The significant finding of Brown’s Australian survey mentioned above, and others, is that with one exception there is little to distinguish whistleblowers from non-whistleblowers. You can hardly tell them apart on any of the usual matrices that differentiate employee competencies, skills and propensities. Whistleblowers hold the same attitudes about their workplace, about their job and about their managers as those who remained silent. Almost anybody in this survey could be expected to speak up and not – as retribution attacks by the organization on the whistleblower would have us believe – just those who were bitter, passed over for promotion or looking for a fight. By the same token, almost any employee could stay silent in the face of wrongdoing. Just one characteristic set those who spoke out apart from others, and that was the high level of ‘organizational citizenship behaviour’ they displayed – that is, they cared about the organization and took their role as part of it very seriously (Brown 2008).
So it is not simple to spot who will whistleblow. If an employer wanted to select (or deselect) people likely to speak out about wrongdoing, they could not easily pinpoint the killer qualities of the whistleblower. Attempts to identify individualized personality traits that set the whistleblower apart from their peers have generally been disappointing. Stansbury and Victor (2009) found that ‘prosocial’ behaviours (behaviour motivated by altruism as well as self-interest, and intended to benefit the public or social good), when reinforced and informally normalized in the workplace, were more likely to increase whistleblowing activity. Younger and short-tenured employees were less influenced by this prosocial control, suggesting that this is learned and reinforced over time in the workplace. As with the organizational citizenship behaviour found in Brown’s (2008) study, when an employee displays prosocial behaviour – when they care about what they do and want to benefit the public or social good – they are more likely to raise concerns about practice. This prosocial behaviour needs an environment in which it is cultivated and valued: an organization and employer that is prosocial, and displays citizenship behaviour in what it does, and how it does it. Context counts.
The power of the context to influence whether employees speak out about concerns cuts both ways. Low-wage sectors and deregulated labour markets (as are significant parts of the US and UK economies), characterized by job insecurity and with limited, if any, employment protection, employing younger employees and women with young children, are more likely to be deterred from raising concerns (Zipparo 1999). Thus pre-existing structural inequalities impact on employee propensity to blow the whistle. Keeping children fed, warm and clothed while working antisocial hours in more than one minimum wage, zero hours job dampens down the appetite for upsetting the precarious applecart that is job (in)security. In health and social care services in the UK, care support workers are typically on minimum wage. The use of agency staff in health and social care services is widespread. These are not job conditions that encourage whistleblowing.
Even though they coined the term ‘ethical resister’, Glazer and Glazer (1989) agreed that the decision to report wrongdoing could not be attributed only to an individual’s personal propensity to do so, or to any identifiable, innate features predisposing one person to raise concerns but not another. Jeff Wigand, the scientist who exposed the duplicity and corruption of the tobacco industry in concealing and misrepresenting data about smoking-related death rates, said there was no great epiphany for him when he went public with his concerns. Wigand came to regard what he did as an ethical decision, an incremental process of unsuccessfully raising concerns inside the organization, and then taking them outside the tobacco industry (Armenakis 2004).
There is, then, no clear profile of the ‘typical’ or ‘predictable’ whistleblower. Who whistleblows, why they do, why some chose one path and not the other, are not questions for which there are evidence-based answers (Bocchiaro, Zimbardo and Van Lange 2012). Searching for the individual traits and characteristics that constitute ‘the whistleblower’ overlooks the power and influence of the workplace context the whistleblower finds themselves in. Any search for individualized predictors of whistleblowing, devoid of attention to context, situation and power dynamics, is unlikely to produce anything other than a list of decontextualized, scientifically weak characteristics with little predictive or explanatory power. Personal and situational characteristics interact, but those contextual variables – the organization, its culture, relationships of power and authority, peer group pressures – explain the propensity to whistleblow more than individual factors (Near and Miceli 1996). If, for example, managers and supervisors routinely raise concerns (thus displaying prosocial organizational citizenship behaviour) the likelihood of a new employee doing so is greater, as they conform to the norms of the workplace and model their behaviour on more positionally powerful colleagues. Co-workers encourage or discourage whistleblowing through social reinforcement of workplace norms, and those informal structural characteristics of group behaviour tend to regulate member behaviour (Greenberger, Miceli and Cohen 1987). Thus whistleblowing becomes likely in organizations that actively support whistleblowing, in word and deed. These are the places with the ethics codes that lift off the page. They are likely to be high performing, relatively non-bureaucratic places, and cluster in the public rather than the private sector (Near and Miceli 1996). Norwegian public sector employees generally have a positive experience of whistleblowing, and many do so (Skivenes and Trygstad 2010). This isn’t surprising. Social behaviour does not occur in a vacuum.
WEIGHING UP THE PROS AND CONS OF WHISTLEBLOWING
To become a whistleblower in health and social care services, whatever the duties of the person’s professional code, requires a bit of thought. The whistleblower is raising concerns about something the organization is doing or not doing. The organization has its particular history, culture, climate and ways of managing dissent, which the whistleblower may well be very aware of. Weighing up whether or not to whistleblow becomes a sort of cost-benefit analysis (Miceli and Near 1985).
Whistleblowing involves other people, both in the organization and outside it (in health and social care, these include regulators, policy makers and politicians). The costs of not whistleblowing may well involve the perpetuation of harm, corruption and wrongdoing; the damage being done to people who are vulnerable, by virtue of their dependency on those health and social care services. The whistleblower’s own personal and professional circumstances – their livelihood, career history and aspirations, their obligations and responsibilities to support others – also figure on the costs side. On the other side is the benefit that exposing harm, poor practices and wrongdoing may bring to those directly affected by it. The organization may benefit from understanding better where, tacitly or knowingly, it colluded in the harm perpetrated. The deep learning on offer to the health or social care organization, which can come from disasters in health and social care, is a benefit beyond measure. But the organization has to engage, systemically and systematically, in that process of deep learning for that benefit to be realized.
CODES AND WOES
In the UK, registered health and social care professionals hold professional obligations not to permit people using their services to come to avoidable harm. These are variously expressed in professional codes of conduct and registration. Laying a mandatory duty on health and social care staff (discussed in Chapter 6) to report poor care typically decontextualizes incidents of poor care from the situational dynamics in which they occur. Registered nurses in the UK, for example, are required by their regulatory body to raise any concerns they might have about healthcare