Senior lecturer Bill Whitehead questions why regulators have been given different advice on blowing the whistle on poor care
In light of the events at Winterbourne View care home and Mid Staffordshire Trust, it is hardly surprising that the recent Commons health committee (2011a) annual report on the Nursing and Midwifery Council recommended that: “The NMC needs to send a clear signal to nurses and midwives that they are at as much risk of being investigated by their regulator for failing to report concerns about a fellow registrant as they are from poor practice on their own part.”
Similar recommendations were made for doctors, however, the committee softened its approach in the report on the General Medical Council by noting that: “Doctors and other practitioners who have raised concerns [about] other staff have sometimes been subject to suspension, dismissal or other sanctions. The committee therefore intends to examine this issue in more detail in due course” (Commons health committee, 2011b).
Is this lack of consistency just an oversight on the part of the health committee or are we again facing the familiar oppression of nurses when compared with medical staff?
“Clearly, if doctors are subject to unfair discrimination when they blow the whistle this is equally likely to happen to nurses”
Clearly, if doctors are subject to unfair discrimination when they blow the whistle this is equally likely to happen to nurses. A recent article in The Independent highlighted that a range of NHS whistleblowers had been “hung out to dry”, including radiographers, nurses, senior managers and medical staff (Lakhani, 2011).
The committee is right to be careful with their advice to the medical regulator and they should be equally considerate with advice to the NMC regarding potential reprisals against nurses.
Our research, which was conducted last year into nurses’ concerns about the “risk of reprisal” when blowing the whistle on poor care, highlighted this issue. We found in that: “Reprisal for whistleblowing remains a major concern for nurses. Future research should concentrate on developing an environment where nurses feel able to report incidents safely. Confidentiality should be given priority, thereby reducing the fear of reprisal or future repercussions” (Whitehead and Barker, 2010).
This would go a long way towards making nurses feel more confident to speak up, facilitating a more effective and safe healthcare environment for patients and healthcare professionals alike.
I’m not saying there is no room for consequences when nurses fail in their duty to protect patients from harm. However, if this is pursued further, it should be the case for all health professionals, including doctors, and it is unfair for any regulator to knowingly put their registrants into a dilemma where they are likely to be punished by employers for upholding their professional standards. Before making nurses accountable for failing to report bad practice, we must ensure that whistleblowers are supported by both their regulator and the NHS.
Bill Whitehead is senior lecturer in nursing and healthcare practice at the University of Derby
House of Commons health committee (2011a) Annual Accountability Hearing with the Nursing and Midwifery Council: Seventh Report of Session 2010-12. London: Stationery Office.
House of Commons health committee (2011b) Annual Accountability Hearing with the General Medical Council: Eighth Report of Session 2010-12. London: Stationery Office
Lakhani N (2011) Hung out to dry: scandal of the abandoned NHS whistleblowers. The Independent, 4 July 2011
Whitehead B, Barker D (2010) Does the risk of reprisal prevent nurses in the NHS from blowing the whistle on bad practice? Nursing Times; 106: 43, 12-15.