Tuesday 22nd October 2024

(2 months ago)

Westminster Hall
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Meg Hillier Portrait Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
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It is a pleasure to serve under your chairmanship, Sir Mark. I congratulate my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell) on bringing this really important debate to the House. I was reflecting on the number of different Departments involved in trying to tackle the issue, so I do not envy the Minister, but I hope that he will take the messages back to the other Departments that are connected, because I want to focus particularly on the NHS.

We know that the courageous people we have heard about, who blow the whistle, protect us and our communities, yet we do not offer them the same protection—that is the nub of the problem. As I said, I want to focus particularly on the NHS, because we have seen many examples—I will not go through them all—where someone in the NHS whistleblows and their career is in effect over, or very badly damaged, as a result. I want to raise that alarm to the House, and I hope the Minister will ensure that these messages are relayed to the Department of Health and Social Care.

In too many cases, whistleblowers face sanctions at work or threats, and the toll that takes on people’s mental health is enormous, as we heard described eloquently by the hon. Member for Strangford (Jim Shannon). Before this Parliament, I was a member of the Public Accounts Committee for a total of 13 years, including nine years as Chair, and back in 2014, when I was a member of the Committee, we looked into whistleblowing and found that there had been failure

“to protect some whistleblowers from being victimised.”

That puts it mildly. We recommended then that where the identity of whistleblowers is known, steps must be taken to

“ensure that they are protected, supported and have their welfare monitored.”

We said that that should include providing whistleblowers with

“support and advice, such as access to legal and counselling services.”

We also highlighted the fact that too often whistleblowers were “unclear” about who to raise their concerns with, and we recommended “a route map” that showed different

“internal and external reporting routes.”

The Government at the time agreed with the recommendations about a route map, but they deferred further action on whistleblowing policies across the NHS, as they were being considered separately through Sir Robert Francis’s Freedom to Speak Up review. That was a reasonable response from the Government at the time. But then I became Chair of the Public Accounts Committee and we revisited the issue of whistleblowing—and guess what? We were disappointed at the slow progress. If I had been paid £10 for every time I had to use that phrase in that role, I would probably not be here now but sunning myself in the Caribbean, because “too slow progress” is often the mantra.

We now have a new Government, with a new Employment Rights Bill, and I hope we will see further progress. We were not really convinced that change had happened on the ground and we were also very clear that whistleblowing is a sign of complete failure of the system. We should not have to have whistleblowing policies, because modern institutions that work well should have routes whereby complaints, concerns and issues are raised as a matter of routine. I will come to some good work in other sectors in a moment, but we found generally that there was not enough focus on whistleblowing in the wider public sector. The Francis review of the health sector highlighted the need for effective whistleblowing policies not just in the health sector, but more widely.

Earlier this year, the Public Accounts Committee revisited whistleblowing again—it seems to be a bit of a theme—and still we stressed the need to embed a “Speak up” environment. We were looking particularly at whistleblowing in the civil service at that point, but the lessons read across, sadly. The National Audit Office found earlier this year that just 52% of people in the civil service

“think it is safe to challenge the way things are done”.

That was from a review of the responses to the 2022 civil service people survey—that is a bit of a mouthful. The National Audit Office also highlighted the number in the NHS with the same concern—61.5%. That was in 2024, so this year. Less than two thirds of NHS workers think it is safe to challenge the way things are done; lots of work needs to be done to improve that.

There are institutions that do this quite well. Earlier this year, the Public Accounts Committee visited NASA, in Washington. As a result of the tragedies with the Columbia and Challenger space shuttles, the people there have a very open approach to raising concerns. However junior someone is, they are expected to raise a concern up their chain of command in their specialist area, and if they are still concerned, they can take that to another party within the organisation—a whole other set-up—to make sure that they are challenging the approach taken on risk. That is expected. It is embedded in the training that people look at the risk and make sure that they are calling things out. Nothing is too small, and no one is too junior.

Gareth Snell Portrait Gareth Snell
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My hon. Friend probably has unparalleled experience in this House, through her important scrutiny work as both a member of and Chair of the Public Accounts Committee; I was happy to work with her on many inquiries when I was a member of that Committee too. Could I tempt her to tell us how many millions on public procurement projects we might have saved had the system that she has just described been in place in this country? How many hours of time might have been spared? It sounds like an incredible system, and one that this country should seek to emulate.

