We need to protect whistleblowers outside the NHS too
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Version 0 of 1. In Freedom to Speak Up, the report on the plight of NHS whistleblowers published this week, Sir Robert Francis interviewed 612 victims, many of whom I know had high hopes. But his recommendations have turned out to be toothless and probably ineffectual. Why do I say this? Because the often shocking travails of whistleblowers are distributed well beyond the NHS, across all industries. What’s more, and this is key, their experiences are universally, uncannily similar in all contexts – from the NHS cardiologist Dr Raj Mattu and Bupa care worker Eileen Chubb to the HSBC whistleblower Hervé Falciani – who, after bravely revealing industrial-scale wrongdoing at the bank, found the authorities investigating him. Related: The HSBC files: what we know so far So when Francis says of the NHS that “We need to explain why these things happen in the system”, he is precisely wrong. We need to explain why these things happen outside the NHS. And the explanation is far simpler than generally believed, because over the past two decades, British society has been reshaped by what amounts to a coup d’etat: a management coup that occurred so stealthily that almost no one noticed. All our high-stakes industries, places where the public might reasonably feel itself to have an interest, have been colonised by this power-suited force: three or four layers of management whose vastly inflated salaries separate them from the workforce psychologically, and encourage them to defend their preposterous benefits through empire building and the ruthless quashing of dissent. Look at any whistleblower’s experience and this is what you see. First, the doctor/nurse/compliance officer/IT contractor/branch adviser – it could be any of us – registers concern over a particular practice or policy. Managers take note and do nothing, so the concern is raised again, then again. But instead of acting to examine or remedy the situation, management now works to marginalise the messenger, until at some point he or she is forced to look outside the organisation for help and become a whistleblower. This can be a shattering, terrifying process, directed at the very people most of us would like to see remain inside the system, the ones who really care – and it usually costs them their careers. More to the point, in every case I’ve looked at the driving force is the same: a detached management with its own priorities, with different incentives to the people on the front line, moving to protect itself from scrutiny or censure. At this point, the needs of staff and customers become secondary, because – consciously or unconsciously – management is running the organisation for itself. Instead of acting to examine or remedy the situation, management now works to marginalise the messenger How else does one explain a case like that of Dr Mattu, a thoroughly decent man and former high-flying cardiologist who raised the alarm about overcrowding in his wards, only to be forced out of the NHS and hounded by a troika of managers who conjured up 200 disciplinary and criminal charges against him – all of which were dismissed by professional bodies and three separate police forces? Having looked in detail at this episode and spent time with Mattu, I have trouble understanding why his tormentors, who in trying to silence him cost the service between £6m and £10m, are mostly still walking the corridors of hospitals – including his ex-boss, David Loughton, who is reported to earn £400,000 a year as the chief executive of Royal Wolverhampton Hospitals NHS Trust. Anyone who has spent time around the big state-funded organisations recognises this situation (councils are notorious for this). However, our public institutions are not demonstrating the folly of state control, they are reflecting a private sector drunk on the triumphalist market fundamentalism that followed the fall of the Iron Curtain – and that progressive governments have forced them to emulate. What many firms did was ‘incentivise' top management and key staff with share options and target-related bonuses This began under Margaret Thatcher, but continued during the New Labour years. Some of the reasoning we can understand: on paper, giving people a clear stake in the organisation they run or work for looks sensible; and in outperforming the slump, John Lewis, where all staff members are shareholders, has proven how effective this can be. What many private-sector firms did, however, was “incentivise” top management and key staff with share options and target-related bonuses, so encouraging a short-term outlook focused on keeping the share price up and turnover high – regardless of its effect on the long-term health of the organisation, or on the quality, sustainability and ethics of the business model. Indeed, the most immediate way to boost profits, and hence share price, is by cutting costs such as wages, so loosening ties between management and workforce still further and “incentivising” the cutting of corners. Hence five beds in a cardiac ward designed for four. For all his well-meaning energy, Francis’s surprisingly meek proposals won’t work, because the NHS is not the problem, it is merely one symptom of a much broader pestilence. In the final analysis, whistleblowers are canaries in our coalmine, relaying a complex message which we need to hear – and fast – before our most cherished organisations and the society they serve are hobbled beyond repair. |