Phil Hammond and Andrew Bousfield came together, in a journalistic sense, to write a Private Eye special called Shoot the Messenger to show how NHS whistleblowers are being silenced and sacked, despite political promises to protect them. It appears in Issue 1292 and is available in reassuringly hard copy from July 5, 2011. Back orders are available by calling Private Eye Subs on 01795 414870.
Phil Hammond is a GP, writer, comic and broadcaster (www.drphil hammond.com). He has been Private Eye’s medical correspondent for 19 years, broke the story of the Bristol heart scandal in 1992 and was summoned to the (belated) Public Inquiry in 1999. In preparing his submission, and wondering whether he might be struck off for putting the Bristol Royal Infirmary’s confidential surgical audit in a satirical magazine, he wrote a book called Trust Me, I’m a Doctor, which argued that Bristol was just the tip of an iceberg of medical harm and that the NHS – like all health systems – operated in a culture of denial where all the bad shit was swept under the carpet. Phil wasn’t struck off, but he was vaguely threatened with a custodial sentence for refusing to reveal all his sources.
In his evidence, Phil suggested that outcomes for heart surgery should be collected, adjusted for those doing riskier operations on sicker patients, and put in the public domain. This has been done, very successfully, for adult heart surgery, but child heart surgery – its poor relation – still hasn’t been safely reorganized twenty years after Stephen Bolsin blew the whistle on Bristol. Phil has promised to set light to himslef outside the Department of Health if the current Safe and Sustainable reorganization fails.
Andrew Bousfield qualified as a barrister before going to journalism school at New York University. Documents show he was soon declared “persona non grata” by the administration after writing a column about American war-mongering as a drunken English colonel. He returned to England to work at the Centre for Investigative Journalism and the Bureau of Investigative Journalism. Andrew has worked with whistleblowers across all sectors, using his legal knowledge to ensure the truth could be released and the source protected. He also still gives legal advice to national newspapers.
About Medical Harm
Medicine is unique amongst legalised industries in that it causes significant harm as well as enormous benefit. We think that in order to do no harm, first you have to count the harm. Patients, relatives and staff should be united in speaking up when shit happens or, better still, just before so we can stop shit from happening. Phil was once in an operating theatre when a strident Irish scrub nurse shouted – very loudly – ‘what the fuck do you think you’re doing?’ – to a junior surgeon who was about to operate on the wrong side. It had the desired effect but more often, people don’t speak up in the NHS for fear of being slapped down, ignored or punished. So a lot of the harm happens that we could have avoided.
Healthcare harms patients and staff in all sorts of ways. Missing or delaying a diagnosis, giving the wrong or suboptimal treatment or even giving the right treatment badly causes harm every day. A lack of compassion can cause both psychological and physical harm, and endless, unnecessary political reorganizations that divert money and attention from the frontline probably harm more patients than the frontline staff. Most staff feel dreadful when they know they’ve harmed a patient but are as likely to be hung out to dry than helped and supported. There’s a difficult balance between an open culture that allows staff to admit to errors and near misses safe in the knowledge that they won’t be punished, and a ‘no blame’ culture where noone is ever held to account for serious failure because it’s always the system’s fault. ‘Fair blame’ is a better concept but still a million miles from the defensiveness, secrecy and denial we have at the moment.
By calling this site Medical Harm, we want the NHS, public, press and politicians to acknowledge that healthcare is very dangerous and harm is surprisingly common. Then we need everyone – patients, relatives and staff – to be encouraged to step in to stop it, or failing that report it so we have continuous ‘harm alarms’ – like smoke alarms – on every ward and in every GP surgery.
Back in the real world, it could be a while – and several more Bristol and Mid Staffs-type disasters – before the NHS takes harm seriously so in the meantime we’re heavily reliant on whistleblowers: patients, relatives and staff who not only spot something that’s about to go pear shaped but speak up and do something about it. They should be heroes but are more often treated as outcasts and crushed by the system. But whistleblowers can fight back by joining forces. Patients, relatives, clinical staff, local journalists, MPs and even the odd lawyer can together provide more effective safety monitoring of the NHS than any regulator, and far better protection against persecution than the Public Interest Disclosure Act. This site will allow you to submit information and documents that we may put in the public domain, and will build networks of those who wish to raise concerns about medical harm and help figure out ways to reduce it. It might even encourage the Health Select Committee to look closely at NHS whistleblowing. If they need some inspirational whistleblowers to give evidence, read Shoot the Messenger and browse this site.