concern.
 
Furthermore, Robert Francis does not seem to have listened to whistleblowers’ concerns about the relationship between regulators and provider organisations, and the extent of regulatory independence.
 
I feel Robert Francis’ proposal of an “Independent National Officer” that has no binding powers and operates “under the combined aegis” of the three regulators and NHS England is unlikely to be workable or credible. NHS England has vested interests in the performance of the organisations that it commissions and oversees. No INO working under the DH or its arms length bodies can ever be truly independent.
 
 
By contrast, the US Office of Special Council, which has a remit to protect federal whistleblowers, has powers to litigate, and answers to the President. Even then the office is not perfect, but at least it is not designed to fail, which I feel is the case with the proposed INO.
 
However, an important clarification is that Robert Francis has stated that regulators have implied powers to protect whistleblowers. This is something that CQC has repeatedly denied to date, so we now have a very interesting situation. I hope CQC will re-evaluate their position and practice.
 
I also welcome the proposal to standardise process, as this opens the door to national audit and better measurement of performance.
 
The recognition by Robert Francis that whistleblower mistreatment is a form of discrimination is also useful. It is welcome that Robert Francis has acknowledged the need to make legislative provision to prohibit blacklisting. I feel he could have gone further and recommended other changes to the legislation, which is acknowledged by pretty much all to be inadequate.
The suffering that whistleblowers have endured could be leavened a little if it was felt that there had been effective learning from our experiences. However, I do not think that taken as a whole, the Speak Up review gives this consolation.
 
It is also very disappointing that no redress is recommended for whistleblowers whose lives have already been seriously damaged by victimisation. This seems to me deeply unjust and fails utterly to do justice to the enormity of these experiences.
 
I’ve heard of several whistleblowers in the most dire circumstances, with little hope of relief. It is simply uncivilised and immoral for the Government to turn its back on people who have been grievously injured for simply doing their duty.
Through its weakness, Robert Francis' report ultimately fails patients.
 
 

Fiona Bell:

Well the long awaited Francis report on whistle blowing , The review its self was finally an acknowledgement of the fact all is not well in our NHS . For years many of us having been highlighting these problems at great personal cost. It has taken many years to simply get the acknowledgement that something needed to be done. 

Would we have had the Francis report without the persistent pressure ? Without the help of Social media , some straight talking ,open emails and of course the help of our national press highlighting our concerns? I suspect not . 

The review team had to work within the terms of reference, That I accept , however I don't believe those in power can clap their hands in joy and claim to have addressed the issues raised and found us all a miracle solution . Why are those that bullied , harassed and hounded good staff out of their jobs still in post? 

Who protects the guardians? And will we now have a new wave of unprotected naive whistle blowers that assume because of the review it is now safe to speak up? 

Has anything really changed ? Has there been a culture change over night? was there at the very least a public apology from. Mr Hunt ? An apology may seem unimportant when there are much bigger issues, but let's face it, if a government/DH/nhs can't deliver a simple basic apology to all those that have lost so much, then what hope is there for the complete culture change? 

In order for all to move forward the issues of the past need to have been addressed , Nothing has changed for those that sacrificed so much in order to protect patients . Friday 13th Canary Wharf I met yet again with a whistle blower , despite The Francis review, the trust in his case continue to persecute. Beware there is no overnight fix, those that bully, victimise, persecute have not been disciplined nor are they likely to be . 

It is often said to me patient complainants suffer in the same way whistle blowers do , it's true. Being a Nhs whistle blower and complainant I have seen this time and time again , many patients themselves, their families are still afraid to complain , leaving issues unresolved . It is the same for whistle blowers . 

Patient families still continue to knock on the door for help despite the other Francis Report , I don't expect my case load to decrease in the coming year . Whistle blowing & Complaining comes with a heavy price tag , The day you dare to speak up is the day your world is turned upside down and life is never ever the same again. 

On the plus side through out the past 7 years I have had the privilege of meeting some incredibly brave people . 

Jo Gilbert

The Francis report was not only 3 months late but could have easily been written without anyone ever meeting a live whistleblower. It is virtually a lit. review that contains readily available information about what employers do to whistleblowers, collated from existing reports and research.

