Doctors are often well-placed to be aware of poor practice, and to report this through their usual management train so that improvements can be made. If changes are not made, however, doctors may feel they have a duty to their patients and or to the tax-payer to escalate their concerns outwith their usual management chain. This is what is usually referred to as whistleblowing.
Whistleblowing can backfire. Managers may be defensive, and seek to discredit the whistleblower rather than make the changes they should have made earlier (which they may view as admission of fault); or they may claim that the whistleblower is seeking to discredit the organisation. This means that whistleblowing has considerable potential to cause stress, and to harm doctors' careers. The problem is not unique to medicine or the health service (or, indeed, to the public services). The UK laws to protect whistleblowers are inadequate, with the Public Interest Disclosure Act 1988 failing to meet international standards.
Guidance has been published on how to be a whistleblower. NHS staff who feel they need advice can also call the @WhistleUK helpline on 020 7404 6609 which is run by the charity Public concern at work and covered by legal privilege.
It is possible that employers will have gagging clauses in employment contracts. These would appear to conflict with any concept of "duty of candour" - but perhaps the duty of candour only applies to the footsoldier healthcare workers, and not to their managers.
It is unclear how enforceable gagging agreements are when they interact with potential issues around patient safety but breaking one will be very stressful.
- Public concern at work
- Whistleblowers UK
- Whistleblower Chris Day and the campaigning 54000doctors web site
- Whistleblowing in healthcare article by whistleblower Peter Wilmshurst.
- Alexander's Excavations the blogsite of campaigning whistleblower Dr Minh Alexander. (There are other useful whistleblowing links at this site.)
- The website of paediatric surgeon Dr Edwin Jesudason, who reported serious safety concerns involving harm to children.
- The website of Dr Sharmila Chowdhury, a radiologist turned NHS whistleblower.
- EU Green Party calls for protection for whistleblowers
- ↑ Jo Revill. Scandal of 100,000 dumped x-ray scans. The Observer. Sunday July 30, 2006. Online - visited 31/7/06
- ↑ DNUK forum Sacking of Dr Otto Chan - available to DNUK members only
- ↑ Barrett A. Voting set to begin at GMC following retirement of Wendy Savage. BMJ (Clinical research ed.). 2005 Jul 30; 331(7511):256.(Link to article – subscription may be required.)
- ↑ Shaw D. Liverpool Prison workers fired for raising safety fears. BBC News website, 2018; Updated 12 Mar 2018; Accessed: 2018 (12 Mar): (http://www.bbc.co.uk/news/uk-england-merseyside-43350287).
- ↑ Drew D. UK law fails to protect whistleblowers. NHS Whistleblower (blog) 2016; Updated August; Accessed: 2016 (12 October).
- ↑ Robbie Coull. Everything you always wanted to know about whistleblowing but were afraid to ask. BMJ Career Focus 2004;328:5; doi:10.1136/bmj.328.7430.s5 (possibly only available to BMA members/subscribers).
- ↑ Donaldson L. Help for NHS whistleblowers. CMO Update 2009(49):8.
- ↑ Gornall J. The price of silence. BMJ (Clinical research ed.). 2009; 339:b3202.(Epub)
- ↑ House of Commons Library. Whistleblowing and gagging clauses. London: House of Commons, 2016(04 Jan); 1-23 (http://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-7442).
- ↑ Wilmshurst P. Whistleblowing in healthcare. HealthManagementorg 2017;17:4 (https://healthmanagement.org/c/healthmanagement/issuearticle/whistleblowing-in-healthcare).
This article is a work in progress. Please feel free to contribute to it.