Exposing the reality behind the spin

Summary

I am a retired healthcare professional, a nurse prescriber with experience in senior management in both the NHS and private sectors. I worked as a clinician with vulnerable adults on the margins of society.

Over the past fourteen years I’ve become involved with a situation I was previously unaware of. The widespread marginalisation and victimisation of health and care staff who raise concerns about patient safety and lose their careers as a result. I’ve learned that this problem is part of a much bigger picture which affects all of society, all industries and public sectors, in all countries of the world.

In this blog I reflect on the situation in England based on my experiences and those of the many people I have met as a result. All of whom experienced the backlash that can happen when organisational reputation trumps patient safety. One thing many of us have in common is that, put simply, we never intended to become known as ‘whistleblowers’, we were just trying to do our job to the best of our ability.

In conclusion, I look at key areas to be worked on in order to protect the public and really ‘learn lessons’. These cross all sectors and areas of work. They include the need for changes in legislation, an end to self-regulation in healthcare and elsewhere, and recognition of the value to society of those who risk everything to fight for justice and truth.

A dawning realisation

I began to realise something was seriously wrong when I returned to clinical work in 2002. Having previously worked in senior management (as Head of I.T. in an NHS Trust) and management consultancy, I became concerned that my employer appeared to be putting reputation over patient safety, and if concerns were raised, they were not followed up. I recall looking at Board papers and directions to trusts from the Department of Health [DH] to try and understand this further. One thing I remember is a letter to Chief Executives from the Department of Health which talked about creating an ‘outward facing’ organisation. I didn’t realise at the time what I now see as the real meaning of this, and its link to the ‘no bad news culture’. This involves putting reputation above patient safety.

Later I tried to raise my concerns with a Trust Executive at an early stage, only to be told in both words and body language that the trust didn’t want to hear anything bad. This attitude, and what I saw happening to the team and staff around me, led me to leave the NHS and become self-employed working for the NHS on projects related to medicines and prescribing. Eventually my experiences led me to make a protected disclosure in 2014, in which I set out the patient safety concerns. As a result, the CQC requested an external investigation of my concerns.

Since being interviewed for the investigation report in 2014 I have heard nothing further. I never saw the investigation report and was never contacted about it. A freedom of information [FOI] request to the CQC produced the response that my concerns were dismissed as ‘all third hand’ (which is incorrect) and I was told that the CQC had ‘lost the report’.

Prior to the FOI request, I was employed as a CQC Specialist Advisor (a zero-hours contract), however following the FOI request this contract was ended without a specific reason being given.

The wider picture in healthcare

I’ve only briefly mentioned some of the aspects of my story here. The most important thing for me was that I found out the common themes behind all genuine healthcare whistleblowers’ stories.

Three things stand out for me.

1. The psychological effect on the whistleblower

I experienced the isolation that whistleblowers are subjected to and the psychological effect this has on individuals. Suddenly you’re on your own, and people you worked with avoid you. In my case, I also kept my distance from some co-workers, as I realised they were being bullied as a result of supporting me.

For me (now self-employed) offers of work dried up and a sickening feeling of being ‘sent to Coventry’ set in. In addition to the loss of income, this isolation has a deep effect on my mental health and home life. I believe the approach of employers here is called ‘gaslighting’. It’s deeply troubling.

2. The NHS cold shoulder / being blacklisted

Secondly, I have discovered through meeting other whistleblowers that blacklisting of those who speak out is very common. This can take many forms, ranging from informal blacklisting to interventions to prevent career development, to giving unsolicited (and unfair) bad references.

For those employed by the NHS the Electronic Staff Record [ESR], which is shared throughout the NHS can be used as a way of sharing detrimental information on whistleblowers. This has caused people to be denied a fair chance to gain further employment. I believe the full extent of this is yet to come to light.

In my case the blacklisting took the form of repeatedly being given the ‘cold shoulder’ for example being excluded from meetings; uninvited from regular meetings I was previously part of (without a reason being given); letters and emails not replied to, a higher education establishment being told not to engage with me, and generally being avoided. Of course, this is subjective, and sometimes I may be wrong, as healthcare is a tough work environment. However, I have been subject to some clear examples of ongoing detriment. This lasted right up to, and beyond, my retirement.

