Whistleblowing

Debate between Norman Lamb and Justin Madders

Wednesday 3rd July 2019 Commons Chamber

[Norman Lamb (North Norfolk) (LD)]

I beg to move,

That this House calls for a fundamental review of whistleblowing regulation to provide proper protection for a broader range of people.

I thank the hon. Member for Stirling (Stephen Kerr) for his support in making the application to the Backbench Business Committee and all the other MPs who supported the application. I also thank the Backbench Business Committee, the Chair of which is sitting in front of me, for enabling this incredibly important debate to take place. I want to start by telling four brief stories to illustrate why facilitating whistleblowing is so important.

I was the Minister in the then Department of Health who initiated the review led by James Jones, the former Bishop of Liverpool, of the horror of what happened at Gosport War Memorial Hospital. In his report from June last year, the very first chapter deals with the nurses who tried to speak up in 1991 about what was happening in that hospital. However, the report refers to the silencing of those nurses’ concerns and to a patronising attitude towards them, although they were trying to do the right thing. The consequence of not listening to those nurses is the extraordinary and horrifying conclusion of the report, which is that over 450 older people died following the inappropriate prescribing of opioids. These old people had gone in for rehabilitation but came out dead.

In this context, we can often be talking about life and death situations, so enabling and empowering people to speak up can literally save lives. That, at its most clear and stark, is why this matter is so important. The horrific scandal at Gosport hospital could have been stopped if those nurses have been listened to, but they were not, and that is an outrage in itself.

Scrolling forward to 2013, Dr Chris Day, a brave junior doctor working in a south London hospital, raised safety concerns about night staffing levels in an intensive care unit. It is in all our interests that brave people should speak out about safety concerns in any part of our health service, but perhaps particularly in intensive care units.

What happened to Dr Day, because he spoke out, is wholly unacceptable. He suffered a significant detriment. His whole career has been pushed off track, and his young family have been massively affected. Junior doctors in that unit were put in the invidious position of being responsible for far too many people compared with national standards, so he pursued a claim against both the trust and Health Education England. The NHS spent £700,000 of public money on defending the claim and, in large part, on attempting to deny protection to junior doctors who blow the whistle against Health Education England. Lawyers, disgustingly, were enriched.

Late last year, the tribunal that eventually heard Dr Day’s case ended early after he was threatened with a claim for substantial costs. He and his wife could not face the prospect of losing their young family’s home, so he caved in. That is surely scandalous treatment of a junior doctor. He was defeated by superior firepower. We have the grotesque spectacle of the NHS, of all organisations, deploying expensive QCs to defeat a junior doctor who raised serious and legitimate patient safety issues.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I pay tribute to the right hon. Gentleman’s work on Dr Chris Day’s case to get the answers we deserve on how he has been treated. Many whistleblowers face an inequality of arms at tribunals. They have often lost their job by that point, and they face a very difficult situation, with highly paid QCs running rings around them, which is often the result of employers trying to find loopholes in the law to avoid liability.

[Norman Lamb]

I thank the hon. Gentleman for his support in pursuing the Dr Day case, and I completely agree with the points he makes.

Sir Robert Francis, in his 2015 “Freedom to Speak Up” report, spoke about how NHS whistleblowers who had given evidence to him overwhelmingly experienced negative outcomes, and he talked of a hostile culture of fear, blame, isolation, reprisals and victimisation—in our NHS, for goodness’ sake.

Those stories continue. The impact on individuals can be devastating and profound. They can be ostracised, abused and disadvantaged in their career, with dire consequences for their mental health. One nurse who tried to expose wrongdoing said, “I would never put myself in that position again. I would rather leave.” What a damning indictment of how we treat people in our treasured and cherished public service.

--- Later in debate ---

[Justin Madders]

My hon. Friend raises an important point, and that is something I will come on to later. The current legislation is retrospective. It is righting wrongs after they have occurred but, as we have heard, it is too late to put a career back in place after the event.

In the NHS, it is particularly important that people feel able to blow the whistle safely, not only because they have general obligations as an employee, but because many staff have a professional duty to raise concerns where they see them and could actually be in trouble with their own regulators if they do not do so. NHS England and NHS Improvement policies are very clear on this. They say:

“If in doubt, please raise it. Don’t wait for proof. It doesn’t matter if you turn out to be mistaken as long as you are genuinely troubled.”

The NHS constitution pledges that NHS employers will support all staff in raising their concerns. As we have heard on a number of occasions, however, that clearly has not happened. Fine words are not enough. Sadly, staff do not have the confidence to raise concerns without fear of repercussions.

The most recent NHS staff survey, in which staff were asked whether they would feel safe raising concerns about unsafe clinical practices, found that only a fifth said that they strongly agreed that that was the case, and three in 10 said that they did not feel safe raising such concerns. When asked whether they were confident that their organisation would address their concerns, just 14.8% of staff strongly agreed with that statement. Given that 17.8% of staff said that they had seen errors, near misses or incidents that could have hurt patients in the last 12 months, it should be deeply concerning to all of us that staff in the NHS do not feel that their concerns are being acted on.

As the right hon. Member for North Norfolk mentioned, junior doctor Chris Day was a prominent example of someone who blew the whistle and was treated appallingly. He raised legitimate concerns about staff ratios, then lost his job. The tribunal action that followed resulted in a lengthy and, in my view, wholly unnecessary legal battle in which Health Education England effectively sought to remove around 54,000 doctors from whistleblowing protection by claiming that it was not their employer. Four years and hundreds of thousands of pounds later, it eventually backed down and accepted that it should be considered an employer after all.

