By Della Reynolds, PHSO Pressure Group
Usually campaigners have to sneak in through the back door if they want to attend NHS safety conferences. These ‘corporate’ events are generally packed with experts in complaint handling, but very short on experts by experience – those on the receiving end. Without complainants in the room there is a tendency to turn human suffering into risk analysis. phsothetruestory.com/2015/07/25/when-complaint-handling-becomes-risk-analysis-it-has-missed-the-point/
This was not the case with ‘Turn Up the Volume’ a conference organised by Steve Turner http://www.carerightnow.co.uk/steve-turner/ specifically for NHS whistleblowers and campaigners; a platform for those too often silenced as ‘vexatious’ and hopefully the first of many. Those in authority prefer to keep campaigners apart and preferably at each other’s throats. Swimming against the tide is exhausting and the hope is that each of us will succumb to emotional burnout if they can just keep us isolated and ignored long enough.
It was a delight to share a table with Will Powell, certainly not burnt out after 25 years of campaigning. This extraordinary man has taken on every part of the establishment and used every means available to obtain justice for his son Robbie who died unnecessarily 25 years ago. He knows the full level of collusion and corruption which keeps the truth hidden and the guilty protected. Julie Bailey was also present and able to offer advice from her years of experience working to promote change through the ‘right channels’. She pointed out that when the pressure builds this will be defused by a disingenuous promise of action. Some crocodile tears will be shed along with the ubiquitous ‘lessons have been learnt’, but behind the words, she warns, no action is taken. Everything goes on as before.
Two questions which emerged time and again were:
Who do you go to?
When will we see some action?
As campaigners for reform of the Ombudsman the PHSO Pressure Group know for certain that there is no point taking your complaint to the Health Service Ombudsman. They are just gatekeepers with a big shovel and a deep hole. PHSO will not investigate whistleblower cases and neither will CQC. Although PHSO are now investigating more cases they still allow serious and unsafe practices to continue unchecked by failing to find maladministration.
Whistleblowers are particularly vulnerable as they have no direct route to remedy and often the raising of serious patient safety issues is demoted to nothing more than an employment dispute. Many brave people took to the stage to tell their stories and how they clung on to decency when the world turned against them. Jenny Fecitt and Tracy Boylin had their lives destroyed when as NHS employees they spoke out about unsafe practice. Both managed to pull back from the brink and have now set up Patients First a campaign for openness & transparency and a just culture in health services to encourage others to speak out.
Joan Pons Laplana is still working within the NHS and his concern for patient safety has caused him to speak out on a number of occasions. Consequently he has had to move jobs 15 times in 15 years. He told us that once you speak out you are labelled a trouble maker and then you have two options; either keep quiet or move jobs. He quite rightly pointed out that the next Mid Staff scandal is quite likely happening as we speak. CQC have found ¾ of trusts to be unsafe, 33 trusts have no permanent CEO and 60% of NHS staff agree that care is not good enough. Creating low staff morale could all be part of the plan for privatisation if you agree with Youssef El-Gingihy a GP who wrote, ‘How to dismantle the NHS in 10 easy steps’. www.zero-books.net/books/how-dismantle-nhs-10-easy-steps First you destroy the present system and then save the people from catastrophe by introducing a private alternative. I can’t be the only person regularly receiving private healthcare mail through my letterbox as they gear up for the nirvana to come.
Maria Paviour www.mariapaviour.com/home an NHS whistleblower victim herself, has looked into the psychology related to bullying in the workplace. According to estimates only 1% of the population are psychopaths – the kind of personality best suited to bullying and 3% are the everyday heroes who have the courage to speak up.
Psychopath definition: A person with an antisocial personality disorder, manifested in aggressive, perverted, criminal, or amoral behaviour without empathy or remorse.
With only 1% likely to posses this personality type how is it that this behaviour has become a widespread management technique in the NHS? Maria Paviour suggests this all stems from the pressure applied to individuals by aggressive target setting. She accepts that most people have good values, but says this isn’t enough as target achievement at all costs creates pressure to fit in with the cultural norms.
