Intended for healthcare professionals


Barriers to whistleblowing in the NHS

BMJ 2012; 345 doi: (Published 09 October 2012) Cite this as: BMJ 2012;345:e6840
  1. Kirsten Patrick, editorials editor
  1. 1BMJ, London WC1H 9JR, UK
  1. kpatrick{at}

Despite protection under the law, fear of retribution still deters those who would speak out

Bullying of staff by senior managers and a culture of fear—often born out of pressure to meet national targets—were some of the main findings of the independent inquiry into Mid-Staffordshire Foundation Trust by Robert Francis QC, published earlier this year.1 The failings at Mid-Staffordshire were unlikely to be unique to that trust, as NHS chief executive David Nicholson acknowledged at the time.2 Sure enough, a recent investigation into NHS Lothian’s management culture that followed the exposure of managers’ fiddling of waiting time figures elicited numerous reports from staff of overt and covert bullying. Threats such as “those of you with mortgages and career aspirations had better be afraid” left staff with little faith that the organisation would handle fairly any concern that they might have about a bullying senior manager.3

The need to change unhealthy ways of working within the NHS featured strongly at last week’s conference on whistleblowing, jointly hosted by the BMA and Patients First, a campaign group comprising healthcare professionals and managers committed …

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