There has been something of a trumpet voluntary on the whistleblowing front over the last week. The King, Queen and Godfather of medical whistleblowers have co-authored a paper, which the JRSM has foolishly – it’s about whistleblowing, for Heaven’s sake – hidden behind a paywall – only to allow its publication, via Queen Blow’s own website. Radio Horlicks simmered away on Thursday, with a half hour Report featuring the shimmery voiced Dr Kim Holt. And the Eye (related website here) has produced a Shoot The Messenger NHS Whistleblowing ‘Special’, an eight page dossier of gagged and stuffed doctors hung out to dry, complete with red borders and menacing target images. Queen Blow, however, is conspicuous by her absence from this report – apparently following an iPal tiff – so leaving the Eye a Wonderbra short on the sex appeal front.
All this tittle-tattle has nonetheless been too much for the Rt. Hon. Wood Ash MP, still warm from his bit part in Basic Instinct III, who has now promised inquiry into the treatment of NHS whistleblowers. But, frankly, worthy as it may be, an inquiry has all the promise of a bonfire in a thunderstorm. It will smoulder, as Wood Ash does, but produce little heat, and no light. And all the while, trusts will continue to toast whistleblowers with impunity.
It is not as if we don’t know there is a problem: we most certainly do. All the recent reports, and indeed many past reports, bear testament to a major problem. The problem is not so much knowing that there is a problem, as knowing what to do about the problem.
The Radio Horlicks’ Report is long on problems, but short on solutions, although it does make it clear that the gagging clauses – which function like super-injunctions – used to silence whistleblowers are illegal. The Eye is hot on ‘something must be done’, but cooler on the practical detail of what that ‘something’ should be – sanctions must be enforced, safety enshrined, the gaggers gagged, etcetera, plus a ‘fast and dirty’ – dirty? – crash squad, alongside an American-style ‘National Whistleblower Centre’. The JRSM authors, fettered by the constraints of a learned journal, warm to a way forward paved with professional consultations and governmental reviews, and – like the Eye – an American-style ‘National Whistleblower Centre’, but offer nothing substantial on tackling the GMC – despite the fact that the body of the paper contains a substantial section that strongly suggests that, at present, the GMC, far from being part of the solution, is part of the problem.
As indeed it is. Almost invariably, medical – doctor – whistleblowers will find themselves reported, all too often on vexatious grounds, by their trusts – trusts, it should be noted, that act with connivance of the whistleblowers former ‘colleagues’ – to the GMC. The GMC may take the whistleblower’s complaint with one hand, but, more often than not, it will then stab back with the other. Doctors contemplating whistleblowing know only too well that such a fate almost certainly awaits them if they do whistleblow, and so they hold back. And so it is that the body that should help concerned doctors to speak out – indeed, its guidance says they must speak out – acts instead to deter whistleblowers.
The double edged sword of the GMC’s conduct is however only a reflection of the fundamental, underlying problem that whistleblowers face, which is that the whistleblower is invariably doomed by the colossal imbalance of power between the whistleblower, and the ‘establishment’ he or she seeks to expose. Once the whistleblower blows, he or she enters a David and Goliath world where neither good, let alone God, but Goliath decides the outcome.
Now, there are some practical changes that could be made now to improve the whistleblower’s lot – notably effective enforcement of the gagging clause ban, with custodial sentences for the perps (and that includes the BMA who often negotiate these clauses) – but if we are serious about doing something to encourage responsible whistleblowing then, above all else, we need to fix the imbalance of power problem. As things stand, the trusts have all the toasters, and the whistleblower all the Hovis – and we all know what happens to Hovis in the face of a toaster.
On paper, it might appear the obvious candidates to address this imbalance of power are the medical defence unions. Doctors pay large sums of money to these organisations to protect their professional reputation, and never is a doctor’s professional reputation likely to be more under threat than when whistleblowing. But in the main, defence organisations, conspicuously absent from this week’s reports, have emerged a dismal, spineless lot – which they can be, because most of the relevant cover they provide is in fact discretionary – when called to the assistance of a whistleblower in distress.
What we need, it seems to Dr No, is one simple action. We can drop all the consultations and inquiries, all the noble aspirations to change the culture to one of openness and transparency – sorry it just isn’t going to happen, because to the establishment the whistleblower will always be a sneak and a grass – and the other myriad recommendations. Instead, what we need is to set up, at the earliest opportunity, a powerful, properly funded National Whistleblower Centre. It makes sense financially – think how much money would be saved had there been no Bristol, no Baby P, no Mid-Staffs – but far more importantly it makes moral sense, not just for whistleblowers, but also for patients.
Backed by a powerful capable Whistleblower Centre, a Centre with both the means and the power to stick the knife back into the establishment toasters, and fuse their miserable elements, whistleblowers will at last be able to step forward and say: ‘Trust me, I’m a whistleblower’.