One night, we sat in a movie theatre consuming large amounts of Haagen Dazs ice-cream. Whistleblower reprisal is difficult to deal with and those of us who survive it end up addicted to combinations of chocolate or ice-cream - if we are lucky! We watched Open Water, a B-movie replica sporting the tale of two divers left in the middle of the sea with an array of sharks. The dialogue screamed "We are stuck in the middle of the ocean" and eventually they were munched by sharks. This is the best analogy of a medical whistleblower's survival.
You can expect to experience character assassination, unemployability, denial of documentation to vindicate yourself, leaving you to face revolving door investigations, financial catastrophe and, the pariah stigma on your own. One of the best summaries of whistleblowing was written by Gavin Yamey in the year 2000. Our 2011 paper showed that it is not any safer to raise safety concerns eleven years later.
For centuries, whistleblowing has been condemned within the club cultures of the medical profession. The protection of establishment interests have taken priority and any challenges are usually silenced. This is no conspiracy theory; each bona fide whistleblower in the United Kingdom will testify to this as fact - there are so many rattling skeletons now that no one is prepared to open the closet door.
The Bristol Inquiry sported the dapper Steve Bolsin complete with mortality data in an emotionally charged area - children. This combination made the subject explosive within the media sending the message - if you whistleblow, you go to Australia. Despite huge amounts of paper, documents, debates dedicated to the Inquiry, the situation remains much the same as it always was.
Since 2001, the peaks and troughs triggered by various high profile cases in the media have been met with the same response - that something will be done but nothing actually is done. The UK's media have no rationale or logic in the subject of whistleblowing opting to dedicate their lives to being organisational mouth-pieces for PIDA, suspensions, gagging clauses and developing the fragile image of the whistleblower as a - "victim" with "work related stress". Of course, the subject is far more complex - involving the establishment interests and a historical reluctance to change medical culture.
While there is a lot of pontificating, intellectualising, tea drinking and cake eating, there is very little by way of positive solutions. The UK's medical establishment has never been keen on resolving its problems preferring to sing the infamous song from Fiddler on the Roof - Tradition - while concealing its problems in a locked closet away from prying eyes. Dr Harold Shipman and the subsequent Inquiry shows the results of a medical club culture .
The GMC has no recognition of whistleblowers' problems - they prosecute for raising concerns and for not raising concerns. Their position on whistleblowing is largely unclear. Medical Self Regulation-Crisis and Change detailed this. The organisation fails to collect data and refused to conduct a consultation into the subject.
The Health Select Committee's Stephen Dorrell MP made interesting noises about a Review/Inquiry into whistleblowing but subsequently went silent. The Department of Health's civil servants continue to advertise the Public Interest Disclosure Act [PIDA] as a guiding light; failing to mention leading research by Professor Dave Lewis of the Middlesex University . In nutshell, PIDA does not work. As Dave points out, few in the higher echelons of power wish to listen.
Overall, there appears to be a reluctance to open dialogue with whistleblowers or examine the real issues. We noticed this when we wrote our paper Whistleblowing and Patient Safety . We suggested that each organisation was inadequate in dealing with whistleblowing. It is extremely difficult to publish critical material in journals funded by the establishment. Obviously, our blunt approach did not go down well. The establishment figures were keen to "show off" on how they were "improving" and insisted that we should not look at the "past" thereby providing their cosmetic ducktape "solution".
In summary, the GMC who should take the lead is in denial. The Parliamentary Health Select Committee may be hoping the issue will disappear, having previously refused a review some years ago. The DOH and the BMA wishes to remain angelic and blameless when the reality is quite the opposite. Consultation questions are limited to the interests and perceptions of civil servants - finely crafted to provide a public illusion.
We question why these authorities are reluctant to offer a basic investigation and recommendations on which public policy can be based on? Their current position is resulting in heavy litigation affecting the economy, a poor patient safety feedback mechanism and increasing patient deaths - all of which are not in the public interest.
Follow Rita Pal on Twitter: www.twitter.com/dr_rita39