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Trust Me, I’m a Whistleblower


Posted on 10 July 2011

trumpet_voluntary.jpgThere has been something of a trumpet voluntary on the whistleblowing front over the last week. The King, Queen and Godfather of medical whistleblowers have co-authored a paper, which the JRSM has foolishly – it’s about whistleblowing, for Heaven’s sake - hidden behind a paywall – only to allow its publication, via Queen Blow’s own website. Radio Horlicks simmered away on Thursday, with a half hour Report featuring the shimmery voiced Dr Kim Holt. And the Eye (related website here) has produced a Shoot The Messenger NHS Whistleblowing ‘Special’, an eight page dossier of gagged and stuffed doctors hung out to dry, complete with red borders and menacing target images. Queen Blow, however, is conspicuous by her absence from this report – apparently following an iPal tiff - so leaving the Eye a Wonderbra short on the sex appeal front.

All this tittle-tattle has nonetheless been too much for the Rt. Hon. Wood Ash MP, still warm from his bit part in Basic Instinct III, who has now promised inquiry into the treatment of NHS whistleblowers. But, frankly, worthy as it may be, an inquiry has all the promise of a bonfire in a thunderstorm. It will smoulder, as Wood Ash does, but produce little heat, and no light. And all the while, trusts will continue to toast whistleblowers with impunity.

It is not as if we don’t know there is a problem: we most certainly do. All the recent reports, and indeed many past reports, bear testament to a major problem. The problem is not so much knowing that there is a problem, as knowing what to do about the problem.

The Radio Horlicks’ Report is long on problems, but short on solutions, although it does make it clear that the gagging clauses – which function like super-injunctions – used to silence whistleblowers are illegal. The Eye is hot on ‘something must be done’, but cooler on the practical detail of what that ‘something’ should be – sanctions must be enforced, safety enshrined, the gaggers gagged, etcetera, plus a ‘fast and dirty’ – dirty? – crash squad, alongside an American-style ‘National Whistleblower Centre’. The JRSM authors, fettered by the constraints of a learned journal, warm to a way forward paved with professional consultations and governmental reviews, and – like the Eye - an American-style ‘National Whistleblower Centre’, but offer nothing substantial on tackling the GMC – despite the fact that the body of the paper contains a substantial section that strongly suggests that, at present, the GMC, far from being part of the solution, is part of the problem.

As indeed it is. Almost invariably, medical – doctor – whistleblowers will find themselves reported, all too often on vexatious grounds, by their trusts - trusts, it should be noted, that act with connivance of the whistleblowers former ‘colleagues’ – to the GMC. The GMC may take the whistleblower’s complaint with one hand, but, more often than not, it will then stab back with the other. Doctors contemplating whistleblowing know only too well that such a fate almost certainly awaits them if they do whistleblow, and so they hold back. And so it is that the body that should help concerned doctors to speak out – indeed, its guidance says they must speak out – acts instead to deter whistleblowers.

The double edged sword of the GMC’s conduct is however only a reflection of the fundamental, underlying problem that whistleblowers face, which is that the whistleblower is invariably doomed by the colossal imbalance of power between the whistleblower, and the ‘establishment’ he or she seeks to expose. Once the whistleblower blows, he or she enters a David and Goliath world where neither good, let alone God, but Goliath decides the outcome.

Now, there are some practical changes that could be made now to improve the whistleblower’s lot – notably effective enforcement of the gagging clause ban, with custodial sentences for the perps (and that includes the BMA who often negotiate these clauses) – but if we are serious about doing something to encourage responsible whistleblowing then, above all else, we need to fix the imbalance of power problem. As things stand, the trusts have all the toasters, and the whistleblower all the Hovis - and we all know what happens to Hovis in the face of a toaster.

On paper, it might appear the obvious candidates to address this imbalance of power are the medical defence unions. Doctors pay large sums of money to these organisations to protect their professional reputation, and never is a doctor’s professional reputation likely to be more under threat than when whistleblowing. But in the main, defence organisations, conspicuously absent from this week’s reports, have emerged a dismal, spineless lot - which they can be, because most of the relevant cover they provide is in fact discretionary - when called to the assistance of a whistleblower in distress.

