By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 18 February 2020
Summary: The National Guardian has been rewarded with an OBE after wasting public money on endless propaganda, encouraging NHS staff to speak up without reliable protection in place. After two successive years of month-long PR campaigns just before staff survey forms were completed, and five years since the Freedom to Speak Up Review on NHS whistleblowing, the overall NHS staff survey score on confidence in speaking up has moved from 70% to 71.7%.
But continuing horrendous victimisation and Orwellian whistleblower witch hunts make the shallow PR achievement somewhat meaningless.
Yet another example of NHS trust whistleblower victimisation is provided. Staff spoke up in a group, but still suffered detriment. This is despite Robert Francis’ highly speculative, non-evidence based claims that protection can be assured by just getting more folk to whistleblow.
Francis has the gall to claim that after five years, his Freedom To Speak Up model – which he originally recommended for purportedly speedy effect – needs time to work. When people will stop listening to the Man with the Non Plan?
The annual national NHS staff survey has today been published. In the few years after Robert Francis’ Freedom To Speak Up Review, the measure of staff confidence in speaking up about unsafe clinical practice flatlined at approximately 70% of all NHS staff:
Last year it crept up to just 70.5% after a massive month of wet and windy PR campaign led by the National Guardian’s Office and supported by hundreds of Speak Up Guardians recruited in NHS trusts, to persuade more staff to speak up. This strategically took place just before NHS staff were due to fill in staff survey forms in the autumn of 2018.
The rationale behind persuading more staff to speak up, according to thin, speculative claims by Robert Francis, is that it is safer for staff when the majority speak up.
I would say that the government has just been irresponsibly duping staff into speaking up without ensuring reliable protection.
After another Speak Up Month campaign by the National Guardian last autumn, with even more trust Guardians recruited, this year’s measure of confidence in speaking up has inched up to 71.7% nationally.
NHS STAFF SURVEY OVER THE PERIOD IN WHICH THE NATIONAL GUARDIAN’S OFFICE HAS BEEN ESTABLISHED:
|Year||National average score on “I would feel secure raising concerns about unsafe clinical practice”
|2018||70.5% (after a month long PR campaign by NGO)|
|2019||71.7% (after a month long PR campaign by NGO)|
Coinciding with this bump, Henrietta Hughes got an OBE in the New Years’s honours for services to comms, sorry, the NHS.
But this surface gloss, of very slightly improved staff perception nudged by relentless comms, is far from proof of real improvement in how the system responds when staff raise concerns.
Matt Hancock still won’t answer me as to whether he will ensure by law that CQC will have a duty and power to investigate individual whistleblowers’ concerns. His permanent secretary is ignoring a complaint about this recalcitrance.
In real time, we have the slow motion car crash of the West Suffolk NHS Foundation Trust whistleblower witch hunt scandal, in which the role of a regulator – NHS Improvement – is highly suspect and is currently being covered up by NHS Improvement, with help from the DHSC.
There are other continuing active cases of whistleblower harm and suppression, some hidden, some in the public domain.
For example, unfairly sacked senior nurse Linda Fairhall has just decisively won an ET claim for unfair dismissal due to whistleblowing, but is still facing more harm because her former employer has threatened to appeal. Her case is another important example of serious failure of government policy, partly because the HR Director at her trust was also the Freedom To Speak Up Guardian.
Yet another recent example of failure of the Freedom To Speak Up project, with disappointing conduct by an NHS Freedom To Speak Up Guardian, is provided below. It shows that despite Robert Francis’s desperate recent claims, there is no safety in numbers for whistleblowers when your employer is determined to be abusive.
The fact that this tale has to be highly anonymised says it all about the emptiness of the continuing government propaganda.
These ongoing failures are set in the context of UK whistleblowing law which is unfit for purpose and has no prospect of real reform under the Johnson government.
