Comment on: CQC hires new national whistleblowing ‘guardian’
I have little faith in the National Guardian office. It started off life very poorly designed, and now CQC et al have gone a bit vague about what the National Guardian will actually do.
Today, I sent this letter to the new National Guardian:
"To Dr Henrietta Hughes National Guardian designate 7 July 2016
Dear Dr Hughes,
Role and powers of the National Guardian for Freedom to Speak up
Congratulations on your appointment to the post of National Guardian.
I am an NHS whistleblower – formerly a consultant psychiatrist - and I have been waiting for news of how the National Guardian’s office will develop.
I wonder if you can help me by clarifying your understanding of the extent of the National Guardian’s powers and role?
There appeared to be an implied change in the National Guardian’s role and powers from differences in the position specification issued for the appointment of Eileen Sills, and that issued for the latest appointment process. The following phrases were not present in the most recent National Guardian position specification:
· “…this would not be a system of case management”
· “…would not involve investigation”
· “…would not be a means of appeal”
· “Where the National Guardian decides to review a case…they will not consider the content of concerns, or investigations or the outcome of these”
Is it possible to say therefore if the National Guardian’s office will operate a case management system, will investigate cases, will offer an appeal mechanism against local employers’ decisions and will examine the contents of whistleblowers concerns and the appropriateness of local investigation findings about staff concerns?
My understanding of information from the CQC is that the National Guardian will be able to substantially influence the office’s scope and role. I would be grateful to hear if this will now be the case, and what your initial thoughts are on developing the office.
Dr Minh Alexander"
There is a serious conflict of interest in Eileen Sills acting as both a purported Guardian of whistleblowers and at the same time remaining the Chief Nurse of a large and powerful teaching hospital trust, that is firmly part of the NHS Establishment
Readers may wish to know that the advertised position specification by CQC, dated 13 Sept 2015, explicitly required that the National Guardian should be independent of trusts. It stated:
"The National Guardian will be independent of NHS Trusts"
It says a great deal that both CQC and Dame Eileen don't seem to think it matters that she is employed by a trust.
I doubt that she will do a great deal for whistleblowers.
I have no personal knowledge of Dame Eileen but I cannot for the life of me understand how CQC and Dame Eileen consider that it is appropriate for her to continue in a role as Chief Nurse whilst holding responsibility for protecting whistleblowers' interests. This disregard of a serious conflict of interest is yet another blemish on this flawed office. However, as the National Guardian office is designed to be ineffective, it does not surprise me that CQC is content to operate it as a part time post. The key weakness of the National Guardian office is that its remit will not include examination of whistleblowers' disclosures. Anyone who knows anything about whistleblowing will be acutely aware that good whistleblowing governance requires a central focus on disclosures and their effective handling. Instead, the National Guardian is designed to be part of the distraction machinery which turns patient safety issues into employment quagmires, and will only examine process. Also, because Mr Hunt and CQC have stipulated that the National Guardian will not examine whistleblowers' disclosures, crucial information about trends in NHS whistleblowing and the nature and scale of staff concerns about patient safety will be airbrushed out of the National Guardian's periodic reports. "Meta-gagging" on a grand scale, in other words. I will just mention one other designed-in flaw (of which there are many). The National Guardian will have "wide discretion" as to which cases she will engage with. This is a recipe for arbitrary decisions and unfairness, and risks continuation of the disproportionate discrimination against whistleblowers with protected characteristics. In all, the construction of this office and this appointment say all there is to say about the government's real attitude to staff empowerment and transparency.
The Rt Hon Jeremy Hunt does not practice what he preaches, but appears to be unembarrassed to espouse standards of conduct that he has failed to live up to.
Report after report has been delayed and suppressed to varying degrees on his watch…
Lord Rose’s report on the quality of management in the NHS, the report of the Freedom to Speak Up Review on NHS whistleblowing and the NHS Trust Development Authority’s (TDA) commissioned report into allegations of whistleblower suppression and manipulation of data at the Royal Wolverhampton NHS Trust, to name recent examples.
In the last few days senior staff at Monitor and NHS TDA were reportedly “leaned on” by government ministers to delay publication of routine reports that would have revealed the real extent of the serious financial crisis in the NHS, because such publicity was unwanted before the Tory party conference.
From the point of view of whistleblowers, Mr Hunt has done nothing to make it safer to speak up. The Freedom to Speak Up review has simply confirmed what was already known – that NHS whistleblowers have been brutally suppressed – but it failed to deliver effective protection for future whistleblowers.
Mr Hunt’s most crucial arms length body, CQC, limps on as an organ of government rather than a truly independent champion of the public’s interests. Mirroring its master, CQC continues in old ways of spin, smoke and mirrors. It has still not published meaningful activity data on its handling of whistleblowing.
CQC has also resisted transparency about a very delayed external review of its performance as a “prescribed body” under the Public Interest Disclosure Act, and its duty to receive and respond appropriately to disclosures from whistleblowers.
All in all it seems that what’s good for the goose (aka NHS minions) is not good for Jeremy the Rt Hon gander.
Minh Alexander former consultant psychiatrist and NHS whistleblower