NHS Whistleblowers

Mike Hill Excerpts

Wednesday 18th July 2018 Westminster Hall

[Dr Whitford]

Obviously, I am unaware of the individual case and the rights and wrongs of it. However, a review of the cost of whistleblowing as it stands shows that having an effective system and effective law would save us money overall.

Sir Robert Francis envisaged “freedom to speak up” guardians in each trust, to whom whistleblowers could go informally to seek advice and support. Such guardians are in all trusts across England. They include a wide range of people, and the appointment system is not altogether clear or transparent. We will have to look at what kinds of staff work best, whether appointments have been appropriate, and whether whistleblower guardians can recognise, if they are clinicians—which many of them are—that there might be a conflict of interest, because the issue might be in their department. The national guardian has been in place since 2016, but her position is non-statutory and sits inside the Care Quality Commission. Her role is described on the website as “leading cultural change” rather than deciding individual cases.

Through all the publicity, there has been quite a change in atmosphere and tone. The whole issue has had a significant airing. In Scotland, we have an alert and advice line run by Public Concern at Work. It is interesting to see the changes from the second half of 2016 to the first half of 2017. The number of concerns that the hospital, or the health board as it is in Scotland, admitted immediately were valid—instead of their having to be proved, or their being put off—went from 0% to 14%. The number of those that were ignored or denied dropped by 30%, and those reported to a manager or a senior manager went up by 30%. That suggests quite a difference in practice. The numbers are quite small, but they suggest a pattern. The data showed that, naturally, the most common group to report is nurses—they are the biggest employed group within the NHS—and the most common reason was still patient safety.

The problem is that that is all still legally underpinned by the Public Interest Disclosure Act, which was passed in 1998. It was a private Member’s Bill very similar to one that had been introduced a few months before. It therefore did not have a Second Reading, and it had only one day in Committee. At the time, it definitely was ahead of what was going on elsewhere, and was a recognition of the importance of whistleblowers, but that was 20 years ago. It really is time for change.

[Mike Hill (Hartlepool) (Lab)]

Does the hon. Lady agree that workers are still put off by responses to whistleblowing allegations and, under the legislation, the threat of disciplinary action if the complaint is perceived to be malicious?

[Dr Whitford]

I utterly agree. It is important to be clear that a disclosure in the NHS, which is what we are focusing on, regarding patient safety as opposed to employment issues, which are quite separate and dealt with differently, is in the public interest. The problem is that in cases where whistleblowers have been punished and have suffered detriment, what starts as reporting becomes a bullying and harassment issue that ends up in a normal employment tribunal setting, and the original concern is not dealt with.

--- Later in debate ---

[Mike Hill (Hartlepool) (Lab)]

Thank you, Mr Davies, for allowing me to speak under your chairmanship.

I absolutely agree with the aspiration of the hon. Member for Central Ayrshire (Dr Whitford) to put in place a separate level of protection. My experience of whistleblowing comes from my experience of many years as a full-time trade union official for Unison. I remember the original PIDA being enacted, and that immediately afterwards employers were scurrying about to design internal policies to make it hard for whistleblowers even to come forward, let alone to proceed with a complaint in comfort and with protection. Many of those policies emphasised that, if the complaint were malicious, it could end with disciplinary proceedings. Certainly the policies were not favourable to the spirit of the legislation.

I agree with everything that has been said, but I must underpin my opinion that employment law must sit alongside the matter in question—there must be protections for workers. Yes, we have had the Francis review, but let us not forget the recent Gosport War Memorial Hospital inquiry, which shows that PIDA is clearly not working as a self-policing device within big employers such as the NHS.

I remember the Winterbourne View scandal. The investigation originated with a different kind of whistle- blowing, through “Panorama”, but it came out of staff concerns. The scandal not only affected how mental health patients were treated in their communities from thereon in—it exposed the difficulties of working in such an environment—but had a knock-on effect for NHS employees. From my time with the Tees, Esk and Wear Valleys mental health trust in Hartlepool, I remember the movement of workers, with patients, into localities. That was disruptive to their jobs and lives; sometimes it led to job losses, so there are consequences.

There are also difficulties with whistleblowing. Often, whistleblowers will blow the whistle at inappropriate times. For example, they might be subject to internal inquiry or a disciplinary, and if the whistleblowing comes at that point it can be seen as disruptive, even when it is not deliberately so. However, that should not deter any important review of the basis of that whistleblowing.

I agree with the hon. Member for Central Ayrshire that local proceedings should be dealt with separately, with whistleblowing dealt with centrally from an independent perspective. We are not just talking about the NHS; there has also been whistleblowing in the civil service, for example.

I hate to see victims. As a trade union activist, I have seen too many victims. Equally, I have seen too many patients let down in mental and core health. Whistleblowers can be young or old. Young people are often concerned about peer pressure. They learn about whistleblowing on the job, and they might see obvious things that more experienced people do not. People at the older end of the shift also whistleblow, for whatever reason, about important issues that are stark-staringly obvious to them. Such things must be taken seriously. We cannot go on and have more and more patient deaths on our hands because we do not have a proper structure.

I apologise to the hon. Member for Stirling (Stephen Kerr). I was interested in the APPG, but I was unable to get there. I have always been keen on the issue. We cannot have a glass-half-full or glass-half-empty situation. We have to have protections for workers, whistleblowers and patients. We cannot live our lives through television investigations, or organisations such as the Nursing and Midwifery Council saying they have fit-for-purpose policies to deal internally with such issues. Whistleblowing is a global matter of protection for all. I appreciate the opportunity to speak in this important debate.