‘Don’t shoot the messenger’: the problem of whistleblowing in general practice

Abstract

On the 9 June 2010 the then Secretary of State for Health, Andrew Lansley, announced a full public inquiry into the role of the commissioning, supervisory, and regulatory bodies in the monitoring of Mid Staffordshire NHS Foundation Trust. The Inquiry was chaired by Robert Francis QC, who has made recommendations to the Secretary of State based on the lessons learned from the failures of care provided by the Trust between January 2005 and March 2009.1 The Inquiry heard oral evidence from six GPs whose surgeries are situated within the Trust catchment area. This focused largely on the extent to which the GPs were aware of problems at the Trust. The Francis Report raises a number of serious issues about NHS ’whistleblowing’ and identifies failures in the application of current whistleblowing policies. The NHS, and GPs in particular, face unique problems in whistleblowing. a. ‘The GMC guidance states that GPs have a duty to raise concerns. When I contacted the GMC, they recommended that I contact the BMA. The BMA recommended that I contact my [medical defence organisation] MDO. My MDO recommended that I contact the BMA’ All doctors have a duty to act when they believe patients’ safety is at risk or that patients’ care or dignity is being compromised.2 This paper defines ‘raising a concern’ as doing so through the normal internal structures of accountability and ‘blowing the whistle’ as highlighting a concern to individuals outside of these structures, often externally, and normally after failing to successfully raise the issue through the expected internal routes. When a GP decides to act as a ‘whistleblower’, for example because of concerns about the patient care provided by a GP colleague, he or she may have an additional challenge because in a practice partnership professional, financial, and social interdependency coincide; …