What we need, it seems to Dr No, is one simple action. We can drop all the consultations and inquiries, all the noble aspirations to change the culture to one of openness and transparency – sorry it just isn’t going to happen, because to the establishment the whistleblower will always be a sneak and a grass – and the other myriad recommendations. Instead, what we need is to set up, at the earliest opportunity, a powerful, properly funded National Whistleblower Centre. It makes sense financially – think how much money would be saved had there been no Bristol, no Baby P, no Mid-Staffs – but far more importantly it makes moral sense, not just for whistleblowers, but also for patients.

Backed by a powerful capable Whistleblower Centre, a Centre with both the means and the power to stick the knife back into the establishment toasters, and fuse their miserable elements, whistleblowers will at last be able to step forward and say: ‘Trust me, I’m a whistleblower’.

9 comments:

Yes, I agree with you - and glad you liked my idea of the National Whistleblower Centre stolen by the Eye :). I have the email to Phil :) Bar the fact the Eye has no original ideas, this is my view on the GMC.

We could not outline the solutions within the GMC because it is quite complicated. While you do not like consults, we actually have no data on exactly what problems whistleblowers face within it. This is why there is a need to consult with the whistleblowers to start at first base then develop solutions. One potential solution is tightening up the Whistleblower protocol there. The second solution is that the Registrar has to have the discretion to understand the difference between harassment of a whistleblower and a genuine complaint. There is no current distinction. So, to discuss the GMC, that would be another large weighty paper in itself that no one would publish. As it is, this controversial analysis was hard to get through publication. A better analysis was written by Mark Davies in his book Medical Self Regulation. He has analysed the GMC far better than I have.

The iPpal tiff was a fairly serious one. There are whistleblowers and there are those who purport to be whistleblowers by playing the whistleblowing card. Make no mistake - Eye has been careless in its research on this occasion. Indeed, I would advise that no doctor approach the Eye to whistleblow as we have no assurances on how their data will be used.

As for Kim Holt - she is a movie star. I think we should let her do what she is good at. In the meantime, there is large amounts of ground work to do and some of us are getting it done. Stardom is one thing, intellect is another.

My main concern is the failure of Eye and other publications to address the concerns of junior whistleblowers. At present, the senior whistleblowers have become a club of doctors. They have defaulted to what they know best - run around in a gaggle. What they have forgotten is that they owe a duty to the medical students, the junior doctors etc. They are largely forgotten in the star status of senior whistleblowing.

Excellent review DN. Much appreciated. May you have all the wonderbras thown at you in one go :)

RP

PS You have no idea how hard it was to get this paper out there. Extracting ourselves from establishment forces was fairly horrible. I didn't want to be a BMA whistleblowing flagship.

I see that Private Eye have stolen half the ideas from the paper and made it their own http://www.edms.org.uk/2010-11/2031.htm . Raj Persaud was once suspended for copyright violation. I wrote the solutions para on the paper, I now see its propagating without citation.

Fascinating to watch don't you think. Those who have fame stealing the ideas of those who actually problem solve.

Rita

As a long time Private Eye reader, with a keen professional interest in the healthcare sector, I would like to stick up for the magazine. It may have stolen ideas but it has brought this issue to a much wider audience which can surely only be a good thing! Not many people will take the time to read a paper on the subject but will read the magazine that they subscribe to. Might it not be worth approaching Private Eye (or at least writing a letter to the editor) outlining your grievance? Knowing the magazine, they would probably print it.

I agree with you as it has done some great work with Geoff Monks a good friend of mine etc. There is no point in approaching Private Eye. It isn't really a grievance but a data protection risk that they placed me in purposefully. I have written a email but it will be summarily dismissed.

In their eyes, Andrew Bousfield - sanctioned by the Bar Council is a far more reliable individual. I cannot change that view nor would I wish to.

The issue isn't about readership - it is interesting, entertaining and amusing. This is about dealing with whistleblowers who have sensitive data. If you were a whistleblower, would you wish to go to a publication who was also dealing with your victimiser. That is my basic point.

My aim on the iPal tiff is not to air this out publicly as a grievance but to inform those who may wish to raise their concerns with Private Eye. There is therefore a distinction between writing fantastic material and placing people at significant risk. These distinct issues are never understood by Private Eye or the two editors MD and Bousfield.

In terms of lifting a research paper's ideas. Citation would be good then no one would mind. Some of us work extremely hard to study the complex material, endless research papers etc only to find that Private Eye discards the source and lifts the ideas for its own.

