Wednesday, May 11, 2016


Was it ever thus? Or is it that the power of social media has just made it more apparent? The culture of silence that is. Or should I say contrived silence? It's very difficult to pinpoint but whichever topic you choose, the culture of silence pervades through the NHS.

Many reasons abound for it..whether it be the fate of whistleblowers, whether it be downright bullying, whether it be political expediency or even the blame culture we all live in. No blame, no shame? The cruel harsh world of social media offers no such clause, it's stark, it's brutal, it's in your face and sometimes, not too far from a lynch mob- and not just the NHS but pervades through all sectors of life now. Sometimes overt, sometimes with a wink and a nudge...either way, the personal finger pointing promotes further silence.

We seem to have created an atmosphere where silence is the easier way out, the one path without much I know the healthcare philosophers will have some glib quote to suggest how patient care and vocation should trump all...but let me put this to you..if being honest and breaking silence puts you in hot water, either via someone baying for your head or resulting in an end of career....none of those philosophers will actually stand by you, will they? It's YOU on your own, so the natural instinct is to say "Hush". Nothing wrong there, vocation doesn't pay the bills nor the mortgage.

There rarely if ever is a healthcare professional in the NHS who doesn't see poor care..the question is....does every single one of us flag it, raise it, take the cudgels up and improve that patients journey or the next one? The answer is possibly no. Let's take my area of specialty....there rarely is a diabetes specialist in any shape or form who isn't aware of what happens to patients with diabetes admitted to hospitals ( I am not even talking about weekends)...many of us have been part of reporting errors, highlighting poor care, simple basics being missed...hand on many of us have tried raising each of these errors and kept going? How many of us at some point haven't been asked to hush as there is no money/stop causing a racket/isn't a priority? Have we then colluded for poor care continuing? Have we chosen the easy way out? Have we decided due to one reason or another to not raising it anymore, to keep quiet? Tough questions aren't they?

There is a reason why journalists finding scoops bemuses me to no end. Because any doctor or nurse worth their salt could actually find you better scoops -except that in the present system, you do so and you are a whistleblower. Finding scoops is easy- just try putting FOI of errors and actions can criticise many an event. In the cold light of time and through the sharp focus of a retro spectroscope, judgement is easy to pass.Patient errors are not too uncommon- what we need to find out what stops us from raising them...what promotes the culture of hush. It's a fine line between accountability and a witch we as a society balance that divide well or does the freedom of social media offer us all opinions without control?

The present contract fiasco is another private, there are few who will admit it's a good thing- at last check, bar David Dalton and Chris Hopson , no one has associated themselves with a public statement. To be clear, I respect them for that- whatever your views on it, at least they have been clear about their views...the rest have either chosen to stay silent or make oblique vague references to working together, having group hugs and all sorts of waffle. So here's my question...if the top echelons of the NHS are adapting the Hush approach, what message does it send to the rest of the staff?

The sadness is that these errors are actually gold dust, complaints are important and we must, as a system, understand why keeping quiet doesn't help anyone...perhaps society also needs to give the NHS staff a break when errors happen- if there is willingness to put ones hand up, learn and improve care, that must be seen as a positive. I am keen to try and improve patient safety- especially for those with diabetes- in hospitals. And I would strongly encourage staff to not walk past the next error, not shrug their shoulder but to raise it, whatever be the due process. If that turns to be a dead end, go further up..if still that doesn't work, I would like to know. I would like to understand what stops a type 1 diabetes patient from being given their insulin in 2016 in a first world country. I don't want a fancy hashtag for that...I want folks to genuinely believe it's worth speaking up.

Hush isn't really an option and in a small way, if I could help to break that cycle, please- do bring it to my attention- if all other avenues seem exhausted. One can only promise to try.

1 comment:

  1. A well written and intend article and as a patient a refreshing outlook. You hinted at and I am aware a lot of the problems stem from BAD MANAGEMENT and or BUDGET stresses. What puzzles me is NOT ONE PERSON either in the NHS or outside will even discuss the impact of our open door immigration policy and the stress that places on the NHS. If you dig down even the recent junior Dr strike actually boils down to money. The NHS was established to serve BRITISH people, not EUROPEAN people so why are they all getting free healthcare. Even worse, the Government and NHS do not even keep a record of how many "NON BRITISH" people get free healthcare, it would be far too embarrassing and may even coat a party their control of parliament! Please have a look at a short piece I wrote about this