Review condemns treatment of trust staff who blew whistle on poor careBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k653 (Published 09 February 2018) Cite this as: BMJ 2018;360:k653
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It is very disheartening to hear how NHS staff are able to cover their errors and harass the whistle-blowers,<1> while junior doctors are instructed to honestly document and reflect on their mistakes.<2> This double standard is not unique to only a certain NHS trust. The BMJ reported incidents concerning the lack of transparency about complaints raised in other NHS trusts.<3-5>. Nevertheless, junior doctors’ whistle-blowing could lead to their careers being destroyed by their employers.<6>
There has been ongoing debate on whether junior doctors' documented reflections could be used against them in court.<7> Furthermore, supervisors have the privilege to use the juniors' documented reflections to cover themselves in disciplinary investigations.<2> This blame culture must sound incredibly frightening to many junior doctors.
I wholeheartedly agree that junior doctors should be honest about their mistakes, but it is equally important that other NHS staff are doing the same. How can people convincingly tell the juniors to be honest, when they are not being credible role models themselves? This double standard would certainly further discourage junior doctors to act responsibly for their deeds.
1. Iacobucci G. Review condemns treatment of trust staff who blew whistle on poor care. BMJ. 2018;360:k653.
2. Dyer C, Cohen D. How should doctors use e-portfolios in the wake of the Bawa-Garba case? BMJ. 2018;360:k572.
3. Dyer C. Health watchdog to look again at reports on maternity services at Morecambe Bay trust. BMJ. 2013;346:f4017.
4. Dyer C. Morecambe Bay trust is criticised for lack of openness about complaints. BMJ. 2014;348:g1860.
5. Dyer C. Francis report recommends a whistleblowing guardian in every NHS organisation. BMJ. 2015;350:h828.
6. Dyer C. Case of whistleblower whose career was "destroyed" prompts review of law. BMJ. 2016;353:i2910.
7. Humm GL, Sutton P, Gokani V, Mohan H. Association of Surgeons in Training responds to GMC erasure case. BMJ. 2018;360:k224.
Competing interests: I have received salaries from working as a medical doctor, but I am not paid to write this letter.
The independent review shaming a NHS trust for “bullying and harassing” staff who raised concerns about poor care and swingeing staffing cuts is counterproductive.(1)
First of all, the bar must be raised. Has the NHS ever commended those who dare to blow the whistle? Has the Department of Health acknowledged Stephen Bolsin for his crusade leading to the implementation of clinical governance? His first awards came from aboard: 1998 Civil Justice Award (Australian Plaintiff Lawyers Association) and 1999 Lambie-Dew Medal and Oration (University of Sydney). No reward is also bullying whistleblowers!
Second, scapegoating is always useless, even the trust.(1) Indeed, the worst are not the guys you whistle on, the worst are those around you who have known and accepted the state of affairs for too long. These latter are numerous, they are your peers, they cannot accept that their lack of action could be disclosed.(2)
The Employment Rights Act (1996) did not protect Stephen Bolsin from leaving England for Australia after he successfully disclosed the Bristol Royal Infirmary case. The United Kingdom has now the most protective legal framework for whistleblowers in Europe: the act was amended as the Public Interest Disclosure Act in 1998, and the Journal played a major role in supporting the Libel Reform Campaign--formed by Sense about Science, Index on Censorship, and English PEN.(3) In contrast, in France, blowing the whistle while a civil servant is a criminal offence ( https://www.legifrance.gouv.fr/affichTexteArticle.do;jsessionid=AEA190D6... ). Proctecting and promoting whistleblowers is far from being deep in the European culture in contrast to the American one.
Last, I’m puzzled by the term “treatment”.(1) However if anyone is caring for whistleblowers, it is the Journal: A Pubmed search among core clinical journals with “whistleblowers” retrieved 189 hits, 115 from The BMJ.
1 Iacobucci G. Review condemns treatment of trust staff who blew whistle on poor care. BMJ 2018;360:k653
2 Braillon A. Whistleblowing: neither reward, nor protection. J Public Health Policy 2010 Jul;31:278-9.
3 Dyer C. Defamation bill gives defence of qualified privilege to peer reviewed journal articles. BMJ 2013;346:f2691.
Competing interests: No competing interests