Whistleblowing and Ethics in Health and Social Care. Angie Ash

Чтение книги онлайн.

Читать онлайн книгу Whistleblowing and Ethics in Health and Social Care - Angie Ash страница 11

Автор:
Серия:
Издательство:
Whistleblowing and Ethics in Health and Social Care - Angie Ash

Скачать книгу

in place solely to meet compliance, regulatory or legal requirements – as a procedural fig leaf we might say – the tacit suppression, discouragement or punishment of dissent is experienced as the organizational actualité, whatever the policy says.

      Vandekerckhove (2011) identified five paradoxes in managing whistleblowing. The first is the truism that all the grand talk about whistleblowing protection doesn’t always get – that whistleblowing policies work best in organizations that don’t really need them; that is to say, in places where early corrective action is taken, where and when needed. Kaptein (2008) put forward seven features of an ethical organizational culture, which were:

      1.clarity (of normative expectations laid on employees)

      2.congruency (with these expectations) by managers

      3.feasibility (how far the organization creates the conditions that enable employees to meet the expectations)

      4.supportability (how far the organization creates support mechanisms to meet expectations)

      5.transparency (employees can only be held accountable if they knew the consequences of their actions)

      6.discussability (the opportunity employees have to raise concerns and issues)

      7.sanctionability (enforcement of sanctions to wrongdoing, rather than turning a blind eye).

      Organizations delivering on these ethical dimensions are not going to need to rely on the paraphernalia of policy, procedures, helplines for whistleblowers and all the rest – but they will have all of that because they manifest ethical virtues that deal with problems before they threaten the organization, and the people it serves.

      Vandekerckhove’s second paradox concerns anonymous reporting channels – something that whistleblowers often say they want but which don’t always help. Hunton and Rose (2011), for instance, found that anonymous reports were seen as less credible by managers receiving them, and fewer resources were allocated to investigating and rectifying reported wrongdoing.

      The third paradox lies in rectifying the problem the whistleblower raises, which may itself create other problems for the organization’s managers. The stakes are higher if the whistleblowing matter threatens the organization; if it does, whistleblowing is less likely to be effective (Near and Miceli 1995). The fourth paradox is the loose procedural talk about the right to blow the whistle, whereas it is, in reality, an implied or disguised duty, as the House of Commons committee referred to earlier made clear. When an issue blows up, those who knew but did not report it are judged, blamed and held to account, no matter what fear of reprisal they may have had about raising the concern in the first place. The right becomes a liability. The fifth paradox is the response to whistleblowing and to the employee raising concerns: this itself can lead to detriment, reprisal and wrongdoing against the employee. These paradoxes are in perfect symmetry: the employee is damned if they do, and damned if they don’t.

      The outlook isn’t always a rosy one for the whistleblower. There is no certainty that anything will change after a whistleblower has put themselves through the procedural mill to raise their concerns. Momentary acclaim for being the heroic martyr who took on the iron cage of a dehumanized bureaucracy won’t pay bills, repair relationships or develop new careers if the whistleblower finds themselves dealing with career ruin, bankruptcy, depression or alcoholism (Alford 2001; Rothschild and Miethe 1999).

      The UK House of Commons Committee of Public Accounts, having taken evidence from four government departments (Education; Health; Revenue and Customs, Ministry of Defence), observed in its 2014 report on whistleblowing that ‘…whistleblowers who have come forward have had to show remarkable bravery’ (HOC 2014, p.3). It commented that the treatment of some whistleblowers had been ‘shocking’, with whistleblowers sometimes left unprotected from victimization. The Committee noted the ‘startling disconnect between the generally good quality of whistleblowing policies in theory and how arrangements actually work in practice’ (HOC 2014, p.6).

      When taking evidence for this report on whistleblowing, the chair of the UK House of Commons Public Accounts Committee (PAC) remarked:

      I will just say that we tried to get a number of whistleblowers whose evidence has been proven credible to come and talk to us about their experience… We had somebody from HMRC [Her Majesty’s Revenue and Customs] who would not come, somebody from the MOD [Ministry of Defence] who would not come, somebody from local government who would not come, and also somebody from the police. That shows there is still a culture of complete fear out there…which demonstrates the difficulties that we are facing. (PAC 2014)

      Giving evidence before the PAC, Kay Sheldon, who had been a board member of the Care Quality Commission (CQC), the health and care regulator in England, described some her experiences of whistleblowing to the CQC:

      …I started to raise some quite serious concerns about CQC – about the leadership, the management and the culture. I felt that the organisation was at risk of not fulfilling its statutory duties, so they were really quite serious concerns. Unfortunately, because the culture was quite oppressive, those concerns were not well received. The more I tried to get them taken seriously, the more I was subject to inappropriate behaviour, such as being excluded from roles that had been agreed. My mental health was questioned. I am obviously open about the fact that I have had mental health issues, but that was used against me. A secret mental health report was done on me…

      As I was really very concerned that the organisation was failing, and failing patients – people who use services – I felt that I had to go outside the organisation. I approached the National Audit Office, the Department of Health and the Mid Staffs public inquiry, and it was the inquiry that responded positively… [U]nbeknown to me, the chair of the Care Quality Commission wrote to (Secretary of State for Health) asking for me to be removed. I did not know that had happened. I was called into the Department of Health and told that there was going to be an independent review, and I was asked not to attend any further board meetings. It was pretty clear to me that they wanted me out of the picture as fast as possible, so I declined. I said I wanted to continue going to board meetings, which I did. I had someone with me, because I knew that would be necessary.

      The review that was set up was not independent; I think that is the thing to say. Frankly, it was a deliberate hatchet job; there is no other way to describe it. I met with the person doing the review for about an hour, and I was told it was going to report within 10 days, but it didn’t. It dragged on. I didn’t hear anything else, but when I got my personal data, I found out that the person doing the review, the CQC and the Department of Health were in quite a lot of contact. I was completely out of it. I didn’t have a voice. (PAC 2014)

      Asked if she thought her concerns would be dealt with differently (than they were in 2011–2012), Kay Sheldon was unconvinced they would be:

      I am not convinced, because of the extreme things that happened – the fact that I did raise some very serious issues and really all they were intent on was to get rid of me. I don’t think the Department of Health and the officials there have really taken responsibility for what happened. Personally, I think that if they did – if they did engage with me or other whistleblowers – that would really help to change things, but so far they haven’t done it, frankly. (PAC 2014)

      As the messenger taking the hit for her message, Kay Sheldon was subjected to referral, without her knowledge, for psychiatric assessment. Sheldon recounted her short conversation with the director of a private occupational health service paid by the Department of Health to carry out this covert, Kafkaesque assessment:

      …(the Chair of the CQC) told me that I had been referred to this occupational health company, Medigold,

Скачать книгу