Meg Hillier Portrait Dame Meg Hillier
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As ever, my hon. Friend manages to cut through to a really important issue. It is not only about the whistleblower; in the whole public sector and parts of the private sector, it is time-consuming and cumbersome to deal with whistleblowing on both sides, and it is very mentally draining, particularly for the whistleblower. It is costly when a mistake happens and is not caught early. A stitch in time saves nine, as they say. That is very much the bread and butter of what the Public Accounts Committee does; it looks at where problems have arisen that could have been predicted and prevented.

The Chancellor is to launch her Budget next week and we need to save money, but—I am not being flippant—in the long term we need to see a change in culture. Aviation is another example of where things happen well. In that sector, it is expected that people call things out. Things do still go wrong, but staff get praised, rather than penalised, for calling out what might happen in safety terms.

This debate has come at an important time for my constituent, Sarah McMahon, who has agreed that I may share with hon. Members her sad experience as a whistleblower. Sarah is a consultant orthopaedic and limb reconstruction surgeon at Great Ormond Street hospital for children. In the summer of 2021, she was asked to look after some patients of her colleague, Yaser Jabbar, after he had an accident. Overseeing those patients, she found things that made her so alarmed that she blew the whistle in the autumn of that year. I am sure many Members will have heard about that case in the media; in short, Mr Jabbar was accused of inappropriate and unnecessary surgeries that led to life-changing injuries for children in his care.

Sarah McMahon wrote to suggest an external review, but nothing was done to address her concerns and Mr Jabbar was allowed to continue operating on children. She tells me:

“I was effectively told to keep quiet and concentrate on my own patients.”

Despite that, Ms McMahon bravely continued to raise concerns about Mr Jabbar and the harm caused to children in his care, and in February 2023—some 18 months after she first raised her concerns—an investigation by the Royal College of Surgeons began. That investigation concluded in spring this year and the outcome is now well known. When the investigation was launched, Sarah learnt that Mr Jabbar had raised counter-allegations against her. It was only last week that Sarah was given any information about those counter-allegations, which Great Ormond Street hospital has now confirmed were completely unfounded.

How terrible it must be for a surgeon doing their very best, working alongside a colleague with no animosity, and then discovering that there were problems. Sarah had to raise her concerns; it was absolutely the right thing to do, professionally and for the patients. She wrote to me about her experience of raising the alarm, saying:

“I have since been threatened with disciplinary action without proper basis. I feel sidelined and excluded in my work and I am exhausted. The impact of this stressful process on my health, family, reputation, and career has been profound. I feel greatly let down by the way I have been treated as a whistleblower.”

Three years into this ordeal, it is clear that hospitals cannot mark their own homework when it comes to whistleblowing concerns.

I want to raise with the Minister some points, not all of which are directly related to his portfolio. I hope that he and his civil service officials will take them back to the relevant Departments, as I ask him directly for a detailed response. An amendment is proposed to the Employment Rights Bill that would give further protection to whistleblowers; I hope it will be considered sympathetically or, if necessary, rewritten by the Government to make it work and deliver on that intention. I also hope that the Cabinet Office works hard to improve the situation across Whitehall. Its representatives appeared before us when I chaired the Public Accounts Committee, so we know that there are some bits of good practice, but a lot more needs to be done. I hope that the Government commit to making that a high priority.

I will not repeat the points that were made very well by my hon. Friend the Member for Stoke-on-Trent Central about the importance of the duty of candour, but I will say that we need that to be embedded in the system if we are to change the way these things work. I endorse the points made about the office for the whistleblower. Crucially, I hope that the Minister will talk to the Department of Health and NHS England. If we want to modernise our health service and ensure that patients are safe, we need to support brave people—like Sarah McMahon—who have had to go through the mill to raise concerns that have been proven to be very well-founded.

I will end with Sarah’s own words:

“Unless the safety system is radically reformed my advice to future colleagues facing this problem would be: ‘raise it, because you must, but do not expect to survive what follows.’”

What a terrible indictment of the system so far. I hope the Minister takes that message back to the relevant Departments.