A man does what he must – in spite of personal consequences, in spite of obstacles and dangers and pressures – and that is the basis of all human morality
Sir Winston Churchill
The raising of concerns about wrong-doing or malpractice in the workplace or in other spheres of public life requires virtues in those who raise such concerns, virtues that include – courage, determination, empathy and self-sacrifice. Those individuals, often termed ‘whistleblowers’, can find their lives and the lives of their families ruined as a result of their decision to speak out. They may suffer miscarriages of justice as a result of going through dismissal hearings that are effectively ‘show trials’ or ‘kangaroo courts’, and may of course be quite humiliating. It can, however, sometimes be difficult to distinguish genuine whistleblowers from those who have perhaps made a mistaken judgment or who may even be insincere in their beliefs or motives when raising a concern. It is important therefore to bear in mind the challenges that face those who have to make a decision on whistleblowing concerns, be they managers, politicians, journalists or judges. Some dismissals or suspensions of staff may of course be fair and justifiable for reasons such as patient care. However, too often they seem to be used for reasons relating to ‘internal politics’, or where someone such as a whistleblower is labelled as ‘a troublemaker’ and he/she is suspended or dismissed for the flimsiest of reasons or under some general charge of ‘bringing the Trust into disrepute’.
The following articles highlight some of the issues that can arise in the case of whistleblowing in healthcare settings. Click on blue text to download file or connect to website.
Abbasi, K. (2011). Editorial: A way forward for whistleblowing. Journal of the Royal Society of Medicine, 104: 275. PDF File
Ash, A. (2016). Whistleblowing and Ethics in Health and Social Care. London: Jessica Kingsley Publishers.
Bolsin, S et al. (2011). Whistleblowing and patient safety: the patient’s or the profession’s interests at stake? Journal of the Royal Society of Medicine, 104: 278-82. PDF File
British Psychological Society (2014). Whistleblowing: an independent review. [Submission to the Francis Review into Raising Concerns]. PDF File
Case, P. (2011). Putting public confidence first: doctors, precautionary suspension and the General Medical Council. Medical Law Review, 19: 339-71. PDF File
Clwyd A, Hart T. (2013). A review of the NHS Hospitals complaints system. Putting patients back in the picture. UK Department of Health. PDF File
Drew D. (2014). Little Stories of Life and Death @NHSwhistleblowr. London: Matador.
Edgar, A. & Pattison, S. (2011). Integrity and the moral complexity of professional practice. Nursing Philosophy, 12: 94-106. PDF File
Edgar, A. & Pattison, S. (2011). Editorial: The problem with integrity. Nursing Philosophy, 12: 81-82. PDF File
Gornall, J. (2009). The price of silence. BMJ, 339: 1000-4. PDF File
Griffith, R. & Tengnah, C. (2011). Whistleblowing and the law. British Journal of Community Nursing, 16: 142-5.
Health Select Committee (2015). Complaints and Raising Concerns. House of Commons. PDF File
Hilton C. (2016). Whistleblowing and duty of candour in the National Health Service: a ‘history and policy’ case study of the 1960s and 2010s. Journal of the Royal Society of Medicine, 109: 327-330. PDF File
Hughes H, Churchill N. (2017). Speaking up in the NHS in England: the work of the National Guardian and NHS England. British Journal of General Practice, 67: 198-199. PDF File
Jones, A. & Kelly, D. (2014). Whistleblowing and workplace culture in older people’s care: qualitative insights from the healthcare and social care workforce. Sociology of Health and Illness, pp 1-17. PDF File
Kapur, N. (2014). The NHS needs a staff support commission. Health Service Journal, June 27. PDF File
O’Dowd, A. et al. (2010). Whistle while you work. BMJ, 340: 1110-13. PDF file
Peters, K. et al. (2011). The emotional sequelae of whistleblowing: findings from a qualitative study. Journal of Clinical Nursing, 20: 2907-14.
Pink, G. (2013). A Time to Speak. London: RCN Publishing.
