By Minh Alexander @alexander_minh, Pam Linton @midwiferysister, Clare Sardari @SardariClare and a fourth NHS whistleblower. First published 2 December 2016
This is a report by whistleblowers that has been submitted to the Health Committee. It describes how the Cat Quality Commission continues to fail whistleblowers and keeps a lid on national whistleblowing data. This vital information should in fact be published and used to drive improvement.
The full report with links to supporting FOI data can be found here:
An article of 6 December 2016 by the Times, which drew on the data from this report and a related article published by Open Democracy on 2 December 2016, can be found here:
Common decency and good governance requires that whistleblower’s concerns are listened to, properly explored, analysed for patterns and transparently learned from. However, governments may deliberately put ineffective or inadequate structures and processes in place to deal with whistleblowers, to make it look as if something is being done when it is not. 1 The Public Interest Disclosure Act (PIDA) 2 is critically flawed partly because it does not set out the responsibilities of the bodies that have a legal duty to receive disclosures from whistleblowers – so called “prescribed persons”. Since PIDA came into force in 1999, prescribed bodies have revealed little information about the nature and extent of whistleblowers’ concerns.
The Care Quality Commission (CQC) is a prime example of such opacity, despite repeated promises to be transparent. The CQC has for years resisted proper, proactive use of whistleblower intelligence. The CQC has unparalleled whistleblowing data, yet it has still not provided a systematic, national picture of whistleblowing in health and social care. The CQC has responded reluctantly, scantily and sometimes inaccurately when asked for data about its analysis and use of whistleblower intelligence. Even with very incomplete and possibly inaccurate reporting by CQC, it seems there have well been over 33,347 whistleblowing contacts with CQC since its inception. From data for the year 2012/13, the great majority (86%) of whistleblowing contacts have related to social care.
However, there is very little data on the nature of concerns or how they were resolved. Only partial information has been provided under FOI, but even this shows that CQC is often informed about serious care failures and institutional cover ups. However, the data also suggests that CQC relies heavily on what employers say they have done to resolve staff concerns. Quite often, CQC does not even contact the regulated body and merely records very serious disclosures as “information noted for future inspections”, with no further record of outcome.
Questions arise about CQC’s past claim to Health Committee that it would investigate “every single [whistleblower] case”. 3
There is no evidence that CQC systematically tracks whether whistleblowers experience detriment after whistleblowing. CQC has made no effort to analyse intelligence supplied by Employment Tribunals about whistleblowing claims against employers. CQC largely does not reveal the numbers of whistleblowers in each organisation. This adds to isolation and marginalisation to which whistleblowers are sometimes deliberately subjected by employers.
CQC has not taken any evident action to deter still widespread use of gags in the NHS. It has not used its powers to remove any senior managers who have covered up and mistreated whistleblowers.
Whistleblowers are not properly protected. Unmet harm and need, and malfeasance identified by whistleblowers remain largely obscured, at a time of harsh public sector cuts when whistleblowers’ voices need to be heard loud and clear.
CQC has failed whistleblowers and the public in the past. It still does not meet parliament’s expectations on whistleblowing. CQC has also not acted properly on the recommendations of the Freedom to Speak Up Review on NHS whistleblowing.
We call on parliament to recognise that CQC has seriously failed and is unlikely to change its approach, and to ensure that there is now serious and credible whistleblowing reform.
1 An example of this is the situation in Hungary where whistleblower protection law was passed, but no agency was established to receive or investigate disclosures.
2 Public Interest Disclosure Act 1998
3 Oral evidence by Mike Richards CQCChief Inspector of Hospitals 17 June 2014 to Health Committee inquiry on whistleblowing:
“What we can say is that every single case will be investigated. We will look at those whistleblowing cases as we hear about them, or other patient concerns, and say, “Who is the most appropriate person to be dealing with that?” It may be one of our inspectors or it may be one of our managers, one of our heads of hospital inspection, but we will take it seriously every time.”