[Norman Lamb]

Is the hon. Gentleman aware that the contract between Health Education England and the trusts, which demonstrates the degree of control that Health Education England has over the employment of junior doctors, was not disclosed for some three years in that litigation? It was drafted by the very law firm that was making loads of money out of defending the case against Chris Day. I have raised this with Health Education England, but it will not give me a proper response because it says that the case is at an end. Does the hon. Gentleman agree that this is totally unacceptable and that it smacks of unethical behaviour for that law firm to make money out of not disclosing a contract that it itself drafted?

[Justin Madders]

The right hon. Gentleman highlights an important point, and in response I will quote something that Sir Robert Francis said:

“When asked for advice by NHS organisations about issues around public interest disclosure, legal advisors have tended to be influenced by an adversarial litigation—and therefore defensive—culture.”

That notion is clearly present in this particular case. At the end of the litigation, Health Education England said:

“Having never wished to do anything other than facilitate whistleblowing for doctors in training, HEE is happy to be considered as a second employer for these purposes if it removes a potential barrier for junior doctors raising concerns.”

However, as we have heard, that did not manifest itself during the four years of the litigation. Why did it take so long for HEE to accept that it should be considered an employer? What message does that send to NHS staff about the corporate attitude to whistleblowers? It is hardly encouraging.

Whistleblowers are a vital safeguard when all other systems have failed. As the right hon. Gentleman said earlier, there is a whole list of cases in which if the whistleblowers had been listened to earlier, lives could have been saved—Gosport, Morecambe Bay, Mid Staffordshire and Bristol Royal Infirmary. The Francis report shone a light on some of the completely unacceptable treatment that NHS staff have experienced. One individual told the inquiry that

“finding employment is proving very difficult and I question whether any of it was worth it”.

Another said:

“I have often been so depressed by this experience that I have often considered suicide.”

Damning words. It shames us all that some people feel that way for having done what we all think is right.

I acknowledge that some progress has been made on the protections afforded to NHS employees in recent years, particularly as a result of the “Freedom to Speak Up” report and the regulations brought forward by the Government to protect whistleblowers’ future employment prospects. I remain worried about other issues, however, such as protections for other workers who support whistleblowers. Where a team of medical professionals are working on the same thing, it is easy to envisage circumstances in which two or more employees notice an issue of concern together, but only one of them actually makes the disclosure. I raised that matter with the Minister, and it was made clear at the time that the only remedy available to the second person or other associated parties would be to register a grievance under their employer’s grievance policy. That protection is not strong enough, so we need to recognise that people work in teams. Unity is strength, and collective arguments are always better, so we need to strengthen the protections in such situations.

Another issue is that it is only once someone has lost their job that they can take their previous employer to an employment tribunal and seek redress, but the onus is on the whistleblower to prove that it was their disclosure that led to them losing their job. The Hospital Consultants and Specialists Association has come across many cases of employees facing action after speaking out based upon circumstances different from their whistleblowing case, but which appear to be clearly linked. Such action can be subtle, such as bullying, harassment, undermining, being overlooked for opportunities for promotion, or a general feeling that the employer may be looking for a reason to act against them. Of course, such instances are virtually impossible to prove, but they contribute to the climate of fear for whistleblowers, who may worry that they are only ever as good as their next mistake. We cannot continue to allow promising careers to be left in tatters as a result of ineffective whistleblowing protections. We must send a strong message to employers that, as the legislation intended, those making disclosures should be protected, not attacked.

By its very nature, the legislation only gives a person protection after a detriment has been suffered, when it is often too late. No tribunal can fully mend a destroyed career after a dismissal. It is disturbing that the success rate of whistleblowing claims that reach tribunal is only 3%, which shows how easy it is for employers to use parts of the legislation to avoid their responsibilities. I do not know of any other tribunal jurisdiction that has such a low success rate. If I was still practising and my success rate was 3%, I would not be in a job for long, but that percentage shows why we need to understand how the legislation is not working as well as it could be.

Of course, as we have already discussed, most employers are in a much better position. They are able to rely on expert legal advice, they can put forward alternative allegations and reasons for treatment, and they can allege misconduct or redundancy. There are too many hoops to jump through and too many opportunities for employers to argue that disclosure does not count under the legislation, which of course removes the employee’s protection altogether. That is wrong.

It is not enough for an employee to rely on their own assertion of subjective belief that the information tends to show a breach of regulations. That leaves them at the mercy of the roulette wheel of justice, and potentially having to wait many months before they can know for sure whether their disclosure will have full protection under the law.

In considering how the law operates, we need to examine whether protected conversations, which were introduced under the coalition Government, are working as intended. Of course, a person can have a protected conversation with someone without mentioning whistle- blowing at all, but a potential disclosure might have been raised earlier. Employees in that situation who have been told that there is a payment for leaving their employment are in a vulnerable situation, and they will not know for sure whether their disclosure would count. We need to see whether there is any correlation between protected conversations and disclosures made under the whistleblowing Act.

Whistleblowers should not only be protected but venerated for their role in defending the safety of others. Nobody who makes a disclosure, wherever they work, should do so in fear or at the risk of having their livelihood taken away. The whole culture of workplace protection in this country is one of extreme disposability, be it temporary and agency work, zero-hours contracts or just the ease with which people can be dismissed. This does not lend itself to a healthy environment in which people feel confident and secure in speaking out without fear of reprisal.

The truth is that we have allowed a situation to develop in this country where job insecurity is considered to be just part of the landscape. That has to change. We owe it to people to ensure that protections are as effective as possible, which is one of my tests for a decent and civilised society. At the moment, it is a test we are comprehensively failing.