Private Eye Magazine, July 22, 2011 – special 8-page report on whistleblowing, entitled Shoot the Messenger. See in particular the excellent piece at the end of the report, How to Skin a Whistleblower, by the late Dr Peter Gooderham who tragically died in 2011 at the age of 46 years, and whose words so vividly mirror many of the first-hand experiences of victimised NHS staff. PDF File
Public Administration Select Committee (2014). More Complaints Please! An inquiry into whistleblowing and raising concerns, with special reference to the NHS. House of Commons, London. PDF File
Public Concern at Work. (2013). Whistleblowing. The Inside Story. Public Concern at Work and the University of Greenwich. PDF File
Sieber, J. (1998). The Psychology of whistleblowing. Science and Engineering Ethics, 4: 7-23. PDF File
Whitehead, B. & Barker, D. (2010). Does the risk of reprisal prevent nurses from blowing the whistle on bad practice? Nursing Times, 106: 12-15.
Wilkes, L. et al. (2011). Nurses involved in whistleblowing incidents: sequelae for their families. Collegian, 18: 101-6.
Wilmshurst P. (2013). No doctor should be untouchable. BMJ, 346: f2338. PDF File
Websites that give information and advice related to raising whistleblowing concerns in healthcare settings
Freedom to Speak Up – The website for the Review into Whistleblowing in the NHS by Sir Robert Francis
Patients First – A campaigning website for whistleblowers
Action against medical accidents – A charity for patient safety and justice
Medical Harm – Articles on healthcare concerns, in conjunction with Private Eye magazine
South West Whistleblowers Action Group – Action group on NHS whistleblowing issues
Public Concern at Work – Helps to raise whistleblowing concerns in the workplace
Doctor Foster Unit – Academic unit that gathers data on patient safety and patient care
NHS Reform Group – Covers issues relating to poor patient care and whistleblowing
Cure the NHS – Patients and relatives involved in the Mid Staffordshire hospital scandal who seek to improve patient care and safety
NHS Whistleblowing Helpline – In the UK, NHS whistleblowing helpline – 08000 724 725
Cause – Campaign against unnecessary suspensions and exclusions in the NHS
Doctors Support Group – Provides assistance and support to doctors and dentists facing suspension, exclusion or investigation
Suppression of Dissent – Website of Professor Brian Martin (University of Wollongong, New South Wales, Australia) which has a wide range of useful academic resources on topics related to whistleblowing
Doctors Defence Service – Although this is a legal firm that specialises in the defence of doctors, its website has some useful summaries of employment law and regulatory proceedings in past cases
Whistleblowers UK – Enables whistleblowers to make contact with media such as the press, and also has links to legal firms
NHS Forum – allows staff in the UK National Health Service to make comments and discuss key issues without fear of reprisal
Sharmila Chowdhury – Sharmila Chowdhury tells her story, and has a number of useful resources and links to whistleblowing in the NHS
For those NHS staff who find themselves subject to investigation, exclusion or dismissal, or for those who are interested in current regulations and their limitations, the following articles and documents may be helpful
Department of Health (2005). Maintaining High Professional Standards in the Modern NHS. PDF File
Department of Health (2006). Handling Concerns about the Performance of Healthcare Professionals: Principles of Good Practice. PDF File
Hendy, J. (2007). Employers’ discipline of doctors in the NHS. In: Savage, W. (Ed). Birth and Power: A Savage Inquiry Revisited. London: Middlesex University Press. PDF file
Hendy, J. (2008). Multiple medico-legal jeopardy. Talk to Royal College of Physicians and Faculty of Forensic and Legal Medicine. PDF File
Jones, J. (2000). Hospital doctors face rising threat of suspension. BMJ, 321: 72. PDF File
Kapur, N. (2013). You’re fired. What next? BMJ. January 12 issue. PDF File
Margerison, N. (2008). Problem psychiatrists? Advances in Psychiatric Treatment, 14: 187-97. PDF File
Stewart, H. (2005). Editorial. Hospital disciplinary procedures. Hospital Medicine, 66: 326-8. PDF File
Tomlin, P. (2003). The suspensions scandal. Journal of Obstetrics and Gynaecology, 23: 221-227. PDF File
Young, J.R. (2008). The Hospital Revolution. Doctors Reveal the Crisis Engulfing Britain’s Health Service. London: Metro.