I despair of senior managers and leaders in the NHS ever understanding why whistleblowing is a very dangerous activity. All their urgings and all the policies and revised constitutions in the world will not change toxic organisations and therefore will not protect whistleblowers or patients. And now, to make matters worse, staff face possible disciplinary action if they ignore poor practice.
The Campaign Against Unnecessary Suspensions and Exclusions UK (CAUSE) was set up twelve years ago to provide information to NHS staff who have been wrongfully suspended, many of whom have tried to blow the whistle and been silenced.
How might staff get into this whistleblowing position? A common process is a nurse who works in an area with excellent leadership where staff are respected and consulted, then changes jobs. They start on a new ward to find poor working practices. They cannot understand why staff seem to tolerate these harmful practices.
They try having a quiet word with colleagues who seem approachable. Some may agree but others are defensive and hostile. They try speaking to the Ward Manager and get a negative response. By this time they are labelled as a trouble maker. Worse still, one day they are called into the office and asked to bring a union rep or colleague with them and in a state of shock they are told of vague, unsubstantiated allegations against them. To their disbelief they are suspended and marched off the premises. This scenario, and the ensuing processes, are unbelievable unless you have experienced them, as the team at CAUSE have done.
Repeatedly we hear of unaccountable managers protecting themselves and undertaking biased investigations, character assassination, lengthy suspensions, disciplinary hearings which resemble kangaroo courts and ultimately dismissal of staff who previously had exemplary work records. The human resources staff seem to feel they need to protect themselves so work with the managers. Undisclosed sums of taxpayers’ money are paid, in out of court settlements if the staff member has the energy and legal support to take their case to employment tribunal.
Being wrongfully suspended is the most harmful, destructive and devastating action that management can take against a staff member. It is devastating to their families too. Other staff think it is such a serious action to be taken, there must be something wrong and this person’s career and reputation is seriously damaged. The effect of this wrongly labelled ‘neutral act’ makes people ill. When colleagues who know what is happening, see all this, it is understandable that they feel powerless to change anything. Who in their right minds would raise a whisper let alone blow a whistle?
The unions have some proactive volunteer reps and fulltime officers who are well versed in employment law and not afraid to speak out for their members. However more often the fulltime officers are hard to contact, probably doubt the member’s innocence and will work for the least serious disciplinary outcome. A final written warning is viewed as a victory because dismissal has been avoided even though their member is not guilty of any misconduct.
Nationally CAUSE asked the unions to establish a joint working group to provide expertise to officers faced with these situations, but the numbers of people affected remain comparatively small and the resources of the unions are limited.
The Nursing and Midwifery Council (NMC) hopes to develop a system to monitor systemic failure in trusts. So far they have ignored the processes I have been describing. This was clearly seen in their ruling for the M Haywood case by the Fitness to Practice team. They described the covertly filmed neglect as ‘failures of an exceptionally serious nature’ but then took no action against the perpetrators and the manager, who had conducted a woefully inadequate investigation . Instead they found the whistleblower guilty and struck her name from the register. The message to whistleblowers was clear – don’t expect us to protect public and staff by taking action where there is malfunctioning management.
The tragedies that have been uncovered will continue until the Department of Health and the Care Quality Commission face up to the complexity of the situation and the need to look at the indicators that suggest all is not well – the number of suspensions and how they are dealt with, levels of staff sickness and staff retention, and most importantly, patient outcomes, in order to identify and change these toxic organisations.
So will Sir Robert Francis be able to achieve anything, as he listens to peoples’ tragic stories? Will he be able to make recommendations that will change this dire situation? I so hope so, but while no action continues to be taken against managers who ignore employment processes and often seem to act out of malice or ignorance as to what constitutes danger to patients etc, then I doubt it.