Whistleblowing in the Health Service:

Accountability, Law & Professional

Practice

edited by Geoff Hunt, Founder of FtC

Published by Edward Arnold (Hodder Headline)

ISBN 0-340-59234-6 (1995)

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EXCERPT (pages 155-158):

How the messenger gets shot

While one should try to be positive about the subject of accountability, emphasising what is necessary for good practice in management and health care (see other chapters of this book), it is judicious perhaps for the conscientious employee about to raise a concern to be aware of what they might expect in the worst scenario. While one hopes and works for the best, one needs all along be prepared for the worst. Just as the citizen at large has lost touch with the realities of democratic decay in the UK in the 1990s, so the health service employee is often (even now) quite unsuspecting about the degree and scale of defensive, capricious or ignorant behaviour on the part of those entrusted with authority.

Furthermore, it is a worthwhile exercise when thinking about reforms to ask why institutions respond in the specific non-accountable ways that they sometimes do. A brief overview of the institutional alternatives to accountable practice would be amusing if they were not so tragic for the victims. One could roughly arrange these by the degree of defensiveness to which the authority feels driven.

Hot air

The authorities will appear at first to share one's concern. Many words will be generated, insubstantial memoranda may fly about, a meeting may be convened, and promises will be made. No action will be taken, except perhaps the most trivial. At a later date any conversation not recorded on paper may be strenuously denied.

Send to Coventry

A change of mood comes over certain managers and colleagues. Initially this is quite subtle. Greetings, smiles and friendly banter are less frequent. At first you brush it off. Then it becomes more pronounced. Eyebrows are raised mysteriously, you are avoided and left out of events and decisions, sarcastic comments are made. If you mention it you may find that your mental health is questioned.

Close ranks

It is clear that what you said to one colleague or manager has been passed on, and possibly distorted, to his or her peers. When you approach a manager further up the line it is clear that they have been forewarned. Your concern has somehow created an anti-you group. You are identified as a 'troublemaker' by most people with any authority, and any attempt to raise your concern is now preempted and prejudged. Some of your colleagues feel that your complaint demeans them by implication.

Stonewall

When you raise your concerns formally you find that your letters are unanswered, the manager is never available, promises to 'get back to you' are broken, you are passed on to someone who eventually sends you a letter saying something like 'your concern has been investigated, nothing is amiss, and the matter is now closed'. You may be told directly not to send any more memos or letters.

Biomedical diagnosis

It is suggested that you have been under a 'lot of stress lately' and that you ought to visit the occupational health department, a counsellor or your GP You are asked if you are 'coping'. It emerges, unknown to you, that you have been informally diagnosed as anxious, depressed, paranoid, having a personality disorder, or as being 'neurotic', too old or too fat.

Spying

A colleague is passing on information about you (and has, perhaps, been asked to do so). You are the object of close observation, fault-finding, and perhaps your mail is being opened and your telephone bugged. Some of your work goes wrong or astray and you wonder about sabotage. If you mention this it is taken as further evidence that you are unable to cope or 'paranoid'.

Grind down

Work becomes more difficult. Your workload increases, you get the tough end of the rota, you are transferred to the most difficult work area, demotion looks more probable than promotion, you do not get your holidays when you want, you are asked to share an office or move out of the one you have, your phone line is put on 'internal calls only' or taken away.

Sticks and carrots

An intermediary, usually a union official, will call you aside for 'a chat' in which offers are made to you concerning promotion, a generous severance package or some other benefit. These will be linked in coded terminology with your concern - the suggestion being that you drop it in return for the benefit.

Alternatively, or if you refuse to accept the carrot, veiled threats will be made such as 'Are you sure you wouldn't be happier working elsewhere?'. These become overt threats such as 'You are jeopardizing your future' and 'You won't be working here much longer'. If you raised concerns about colleagues, such as their abuse of patients, you may find that you receive hate mail and threats of violence.

Character assassination

Aspersions will be cast on your character, your personal conduct, your personal past, your political views, your class or ethnic origin, or your sexual orientation. These may progress to accusations of abuse of clients, theft of documents, lying, disloyalty, breach of confidentiality, and the like.

First strike

Official counter-complaints may be formulated against you in a disciplinary hearing before your own concerns are addressed or instead of addressing them. You may be made a scapegoat. Disciplinary or grievance procedures may be used as a preemptive or retaliatory measure. The authorities will attempt to get their revenge in first.

Make redundant

Your presence is no longer tolerable. You may be suspended and then dismissed or there may be a reorganization in which your post is made redundant. You will proceed to an industrial tribunal. If you win you are paid a maximum of £11 000 - which the authorities consider cheap at the price.

Cosmetic reshuffle

If your concerns were of a serious nature, especially if an inquiry took place, then there will be some changes at your workplace of a cosmetic nature. Some posts may be reshuffled, but it is unlikely that policies will be revised or that managerial heads will roll. Certainly no acknowledgement will be made that there is any connection between your raising a concern and the changes which followed.