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

Автор: Angie Ash
Издательство: Ingram
Серия:
Жанр произведения: Социология
Год издания: 0
isbn: 9781784501082
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of health and social care and the organizations and services that employ health and social care professionals and others. The chapter maps out what this might mean, and how it might manifest. Its crux is the need for ethical care that, routinely and as a matter of course, is intolerant of poor, marginal or downright dangerous action, and which expects and encourages people to speak out.

      Chapter 8 returns to the overwhelming significance of organizational culture, and of those in leadership positions, on the behaviour of people working in it. If an ethic of care is to drive the work of the health and social care system, and the speaking out about shortcomings of care, then it needs clear expression and realization by its leadership. The chapter considers what ‘ethical’ leadership would look like, how it would influence the organizational culture and its responses to whistleblowing. The emotional intelligence of the leader, their awareness of self, others, the culture and climate of the organization and its secrets and silence, are put forward as hallmarks of a leadership style that is well-positioned to deal, ethically, with disclosures a whistleblower makes.

      Finally, Chapter 9 summarizes the critical need to understand whistleblowing as a moral act that requires a moral response. If the whistleblower is the messenger, why not listen?

      WHAT THE BOOK IS NOT

      This is a wake-up book, not a feel-good guide. That these things happen to whistleblowers should alert the reader, not render them mute, inert or silent. Nor is this a whistleblower’s self-help manual, how-to handbook or legal sourcebook. There are good sources of help, and the book’s Postscript on its final pages has a few words to say about these to a prospective whistleblower. These can be summarized: get wise and get prepared.

      At some points, the author’s weariness with the myopic policy fixation on delivering targets by any means necessary bleeds through. It would be wrong to read this as a call for targets, standards and the related regulatory apparatus to be junked. Not so. The problem isn’t the targets or standards, but the obsession in hitting them, rather than understanding the point of them – the people, humanity, pain and suffering that lie behind the numbers. The problem is believing that targets, ipso facto, safeguard patients and citizens from harm. The problem is their deracination from an ethic of care and from the affective, human dimensions of competent health and caregiving. You may have been seen within two, four or however many hours the target for attention in Accident and Emergency is that day, but if you have a ruptured spleen and you are sent home with aspirin this (achieved) target says zilch about your health, care or prospects of survival.

      There is not a great deal of evidence that training employees on ethics and morality has much resilience beyond the training room. In laying out these limitations, the book is not suggesting such training is worthless but that its application back at work is what counts. All that training has to be given the chance to work – in the workplace. If it’s strangled at birth by a disinterested leadership who want the numbers of people trained but not the outcome, then the impact of this training will be negligible. It won’t change a thing: what happens in the workplace will.

      Health and social care are used mostly as conjoined entities in this book, though the reality of health and social care service planning and provision in the UK is far from that. ‘Health’ is used to refer to regulated public or private healthcare. ‘Social care’ includes statutory or voluntary social work, provision of personal care, support to the person, whether adult or child. Aggregating adult and children’s services in this way is done expeditiously. (In some parts of the UK adult and children’s social services have been separated.) The point of the book is not the organizational structures of health and social care. They shift over time. Its concern is what happens inside those organizational entities when people speak out about wrongdoing. That changes much less.

      Whistleblower and person raising concerns, and ‘whistleblowing’ and ‘raising concerns’ are used interchangeably, but legally they are different. The person blowing the whistle, if they are making a protected disclosure in law, has such protection as is afforded by whistleblowing legislation in place in their jurisdiction at the time of the disclosure.

      WHISTLEBLOWING

      GOOD, BAD AND UGLY

      Commentary, reaction, blame or praise about whistleblowing – take your pick – are not generally informed either conceptually or empirically. Whistleblowing can crop up in casual conversation when a whistleblower case hits the headlines. The general public may have a view, often of bewilderment, about the behaviour of those running the bank, corporation, health or social care organization that allowed the corruption, poor care or illegal activity to occur in the first place and, even more disconcertedly, of the retribution heaped on the whistleblower after their exposure of it. It is hard for the outside observer to grasp what appears to be the irrationality, if not insanity, of the denial/defence/blame response of large organizations to whistleblowers and the matters they raise concerns about. It seems to be even harder for those organizations to think more carefully about how they respond to the whistleblower.

      This chapter provides an overview of whistleblowing, the whistleblower, and of what they may anticipate after they blow the whistle. First, some of the fables, fantasies and facts around whistleblowing and the public reaction to whistleblowers are discussed. Next, what whistleblowing is, both conceptually and practically, is considered, followed by, third, a review of the characteristics of whistleblowers. Fourth, what is involved for the whistleblower in weighing up the costs and benefits of speaking out is outlined, along with the double bind that is the requirement on the health or social care professional to report wrongdoing, and the detriment they personally may suffer when they do. The fifth part of the chapter, on UK whistleblowing legislation and policy, is a bridge (or breathing space) before the final section. This looks at what happens when people whistleblow, particularly the retaliation and retribution they may suffer, notwithstanding any protection under law they may have. Turning a blind eye to the possibility of retaliation is like turning away from the wrongdoing itself. Both are denial. Better for the whistleblower, and their managers, to face into this, than pretend it doesn’t exist.

      Media coverage of whistleblowing is fond of constructing a narrative of the lone hero taking on organizations, agencies, companies (as Time magazine’s 2002 ‘Persons of the Year. The Whistleblowers’ (Lacayo and Ripley 2002)) or sometimes an entire industry (such as the scientist Jeffrey Wigand’s exposure of tobacco (Armenakis 2004)). This storyline plots the whistleblower’s selfless drive to counter injustice and corruption, to stop harm and suffering being visited on people, animals, and the world in which we live, by the actions or inaction of organizations, corporations or professions. The ‘selfless heroism’ portrayal of the whistleblower and the whistleblowing dovetails nicely with the individualistic, ‘small person against the big corporation’, David v. Goliath cultural motif that sells front covers and makes blockbuster films. Goodies and baddies, heroes and villains, right and wrong, make good copy. It is a neat duality that has little or no concern with the lifelong, life-changing, personal, financial and human costs to the whistleblower and their family, or to the victimization, retaliation or ostracism they may well live with for the rest of their lives as a consequence of their raising concerns and speaking out.

      In this vein, Grant (2002) wondered if whistleblowers were ‘saints of secular culture’. Whether saint or sinner, the whistleblower and whistleblowing encapsulate conflicting and conflicted social values. We love the underdog taking on the organization, but hate sneaks, snitches and grasses. We revere the charismatic individualist, but at work want everyone to keep their head down, get on with their job and, above all, fit in with the team. There is public outrage about domestic violence, yet banging and shouts from next door are ignored and the TV turned up. We elevate ‘family’ and worship family life, but anyone speaking out about abuse and mistreatment by a family member had better watch out. Not seeing, not hearing and not speaking out about injustice coexist with relief that someone else did, and we’re glad it wasn’t us.

      The popular narrative places great expectations