NMC defends decision to strike off undercover nurse Margaret Haywood.

17 April, 2009 | By Richard Staines

A war of words has broken out over the NMC’s decision to strike off undercover nurse Margaret Haywood for breaching patient confidentiality.

In a strongly-worded statement, the union Unite accused the NMC of being ‘heavy handed’ in its treatment of Ms Haywood.

Karen Reay, Unite’s officer for health, said: ‘We can’t have a culture where ‘whistle blowers’ feel intimated into not legitimately reporting wrong doing and bad practice in the NHS. We need a safe environment for ‘whistle blowers’ who feel that they can complain without losing their livelihood.

‘There appears to be a number of extenuating circumstances in the case of Margaret Haywood and the NMC could have imposed a lesser punishment than that of being struck off.’

‘The NMC exists as a regulatory body to protect patients and clients first and foremost, and not the alleged failings of members of the nursing profession in caring for the elderly.’

However, the NMC has defended its actions. Craig Turton, a spokesperson for the NMC, said in an email response: ‘Margaret Haywood was struck from the register because she failed to gain the consent of the patients prior to secretly filming them and not, as reported by some media, for whistle blowing.

‘A patient should be able to trust a nurse with his/her physical condition and psychological wellbeing without that confidential information being disclosed to others.

‘Only in the most exceptional circumstances should the cardinal principle of patient confidentiality be breached. Based upon the evidence it heard, the independent panel did not believe that this was the case and although the conditions on the ward were serious, it was not necessary to breach confidentiality to seek to improve them by the method chosen. The panel believed that the method was unlikely to benefit the patients that were on the ward at the time of filming and under Margaret Haywood’s care.’

Readers' comments (23)

Anonymous | 17-Apr-2009 6:16 pm
The health, safety, wellbeing and care of patients is what is meant to concern us. This principle should over-ride any requirement to ask patients permission to record the lack of, or poor quality of, the care and treatment they are receiving. After this foolish ruling nobody will feel inclined to raise concerns about any aspect of treatment and those who suffer will be the patients whose care is our number 1 concern!
Unsuitable or offensive?
Phil Dup | 17-Apr-2009 7:03 pm
Mmmm what a surprise...The NMC continue to make crackpot decisions from their comfy well paid nests.
Perhaps its better to keep quiet from now on if we see poor conditions at work otherwise we may be joining the ranks of the unemployed - and then we will have even less Nurses and then even greater patient care problems.
Unsuitable or offensive?
john warwick | 17-Apr-2009 8:29 pm
How like the NMC blame the whistleblower but not the matron or ward manager that let patients lay in filth. THe NMC and NHS management must be held accountable , When the secret filming was done at Ealing hospital the Ward manager was moved to a differant ward and the Director of NUrsing and ADN stayed the same no one was fired and sincw then Ealing has lost all its stars NOTHING CHANGES
Unsuitable or offensive?
Anonymous | 17-Apr-2009 11:25 pm
margaret was brave to do this for her patients Would asking their permision have changed their care, she was speaking for them, NMC should be ashamed ,how long since any member has been on the shop floor and seen this happening, it is a daily happening in my trust, who are intent on targets and finances and have reduced staffing levels!!!!
Unsuitable or offensive?
. . | 18-Apr-2009 8:20 am
The intent of any action is most accurately judged by its outcome. The outcome of Margaret's action was to improve care for her patients. The outcome of the NMC's action has been to warn nurses all over the country to keep their mouths shut. Margaret comes out of this with honour.
Unsuitable or offensive?
Anonymous | 18-Apr-2009 10:51 am
I refer to article's last sentence "The panel believed..etc " Never a truer word! Seems like the NMC is about as useful for clients as the FSA has been in banking circles. If any changes have been made on the ward, (not to mention in trusts elsewhere), well no, I have not heard about them. So, NMC, time to get out of your cosy little unstressed cocoons and down to the shop floor. End of slagging match. If you want to serve, start now, will you?

A medal for bravery would be most apposite here. Caring people should not have to do what Margaret Haywood's heart has led her to do.

As things stand, this outcome becomes blatant intimidation of both nurses AND clients alike, present and future, (Hey, that includes YOU!). Over my dead body! Hurrah for leaders - our country needs many more like you, Margaret.

