By Minh Alexander @alexander_minh, Pam Linton @midwiferysister, Clare Sardari @SardariClare and a fourth NHS whistleblower, 9 December 2016
Some folks may think the Care Quality Commission is in denial of the scale of its failure, obfuscation and lack of expertise on whistleblowing. We recently produced a report collating evidence of failure on whistleblowing and campaigners wrote a letter to the Times. Our report and the related Times article and letter by campaigners can be found here:
We have now invited the CQC to respond to our report and to publish whistleblowing data that the CQC chief executive claims has been reviewed by the CQC Board on a quarterly basis, but which we cannot find in the public CQC Board meeting papers. We also ask the CQC to clarify once and for all if it will investigate individual whistleblowing cases, not least because its Chief Inspector claimed two years ago that every single case would be taken seriously and investigated.
Several individuals submitted written evidence about CQC’s failures on whistleblowing to Health Committee’s CQC accountability hearing, and the Times article and letter to the Times by campaigners was published just before the hearing.
At the hearing, the Times letter came up and it was evident that CQC’s two chief officers are in denial of the scale of the failure. David Behan its Chief Executive claimed he was not “complacent”. Yet he dismissed concerns about CQC’s whistleblowing failures and repeatedly claimed that the CQC had a “good story to tell”.
Behan also cited the fact that CQC consulted whistleblowers when it reviewed its response to whistleblowing disclosures. He conveniently side-stepped the fact that the whistleblower whom the CQC employed for six months to conduct this work has now joined the chorus of criticism about CQC.
Behan implied that some signatories to the Times letter have been droning on about the same point for four years, when in fact what has been presented is evidence of continuing failure.
All that Behan could muster was a few bald statistics and anecdotes that sounded superficially reassuring but proved nothing.
He also claimed that detailed activity data about the issues has been presented to the CQC Board on quarterly basis, but we found no such data in CQC’s public Board meeting papers for the last year. So if it is true that such data has been collated but not shared with the public, it is ironic that CQC has been working in the dark about purported transparency.
Behan’s claims at Health Committee in fact conflict with CQC’s recent claims via FOI that it held no centrally analysed data and so could not provide such data:
“Currently the CQC has not conducted any analysis of enquiries recorded as whistleblowing…We do not hold data on the nature grading or outcomes of such disclosures” CQC 13 September 2016 1
“CQC can give you the number of enquiries we hold on our system for all NHS services, but no other data is centrally collated.” CQC 21 September 2016 2
Peter Wyman CQC Chair, whose former trust Yeovil District Hospital admitted to super-gagging 22 members of staff 3, patronised campaigners: He attributed the dissatisfaction with CQC to campaigners’ lack of understanding of the issues.
Wyman also suggested that it is a simple matter of the CQC forgetting sometimes to tell whistleblowers what action it has taken. This may come as a surprise to the many anxious and distressed whistleblowers who contact CQC repeatedly – in vain – for confirmation that CQC has acted upon their disclosures. In such cases, it does not appear to be so much a matter of mere CQC oversight, as deliberate resistance and silence.
Both men omitted to mention that CQC’s own published papers have flagged risks on delivery of CQC’s “Responding to Concerns” programme and “inadequate” performance on responses to Safeguarding alerts and concerns. 4 5
But perhaps Behan is right. What the CQC does best is tell stories and hit out at critics.
A late submission published by the Health Committee comes from a departing CQC NED, who also shakes a fist at CQC’s critics:
“Most people who pass on concerns to CQC don’t see themselves as whistleblowers but there are people who do, sometimes to the extent it is central to their identity. In truth I have been dismayed at the behaviour of a small group who seem unwilling or unable to listen to different perspectives and work collaboratively on a common purpose to improve things.” 6
CQC has demonstrated yet again that it is not a friend to whistleblowers, responds poorly to challenge and is unfit to host the office of the National Freedom to Speak Up Guardian.
We have written to the CQC Chair to invite CQC to respond to our report and to publish all the detailed activity data that Behan says has been reported to the CQC Board.
We also suggested that CQC clarifies why its Chief Inspector of Hospitals’ claims that “every single [whistleblowing] case will be investigated” 7 have not been acted upon, and what exactly CQC will do in future in response to individual whistleblowing disclosures.
Will CQC investigate and if so, which cases, what and how will it investigate?
- Our letter of 9 December 2016 to the CQC chair, which contains a transcript of the relevant sections of Health Committee’s CQC accountability hearing can be found here:
- The televised Health Commitee annual accountability hearing on 6 December 2016 can be viewed here:
- Letter 19 October 2015 by whistleblowers to CQC about its lack of credible inspection methodology on whistleblowing:
1 CQC FOI response IAT 1617 0354, 13 September 2016
2 CQC FOI response IAT 1617 0243, 21 September 2016
3 Yeovil District Hospital FOI response 4 January 2016
4 CQC Chief Executive report to the CQC Board, Annex, 22 September 2016
This showed medium risk even after mitigation:
5 18 May 2016 Board paper 2015/16 Quarter 4 Corporate Performance and Finance report
“The KPI which requires inspectors to action one of four mandatory actions within 0- 5 days for alerts and concerns however remains inadequate at 83%, but this is an improvement from Q3 (79%). The figures for hospitals and PMS are significantly below target considering numbers of safeguarding records being managed.”
6 Late submission by Kay Sheldon to Health Committee’s CQC annual accountability hearing 2016, ordered to be published 6 December 2016
7 Oral evidence by Mike Richards CQC Chief 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.”