People seeking NHS employment will be protected from being discriminated against because they are known to be whistleblowers, under legislation to be introduced within weeks, the government has pledged.
Jeremy Hunt vowed to change the law by the end of this parliament after an independent review commissioned by the health secretary detailed shocking treatment of whistleblowers, with some victimised to the extent that their careers were left in tatters and their families torn apart, and causing some people to have suicidal thoughts or even attempt to end their lives.
The Freedom to Speak Up report, published on Wednesday, also said that patients’ lives were put at risk by whistleblowers’ concerns being ignored.
Hunt said: “The whole house [of Commons] will be profoundly shocked at the nature and extent of what has been revealed today. The only way we will build an NHS with the highest standards is if doctors and nurses who have given their life to patient care always feel listened to if they speak out about patient care.
“The message that must go out today is that we are calling time on bullying, intimidation and victimisation, which has no place in our NHS.”
He said he accepted all of the recommendations made by the report’s author, Sir Robert Francis QC, “in principle” and would legislate accordingly, with Labour indicating that they would support a change in the law. The shadow health secretary, Andy Burnham, said the measures were overdue and called for them to be extended to social care, which Hunt said would be done.
Francis, who led two inquiries into failures at Mid Staffordshire NHS foundation trust, said raising concerns should be part of everyday working life.
He made a number of recommendations, including a named person in every hospital – a “freedom to speak up guardian” – to support whistleblowers and help them draw attention to the issue they have identified.
“The evidence received by the review has confirmed that there is a serious issue within the NHS,” said Francis. “This issue is not just about whistleblowing; it is fundamentally a patient safety issue.
“Everyone in the NHS needs to support staff so they have the courage to do the right thing when they have concerns about patient safety. We need to get away from a culture of blame, and the fear that it generates, to one which celebrates openness and commitment to safety and improvement.”
More than 20,000 staff shared their experiences with the review, with bullying the concern most frequently raised by those who contributed.
One person quoted anonymously said: “I have often been so depressed by this experience that I have considered suicide. I live in fear that the hospital will carry out its threat to sue me and take my home from me.”
The report found some groups are particularly vulnerable when they raise concerns, including locums and agency staff, students and trainees, black and minority ethnic (BME) groups and staff working in primary care.
Some students with previously good records were criticised or even failed after speaking up, prompting Francis to urge extra protection for them. He said there was “a perception that BME staff are more likely to be referred to professional regulators if they raise concerns, more likely to receive harsher sanctions and more likely to experience disproportionate detriment in response to speaking up”.
The freedom to speak up guardian is based on the role performed by nurse Helene Donnelly at Staffordshire and Stoke-on-Trent NHS trust. Donnelly, one of those who raised the alarm at Mid Staffordshire, said her role had prompted people to come forward who would not have previously.
Francis said the guardians would advise whistleblowers and have access to the chief executive and regulator to follow up their concerns. But it was unclear what their actual powers would be. Given they are likely to be appointed by trust chief executives, there may still be concerns about their independence.
A national independent officer should also be appointed to support local guardians, where the latter fail to get results, said Francis.
The NHS England chief executive, Simon Stevens, said that the new national office of the whistleblower would “provide clear new safeguards and signal a decisive change in culture in every part of the health service”.
The British Medical Association and the General Medical Council said that ending a culture of fear was vital to encouraging more staff to raise concerns.
Whistleblower’s view
Jennie Fecitt, 46, a senior nurse, was bullied for blowing the whistle on a colleague who had lied about his qualifications.
I am pleased with these recommendations. I particularly like that he [Robert Francis] recognises the horrific treatment of whistleblowers, the bullying, the culture of fear. He’s showing that everyone needs to shine a light into their organisation.
I am pleased that he’s not recommended more regulation. I think more regulation doesn’t help the culture change - it worsens it because it’s punitive.
I like that all trusts should have independent guardians who whistleblowers can go to. I would say that they have to be truly independent - effectively a trust can appoint somebody that is a yes person. They need to think about the rules and the type of person they need to appoint. How can you totally safeguard the independence when the trust is appointing the individual? Could the guardians come under the Department of Health, Monitor or the CQC (Care Quality Commission) so that they are totally independent? They will play a very key role.
He’s recommending that the law gets changed so that whistleblowing [employment] law is akin more to discrimination law which is frustrating for me. Judge Serota at my EAT (employment appeals tribunal) aligned whistleblowing law with discrimination law but Manchester NHS trust successfully challenged it in the court of appeal.
I am still a little bit concerned about whistleblowers out there now that have been suspended. We need to know how they are going to address past cases.