UK whistleblowing Law and internal champions
The UK government pretended to lead the world with the Public Interest Disclosure Act 1998, a badly written, weak whistleblowing law that:
– Did not compel anyone to protect whistleblowers
– Did not compel anyone to investigate concerns and rectify wrongdoing
– Did not robustly deter reprisal or provide sanctions against individuals responsible for reprisal
It may have been well meant, and was unique in its time, but deliberate compromises against whistleblowers’ interests were made to assuage industry.
For the last twenty years, the UK government has had a symbiotic relationship with a charity, Protect (previously known as Public Concern at Work) which helped give birth to this bad law.
Both had evidence of the law’s serious failures but neither took radical action to put this right. The law has only been occasionally tweaked in the last twenty years, and Protect has recently put yet more tweaks on the table.
In 2015 a review of NHS whistleblowing by the government, the so called Freedom To Speak Review by Robert Francis had a chance to recommend substantive law reform but did not.
Instead, Francis made superficial and tokenistic recommendations for NHS organisations to have internal whistleblowing champions or “Freedom To Speak Up Champions”, who had no powers but would purportedly “oil the wheels”.
They were to be coordinated and supported by a National Guardian, who was equally powerless, and whose remit excluded the investigation of whistleblowers’ concerns. The handling of whistleblowers’ concerns remained wholly the responsibility of employers, and this left power in employers’ hands.
Such a model is of course riddled with conflict of interest, because it is hard for a Freedom To Speak Up Guardian, an employee, to truly hold an employer to account. Those who challenge a bad employer run the risk of being victimised, as has happened to some Freedom To Speak Up Guardians.
All such internal whistleblowing champion models are weak and doomed to fail:
Since the establishment of the Freedom To Speak Up project, the confidentiality of disclosures to some Freedom To Speak Up Guardians have reportedly been breached, for example, at West Suffolk.
Some Guardians have breached their duty of care to whistleblowers by sitting on their hands and not helping when asked to do so, and they have instead allowed abuse to take place unchallenged.
Some Freedom To Speak Up Guardians have been trust directors who were actually responsible for or party to reprisal. All whilst hypocritically churning out sickening publicity material about values and transparency, and encouraging staff to whistleblow.
Much like crocodiles inviting a wide eyed fawn into the water.
The NHS Nowheresville Freedom To Speak Up Guardian
Experienced NHS clinical staff at St. Nowheresville became concerned about serious risks to patients.
The concerns were widely shared amongst clinicians.
When these concerns were raised, the senior management response was hostile and provocative.
Staff were vilified.
The raising of concerns was not valued, but decried and criticised as trouble making.
Staff who were seen as the greatest threat to management were picked off, to decapitate the group.
Familiar, orchestrated tactics of isolation, trumped up charges and unfair processes were applied.
Staff appealed to the Freedom To Speak Up Guardian for support, but no response was forthcoming.
Staff suffered various kinds of detriment.
Serious issues with patient safety continue.
The injustice still angers and distresses the staff because it was never put right, and there is little prospect that it will be put right in the current system.
They still see the trust Freedom To Speak Up Guardian encouraging other staff to speak up, although they are aware that some staff have been deterred by their horrendous experience.
Robert Francis says give it more time
In 2015, Robert Francis dodged making a recommendation to substantively reform unfit UK whistleblowing law by claiming that this would take too long.
Instead, he maintained that his voluntary Freedom To Speak Up model, based on soft culture change, would deliver faster results.
These days, he bends the other way and claims that culture change takes time and that we must give his appalling Freedom To Speak Up model time to work.
For example, a good Samaritan sent me an exchange of correspondence with Robert Francis which included these comments by Francis on 14 January 2020:
“I fear we are not going to agree about the value of the Freedom to Speak Up National Guardian. Her office and the network she leads is making a great deal of progress on promoting the freedom to speak up without legislative or regulatory powers. The concept of guardians in this context is a new one and needs time to develop.”
That’s the contempt of the British ruling classes for you.