After the Letby and latest Metropolitan Police cases (Andrew Provan), one question asked is: How does an organisation create a good whistleblowing process and culture?

This has been asked before in the NHS. And answers given. Both the 2013 Francis report (on Staffordshire hospitals) and the 2018 report (on the Gosport War Memorial Hospital) made many recommendations, many still not implemented. The creation of NHS guardians to make staff feel safe about raising concerns was urged. We have not heard much of them lately.

It is assumed that the right processes, policies, structures and guardrails, along with good training, will do it – or much of it anyway. But this is to approach it from the wrong end. The first, and most important, question is: Why do people behave in the way they do? When you understand that, then you can build the necessary structures.  

Why do people not speak up?

It goes against the grain, against everything we’re taught and socialised into since childhood: in the family, at school, university and, yes, at work. Team bonding, loyalty, signing up to the corporate ethos, collaboration: all these are praised, encouraged and rewarded. It is hard to go against that, to be seen as a “snitch” especially when you cannot be confident that anyone will have your back.

Most people are not – and do not want to be – heroes. They are scared of or just worried about the consequences. Speaking up may be the right thing in the long run. It may bring long-term gains for an organisation but it often also brings short-term pain for the individual. Or so they fear. So it is rational to find reasons to avoid doing it.

 It is easy to rationalise why there is no need for them to do so:

• “I don’t have any / enough evidence.”
• “It’s someone else’s responsibility.”
• “It’s not my job.”

Then there are other reasons:

• “I’ll get criticised / not be put forward for promotion / not get a good reference.”
• “I have a family/mortgage.”
• “I don’t need the hassle.”

Why do people speak up?

Some strong countervailing ethos exists which makes people speak up: professional training, for instance / legal duties to external bodies.

An appreciation of the risks of not speaking up – either because they can see it happening or have experienced it or understand from others what happens when they do not.

Fear of being blamed if they do not speak up. This may be more acute when the person has a professional obligation to act and can therefore be more easily criticised for not doing so.

What do whistleblowers want?

• To be listened to.
• To have their concerns properly and thoroughly investigated.
• To be able to trust those who carry out the investigation.
• To have confidence that, even if their worries are unsubstantiated, they will not suffer any prejudice as a result.

Why might the top brass not act?

If the allegations are very serious, the most serious, they can be hard to believe. People find it easy to say: “This cannot be true.” If someone’s reaction to bad news includes the word “cannot”, self-deception is not far away.

It is often easier to do nothing, to wait and see, to say that because there is no hard evidence, the matter is being overstated.

It is even easier to dismiss the concerns or their seriousness because of who the messenger is. Whistleblowers can often be difficult people, obsessed, easy to pigeonhole as “not one of us” or a nuisance. It is hard to detach the message from the messenger.

It is very common to attribute the raising of concerns to other motives – internal politics, dislike of individuals, a cover for something else, a wish to deflect blame for the whistleblower’s own failings, a desire to protect themselves against redundancy or dismissal or discipline. Or see it as a vendetta against another employee.

The CYA motive: commissioning an investigation involves time / money / disruption / upset / reporting internally and – oh, the horror! – a written report that might require difficult judgment calls and tough actions. Saying: “I took no action because there was no real evidence.” is a lot easier than saying “I took no action despite being given a report telling me that bad stuff was happening and this was the action needed to stop it.”

A conflict of interest: senior managers have other matters to consider. It can be all too easy for them to think that an organisation’s reputation will be harmed if they admit to problems. All too easy also to confuse their own interests – dealing with a difficult problem – with the organisation’s interests. It mirrors the thinking of potential whistleblowers: “If I act, I get a lot of short-term pain.”

They forget that an organisation’s reputation is ruined if bad events happen, as is their personal reputation if those events are discovered on their watch. But if they are not discovered, what’s the problem? So the perverse incentive is not to discover them.

Loyalty to other staff: see the judge’s statement in the Provan case about ‘the police being “more concerned about looking out for ‘one of their own’ than in … investigating”.

No external stakeholders to hold them to account or a countervailing strong professional ethos.

What the top brass should not do

If you think some performative grandstanding – a nice little film or a carefully crafted message prepared by a PR/communications department unaccompanied by any substantive changes – is what is needed, think again. These have a habit of being unearthed at the most inconvenient time possible making you look like a fool. See here for a recent example. (The ex-CEO of The Countess of Chester Hospital said on film nine years ago that his “Game Changer”pledge was to support staff when they raised concerns and listen to them when they did. Oops!)

What do whistleblowers need?

That’s for next time.