Time for a change of attitude

Why is it so hard to stand up and speak out against poor standards and bad practice in the NHS? This is a question that has vexed politicians, health professionals and patient groups for years. When the Healthcare Commission's 2009 report into Mid-Staffs asked why no staff had come forward to raise concerns about care standards, staff nurse Helene Donnelly wrote to their CEO explaining that she had on several occasions raised such concerns, even producing a detailed report on specific incidents, only for it to be buried by the trust management.

Others who have raised concerns about colleagues or units where standards were unacceptable have lost jobs, reputations and even careers. At the very least, their concerns have been ignored. (3)

Donnelly said, 'I'd stop and look round the department and think to myself, “If this was my mother or my grandmother, would I be happy with this?” And the answer is “No, I wouldn't be”.' (4) Surely speaking up for the voiceless and against abuse or injustice should be a fundamental professional and Christian value? Why is it so hard?

Every Secretary of State for Health since Frank Dobson at least has made protection of whistleblowers a matter of policy – even bringing in legislation. (5) When the Francis Report (6) highlighted the practice of gagging orders against whistleblowers, Health Secretary Jeremy Hunt said the practice 'had a chilling effect' and sought to outlaw it. (7)

So far, these political legal pronouncements have had little real impact. Doctors, nurses, managers and others are all scared to raise their heads above the parapet. At best they fear being ignored, at worst losing everything.

Professional bodies have often been weak, urging people to withdraw concerns or go for pay-outs rather than fight their cases all the way. This was another criticism from the Francis Report – if the BMA and RCN will not stand up for you as a whistleblower, then who will?

Yet there is help – the charities Public Concern at Work 8 and Patients First 9 are working with parliament, professions and individuals to help people raise concerns effectively and get support and protection when doing so.

The culture of the NHS, like most big institutions, is prone to silencing dissent and cutting down the tall poppies. For the sake of our patients and colleagues, and above all in God's name, we need to speak out and challenge this.