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Editorials

Barriers to whistleblowing in the NHS

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e6840 (Published 09 October 2012) Cite this as: BMJ 2012;345:e6840

Re: Barriers to whistleblowing in the NHS

The way in which 'whistleblowing' is used by Patrick is probably wider than disclosures under the Public Interest Disclosure Act 1998 (1). What she is talking about is having an open culture in the NHS about performance management. I think the culture is shifting. And this makes me bold enough to talk about what happened to me when I was a 'whistleblower' in this wider sense (2). The fact that I have not done so until now shows that 'whistleblowing' has been a genuine problem.

My concern was, and still is, about inquiries into homicides by psychiatric patients, which can become destructive when deflecting obloquy becomes an overriding factor at the expense of professional consequences for staff (3). I think this is what happened with my own Trust's inquiry into the care and treatment of Richard King (4).

I produced a written critique of the Trust report, as it had been written to maintain public confidence in mental health services by identifying mistakes and errors of judgement. There were injustices for staff in the Trust action plan and I spoke informally to the Trust chair, who said it could not be changed. I, therefore, made clear that I would go to the Strategic Health Authority (SHA), which had a responsibility to commission an independent report following Department of Health guidance.

I did eventually receive a reply to my critique, to which I responded. Just before this, a formal investigation was initiated into me on another matter. This investigation led to me being told I would face a disciplinary panel, which never happened after I involved the National Clinical Assessment Service.

An independent SHA report was eventually produced (5), which I welcomed. I can't say for certain that the timing of the disciplinary matter was related to my raising concerns about the Trust report. What I can say is that it made it more difficult to keep on top of the process of following through on my concerns. There are still issues about homicide inquiries by psychiatric patients that need to be discussed openly.

(1) Patrick K. Barriers to whistle blowing in the NHS. BMJ 2012;345:e6840
(2) http://dbdouble.blogspot.co.uk/2012/10/barriers-to-expressing-concern-in...
(3) King, M. & 59 other signatories (2006) Community psychiatry inquiries must be fair, open and transparent [Letter] The Times, Dec 4.
(4) Norfolk & Waveney Mental Health Partnership NHS Trust. Panel report from the inquiry into the care and treatment of Richard King. 2005
(5) NHS East of England. "Looking through the reeds" 2008

Competing interests: No competing interests

15 October 2012
D B Double
Consultant Psychiatrist
Norfolk & Suffolk NHS Foundation Trust
Victoria House, 28 Alexandra Rd, Lowestoft NR32 1PL