So nurse, NO LONGER are you going to be as disempowered as a Woodpecker at a Nuclear Power Plant; you are at a major turning point: Stand up and stand out!

Arise and shine.
`
Unsuitable or offensive?
Anonymous | 18-Apr-2009 11:09 am
Margaret was an advocate for her patients she deserves a medal not to be struck off.
the NMC and the government should spend less on advertising and put the money, to good use for patient care and staffing. If it was their relative I wonder if her outcome would have been different, the NMC should have thanked her. Nurses today have no say consider it is supposed to be a caring profession well only when it suits them I hope Margaret appeals and I hope she wins
Unsuitable or offensive?
Anonymous | 18-Apr-2009 11:19 am
Nurses, well the NMC obviously does not know what it is to be a nurse. I hope one of their relatives never has to experience that kind of care, No one deserves to be given sub-standard care. Margaret was their voice, and I am sure if asked then those patients would have been grateful to have someone speaking out for them.
Margaret deserves a medal NMC it time to support nurses not the government.
Unsuitable or offensive?
Anonymous | 18-Apr-2009 11:46 am
this is a difficult scenario, as the Code clearly states confidentiality is paramount. however, the nurse is also the patient's advocate... had she informed the highest echelons of the Trust first? there needs to be a middle road - i hope the appeal is successful
Unsuitable or offensive?
Anonymous | 18-Apr-2009 12:17 pm
I was shocked to see that she had been struck off and I was left with the feeling that the NMC were almost in denial about how poor nursing care can be. Margaret did not address confidentiality issues correctly, however, when people's lives are at risk as these clearly were, where do we draw the line? As a nurse I have seen the other side of nursing. In the past 3 years I have been a patient on acute wards an intensive care units. The care varies considerably, from the very best to appaulling life threatening care and in some cases I witnessed people suffer in circumstances that everyone in the UK should be aware of.
I'm sure, whatever lies ahead she'll be remembered by many as courageously her blowing the whistle on the poor conditions patients were enduring.
Unsuitable or offensive?
Anonymous | 18-Apr-2009 12:35 pm
It seems sadly clear that the NMC, rather than having the credible reputation to support nurses and protect the public. once again prefers to be the smiling assassin on behalf of the health trusts , strike off anyone who because of the whistleblower legislation is otherwise protected , and to think we are paying £75 a year for this privalege
Unsuitable or offensive?
Linda Nazarko | 18-Apr-2009 1:51 pm
Its a very difficult case. On the one hand yes the "care" was dreadful but did the ends justify the means?

Margaret Haywood as a registered nurse went to work with a secret camera to film patients and staff. If I were ill and vulnerable I would not wish to be filmed covertly whatever the motives of the nurse. If I were asked to give permission for one of my relatives who was unable to give informed consent to show such things as were shown on the programme I would not give consent. I personally would consider my loved one's privacy and dignity in such circumstances to be of paramount importance. I don't know if I would give permission to show the film with the face digitally blacked out.

The question I ask is would it be acceptable to covertly film younger people, maybe women on a delivery ward? When people are old they are more vulnerable than younger people. The older person may lack capacity because of delirium or dementia. The older person may feel that he or she has less power than a younger fitter person.

I don't know if the NMC did the right thing. I do know that I think its wrong for programme makers to carry out secret filming of the sick and vulnerable and ask for permission after the event. Our society has become so desensitised to people's rights to privacy and dignity when they are so vulnerable. This is not a reality show it’s the sick and vulnerable in hospital. I'm not saying that we should sweep poor care under the carpet I'm just unhappy about it being used as programme fodder. I don’t think that this sends a message that we can not whistle blow.

