Gagging clauses and a culture of bullying are preventing NHS staff from raising concerns.
This problem was first highlighted by Gary Walker, former chief executive of United Lincolnshire Hospitals Trust (ULHT), who broke the terms of his compromise agreement to raise concerns about care. He described how the NHS regularly used ‘gagging clauses’ in severance agreements to stop former employees speaking out about problems with patient safety or care.
It is thought the use of gagging clauses within the NHS has been widespread in recent years, although health secretary Jeremy Hunt has since suggested they will be banned. Mr Hunt emphasised how the scandal at Stafford Hospital, where hundreds of patients died due to poor care, “happened because there was a culture of covering up problems.”
He added: “We need to encourage front-line NHS employees who see problems to come forward, in the first instance to tell their own institution about them, but then having the ability to go beyond that if they don’t think anything is being done about their concerns.”
However, a ban on gagging clauses may not be enough to tackle what Mr Walker describes as the “culture of fear and oppression” within the NHS. The worry over whistle-blowing was recently reiterated by the Nursing Times which found the NHS discourages staff from reporting problems.
The magazine asked more than 800 nurses to complete a survey. The findings revealed nurses were too scared to highlight concerns about patient care, with 30% believing they would be labelled as a troublemaker, and 23% believing managers would not take any action anyway.
Of all the nurses who took part, 84% had previously raised concerns, of which 52% said there had been no appropriate outcome, and around 50% saying this had led them to suffer negative consequences.
According to Jenni Middleton, Nursing Times editor, there are nurses “who, having raised concerns, have been side-lined and ostracised by their employers, bullied and marginalised by their colleagues – and end up feeling ashamed and guilty, as well as concerned that their careers are over.”
Both news stories seem to suggest that covering up problems is a habitual practice for the NHS – something which could easily cause another Mid-Staffs scandal. It therefore seems we are a long way off the “culture of openness and transparency” the health secretary says he is attempting to create.
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