Our Campaign

We’re going to start off simply. We’d like a Health Select Committee Review on Whistleblowing. This isn’t our idea – many whistleblowers  have campaigned for this over the years – but the failure of the government to follow up on its June 2010 pledge to strengthen the protection for whistleblowers means that the HSC should now look into this as a matter of urgency. We need proper consultation and enforceable solutions.

This page will be updated as our positive ideas develop.  Version 2 below.

We think the following should be considered:

1     An end to all gagging clauses of any sort in the NHS and the protection of a clinician’s professional right to free speech, including the right to go external to the trust and raise concerns with an MP.

2  A possible statutory duty to investigate and publish the investigation once whistleblowing concerns are raised.  It cannot be right that the report is “owned” by the trust, and such secrecy allows the whistleblower to be persecuted.   The Royal Colleges should also publish the report they are asked to produce.  The only investigation of whistleblower’s concerns at the moment is via the proxy of suing in the employment court – but this only enriches lawyers, is a dreary business, and lawyers are sometimes poor investigators (especially in medically or surgically complex cases).

3.  A compulsory duty of candour so that patients and relatives are told promptly and compassionately when harm has occurred, irrespective of the cause.

4.  A compulsory duty to both blow the whistle and – for those in authority – act on it. Voluntary just doesn’t work. The aim should always be wherever possible to speak up and prevent harm.  Bill Cash MP has suggested a law that would allow for the removal of an NHS Chairman by politicians if it can be proved he/she was appraised of safety concerns but failed to act.

5.   An NHS redress fund that gives patients swift and proportionate compensation when they’ve been harmed by healthcare, irrespective of the cause

6.  Continuation of legal aid for clinical negligence claims for those who want to take it further. Most people who receive a prompt, kind apology and explanation don’t.

7.  Training and support for NHS staff in how to have these difficult consultations – blowing the whistle, responding to a whistleblower, telling a patient they’ve been harmed by care etc

8.   Real time monitoring of patient harm on a ward by ward/ practice by practice basis that everyone can contribute to (staff, patients, relatives) and can take pride in reducing. Safety has to be   tackled on the ground, in the now, in teams with the cooperation of staff and NHS users.

9.  A truly independent medical inspectorate (similar to the Rail and Airline Industries), staffed by experts that go in hard and fast to investigate all unexpected deaths or cases of serious harm and publish the results swiftly for the regulators to consider.  At the moment SUI’s are reported to the Board (and should appear in minutes) but are internally investigated.

10.  If you win as an NHS whistleblower, the Trust should pay your legal costs, as it’s in the public interest. At present, whistleblowers can win in court and be crippled with legal costs.

11. A National Whistleblower Centre in the UK, similar to the US. http://www.whistleblowers.org/ Whistleblowers deserve proper advocacy. At the moment, many of them try doing it themselves and are crushed by NHS Trusts with huge legal teams funded out of public money.  They also need counselling and career support.

Please add your comments and suggestions.

11 Responses to Our Campaign

  1. Rachel Lindley says:

    Brilliant campaign for an organization which is sorely needed. I teach undergraduates who are training to be doctors. I know that students see these things happening and quickly pick up the dominant ‘hide the error’ culture despite what we might try to teach them. Is there a group looking at the new recruits training or how we might work to embed a core student curriculum on this important issue?

  2. Alan Bird says:

    Have you considered the mechanics of whistleblowing? I image a system something like this:
    1 An NHS-wide documented process, including guidance notes and maybe a reporting form, perhaps to be owned by your independent medical inspectorate.
    2 Some sort of logging and tracking system across the whole of the NHS, perhaps a database. Complaints could either be made directly to it, or, if made to a line manager, copied in.

    (Btw, do any parts of the NHS have ISO9000 certification? If so, they should have a customer complaints system already. Maybe the term Customer should be re-defined to included Staff, but it would be instructive to ask the auditing body whether they examined the complaints system – especially in areas we know to have failed, such as Mid Staffs. If a national staff complaints system were to be set up, the relevant parts of it could then be included within the scope of every quality audit.)

  3. SoupDragon says:

    A suitable Register/Registrar for anonymised events, which perchance already exists, is The Coroner Office [and the nationwide network that commands].

    A suitable inquisitor for the above, who was the powers of a high court judge and the facility to revisit the event to see the remedy is enduring, is the Ombudsman.

    We already have the ‘suits’ in the pack of cards, that is Healthcare.

    Join the two agencies together and the abomination that is CQC need not exist.

    Trouble is, who has the imagination and Cajones to sculpt such?