I have been nursing older people for 30 years and the same old problems keep coming up. It breaks my heart and the only way that we will ever make it better is to improve training, education and the status of nurses who care for older people. That will take more than a Panorama programme.
Unsuitable or offensive?
Anonymous | 18-Apr-2009 3:42 pm
Theres the safe ' whistle -blowers act 'well and truly out the window.
Unsuitable or offensive?
Linda Rogers | 19-Apr-2009 7:02 am
What does the NMC consider to be exceptional circumstances? Apparently not the circumstances at Ealing! The NMC are probably correct and unfortunately these conditions are probabaly not exceptional and therefore the NMC is just doing it's duty to uphold these conditions in a spectacular display of not seeing the wood for the trees!!! Their actions do nothing for care and protection of patients and nurses especially in what was clearly a difficult and traumatic experience for Margaret Heywood. Is it surprising that there is only one positive comment here of the NMC's decision as opposed to overwhelming support of Margaret Heywoods actions? The NMC should wake up to public opinion of it's decision,and get in touch with reality. Clearly it has lost all credibility with the public, and nurses everywhere as comments here and elsewhere prove. As a nurse my friends and family look to me to explain and defend the NMC's decision sadly I am not able to.
Unsuitable or offensive?
Anon | 20-Apr-2009 8:38 am
What does the NMC consider to be exceptional circumstances? Apparently not the circumstances at Ealing! The NMC are probably correct and unfortunately these conditions are probabaly not exceptional and therefore the NMC is just doing it's duty to uphold these conditions in a spectacular display of not seeing the wood for the trees!!! Their actions do nothing for care and protection of patients and nurses especially in what was clearly a difficult and traumatic experience for Margaret Heywood. Is it surprising that there is only one positive comment here of the NMC's decision as opposed to overwhelming support of Margaret Heywoods actions? The NMC should wake up to public opinion of it's decision,and get in touch with reality. Clearly it has lost all credibility with the public, and nurses everywhere as comments here and elsewhere prove. As a nurse my friends and family look to me to explain and defend the NMC's decision sadly I am not able to.
Unsuitable or offensive?
Anonymous | 20-Apr-2009 9:41 am
Surely this woman broke not only the confidentially aspect of her nursing role but and also the mental capacity act as the people involved were unable to state there wishes and give consent to allow the filming. Relatives cannot give consent as such, there wishes can be taken into condideration but others should be involved in these decisions
Unsuitable or offensive?
Anonymous | 20-Apr-2009 12:03 pm
I am always reluctant to pass judgement or praise on the actions of any person or body unless l am aware of all the facts.

Clearly in this case there were extremely poor and dangerous circumstances when it came to standards of care and this nurse as l understand it, did raise her concerns with local management as l would expect her to.

In the event that there was no positive response then she was required under her professional code to take action as the patients advocate.

I do feel she was wrong and probably misguided in taking the course of action she did by involving a TV programme or to use covert filming to obtain the evidence.

All she had to do was to log the evidence and then report the Nurse Managers to the NMC and ask them to investigate the mal practice that was clearly going on on this ward.

Her motives were correct and although in doing it she breached the code, the one thing that is clear is that the NMC should have used their discretionary powers when determining the level of action they needed to take.

In my experience, nurses are only human and do make mistakes, these days they are far more vulnerable because of circumstances which are outside of their control, financial stringencies, lack of sufficiently qualified and support staff being the main ones.

Her motives were admirable, but her methods of resolving them were the wrong ones.
Unsuitable or offensive?
Anonymous | 20-Apr-2009 12:06 pm
Can l ask, are the NMC investigating the standards of care provided by the qualified staff on this ward or are they waiting for someone to report them?
Unsuitable or offensive?
Anonymous | 21-Apr-2009 11:33 am
I made a complaint to the NMC as a former nurse, now retired. It is clear from their reply that in exceptional circumstances they do not need to strike a nurse of the register. And these circumstances were in my opinion so.

I have experienced poor nursing on occasions during 7 operations and it is difficult to complain. I am afraid that vulnerable patients need people like Margaret Haywood to do what they did.

The reply also blamed "media interest" for the vast number of phone calls and emails received, as though this was wrong for heavens sake.

How on earth are the public to know what is going on without the media?

This and the previous governments policies have combined to ensure that hospital beds have been reduced and turnovers are too rapid. Care Assistants training is too short and Nurses have not the time to supervise properly. There is too much paperwork - a lot of it duplicated.

Dare I say that making nursing a degree course has led nurses to undervalue the importance of basic nursing care and the excuse of early mobilisation is used to neglect it.
Unsuitable or offensive?
Anonymous | 22-Apr-2009 9:27 pm
Having actually read the full NMC report on this RGN - I believe their rationale does withstand logical analysis and as such, their decision justified.

I wonder how many people supporting Ms Haywood formed their opinion from the original source material rather than the rhetoric of the tabloid press?
Unsuitable or offensive?