That’s the view of Margaret Heffernan, author of Wilful Blindness and Beyond Measure, who has researched cultures that dissuade people from speaking up. She was appearing last week at the launch of whistleblowing charity Public Concern at Work’s review of the first group of companies to implement the recommendations from its Whistleblowing Commission. See our story on this at bit.ly/whistleblowing_commission.

The launch came the same week as the whistleblowing policy – drawn up by NHS England, Monitor and the NHS Trust Development Authority in response to Sir Robert Francis’s Freedom to Speak up Review – was put out for consultation. The policy reassures staff who speak up that they will be listened to, their concerns will be investigated, and they will not suffer detriment.

These are laudable aims. But I am not convinced that one national policy peppered with a few local freedom-to-speak-up guardians answering to one national figurehead for concern-raising everywhere will do the trick.

The culture is so toxic in many NHS organisations that they refuse to listen to those who know best when problems arise. Staff are fed up of being ignored and bullied when they put their heads above the parapet, and are unlikely to do so just because the NHS has published a document saying they should. The NHS needs to celebrate staff who have saved lives and trusts by speaking up – and normalise the process of raising concerns.

Ms Heffernan argues that organisations should encourage staff to say the unsayable, and train and retrain their managers to hear the issues that are raised without becoming defensive.

That’s what we’ve been encouraging people to do through our Speak Out Safely campaign. We want employers to sign up to publicly demonstrate that they support staff who raise concerns. Despite numerous invitations, many have not yet felt the need to.

Check today whether your organisation is signed up at nursingtimes.net/sos and let us know if they aren’t by emailing speakoutsafely@emap.com.

Speaking up can save money in some organisations, but, in healthcare, it also saves lives. Every nurseshould feel able to speak up as a matter of course.