  4. Dee Speers says:

    Before Health Select Committee start another inquiry ,can they correct the acknowledged error in the Complaints and Litigation Report regarding the term used by the Parliamentary Health Service Ombudsman ..”A Worthwhile Outcome”
    I noted the error and said:”I would be very grateful if you could explain to me how “the prospect of a worthwhile outcome” has its origins in the Health Service Commissioners Act, as your report would have it. By my reading, this Act contains no such provision but gives the Ombudsman wide-ranging discretion, which the Ombudsman has personally chosen to use in order to enforce criteria which she/ her predecessors / invented”

    HSC Replied: “You have righty identified that the prospect of a worthwhile outcome is an internal test used by the Ombudsman. The statutory basis for this is in the discretionary powers given to that office in the Health Service Commissioners Act. This is an error in the report arising from oral evidence that was somewhat unclear.

    Can I assume the explanation will be published forthwith!

  5. Dee Speers says:

    If the Health Select Committee have found “The NHS Complaints system is not working, say MP’s” and “Parliamentary Health Service Ombudsman role needs a complete overhaul” …..why the Public Administration Select Committee didn’t find this during its annual scrutiny of PHSO process just two weeks earlier?

  6. Dee Speers says:

    For info:
    PHSO often refuses an investigation quoting “no Worthwhile outcome”….a phrase she has invented!
    PHSO investigates less than 1.5% of complaints.
    PHSO has never investigated an ‘reconsidered complaint’ despite keeping the complaint in ‘reconsideration for up to a year!
    PHSO process costs us the tax-payer, in excess of £34m per annum….FOR WHAT?

  7. Dee Speers says:

    Fully agree re Whistleblowers Consultation and solutions!

    Changes to the NHS MUST include a tenable NHS complaints system.
    “NHS Complaints ….a money-saving idea for UK Taxpayers!!”

    Every Trust must pay into an Complaints Pool (run by the Independent Complaints Advocacy Service-ICAS) and every investigation into the most serious complaints MUST by fully Independently investigated…..preferably by a professional solicitor and not just a management consultant employed by NHS.
    At present many Trusts fail to resolve complaints and just say “If unhappy, escalate it to the Parliamentary Health Service Ombudsman —-As you have been advised PHSO, also fails to resolve it as she only investigates less than 1.5% of complaints yet this ‘public service’ costs in excess of £34m per annum.

    So Trusts failing to resolve complaints at local level MUST pay substantially more into complaints pool……this would have the added benefit of a greatly improved ‘Learning Lessons’ complaints service with Finance Directors ensuring full accountability from their Senior management teams ….and maybe a massive saving on an ineffective PHSO service!

  8. Daphne Havercroft says:

    I like Rachel Lindley’s suggestion about finding a way to get the culture change we need brought into the core curriculum for medical undergraduates.

    Is ethics part of undergrad. training?

    If so perhaps it would fit well there, with some assistance from patients who can take a pragmatic and balanced view contributing to developing the curriculum?

  9. Daphne Havercroft says:

    One of the problems with the NHS is that it has the Code of Conduct for NHS Managers – that covers doctors in management positions too, and, if followed, ought to prevent the need for people to blow the whistle as a last resort.

    However, as we all know, when managers ignore the Code of Conduct, nobody does anything about it, and even if they do, the chances are that cronies will be brought in to investigate and there will be no thorough, impartial investigation.

    Look how NHS Bristol reacted to my concerns that its Chief Executive and former Director of Commissioning had breached the Code of Conduct for NHS Managers in respect of their behaviour leading up to Bristol Histopathology Inquiry (and since as well).

    NHS Bristol commissioned a review, paid for with public money, which was conducted in secret by a Panel chaired by a non-exec from a nearby PCT and which included two of NHS Bristol’s own non-execs.

    The Panel used a document I’d written as one of the reference documents, yet didn’t have the courtesy to invite me to give evidence. Also it has made some incorrect statements in its report that I intend to correct as a matter of public record in due course.

    http://www.bristol.nhs.uk/about-us/our-board/board-meetings-2011/april-28.aspx

    see 9.3 and 9.3a

    The review’s aim is obvious – damage limitation and covering of the Deborahs’ backsides. (Evans – Chief Executive, and Lee former Director of Commissioning and now on the Board of UHBT – University Hospitals Bristol NHS Foundation Trust)

    Much of what goes wrong in the NHS is due to poor quality and lamentable standards of administration in some parts of the organisation.

    The Public Administration Select Committee examines the standard of administration in the Civil Service and its remit also covers the NHS (I asked)

    http://www.parliament.uk/pasc

    Therefore another strand to the Campaign, or perhaps a separate campaign is to request the PASC to examine the quality of the NHS’s Public Administration.

    Why does it have all these clinical and corporate governance procedures and Codes of Conduct that are ignored by some senior executives and doctors?

    Who audits the NHS? Does it have a national policy for implementing ISO9000?

    I’m sure there are plenty more questions to ask, but these will do as starters.

  10. Daphne Havercroft says:

    Council for Healthcare Regulatory Excellence Consultation on Standards for Senior NHS Managers.

    http://www.chre.org.uk/media/18/408/

    Register interest by sending email to policy@chre.org.uk

  11. Pilgrim says:

    At last a glimmer of hope
    Lansley’s gone. about time too.

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