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NHS Whistleblowing

I congratulate the hon. Member for Wyre Forest (Dr. Taylor) on securing this debate on such an important and topical issue. Let me at the outset state unequivocally that the Government support whistleblowing and the NHS is expected to support it too. The NHS exists to serve the needs of patients and the public, not for the convenience of managers or staff. Staff have the right under the law and a professional duty to raise any concerns that they may have about the quality of patient care with their employer. They must feel free to raise legitimate concerns with their line managers, more senior managers or, on occasion, publicly. NHS organisations are required to have policies and procedures in place that support, encourage and celebrate whistleblowing. In well run organisations, it should not get to the stage where staff feel they have to approach their MP or go to the media. Legitimate concerns will be listened to and acted on. Of course, it may not always be easy to distinguish between someone who has a genuine, legitimate concern, and someone with a personal grievance or axe to grind. Good management is about being able to make the distinction in an atmosphere where people feel able and encouraged to come forward. Of course, there is also an onus on the concerned member of staff to act responsibly and professionally. They should go through the correct procedures first and only go public if they feel their concerns are not being listened to or acted upon. Back in 1998, one of the first pieces of legislation passed by the new Labour Government was, as the hon. Gentleman has mentioned, the Public Interest Disclosure Act 1998, which provided statutory protection for whistleblowers for the first time. He described it as a vital piece of legislation—and, indeed, it is. It came partly in response to a report by the Nolan Committee on Standards in Public Life, which had criticised the fact that people often felt compelled to go public with concerns because of the lack of protection for whistleblowers and the lack of robust procedures in place for organisations to deal effectively with employee concerns. The Government require every NHS organisation to have policies and procedures in place to comply with that Act. Indeed, we have seen a significant increase in the number of successful whistleblowing exercises thanks to the Act, and there have been hundreds of successful uses of the Act—for example, the case of a cleaner at Charing Cross hospital, who raised concerns about cross-contamination due to unsafe hygiene practices in 2005. She was initially dismissed, but an employment tribunal found that her concerns were well founded and that the 1998 Act applied. She was reinstated and awarded £7,000 compensation. We have also commissioned a charity that specialises in the issue called Public Concern at Work. It provides an independent helpline that is staffed by lawyers with expertise in whistleblowing. That is available to all NHS staff and calls are treated in the utmost confidence. Last year, Nursing Standard magazine, along with Public Concern at Work, asked nurses about whistleblowing. Of those who had been concerned about a serious risk to patient safety in the last three years, 87 per cent. had raised that concern—43 per cent. did so with their line manager, 18 per cent. with their team leader and 20 per cent. with senior management. Some 232 nurses said that they had successfully blown the whistle and protected patients from harm by doing so. When asked if they would raise such an issue again, 85 per cent. said that they would. Public Concern At Work said:""Week in and week out, staff blow the whistle across the NHS…This is a welcome change from the culture that bedevilled the NHS a decade or more ago where staff were too scared to raise concerns and which allowed the scandals of Harold Shipman and the Bristol Royal Infirmary to go unchecked for so long."" We also know from our staff surveys that more and more NHS staff know about their right to whistleblow and how to go about doing it. The hon. Gentleman raised two recent high-profile cases that have brought whistleblowing to people's attention. Let me deal first with the case of Margaret Haywood. She was the nurse who, in 2005, helped the BBC's "Panorama" programme make a film highlighting poor quality care at the Royal Sussex hospital in Brighton. She was recently struck off by the Nursing and Midwifery Council. I do not intend to go into the ins and outs of the case. The NMC is an entirely independent professional regulatory body and its fitness-to-practise panels operate independently within it. That independence is a vital component in securing public confidence in the system. Hon. Members can read the NMC panel's report at their leisure. It is still open to Mrs. Haywood to appeal to the High Court against the decision. Her union, the Royal College of Nursing, has said that it will support her in any appeal and has made it clear that it thinks that, given the range of sanctions available, the decision to strike Mrs. Haywood off was unduly harsh. Having studied the report myself, and having considered the wider implications of the ruling on our whistleblowing policy, I have to say that I agree with the RCN's position. I can confirm, as the hon. Gentleman asked, that the NMC does not have the power to overturn the decisions of its panels itself. The appeal must be made to the High Court. The second recent high-profile case that the hon. Gentleman raised in connection with whistleblowing was the devastating report by the Healthcare Commission into the standards of care at Stafford hospital. He raised one of the great questions in this case, which was highlighted in the Healthcare Commission report and by others who have looked into events at the hospital in more detail: where were the whistleblowers? Where were the professionals, the royal colleges and the unions? Since the report was published, there have been suggestions that some staff did raise concerns but were not listened to. I urge anyone who has had experience of that or has had it reported to them to bring evidence of such examples forward. But, to be frank, given what we know was going on at the hospital, one would have expected not one or two whistleblows but a cacophony of whistleblowing. One of the things that is clear about how the hospital was run is that there was a closed culture in which the management failed to take public and staff concerns seriously. In response to the two follow-up reports on Stafford hospital that were published last week, the Government announced a range of measures to ensure that NHS organisations fulfil their existing obligations to include the public and staff in decision making, including taking their concerns seriously. We also announced that we will reinstate a question in the annual staff survey asking people what they think of the quality of care where they work. As the hon. Gentleman rightly said, it was one of the measurements that helped alert the Healthcare Commission to the problems at Stafford. I understand that the commission—it is its survey, not ours—dropped the question in 2007 because of concern that it might skew results against certain types of provider; for example, a psychiatric hospital where staff may answer when asked whether they would be happy to be treated in their hospital with, "No, because it would mean that I have a mental health problem." A problem with the wording led the commission to drop the question from its survey, but we strongly believe that asking staff what they think of the quality of care in their hospital is important, and that, done anonymously, it can tell a great deal about the quality of care at a hospital. I hope that I have made it absolutely clear to the hon. Gentleman, both in my general remarks and in what I had to say about the Margaret Haywood and Stafford hospital cases, that the Government fully support whistleblowing. We have provided unprecedented legal protection for those who whistleblow and have emphasised those rights in the new NHS constitution. We will not tolerate management that bullies or discourages whistleblowers. Listening to and acting on the concerns of staff are vital ways to drive up standards and help ensure against poor or unacceptable quality care.