National Guardian: Blame…or accountability?

Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 28 February 2017

Henrietta Hughes the National Freedom to Speak Up Guardian spoke of negative culture and blame shifting in response to being asked about, her host and part funder, the Care Quality Commission’s many failures on whistleblowing:

“I’m not going to perpetuate harmful, negative cultures, blame shifting.”

This was at a meeting on 2 February 2017, agreed records of which can be found here:

Click to access hh-meeting-records-23-01-2017-and-2-02-2017.pdf

An unchecked transcript from a conference on 26 January 2017, released today, suggests that she made similar comments on 26th January, and that she wished to emphasise ‘good news’:

“We also heard about hospital acquired infections and one of the things that I found from my experience as a commissioner was that although trusts have brought the number of infections right down, when it comes to the actual meeting where they’re being held to account, the key thing they wanted to do was pass the attribution of the blame onto somebody else and I think that was a real essence of the feelings and the culture in the NHS as it stands at the moment, but I think there is good news and that’s what I’m going to talk about in terms of the work that is happening so far.”

The Chair of the conference MP Rosie Cooper stepped in to make it clear where she stood on ‘fair blame’:

“I’m not one of these people who do no blame, what I believe is in fair blame, we all just do it and get on with it, if it’s wrong, put it right, move on but there are consequences on both sides for those things that you do”.

She also reminded Henrietta Hughes of the grave governance failings and persecution of whistleblowers at Liverpool Community Health NHS Trust.

“…may I just say to you that in places like Liverpool Community Trust, nurses who voiced concerns or didn’t do what they were told were given the alternative of going through a disciplinary procedure where they would be found guilty and would be reported to the NMC or to retire and resign. My response to that is not at all, I don’t think you’ll find it surprising in that now we’ve got to this point I have reported the Chief Nurse to the NMC and she is currently suspended and we await what will happen. So that procedure she applied to those who were subordinate to her is now being applied to her and I think that’s the route..”

At the conference, Sharon Brennan from the Health Service Journal asked Henrietta Hughes about potential retaliation against Speak Up Guardians if they, as trust employees, challenge trust directors. She also asked if legal clarifications were needed to safeguard Speak Up Guardians against retaliation.

Henrietta Hughes seemed optimistic that Speak Up Guardians employed by trusts can hold boards to account even in highly intricate situations where it is a board member who is whistleblowing:

“When it comes to board members raising concerns about each other or staff raising concerns about board members, my advice to Freedom to Speak Up Guardians is to provide the same level of support to the board member as they would to any other member of staff. Now that obviously can be really challenging and I think that that’s where we can also provide advice and support for them. When it comes to any detriment to the Freedom to Speak Up Guardian, I think that’s where our office would also come into play. I think what’s really significant is that looking at Freedom to Speak Up and the Freedom to Speak Up process will become part of the CQC well led inspection and we’re going to be developing guidance with the CQC inspectors and also Freedom to Speak Up Guardians together so that it will become a really valuable part of understanding what’s happening in the culture of the Trust. And obviously the more senior the members of staff are that are raising concerns, I think that also you know feeds into the leadership and the well led domain of the CQC inspection”.

She did not, however, answer the question about legal clarifications.

The transcript of Henrietta Hughes’ presentation, and answers to questions, at the conference is provided here:


So, the Department of Health will doubtless be content with the core messages:

  • Emphasise Good News & purported action to protect NHS whistleblowers
  • Minimise issues of accountability
  • Stress that blame is negative
  • Side step legal reform

Related items

1.Critique of the National Guardian’s policy proposals

2.Summary of Jeremy Hunt’s inaction on NHS whistleblowing

3.Hansard record of the debate about whistleblowing failures and other governance failures at Liverpool Community Health Trust

3 thoughts on “National Guardian: Blame…or accountability?

  1. Yes, blame is negative.
    Look at that Dr Harold Shipman. He was blamed for lots of bad, bad things. And he got so negative, he hanged himself.
    Now, we don’t want to see these fine upstanding, vital NHS employees copying him. If you do ruin someone’s life or, if you are being really negative and killing them, please walk away from the noose. Instead, find someone important within the NHS (there are lots and lots) and have a nice chat with them. Avoid negativity and blame at all costs and then, like all of those within our bureaucracies, you can rinse and repeat!
    Thank you Dr A.
    Kindest, Zara.


  2. It s a bit like The Potato /Potato song except it doesnt rhyme as well! Tomato/Tomato Blame/Accountability Hunt sings “lets call the whole thing off” WISHFUL THINKING


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