Francis report: lives have been ruined

Inquiry reveals shocking extent of the mistreatment suffered by NHS staff who raise concerns


The landmark review into whistleblowing in the NHS, published earlier today, calls for major reforms in the treatment of NHS staff who report flaws in the system.

In his introductory letter to Health secretary Jeremy Hunt, the report’s author Sir Robert Francis emphasises the gravity of the mistreatment faced by those who raise concerns:

“In some, sad, cases, it is clear that the toll of continual battles has been to consume lives and cause dedicated people to behave out of character.

“Just as patients whose complaints are ignored can become mistrustful of all, even those trying to help them, staff who have been badly treated can become isolated, and disadvantaged in their ability to obtain appropriate alternative employment. 

“In short, lives can be ruined by poor handling of staff who have raised concerns.”

The report, which took evidence from over 600 people, makes frequent reference to the unique position of the NHS in our society, and to how complex and emotive any disputes within it can be.

What Sir Robert calls ‘the political significance’ of everything the health service does means that there is ‘often intense pressure to emphasise the positive achievements of the service, sometimes at the expense of admitting its problems’.

Nevertheless, as with any service where safety is an issue, staff should be encouraged to raise concerns, and made to feel that they are in an an environment where they will not be punished for doing so.

Instead, the report finds that whistleblowers frequently have their concerns met not with attempts to address the issue, but rather with disciplinary action against them.

Today’s report also identified bullying as an issue that appeared far too often in the evidence provided, with staff afraid to voice their concerns because they fear being bullied. Contributors also expressed frustration that no disciplinary action had been taken after reported incidents of bullying.

As well as the culture which works to stifle whistleblowers, Sir Robert identifies problems in the legislation in place to protect them. There is, he says, confusion around the term ‘whistleblowing’:

“It was clear from the written contributions and meetings that the term means different things to different people or organisations.

“It is sometimes taken to imply some sort of escalation: someone ‘raises a concern’, then ‘blows the whistle’ when they are not heard, either within the organisation or to an outside body.

“Yet this is not how the law defines a protected disclosure.”

Sir Robert, who led the inquiry into the scandal at Stafford Hospital, makes a number of recommendations, all of which have been immediately accepted by the government. They include:

  • Extending legal protection
  • Appointing a ‘Freedom to Speak Up’ guardian to every NHS trust
  • A scheme to help staff who have lost their jobs as a result of raising concerns to find new employment elsewhere in the NHS.
  • New measures to support good practice
  • Special measures for vulnerable groups, including locum and temporary staff, and BME staff

Speaking to Commons today, Jeremy Hunt said that ‘the whole house will be profoundly shocked at the nature and extent of what has been revealed today’. He added:

“The message must go out today that we are calling time on bullying, intimidation and victimisation which has no place in our NHS.”

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