By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist, 12 October 2016
How many distressed whistleblowers hear back from St. Robert of Richmond House? The answer is that we don’t know, but here is a tale of apparent silence.
Whilst wrecking the NHS with dangerous cuts, Jeremy Hunt likes to spin about the infallibility of those whom he has used to build his false narrative of tough regulation, prioritisation of patient safety and hard-nosed efficiency. After a conflict between GPs and Steve Field CQC Chief Inspector, who had made some generalised comments about GPs “failing as a profession”, Jeremy Hunt effectively pronounced that Field was un-touchable:
“A former GP and President of the Royal College, his credibility is beyond question, and we absolutely back his independent judgements as Chief Inspector.”
So much for just culture.
Similarly, Sir Robert Francis’ name has been used by the government and by Jeremy Hunt as a powerful PR weapon. It has been incessantly built up as a cipher for patient safety, a trusted brand logo. Where you need to brush a little gloss on a project, manage a scandal or sell another Department of Health or Care Quality Commission good news story, just pop in those magic words: “Sir Robert Francis said…..”.
When Hunt and the CQC were in choppy water because the previous National Guardian Eileen Sills resigned within two months of appointment – after a head-hunting exercise that cost the public £61,300  and after she dropped clangers which showed that she was ill-informed about whistleblowing – who was wheeled in? Sir Robert. Sir Robert was unfurled and run up the CQC flagpole:
“Sir Robert Francis QC, CQC board member and author of the ‘Freedom to Speak Up’ review, said:
“The Office of the National Guardian is a key part of the promotion of the freedom to speak up in the NHS. I remain personally committed to help see a new National Guardian appointed as soon as possible and to oversee the continuing development of the infrastructure required to support the new appointee. I am confident that the team at CQC is working hard to ensure that the new Guardian has the support in place to enable this vital work to be done.”” 
Never mind of course, that Sir Robert had a hand in this failed appointment.
Sir Robert gets invited to all the right parties, and continues to say all the right things. At the recent launch of the annual report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, attendants reported that he made these laudable comments:
“You would think that patient safety would be a priority in all health services, this isn’t the case… We need to go further in creating safe spaces where staff can discuss and learn from error….if you don’t care for staff, they don’t care for patients” etc….
Sir Robert also struck out for the little guy – or in this case, gals – when in February 2014 he publicly criticised the conduct of Paula Vasco-Knight’s trust – South Devon Healthcare NHS Foundation Trust – towards two whistleblowers, Clare Sardari and Penny Gates:
“It is important that no tolerance is afforded to oppressive managerial behaviour of the sort identified only last week by an employment tribunal in the South West, which victimises staff who raise honestly held concerns.
“Every such case is hugely damaging to the confidence of other staff who are contemplating raising concerns. It is clear that there is much to do in this area.” 
But what happened when one of the whistleblowers – Clare Sardari – wrote him a distressed letter in August 2015? This was at a time when she was significantly depressed and had required professional care, and had not long lost her mum. Clare Sardari never heard from Sir Robert.
Her letter informed Sir Robert that due to the vagaries of the Employment Tribunal system and her employer’s actions, she had ended up in very difficult financial circumstances despite winning her case:
“…I was given only a very short time to make a decision, and on the advice of my legal team… I accepted the settlement offer of £233,000. This figure did not take into account any future loss of earnings or future pension loss. I have legal costs of over £100,000, will have to pay 40% in tax and have built up significant debts in the two and a half years I have been unemployed. What I will be left with is a very small amount and at 58 years of age, having tried my hardest over the past 3 years to find a job, blacklisted by local NHS Trusts, I have no future!”
The letter also recounted how her employers agreed to make a formal apology, but did not in the end do so. Her letter ended on a highly personal note:
“I need a job as my financial situation is dire. I need a job because my self esteem is at rock bottom. I need justice but am unlikely to get it. I need your support and your help, if there is anything you can do.”
But there was only silence.
It’s possible Clare Sardari’s letter was lost in the post and never arrived, or that Sir Robert replied but his response did not arrive. Perhaps he can tell us. Robert Francis told us in 2014 that he has heard from many whistleblowers, and also from staff too frightened to speak out:
“Sir Robert said that since publishing his findings 16 months ago into the unnecessary deaths of hundreds of patients at Mid Staffs, many staff had contacted him saying they were still too scared to speak out.” 
I would like to think that Mr Hunt’s totem of moral authority does not ignore people who are in a state of obvious distress. It is well known that the whistleblower’s journey often includes serious ill health, mental and physical.  Soeken and Soeken reported this years ago:
These were early, rough results from an investigation beset with the usual problems of sampling in whistleblowing, but nevertheless, they provide a picture of significant suffering.
Being cold shouldered and finding doors repeatedly closed in your face – or never opened – is part and parcel of the isolation and despair that many whistleblowers experience.
And as Sir Robert has observed, “…if you don’t care for staff, they don’t care for patients”.
Clare Sardari tweets at @SardariClare
1) Sir Robert’s Flip Flops
An account of Robert Francis’ u-turns on his original recommendation from the MidStaffs public inquiry to criminalise whistleblower reprisal.
2) Open letter by Clare Sardari to the governors of St. Georges, where Paula Vasco-Knight her former Chief Executive was recycled into a board position and then promoted to Chief Executive, only to fall from grace again after allegations of a financial nature.
3) CQC’s Fit and Proper Parade
A summary about the Care Quality Commission’s failure and obfuscations on holding any unfit NHS directors to account under Regulation 5 Fit and Proper Person, with details about CQC’s highly questionable behaviour in response to an FPPR referral on Paula Vasco-Knight, Clare Sardari’s former Chief Executive.
 NHS bosses blew £61,000 on whistleblowing tsar who QUIT before starting job
 National Guardian update. CQC press release 5 April 2016
 Francis criticises Vasco-Knight trust, Judith Welikala, Health Service Journal, 7 February 2014 https://www.hsj.co.uk/sectors/acute-care/francis-criticises-vasco-knight-trust/5067807.article
 NHS is still gripped by a culture of fear: Inquiry into whistleblowing set up by barrister who investigated Mid Staffs, Sophie Borland Daily Mail, 25 June 2014