Whistleblowing about private providers will be discouraged in the new privatising NHS

Regular readers of my blogs will know of my enthusiasm for the publications of the House of Commons Library, which give independent guidance to MPs in all sorts of things, but often it is aimed at situations where they are trying to help their constiutents. There’s a recent very useful example on whistleblowing in the NHS. You can download it from the Parliament website.

This makes it very clear that the NHS is supposed to support its staff in raising issues about patient care and organisational problems, and it covers the law according to the Public Interest Disclosure Act 1998, and various statutory guides and legal developments, all with links on the internet. Aren’t MPs lucky to have this service, and isn’t it good we get access to it too?

One useful point it makes is the difference between allegations and disclosures. Staff are protected from being persecuted by their employers if they disclose information, but not if they make allegations. Here is a quotation, in the publication, from a Tolley’s employment law guide discussion of a case that describes the difference (an EAT is an Employment Appeal Tribunal):

…The EAT held that there was a distinction between communicating “information” (which is protected) and making an “allegation” which does not convey facts…which is not protected…The distinction is well illustrated by an example given in Mrs Justice Slade’s judgment in relation to the state of a hospital. To say “health and safety requirements are not being complied with” is an unprotected allegation. To say “the wards of the hospital have not been cleaned for two weeks and sharps were left lying around” is conveying “information” and is protected.

You might ask why responsible employers would not want to have this kind of information given to them so that they can act. One of the answers is the assumption that employees are there to do what the management tells them, not what is good for the people that they serve. This attitude has been encouraged by the ‘new public management’ or managerialism that has been rife over the past twenty years. This says that managing effectively is more important than professional responsibilities or good service, and disclosing information, particularly if it is likely to make the organisation liable for damages for neglect or worse, is anathema to the manager’s right to manage: how can you manage people if they have the right to let out all the secrets of your organisation?

This kind of attitude has infected the NHS from the private sector, where loyalty to your employer is paramount. A very experienced nurse friend was recently forced to work for a private medical practice because the NHS would not give her flexible enough work to enable her to care for her children. Faced with a patient worried about whether the treatment was working for her, she worked through the various ways in which the patient could raise her concerns, only to be told by the doctor that they didn’t want any of that NHS nonsense about patients’ rights here. We can see this kind of attitude in the reaction of some of the private clinics to the pip breast implants disaster.

We all need to be concerned about this, because since a lot of the NHS is going to be contracted out to private suppliers in the near future, the rights to whistle-blow over bad patient care is going to disappear. I can imagine the government would say that the right will still be there, but the reality will be that the pressure from employers not to raise any concerns about care standards will increase. And what will NHS employees do, faced with concerns about the people they are contracting with? Not a lot, if my experience of how they deal with unsavoury or just insipid care homes at the moment is anything to go by. Increasingly, the difficulties of contracted private providers will be ‘commercially confidential’ and there will be pressure not to disclose information which might be against the interests of private providers to the NHS.

Another weakness of this guide is its focus on the NHS, rather than health and social care. Really whistleblowing about healthcare should be possible from social care and vice versa; the separation of the services means that it’s not clear that you are protected if you disclose information about the other.

Courtesy of Malcolm Payne via Social work and end-of-life care