Best

RP

And now we have those who believe the country's policies should be developed on the articles run by Private Eye as opposed to peer reviewed research papers. If that is so, why don't we just throw out the scientific papers and just let Private Eye run the show on all medical policies. Just an idea.

Whistleblowers are at the other end of the spectrum to NHS Complainants with 'significant' cases.

We are all silenced.

As a member of the NHS Reform Group (www.nhsreformgroup.com)I was was under the impression that there was going to be an Inquiry into Whistleblowing, but over on Lynne Featherstones blog, Kim Holt is saying that "Sadly the Health Select Committee have changed their mind it seems to conduct a review into whistleblowing, saying that there has been a misunderstanding."?

Misunderstanding, misleading, poor communication - all terms used to 'bat off' the NHS Complainant and the NHS Whistleblower.

Of course while ever the NHS Whistleblower and NHS Complainant are silenced - Patient Safety will suffer. Dumbing down yet again!

I am sure the Health Select Committee will come around to the idea of an Inquiry. Their position is as yet undecided - the Independent yesterday

"Whistleblowing is a particularly fraught topic in the NHS, where lives may depend on it, and the Commons Health Select Committee has announced an investigation. Governments have repeatedly promised protection for whistleblowers, but in case after case the protection proves illusory"

http://www.independent.co.uk/life-style/health-and-families/features/jer...

As for Kim Holt, she may well have inside information - she doesn't cite her sources unless her collaboration with Phil Hammond of Patients Association as rendered some special contacts with El Gov. Kim should concentrate on being a star. She should also remember that a Guardian journalist asked her to support the Whistleblower Inquiry [ via me] and she made no appearance. For avoidance of doubt, Andrew Mitchell MP has not informed me that there is no inquiry.

As the matter is still on the cards, I believe that Dorrell - will make the right decision. It would be a sad day if whistleblowing continued to fracture the NHS just because he didn't want to hold an inquiry and listen to the whistleblowers.

Incidentally, I don't recommend the website Holt, Bousfield, Hammond, Kenny Boy have made. I am not in favour of making victim hubs ready for lawyers. I am of course surprised with Hammond's allegiance with a lawyer. Mind you there was always ex Gooderham, friend of Jenny Colman, the man who tripped over Clause 1 at the Press Complaints Commission and the guy who failed to spot that PIDA didn't work but yet is hailed an angel. Afterall, to err is human and to be an angel is godlike.

Rita Pal

I have a new e-petition just posted on the government's website:
"Petition to enhance patient safety, save public money, and protect NHS whistleblowers, through statutory disincentives for mismanagement".
http://epetitions.direct.gov.uk/petitions/15692
I hope you will sign, and tell people about it.
Thank you

It has been a roller coster ride for me and I hope no one should be treated the way people in power, institutions and the law treated me for raising concern about patient care in the NHS.

I published a letter in doctors.net, Gp forum about nurses (Independent nurse prescribers and practitioners) made to work as doctors (examine, diagnose, prescribe and on call for emergencies) in the NHS. The Mid-Stafforshire Hospital scandal could have been averted if the primary care trust had acted when I raised my concern in 2004. The politicians are blaming the culture of "Targets" but not explaining why and how this resulted in complications and death.

I personally met and informed the commissioner of service not to licence nurses (who have no formal training in medical school and supervised training as a junior doctor) to clinically examine, diagnose and prescribe drugs. I collected information to prove why and how mistakes are made by nurses working in the Walk-in-clincs and Nurse-Led Practice. Wrong diagnosis offered false reassurance, resulting in delay in correct diagnosis, complication and death which is un-ethical medical practice.

After years of struggle to defend my self, I have stopped working as a doctor in UK because it is against my principle to work in an organisation that actually harm people and do not defend people like me who raise concern.

I have created a blog and will be soon publishing all the documents to help doctors to learn how not to be a victim but make sure you are adequately protected. My mistake was to trust BMA, GMC and WMA to help defend me but I was badly let down. They ignored my claim that I had raised concern about patient care (2004 - 2007) and allowed my family and me to suffer. I have written documents and emails to show how pathetic and dependent on the politicians these organisations are.

Mid-Staffordshire hospital report has drawn the attention to Whistleblowers. The health minister, the PM and other people in power are all claiming to protect Whistleblowers. I have written to them but have not even received any reply.

If you are the one who wish to make the information public, Please "THINK HARD" or find an alternative job.


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