Whistleblowing and Ethics in Health and Social Care. Angie Ash. Читать онлайн. Newlib. NEWLIB.NET

Автор: Angie Ash
Издательство: Ingram
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Жанр произведения: Социология
Год издания: 0
isbn: 9781784501082
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organizational culture

       Designing ethical leaders

       Emotional intelligence and the ethical leader

       Emotional intelligence in the workplace

       CHAPTER 9 THE ETHICAL POINT OF WHISTLEBLOWING

       Leadership, Anti-Bathsheba style

       The virtue of whistleblowing

       POSTSCRIPT FOR THE WHISTLEBLOWER

       REFERENCES

       SUBJECT INDEX

       AUTHOR INDEX

NGONon-governmental organization, such as a charity or not-for profit agency
NHSNational Health Service (UK)
PCaWPublic Concern at Work, a UK whistleblowing NGO
PIDAPublic Interest Disclosure Act 1998 (UK)

      THE PARADOX OF WHISTLEBLOWING

      Many who report wrongdoing in the workplace – whistleblowers – become targets of harassment, intimidation, investigation, persecution and prosecution, to name but some acts of retaliation. The whistleblower may well be protected in law in a number of jurisdictions globally (the UK is one), yet that protection may not save them from the personal damage and professional detriment that is losing their job, career, family and financial security.

      Great claims are often heard about the heroism of whistleblowing and whistleblowers. Public Concern at Work (PCaW), a UK whistleblowing charity, paid tribute to the ‘important role that whistleblowing plays in achieving effective governance and an open culture’, and regarded whistleblowing as ‘one of the most effective ways to uncover fraud against organisations’ (PCaW 2013, p.5). Fine words may pour forth from the mouths of politicians, usually long after the mobilization of state-funded retaliation against the whistleblower has done its work. The then UK Prime Minister, David Cameron, said in the House of Commons in answer to an oral question on 24 April 2013 that, ‘…we should support whistleblowers and what they do to help improve the provision of public services’. While it’s always nice to be appreciated, even by a prime minister, the damage and destruction meted out to the whistleblower after they put their head above the parapet to speak out, suggests that relying on any appreciative accolades would be ill-advised. Grand words about the great job the whistleblower may do sit uneasily alongside evidence of the collateral, lifelong damage to lives, livelihoods, relationships, careers and health of those who stepped up to speak out: the whistleblowers.

      Whistleblowing is the raising of a concern in the workplace or externally, about malpractice, poor practice, wrongdoing, risk or danger that affects others. There is no common definition of whistleblowing internationally. The whistleblower is a person who raises concerns in the public interest. They may not recognize themselves as such at the time they do this. Their concerns may be about the safety of a patient or user of health or social care services, or the integrity of the health or care system itself, as in the case of theft, waste, deception and duplicity (Francis 2015).

      Whistleblowing – the act, the response, as well as the deafening silence of those who stand by in the face of wrongdoing – touches some very deep recesses of what it is to be human, to bear witness to wrongdoing, or to turn away. Most employees have observed wrongdoing. But most employers do not act to stop wrongdoing they know is going on (Miceli, Near and Dworkin 2009). These are but some of the paradoxes that whistleblowing presents, and which this book examines.

      The UK prime minister quoted above was barely out of college when Stephen Bolsin took up post as a consultant anaesthetist at the Bristol Royal Infirmary (BRI) in England in 1988. From the start of his time in that hospital, Stephen Bolsin was troubled by the very high mortality rates for children undergoing heart surgery. Bolsin’s were very serious concerns, substantiated by data on mortality outcomes. He raised these matters repeatedly with senior consultants in the hospital, with the national Department of Health, and the General Medical Council, the UK regulatory body of registered medical practitioners. When no action was taken by the hospital or the Department of Health, Bolsin took his concerns to the media. This prompted inquiry by the General Medical Council. Dr Bolsin was struck off the medical register. In 1995, he left the UK to work in Australia. Nineteen years after Bolsin first raised concerns, the public inquiry chaired by Ian Kennedy concluded that between 30 and 35 children had died unnecessarily, and that one-third of children undergoing heart surgery at the BRI prior to 1995 had had less than adequate care. The Kennedy Inquiry found Dr Bolsin had been right to persist in raising his concerns. It recommended a new culture of openness within the National Health Service (NHS), with a non-punitive system for reporting serious incidents (Hammond and Bousfield 2011; Kennedy 2001).

      Fourteen years after Kennedy reported, the public inquiry chaired by Robert Francis into the failures of care in Mid Staffordshire NHS Foundation Trust reached that very same conclusion: the need for a culture of openness in the NHS. (Francis 2013a, b, c). A few months after Robert Francis reported in 2013, Dr Bolsin was awarded the Royal College of Anaesthetists’ Medal in recognition of his work to promote safety in anaesthesia (PCaW 2013). Such is whistleblowing’s pattern of paradox: blame the messenger for the message and hammer them hard. Then, after significant life-ending failures of care, spend millions of public money on public inquiries which, after several years, conclude that both messenger and message had been pretty much right all along.

      THE WHISTLEBLOWER’S PROTECTION

      The Public Interest Disclosure Act 1998 (PIDA) went onto the UK statute book some years after Dr Bolsin had raised concerns about child mortality rates, been struck off the medical register and relocated to another continent. The UK was one of the first EU states to legislate to protect whistleblowers. PIDA is intended to provide protection to people who make protected disclosures. Yet, in another paradox, the experience of people who blow the whistle on poor, corrupt and unethical practice, is seldom anything other than negative. Witnessing what happens to whistleblowers does not inspire others to do likewise, the House of Commons Health Committee concluded in 2014 (HOC 2014).

      The use of so-called ‘gagging orders’ in the NHS was another twist in the tail of whistleblower protection. Payment of these gags in the UK NHS was halted in 2013, meaning special payments made outside an employee’s contract have to make clear that nothing in such an agreement prevents the individual whistleblowing in the future.

      That these gagging orders existed at all was denied in 2013 by the then Chief Executive of NHS England, David Nicholson (Ramesh 2013). Nicholson claimed some people ‘felt they’d been gagged’; and that the case of the whistleblower contacted by NHS lawyers, who threatened to demand repayment of their settlement agreement if they spoke out, ‘was a mistake’ (Aitkenhead 2013). Be that as it may, a request made by a Member of Parliament under UK Freedom of Information legislation revealed that the NHS had spent over £2m on over 50 ‘gagging orders’ between 2008 and 2013 (Hughes 2013).

      Nicholson’s denial that gagging orders existed (it is important to notice the syntactical sleight where people are said to feel gags existed) was news to Gary Walker, who had been sacked as chief executive from United Lincolnshire Hospitals Trust in 2010 (Walker 2015). As chief executive, Walker had raised patient safety concerns about hospital capacity to meet government targets for non-emergency care. Walker was later dismissed for allegedly swearing in a meeting, an allegation he denied and said a witness statement disproved. Walker intended to present that statement,