Over the last few days, The Telegraph has been running a series of articles about NHS whistleblowers who have had their careers and lives ruined while trying to raise concerns over patient safety.
More than 50 doctors and nurses have told The Telegraph they have been targeted after raising concerns about upwards of 170 patient deaths and nearly 700 cases of poor care. Instead of trying to fix the problems, NHS bosses are spending millions of pounds of taxpayers’ money hiring law firms and private eyes to investigate them.
One of The Telegraph articles reveals how the NHS uses a four-step playbook to break whistleblowers.
If we want to understand why some NHS staff did not speak out during the covid era, perhaps we should consider whether the culture of fear that the NHS has fomented has played a role.
The following is an abridged version the article ‘The four-step ‘playbook’ the NHS uses to break whistleblowers’ written by Janet Eastham and Gordon Rayner published by The Telegraph on 15 May 2024.
NHS managers use a playbook of tactics to silence whistleblowers that is “designed to break you,” according to doctors who have tried to raise patient safety concerns.
A Telegraph investigation has found so many similarities in the way different NHS trusts and clinics deal with whistleblowers that many doctors believe the problem is systemic.
The doctors complain of bullying and harassment, both from managers and colleagues, which they claim creates a culture of cover-up.
Law firms and private investigators are also often brought in to investigate the whistleblower, who is then told they are being suspended.
Years of internal investigations, disciplinary hearings and legal battles typically follow, until medics succumb to the personal, professional and financial pressure and quit.
Many doctors who have decades of expertise in their field and distinguished careers are reduced to depression and suicidal thoughts by the situation they find themselves in.
Some sign non-disclosure agreements, enabling them to return to work if they promise to keep their mouths shut, others try to fight back through the High Court or employment tribunals, and others leave the NHS for private hospitals or quit the medical profession altogether.
The pattern is not dissimilar to the punitive measures – including suspensions and contract terminations – employed by the Post Office against its sub-postmasters and employees during the Horizon IT scandal.
Step 1: Investigate the whistleblower
The evidence collected by The Telegraph suggests NHS employers are more likely to investigate the conduct of whistleblowers than the issue they have raised.
Of the 52 medics interviewed by this newspaper, 41 said their own conduct was put under investigation. They were all subjected to counter-allegations after raising concerns.
Only 28 – barely half – said their employer carried out a patient safety investigation, and where patient safety investigations were conducted, the vast majority – 24 out of 28 – had serious concerns about the way the probes were conducted.
External law firms and private investigators, some of whom are ex-policemen, are often brought in to investigate the whistleblower’s own activities.
The formal process for investigating doctors usually begins with a maintaining high professional standards (“MHPS”) investigation, which is supposed to be wrapped up in six weeks, but which often lasts much longer.
Martyn Pitman, a consultant obstetrician and gynaecologist at Hampshire Hospitals NHS Foundation Trust, was placed under an MHPS probe after he raised concerns about maternity care. He said he was warned by his British Medical Association representative that it would take between six and 18 months.
He said the BMA rep told him that trusts “deliberately extend it because they want to break you. They want to absolutely destroy you.”
Another consultant told The Telegraph the MHPS process “gives hospital management unbelievable power with no accountability. “Essentially the NHS trusts investigate themselves, mark their own homework, and they become the judge, jury and executioner for the whistleblower all in one go.”
Serryth Colbert, a maxillofacial surgeon, said the process “keeps you walking on the cliff-edge threatening to push you over”.
He said: “Doctors break. Many drink to excess to drown their sorrows, most feel sorry for themselves and eventually become depressed, or suffer PTSD and become clinically depressed from the ostracisation and overnight loss of identity when you are kicked out from the job you love.”
Step 2: Bully and intimidate
Of the 52 medics interviewed by The Telegraph, 45 reported being the victims of victimisation, harassment, discrimination, bullying or intimidation after they blew the whistle. Sixteen were inappropriately referred to psychological or psychiatric services. Five were victims of vexatious referrals to the police, social services and HM Revenue and Customs, with each found to have no case to answer.
