NHS Whistleblowers

Debate between Mike Hill and Philippa Whitford

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.

Social Care

Debate between Mike Hill and Philippa Whitford

Wednesday 25th April 2018 Commons Chamber

[Dr Whitford]

I thank the hon. Lady for her intervention. In my years of working particularly as a breast cancer surgeon, where I was involved in the palliative care of my own patients, we often met that as a barrier. We started to have the fast response teams who could get hold of hospital beds and commodes and get the changes done, particularly for somebody who actually might not have very long to live.

Since 2015, those who are defined by their medical care team as being in the terminal phase of an illness, whether it is cancer, motor neurone disease or another condition, have not been charged for personal care or nursing care at home. This means that they are not delayed by means-testing, which is another thing that can end up keeping a terminal patient stuck in hospital for weeks and weeks that frankly they just cannot spare.

Younger people with disability have been mentioned. In England, approximately half of local authority spend, and in Scotland approximately 40%, is for the working-age disabled. However, Scope, a charity involved with those with disability, says that two thirds of those who applied to local authorities for care were offered no help and were simply signposted to other charities. The 83% who were given some care felt that they did not get enough hours for it to support them sufficiently.

When we discussed social care in October, I mentioned that in Scotland we were hoping to pass Frank’s law, which is in honour of Frank Kopel—a footballer who played for Man Utd and Dundee Utd and who, possibly related to heading the ball, developed dementia at a very young age. I am glad to report that this law has now been passed. Starting from April next year, those under 65 with degenerative, chronic and eventually terminal illnesses will also be able to have personal care, and this will simply be needs-based, as it is for those over 65. I pay tribute to his widow, Amanda, who fought for a very long time to raise the issue of people who are being excluded from care based on precisely when their date of birth is. However, the Scottish Government are trying to clarify with the Department for Work and Pensions whether providing this additional free personal care to someone under 65 will not result in cuts to their disability benefits, because to give with one hand and have it taken away with the other would be tragic.

The UK Government’s Green Paper provides a chance to step back and rethink care. Obviously, the aim is to achieve sustainable care—as I say, perhaps to look at more radical considerations such as combining it with health and not having it as an utterly separate system.

On those who are younger with disability, the Minister talked about a parallel workstream for the under-65s. What are the terms of reference for that? What can people with disability expect?

After the complete shambles of the 2017 manifesto, it is crucial that there are no sudden changes or things that catch people out, with no notice to prepare for what they might have to pay for care. This is something that will affect people in the future. We have all debated the WASPI women in this place. Let us not create a new tragedy of people who are trapped by some sudden change in how social care works.

As the Minister said, the workforce are absolutely key to the care service. This is a service that is utterly delivered by people. It is not high-technology or machines, and by and large, it is not hospitals. In Scotland, the homecare workforce has risen by 11% over the last three years, but all care providers are reporting that they are struggling to recruit, and all of them see that Brexit will make that much worse, because colleagues who have come from Europe, and particularly eastern Europe, make up a significant proportion of our social care workforce.

We need to value carers. They have often been treated far too much as a cheap workforce, and that says to people, “This is not a profession or a job to stay in long term. This is until you get something better.”

[Mike Hill (Hartlepool) (Lab)]

There are of course also carers who are not employed. I came across kinship carers in Hartlepool. Does the hon. Lady agree that kinship carers, and in particular those who receive no benefits, should also feature in this debate?

[Dr Whitford]

I thank the hon. Gentleman for his intervention. There are all sorts of aspects to the provision of care, for whichever age group or needs, and the Green Paper will fail if it does not result in us stepping back and taking a wider view.

It is important to pay the real living wage, which the Scottish Government already support and fund, and not the national living wage. All hours should be paid—that commitment is being consulted on in Scotland at the moment—and that should include travel as well as overnight care.

For local authorities that have social care within their service, this is the biggest driver of the gender pay gap. Men who empty the bins are paid considerably more than the women who are caring for our grandparents. We should think of job satisfaction and give them the time to care, not 15 minutes. We should think of continuity for both the patient and the carer, but particularly we need to think of the career structure and the training. Caring needs to be a profession, and a profession that is respected.