On one occasion my company was enthusiastically awarded a contract of work one day, then the very next day the same person ‘phoned me and cancelled the order saying only that it ‘wasn’t what they wanted’.  Very strange. Also, I found out years later that staff from the trust I worked for were told not to speak to me, even though in one case it was to ask me a question about my clinical work.

In addition, I was deeply upset when the NHS Trust, who commissioned one of my projects, failed to acknowledge its success. A poster was presented at the NICE Conference in 2015 and it was highly commended by NICE.

Prior to the Conference, I contacted the trust to let them know of the success and all attempts to engage the trust were ignored. As you can see on the poster (which was produced by NICE) the space for the trust’s logo, on the bottom left, is empty:

In fact, I have several examples of work on the NICE Shared Learning pages, none of which have ever been acknowledged in any way by local NHS Trusts, or any healthcare organisations in Cornwall.

3. The effect that the victimisation of healthcare whistleblowers has on patients

Thirdly, as I looked further into the problem, I began to see the full impact that the victimisation of genuine healthcare whistleblowers has on patients. This for me is the most shocking aspect of the problem.

In 2015 I set up the Turn up the Volume! Movement. This was an attempt to bring together all involved in an open and transparent way, with a focus on the core issue of patient safety.

Through this initiative I have met many more people in a similar situation and learned first-hand the effect lack of transparency and denial has on patients. This is well illustrated, for example, in the report of the Gosport Independent Panel Report (2018), where those who raised the alarm were initially listened to, then ignored and their concerns re-labelled as ‘allegations’. As a result of this, in the words of the report, ‘the lives of over 450 patients were shortened while in the hospital’.

Next steps

Based on my experience in trying to link together people in health and care with similar experiences and focus on patients, I believe there are three vitally important areas in healthcare that need addressing.

The need for an individual duty of candour

Firstly, I was shocked to find out that in the NHS the duty of candour (duty to tell the truth), brought in following the Mid Staffordshire inquiry, is an institutional duty of candour. This relies on staff telling the truth to their employer in order to highlight what went wrong.  Thanks to the tireless work of campaigner Will Powell the need for an individual legal duty of candour for professionals, managers & leaders in healthcare has been demonstrated. This has parallels to the calls for a ‘Hillsborough Law’. Without this, there is no real mechanism to hold individuals to account for cover-ups and for not being honest.

Making sure initiatives are effective

Secondly, I’m disappointed at the failure to learn and improve patient safety through listening to genuine whistleblowers, whether they be patents or staff, and failure to take measurable actions to change. I believe the effect of the National Freedom to Speak Up Guardian programme needs a full independent review (from outside the NHS). Evidence suggests it is making the situation worse in some trusts, where it is used as a cover for continued victimisation of those who speak out.

Ending self-regulation & providing independent oversight of whistleblowing

Thirdly, in common with industry, I believe that self-regulation in health and care does not work, and the only solution will be to set up a truly independent body to oversee and enforce this. This body must involve patients, who raise concerns at great cost to themselves and their families, against all the odds, often when people have suffered and died.

Health regulators in England and the people who they regulate are often uncomfortably close. For example, I was deeply disappointed when I found out only that the CQC Inspector involved in dealing with my concerns raised in 2013, later became employed as Compliance Lead in the same trust.

This is why I joined WhistleblowersUK and support the Protection for Whistleblowing Bill [HL] which includes setting up an Office of the Whistleblower. This will provide independent oversight of whistleblowing and support those working towards identifying and tackling the root causes of whistleblowing. This is one of the most pressing patient safety concerns of our time.

Author: Steve Turner

Revised and reposted: 27.05.2023

Related posts:

‘The systemic silent killer – ending the stigma around whistleblowing: a blog by Steve Turner’ (2023) on the Patient Safety Learning Hub.

Keeping it simple – Why ‘independent oversight of whistleblowing’ matters for patients – (14.04.2023) blog by Steve Turner on the WBUK web site.

Clegg, A (2022) How cronyism corrodes workplace relations and trust Financial Times. WWW: https://www.ft.com/content/98fdcde8-eba1-45b3-98a6-eceb5269e07c (accessed 23.01.2023)  

Mavis Bowers was born prematurely on 26th September 1929, at home in Bull Hill Stafford. She had a twin brother David who only lived for a short while. Mum was ‘smaller than a bag of sugar’ when she was born and for the first weeks of her life had to be washed in olive oil, dressed in doll’s clothes and a small drawer was used as a cot. Her birth wasn’t registered for two months.