Chris Day Director of Engagement from CQC also commented on dysfunctional cultural norms when he described many organisations as having a ‘can’t fail’ attitude which requires them to distort the facts. The pursuit of target achievement above all else was a key factor in the Mid Staffs inquiry. I’ve put my own thoughts on the link between target setting and pervasive defensiveness in the NHS here: phsothetruestory.com/2015/10/21/fantasy-targets/
Wendy Addison was reduced to sleeping on the streets and begging for food due to the fall out of her whistle blowing in South Africa. As the Finance Director of a major company she spoke out over fraud and paid a heavy price. /wwwspeakout-speakup.org/#/ She survived, grew stronger and set up Speak Out – Speak UP to help other whistleblowers come forward. She spoke about FRAUDSEC which is an encrypted web platform which allows people to blow the whistle anonymously. www.smh.com.au/it-pro/business-it/whistleblower-app-fraudsec-features-anonymising-encrypted-messaging-20150504-1mzc51.html
Jenny More and Christina Taylor from ‘Your Voice Matters’,http://www.yourvoicematters.org.uk/ have been campaigning for improvement to care homes for the last five years. Both have been personally affected by poor care and poor accountability and told horrific stories including that of a blood soaked nightie disappearing after an elderly parent was assaulted by a care worker. Nothing was done. The PHSO Pressure Group have been campaigning for the last two years to improve accountability through reform of the Ombudsman. Our stories run in parallel. Jenny noted that regulators often failed to find the truth (CQC), that politicians were disinterested and if there was media coverage they were gagged from speaking the truth. All in it together. Jenny, Christina and the team at Your Voice Matters have put their lives on hold to fight for the rights of this very vulnerable group.
Not everyone was a campaigner or whistleblower. Jonathan Hazan, the chief executive of Datix http://www.datix.co.uk/ told us about the on-line data base for recording clinical incidents with a view of reducing them. He informed us that 80% of the NHS use Datix though some are finding the form filling too time consuming. Surely this depends on the outcome; form filling for the sake of it is onerous, but form filling to save lives should be a different matter. Recording the data should only be the start of the process and Jonathan confirmed that the most effective model then used independent, external investigators to follow up incidents. He confirmed the futility of self-evaluation, yet this is exactly what we have through much of the NHS complaint handling process.
James Munroe is CEO of Patient Opinion. https://www.patientopinion.org.uk/ a trip advisor style website for NHS issues. James accepts that Patient Opinion is for the everyday niggle rather than a major incident as service users and service providers are put in touch with each other to iron out service delivery issues. There is a valuable sense of ‘victim empowerment’ in this project; that patients can have a voice and be heard directly by those with the ability to make change. James reiterated the conclusion of the Francis report into Mid Staffs. Feedback is important, it must be acted upon and people should be able to see what changes have taken place as a result. Patient Opinion is independent of the NHS, but unfortunately, dependent for funding on NHS trusts signing up to the service which can create a conflict of interests.
Dr Umesh Prabhu and Kim Manley both spoke about improving workplace cultures. Both agreed that it should be person centred and that the patient is at the heart of the process.
“We must never lose sight of the fact that patients are human beings – culture is what you do when no one is looking.”
So after a very long and eventful day did we find answers to our recurring questions?
- Where do you go to? We go to each other; the only people with the ability to listen with honesty and compassion.
- When will we see some action? When we take some, for those in power are content to push this issue round in circles for many more years to come.
A fantastic and inspiring day. Some great contacts made and Steve Turner is to be commended for providing a platform and bringing us all together. This may be the start of something big. Perhaps an umbrella organisation enabling campaigners to work and support each other more effectively, for it is certain that change rests on our shoulders.
More information on the conference here: http://www.carerightnow.co.uk/turn-up-the-volume-resources-2/
NHS Heart of Darkness paper: (Well worth a read).