They said the bullying and intimidation appeared to be aimed not only at weakening their resolve to continue fighting but also at damaging them psychologically.
Step 3: Weaponise General Medical Council referrals
Referral to the General Medical Council – the regulator for doctors – is routinely used as part of NHS managers’ kit bag for silencing whistleblowers, it is claimed.
The Telegraph has spoken to 22 whistleblower doctors who were between them referred to the GMC a total of 30 times. To date, only two of the referrals resulted in a fitness to practise hearing and neither was upheld.
Nine of the doctors claimed to have been threatened with a referral to the GMC if they didn’t withdraw their complaint, or stop raising patient safety concerns.
This group includes Dr. Peter Duffy, who won his employment tribunal against University Hospitals of Morecambe Bay NHS Foundation Trust in 2018, was anonymously referred to the GMC a total of seven times.
Three of these referrals proceeded to an investigation, but none to a full hearing. In every case, the regulator concluded he had no case to answer.
Morecambe Bay said that the trust “has never referred Mr Duffy to the GMC nor encouraged others to do so.”
The former consultant urologist told The Telegraph that after the seventh and final GMC referral, his lawyer advised him to take early retirement and request voluntary erasure from the medical register.
He explained: “I was told by my solicitor, ‘there may be no end to this. If the GMC throws the case out, you may find they report you again, there is no limit to how many times you can be reported.
“‘You can’t sue the person or the organisation reporting, because it has absolute privilege. If you’re reporting something to the GMC, you can allege whatever you want. And our fear is that this is just going to carry on until they find a weak spot … you’re a sitting duck’.”
In 2014, retired judge Sir Anthony Hooper was commissioned by the GMC to conduct a review into its treatment of whistleblowers.
Sir Anthony was concerned that GMC referrals could be made as “an act of retaliation” and that “the GMC unwittingly becomes the instrument of the employer in its campaign against the doctor”.
He commented: “It would be both cruel and counterproductive to require doctors to speak up and then unfairly or inappropriately damage or destroy their careers when they do so.”
To mitigate this risk, the regulator required trusts to specify if the doctor being referred had raised patient safety concerns and if these concerns had been investigated.
But The Telegraph can reveal that many institutions are simply failing to tick the box.
Out of the 22 doctors who were referred to the GMC, 14 of them said the referrer did not correctly identify them as a whistleblower.
Step 4: Demotion, disciplinary action and dismissal
Aside from GMC referrals and MHPS investigations, hospitals and clinics can employ a suite of punishments to silence doctors or force them out if they dare to raise concerns about patient safety.
Of the 52 whistleblowers interviewed by The Telegraph, 25 faced disciplinary action, 19 were suspended and 16 were dismissed.
As one nurse who was excluded from work after raising concerns said: “My mum and dad are so terrified. I’m their son who they’re so proud of, who went to university as a nurse.
“And now in the home town we live in, I am known for being this bully, and suspended and pending investigation.
“It is horrific what they have put me through. I haven’t murdered anyone!
“Even if I had committed a serious crime – rather than just protecting my patients – I still deserve a fair trial, which is more than I am getting now.”
Others faced more subtle forms of punishment: 15 were demoted, 16 had adverse changes to their terms and conditions, 11 were given a pay cut,12 had extra workloads heaped on them and three said they were left with no option but to resign.
Two experienced consultant anaesthetists who raised concerns claim they were instructed to reapply for their positions as educational supervisors.
Despite each having over 10 years’ experience in trainee supervision, their hospital appointed two junior consultants in their place. “It was clear that it was a fix,” one said.
To add insult to injury, the whistleblowers also had their annual leave allowance reduced. “They brought in a new way of calculating it which only applied to us,” one of the consultants explained, adding: “They also refused me leave despite me complying with all the rules.”
For those who would like to read the full article, we have attached a copy below.