When the picture of mum and the challenge shield was taken mum was eight months’ old, & still not able to sit up for herself. The wooden “Challenge Shield” was an engraved silver plaque for “Stafford Infant Welfare Centre’s Annual Competition for infants during their first year”. This began in 1920 and ended in 1948 (the year the NHS was set up). Mothers who won were presented with one small shield which they could keep, and the large ‘Challenge Shield’ which they kept for 12 months. They also pushed the baby in a pram along Stafford’s main street at Stafford Pageant. The silver plaque was made by G & S Ltd.
Mavis’s mother Frances Bowers brought up her three daughters on her own. They lived in Prospect Road, Coton Fields, Stafford.

Another picture shows Mum and her older sisters, Olive and Joyce with mum in her dad William Bowers’ arms . Shortly after this my grandad William went into St George’s Hospital, where he remained until he died, about 30 years later. Mum can remember visiting him in the hospital as a young child. She described how there were many doors to unlock and how the attendants (this was before mental health nurses) were very kind to her and her mother.
We now know granddad had some sort of post traumatic illness, although at the time people didn’t talk about it, and it was said he had been ‘gassed in the first world war’. We have now found out that Fabry disease runs in the family (originating on mum’s side). This rare enzyme disorder, which causes limb pain and organ degeneration, has been misdiagnosed as a mental illness in the past. We wonder if that’s what granddad was suffering from.

Mavis and her two sisters brought up in poverty by their mum Frances. Mum remembers her childhood as happy and secure. One of mum’s memories was being sent by her mum to fetch dripping from a local hospital. (Dripping is the fat and juices that come off roast meats.) Mum and her sisters had to take a walk across some fields, where they used to be frightened of the horses, and knock at the kitchen door of the hospital. They then gave a penny for a jug to be filled with dripping. Mum also remembered how her mother used to wash and dry the girl’s school clothes every night, as they only had one set of school uniforms.

Mum’s upbringing made her really appreciative of the small things in life and never to take anything for granted.

After leaving school at 14 Mavis started training as a seamstress and later worked at Lotus shoe factory. Mavis Bowers married Jim Turner a chartered electrical engineer, originally from Plymouth, who worked at English Electric in Stafford, and went on to have two sons, Steve and Nick. Mavis enjoyed sewing and, after the children left, worked from home as a seamstress. Mavis and Jim enjoyed travel and visited Europe often when they were older. At the age of 70 Mavis also went to Australia on her own and had the holiday of a lifetime travelling from Melbourne to Townsville in north Queensland, visiting friends of her son Steve who have lived there for 5 years. After 59 years of marriage Jim Turner died in 2016.

Mum took up paintings at age 80 and completed several pictures, some abstract and some from memory. The picture above is of Mungo Lakes, where mum visited when she was in Australia.

In the latter years of mum’s life she had glaucoma, osteoporosis Parkinson’s disease and heart failure and was unable to leave the house. Despite this mum remained independent and lived on her own, with carers visiting. This continued until a couple of years before she died, when she had a live-in carer.

For the final months of mum’s life she was cared for by Belinda Comfort Damoah. Belinda stayed with mum for six months, throughout the covid-19 epidemic, and is held in high esteem by mum, all the family and friends.

I was able to spend the final 12 weeks of mum’s life helping look after her at home, where she passed away in July 2020.

Belinda has recently spearheaded the formation of the Akwaama Toprefo Female Club (ATOFEC) which has the education of young women and the skills training of women as it’s objective.

We collected for this project at mum’s funeral, and the family is proud to be linked with such a worthwhile endeavor. Mum’s picture now hangs on the wall of the schoolroom.

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Written by Steve Turner Version dated: 14.12.2020

Revisions: Picture of Bull Hill, Stafford added. 25.01.2021

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Thanks to Melanie Williamson, Collections Assistant, Staffordshire Archives and Heritage, Staffordshire County Council for finding the shield and providing pictures and information.
Website: http://www.staffordshire.gov.uk/archives
Facebook: http://www.facebook.com/StaffordshireArchivesandHeritage
Twitter: http://www.twitter.com/@ArchandHeritage

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