Sir Robert Francis QC, who was commissioned to chair an exhaustive inquiry into the gross failings of the Mid Staffordshire NHS trust, stated that “Openness means enabling concerns and complaints to be raised freely and fearlessly, and questions to be answered fully and truthfully”. Clearly moved by some of the harrowing accounts of patient neglect, Francis proposed that an uncompromising culture of scrutiny and transparency be applied throughout the NHS, without hesitation. He also went on to express a determination to implement the necessary statute to ensure that it happens.
Eighteen months on, institutional obfuscation and gagging, in one form or another, are difficult habits to kick according to a damning report of 70 cases filed by the Patients First organisation, a network that supports whistleblowers. The dossier was submitted back to Francis for review by the chair, Dr Kim Holt, who established Patients First after a spell working in a Haringey clinic left her demoralised. Back in 2006 her urgent criticisms of a dire situation were treated with intolerance and hostility, with this situation ultimately foreshadowing the Baby P tragedy.
Dr Holt claims that far from a free and fearless environment, 79% of the cases submitted for review suggest that whistleblowers raising concerns and criticisms, contrary to the recommendations of the Mid Staffordshire Hospital report, are met with bullying, significant counter-pressure, and that “a culture of fear still exists”. Another fifth of cases demonstrated that whistleblowers suffered financial losses as a result of their actions. Criticisms made and then pursued could result in a legal battle between the employee and an employer who can afford to spend significantly more on legal representation. At the very least, mismanagement of complaints was common.
Although gagging orders are currently proscribed, other methods and areas of pressure can still be applied to the same effect in an effort to wear down the resolve of the whistleblower. In an attempt to provide countermeasures to the stubborn climate of resistance from some NHS trust-appointed managers to the exposure of unhealthy practices, the government has set-up a new hotline especially for whistleblowers. The government has also insisted that the NHS adopt a “duty of candour” policy in disclosing all mistakes and failures.