Freedom to speak up—easier said than done

In February, Robert Francis outlined his review into whistleblowing in the NHS and the freedom of nurses and midwives to speak up (Francis, 2015). There is a duty to do so within the Code (Nursing and Midwifery Council (NMC), 2008) and no doubt there are some clauses within contracts of employment in relation to this.

The review and subsequent report looked at how NHS staff are treated when they raise concerns. It found that the vast majority who participated in the review had a poor experience of raising concerns, often describing reprisals and bullying. The report identified five overarching changes that need to happen (Francis, 2015):

None of the above is new to those working in the NHS or other organisations. As post–registration students in the 1990s, we were taught about Graham Pink, a nurse in elderly care who set out, in a series of letters to a news-paper, the substandard care his patients were receiving due to lack of staff and resources. He was eventually dismissed from the Trust on the grounds of breach of confidentiality but also suffered from isolation in the workplace with variable support from colleagues. More recently, Margaret Haywood was highlighted in the press when she was struck off by the NMC (a reduced sanction was later given on appeal) for undercover filming of neglected elderly patients in a hospital setting. She stated she received no support from her manager and had no other means of raising concerns. Both of these nurses resorted to extreme measures to try and protect their patients. Agree or disagree with their methods, no-one can deny that improving care and respecting the dignity of their patients was their motivation.