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Having sung the praises of the NHS in my blog last week, this week my blog will focus on what can and does go wrong in the NHS.  The Public enquiry into the scandal at Mid Staffordshire NHS trust is due to report this week. About 500 people are estimated to have died of negligence and appalling standards of care seem to have been unearthed.

It emerged that staff who tried to bring the crisis to the attention of their superiors were bullied into silence. Sir Professor Brian Jarman of Imperial College heads the health analytical company Dr Foster which looks at hospital statistics [It was the statistical analysis from the Dr Foster unit at Imperial which first led to questions being asked about the standard of care at Mid Staffs] stated that the NHS still continues to foster ‘a culture that allows suppression of the truth and victimisation of whistleblowers.’

Whistleblowers are people who bring attention to the failings of the organisation they work for. They have been described as a combination of hero and disloyal sneak, which illustrates exactly what a difficult position they are put in. They are rarely popular, are denied promotion and often have to sacrifice their careers.  But as Carol Parkes writes in this weeks BMJ

If no one dares to ask the unpopular questions and everybody keeps their heads down, the organisation can succumb to poor thinking, poor strategy, and poor leadership.’

In Mid Staffs case it seems that a culture of target chasing and management agendas of cost cutting took precedence over patient care. The GMC states ‘make the patient your first concern– this often contradicts with saving money.

NHS staff have the knowledge and the understanding to know when care is not being properly provided by their organisations. Patient feedback is valuable but enabling staff to speak up about faults within the NHS is probably more important in the effort to improve the NHS. A poll released yesterday in the Nursing Times found that 80% of nurses thought neglect of the kind at Mid Staffs was still happening. Numerous scandals over patient care have occurred. We had the Bristol Heart scandal in which incompetent surgeons operated on babies [the anaesthetist who reported it to the press had to find work in Australia], the Winterbourne Home scandal last Autumn and now Mid Staffs. NHS staff spoke up in all these cases but were not listened to! More needs to be done to protect the whistleblower!


whistleblowers cartoon