Open. Candid. Transparent. Apparently, that is what the NHS needs to be, according to Robert Francis QC’s report.
Health service staff need to “fess up” to making mistakes, not blame each other, learn from them and move on. Nothing should be concealed, nothing should be hidden. It sounds so easy when you say it like that doesn’t it?
However, it seems to be proving pretty hard to achieve in real life. Take, for example, former United Lincolnshire Hospitals Trust chief executive Gary Walker’s eagerly awaited appearance before the Commons’ health select committee last Tuesday. The day before, Sir David Nicholson, chief executive of the NHS and formerly of the East Midlands SHA, had appeared before a different Commons’ committee and denied Mr Walker had ever identified himself as a whistleblower. But Mr Walker produced a letter he wrote to Sir David claiming exactly that. Was this an example of a senior manager forgetting the details of the case, or an example of an ethos where you deny all knowledge of something until someone can prove otherwise? The Department of Health claims the former.
Witnessing that health select committee “grilling” made me think even more about how we treat people who raise concerns. I appreciate Mr Walker and his former chair David Bowles were making serious allegations, and challenging those is fit and proper. But at times, it felt like those people raising concerns were on trial.
This was a high-profile case and will have been watched by many NHS staff. And the impression they will have taken away is that if they raise concerns, they will be disbelieved, discredited and subjected to an ordeal that would vilify rather than vindicate them. Is this really what Mr Francis had in mind?
The Walker case has strengthened our resolve in our Speak Out Safely campaign, which aims to ensure all NHS staff feel able to raise concerns, and are protected and supported when they do so.
Speaking out should not make you a hero. You shouldn’t have to be brave to tell the truth. It should feel ordinary, not special.
But it’s not just nurses’ voices that have been attacked. Their pay is under fire too. Chancellor George Osborne’s Budget last week said pay rises would be limited to a rate of 1% until 2015-16. He also signalled more alterations to Agenda for Change.
Perhaps if the health service hadn’t spent so much money gagging staff who raised issues about patient safety, then maybe, just maybe, it could afford to pay its nurses a fair wage.
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Jenni Middleton, editor
firstname.lastname@example.org. Follow me on Twitter @nursingtimesed