Editor-At-Large: Whistle-blowers risk all while the chiefs do nothing

By:Janet Street-Porter

Sunday, 5 June 2011

The fallout from the BBC’s Panorama shown last Monday about torture and bullying at Winterbourne View care home, was depressingly predictable. The public, medical experts, social commentators and politicians were shocked and upset. The images were reminiscent of the Abu Ghraib photos of US soldiers maltreating prisoners in Iraq – but this was taking place in a purpose-built new facility in Bristol, where it costs £3,500 a week to “care” for mentally challenged patients who have committed no crime. The reaction was immediate: 13 members of staff were suspended, and the police launched inquiries into possible illegal behaviour. Distressed relatives removed family members, and the head of the private company who ran the facility offered apologies. The regulator, the Care Quality Commission (CQC), admitted there had been “a misjudgement”, an understatement, considering it had inspected the place regularly and found nothing wrong.

It’s all part of a familiar pattern. Complaints build up, the sick, weak and elderly suffer, till eventually one brave person manages to lob a missile into the mess that is our care system. Very little has been written about Terry Bryan, the senior nurse who worked at Winterbourne last year. Mr Bryan was so concerned about inappropriate staff behaviour that he complained to his manager. When nothing happened, he wrote to someone higher up the food chain at Castlebeck, the company that runs the facility. Mr Bryan named names and gave descriptions of incidents. Still nothing happened. He contacted the CQC, set up to monitor the industry – not once, not twice, but three times. Still nothing happened. Finally, he contacted Panorama, and they sent in an undercover reporter.

If it were not for Mr Bryan’s determined campaign, poor Simon and Simone would still be lying on the floor of the residents’ day room at Winterbourne, while staff members poked at their eyes, stood on their legs or tried to throttle them. Strangely, not one government minister, not one person from the CQC, and certainly not one CEO from a private care-provider has seen fit to praise Mr Bryan. So I will redress that oversight here. Thank you, for being brave enough to speak up in 2011.

The people who run social care in this country are not interested in whistle-blowers. When patients die in care and relatives complain, they are always promised a review, which generally means that a report will be concocted, packed full of phrases promising better “outcomes” (i.e. fewer deaths), and cosmetic changes will happen, but not one member of staff will be sacked. At Staffordhospital, complaints piled up and, in three years, as many as 1,200 people died who need not have done. Finally, an official report laid bare the full extent of the scandal in 2009. Since then, standards of care don’t seem to be getting much better, even with the CQC monitoring results. Only the other week, it announced the results of a survey into 12 NHS trusts which found that three – a shocking 25 per cent – failed to meet the minimum legal standards in two key areas, including nutrition. In one hospital, staff were forced to prescribe water, to ensure patients got enough to drink.

You might wonder why staff at these hospitals did nothing. The answer is simple. Being a whistle-blower in the care industry brings you nothing but grief. In 2007, Karen Reissman, a nurse with 25 years’ experience, expressed concern about the impact of NHS cuts and privatisation on patients in an interview with a local magazine. Result: she was sacked for gross misconduct by Manchester Mental Health and Social Care Trust. Paul Abbott, the writer of Shameless, supported her, and more than 100 colleagues went on strike for five weeks. Backed by Unison, she took legal action against her former employers, eventually reaching an out-of-court settlement. She did not win her job back.

The story would have been familiar to Margaret Haywood, a nurse with 20 years’ experience. In 2005, shocked by the treatment of elderly patients, she agreed to secretly film conditions at the Royal Sussex Hospital in Brighton for Panorama. Patients with terminal cancer were in terrible pain because drugs weren’t being properly administered, the wards were filthy, and the staff were eating in the kitchen while the patients went hungry. Was Mrs Haywood appointed OBE, praised by the PM, or thanked for lifting the veil on shocking abuse? No, she was sacked for misconduct and faced a tribunal, accused of breaching patient confidentiality by filming without their permission. She was struck off by the Nursing and Midwifery Council, which meant she’d lost her livelihood. Just like last Monday’s Panorama, the “Undercover Nurse” report caused widespread outrage, and we were told by ministers that never again would patients suffer. Blah, blah, blah. If it were not for whistle-blowers, you can rest assured that elderly and special needs patients would be lying in their own urine or starving routinely.

After a long campaign and a petition, Mrs Haywood was reinstated on the nursing register in 2009 and given a caution, but what a traumatic time she must have had. The Royal College of Nursing conducted a poll and found that two-thirds of their members who reported concerns over patient safety were worried about being bullied or sacked. The Department of Health says that whistle-blowers are protected by law, and the NHS has a contract with the charity Public Concern at Work, which runs a helpline staffed by lawyers, but evidence suggests whistle-blowers risk their health, reputation and livelihood. In the meantime, please note that the relevant NHS bosses, the head of the Quality Care Commission and the regional director for the Bristol area are all still in their jobs, on full pay and nice pensions.

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