 Will it make one iota of difference to current whistleblowers? (“Current” is defined as those of us who are still asking and waiting for help four, five, ten years after we reported and were vindicated. There is no such thing as “historic” whistleblowing.)

 The answer is “No”. It will make no difference whatsoever. Francis and the report editors intentionally neglected to include any suggestions about what will be done to right the wrongs that everyone acknowledges has been done to those of us still fighting for justice.

 Will it make a difference to those who might have been “future whistleblowers”? Probably. It is likely to discourage them from making protected disclosures as they have now seen a written report which confirms that many are not protected, and have no recourse. The report confirms that whistleblowers are bullied, illegally sacked and blacklisted by the NHS, ESRs contain illegal and inaccurate data; they will probably see their careers terminated and are likely to lose their homes and families too. 

 The word “consequences” appears in the report 16 times. In 14 of those cases it refers to consequences of reporting that are experienced by whistleblowers. In one instance the report quickly and vaguely skims over a suggestion that NHS managers will receive “consequences” for doing what it recognises – 14 times – that they do. It simply says “there will be consequences” and does not even suggest what those should be or who will charge them with the offences (p.163, 7.5.8. The other case, p.105, 5.5.15, refers to the reference that will be made in 7.5.8).

 We have proved that NHS staff, Board members, NEDs, failed to do their duty, ignored PIDA, committed misconduct in public office and received rewards for their co-operation: Promotions, contracts, payoffs, prestigious positions. Who would voluntarily discontinue this lucrative practice?

 These are the facts. Until justice is done for those still struggling and fighting for it, who need nothing more than cash to buy it, this is never going to be over. This is not a life. It is a barely tolerable existence, we did nothing to deserve it and it gets progressively worse. It is not historic. It is daily. 

 There must be consequences for the many identified NHS staff and NEDs who have destroyed whistleblowers, ridden the Magic Roundabout and are still employed – either within or outside the NHS – before we will accept that our situations are sufficiently understood, are being taken seriously and are being corrected. So far there is no evidence that this is even being considered. There is no safe way to blow the whistle. We waited, tentatively hopeful, for months, for nothing.

 

 

Will Powell:

History has repeated itself, yet again, with regards to Sir Robert’s Report on whistleblowers as it would appear that there is no recommendation to address the injustices suffered by individual historic whistleblowers notwithstanding some have lost both their beloved careers and homes. I am told that some may have even lost their lives as a consequence of suicide.

I see whistleblowers and NHS complainants fighting the same cause and that is to improve patient safety issues within our NHS. However, the establishment see us as the enemy, not because we are wrong, but because we expose gross failures in the system and individuals, which is clearly detrimental to the wellbeing of our NHS. The establishment would rather cover up errors than address them for the better of all. There is conveniently no accountability when protocols, guidelines and laws are blatantly breached and that’s exactly how the establishment, in my view, want it to stay. I believe Sir Robert has failed again to ensure accountability when whistleblowers are vilified for speaking out.

It also frustrates me so very much when I hear arguments that healthcare professionals fear being open and honest about errors because of the alleged blame culture. All patients request is that doctors who make mistakes should be honest and accept responsibility for their actions – is that really too much to ask in a purported democratic country? It’s not the blame culture that healthcare professionals should fear but the consequences when they decide to lie and cover up their mistakes. The cover up culture in the NHS is like a very naughty child – it needs to receive appropriate punishment to make it stop.

 

Paul Cardin:

 Following this whitewash, if Sir Robert Francis becomes further enriched or is elevated to the House of Commons, then his own personal journey will have been successful.  As for the general public, patients, patients’ families, and the taxpayer, they’ve been betrayed by an establishment ‘shill’, who was selected by the powers that be, and who knew at the outset that whistleblowers would be offered a few crumbs and left to carry on fighting for justice.
Yet, despite strong sentiments from whistleblowers and supporters – only a handful have been mentioned here, Hunt has published the following message to staff

2 thoughts on “Response to Francis Report

  1. Have we lost the meaning of Justice, what kind of society is being created, if power is greater than truth, then confidence will be lost

  2. Pingback: Jeremy Hunt – Help & Justice for NHS whistleblowers | sharmilachowdhury

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