David Roulston writes in praise of whistleblowing in the health service

No one who follows the news will fail to have noticed the frequent episodes of whistleblowers coming forward who have previously worked in health and social care.

The issues raised by their stories are not just the shortfalls described but the failures by their managers to act on the whistleblowers’ concerns. Instead of being valued for raising evidence of poor practice or neglect of patients, whistleblowers are all too frequently treated like pariahs and lose their jobs.

The inquiry led by Sir Robert Francis into high mortality rates and issues surrounding patient care at the Mid-Staffordshire NHS Trust found that there was inadequate attention given to the core activity of looking after patients properly, and too much attention given to meeting financial targets and ticking boxes.

A crucial finding was that staff working for the trust were aware of the poor care taking place, but many were either too institutionalised that it did not register, or felt too frightened to raise or pursue concerns.

Accident and emergency nurse Helen Donnelly, who spoke at the inquiry, raised concerns about her department in 2007 to no avail, reporting that “the fear factor kept me from speaking out (initially) plus the thought that no one wanted to know anyway”.

She described a culture in her department which had declined to the point where all of the staff were scared of their managers and were afraid of speaking out against the poor standards of care.

Recent examples of whistleblowing have included an administrator who raised concerns about records of mortality rates in a hospital being manipulated, and a security manager who drew attention to children and pensioners being restrained and locked in hospital cubicles for up to 12 hours without food or drink.

It is worrying that so many staff who show the necessary courage and integrity to raise such concerns appear to be seen as troublemakers. Instead such staff should be recognised as an early warning system which allows matters to be put right quickly.

Organisations which fail to recognise the important role played by whistleblowers are like a householder ignoring the alarm raised by a smoke detector, only to see their house burn down. It is the staff who are working most directly with patients who will often be the first to recognise when things are going wrong and they should be supported to bring forward their concerns for resolution.

And yet too many health and social care workers fear the consequences if they speak out, worried that they will lose their job and permanently damage their career. It is for this reason that Healthwatch Oxfordshire set supporting whistleblowers as an early priority. We are one of 152 local Healthwatch organisations across the country who have been established to champion the interests of people who use health and social care services. We are seeking reassurance that organisations across Oxfordshire who employ staff working in health and social care services have the right culture, policies and practices in place to support staff to bring forward their concerns.

We support the ‘Speak Out Safely’ campaign being run by the Nursing Times which encourages organisations to develop cultures which are honest and transparent, to actively encourage staff to raise the alarm when they see poor practice and to protect them when they want to do so.

Like the majority of people in the UK I am very proud of the NHS which was established in 1948 based on the ideal that good healthcare should be available to all, regardless of wealth.

However the reputation of the NHS has been damaged by the frequent stories about the poor treatment of whistleblowers. Let’s change that impression by seeing whistleblowers as part of the solution for improving the NHS rather than part of the problem.

David Roulston is director of Healthwatch Oxfordshire