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Care services need to have a whistle-blowing policy and procedure, which should be followed by staff who wish to report wrongdoing. This will usually involve reporting to the management of the service. However, if this is not possible (because of previous inaction after being reported, for example, or through genuine fear of retribution), then a list of prescribed agencies can be contacted. The regulators of social care staff and of social care, in England, Wales and Scotland are included on this list.
These measures are spelled out in the Pubic Interest Disclosures Act of 1998. There is a helpline for providing advice to NHS and social care services on whistle blowing, 08000 724 725 at time of writing (see also this link).
Providing the disclosure is carried out according to procedures and government guidance, and is made in good faith, then the whistle-blower's employment is protected and action can be taken against the employer if staff are dismissed because of the whistle-blowing.
Failures of whistle-blowing?
A recent investigative report by Professor Jay has found that there was extensive child abuse over a number of years in the Rotherham area, and that a research report of 2002, commissioned by the Council, was suppressed. Professor Jay found this report was, in retrospect, largely accurate in its indication of extensive, un-investigated child abuse.
Newspapers have reported that councillors, police and social services turned a blind eye to the abuse of at least 1,400 children. Disclosures had been made directly to responsible officers, but to no avail.
In May 2011 a BBC Panorama program documented wrongdoing and abuse at Winterbourne View private hospital. After investigation, six former members of staff were convicted and given jail sentences.
Placing agencies, the local council, police, the care regulator and the staff themselves were found not to have responded properly to allegations of abuse. This emerged after a Department of Health investigation was reported.
Clearly in these cases disclosure of abuse and wrong-doing was not effective, but had to be confirmed by official investigations.
Disclosures in the public eye.
There have been high profile cases of whistle blowing in recent years across a range of NHS hospital trusts in England. North Staffordshire, Tameside and Basildon whistle-blowing led or contributed to further investigation. Reviews and investigations of performance resulted in a round of inspections and improvements.
Indeed, the Government is currently, in August 2014 initiating a review of NHS whistle-blowing under Sir Robert Francis, called the 'Freedom to speak up' review. It aims to end what has been called a 'climate of fear' which has been thought to restrict the willingness of some staff to speak out against poor practice in the past. This is to be welcomed, as a review of the effectiveness of whistle-blowing itself, and of its procedures and operation in public health care trusts.
A range of Trusts have been put under special measures because of concerns about quality of care and mortality rates. Progress has been made in many of these cases, leading to special measures being lifted after inspection by the Care Quality Commission. Again, this is to be welcomed as a positive sign that whistle-blowing can be effective.
Taking people seriously?
In my career, I have worked with young people who have made allegations of abuse against them and have not been believed. Even after many years, they have stuck to their story. One person, by then an adult, thanked me as the only person who had believed them.
In another situation, a young person told me of occasions where they had gone for help, but had not been believed. They were sent back to an abusive situation, only to need to be 'rescued' again when the abuse recurred.
Why is it that there seems to be in some cases a presumption that the person who is vulnerable is not to be believed?
Perhaps it is seen to be putting your head above the parapet, only to have it shot at - this fairly describes the reaction to the 2002 researcher in Rotherham.
Or perhaps it is to not 'rock the boat', that sometimes allegations are played down and put in a context where people think, mistakenly, and often horribly so, that an overall good service is being provided.
Or perhaps sometimes investigations go some way, then reassurances are accepted from the service or workers concerned and no further action is taken. This seems to have happened in the Winterbourne case. It took the public display of overt abuse on our screens before action was taken.
There is clearly an onerous duty on all personal support services to strengthen our responses to the vulnerable, and that is a certain lesson we can take from the situations which have come to light.
Responsive services and whistle-blowing.
The need for whistle-blowing is sad, and depressing, but is a result of inequalities in power and inevitable faults in human nature, something which we all share.
Some areas to be looked at by managers and staff in care and support services could, I believe, improve quality and minimise the need for the complex arrangements for whistle-blowing.
Respect, not status should be the watchword. We are serving people who ultimately employ us. They are not to be seen as replaceable units in our service.
We should cherish and involve carers, representatives and families who are seen as important to them by the people we serve.
Sharing information and good communication with other services is important: we are not competitors, but often share the same task of looking after the same people.
Independent advocacy is invaluable. However it needs to be more readily available when and where it is needed.
We need to recognise that we all have an interest in effective and independent regulators who should be equally supported and scrutinised themselves.
Training for staff and managers should encourage openness about each other's practice. Secrecy is, after all, often a context in which abuse and mistreatment can take hold and grow.
Too often there are whistle-blowing procedures which seem designed to restrict the reporting to within the organisation itself.
Our training and procedures for staff must make clear the employment protection which is provided to genuine whistleblowers. We need to support staff directly in following the required procedure, as well as informing them about the official whistle-blowing helpline.
Tony Clarke – QCS Expert Scottish Care Contributor