The Public Information Disclosure Act and Public confidence.

The Public Information Disclosure Act and Public confidence.

The anticipated review and update of the Public Information Disclosure Act 1988 (PIDA), would be seen by many employees as progress in any industry, but especially so in the health sector (GPs, student nurses, doctors and allied health care professionals would now be included).

Given the very nature of the health sector, any highlighted or disclosed problem would be emotionally charged, contentious and potentially dangerous if patient safety were an issue.

Currently, the law protects employees who whistle blow from harassment or bullying by an employer. Suggested amendments to PIDA under the Enterprise and Regulatory Reform Bill (ERRB) would extend this protection to include harassment and bullying by colleagues.  Under the proposals the categories of protected disclosure are not confined to breach of a legal obligation, but would now cover gross mismanagement gross waste, abuse of authority and serious ethical concerns.

Such amendments have received criticism as they are thought to be insufficient.  Indeed some campaigners want PIDA to be entirely re-written believing it is only then that employees who have difficult information to disclose, will feel safe to come forwards.  Lord Touhig, who helped draft stages of the original PIDA, has been reported as wondering if current legislation is, “not appropriate any longer”. Certainly, some whistleblowers may have found it did not offer them the legal protection for which they had hoped.

Future generations of health professionals, whether clinical or managerial will be looking for a significant improvements to PIDA, thus if they ever find themselves in the extremely difficult position of becoming a potential whistleblower, they can raise genuine concerns appropriately, without fear of the type of reprisals that have recently come to light.

The Royal College of Surgeons has just bought out new detailed guidelines for whistleblowing, which emphasize the obligation that surgeons have to raise concerns. However, such guidelines are far from new, the GMC has detailed guidance for all doctors, and have more recently formed a helpline for doctors who want to raise concerns.  The current GMC guidelines on raising concerns (whistleblowing) mean doctors are actually obliged to take action and raise concerns regarding, colleagues, protocols, policies or any inadequate premises or resources

No other professional governing body has quite such ethical and strict guidelines. However, the current proposals for PIDA reform may mean it is practically impossible to follow them. This unique position means doctors have an emphasis placed upon them of being obliged to highlight areas of concern and yet the judicial system will not be able to protect them, within its current remit.

Although doctors are supported by the GMC’s guidance, which helps ensure doctors do not enter in to contracts that prevent or restrict them from raising concerns relating to patient safety, and highlights that contracts are void if they would prevent a doctor from making a protected disclosure and thus whistleblowing, many feel that this is not enough.

Dr. Kim Holt (of Patients’ First) points out that  the NHS is effectively “a monopoly employer of doctors” and has previously sought to penalise whistleblowing doctors, by way of complaints about them to the GMC;  alleging undue delay amounting to a breach of GMC  guidelines in not raising their concerns sooner.  She also feels that the fear of poor references and an endemic culture of coercing those who may wish to raise concerns exist in the NHS.

It seems improvements to the way concerns are raised and in how whistleblowers are safeguarded must be robustly developed. Without significant progress in this, the public, will rightly, have far less confidence in the NHS and health policies, than before. This would be a shocking loss, as the overwhelming majority of doctors, nurses and other hospital staff work tirelessly in demanding situations to provide the best care possible.

I believe that no clinician enters the health profession without the genuine wish to do good. It is important to recognize that thankfully in the vast majority of situations, when incidents are reported or concerns are raised, they are escalated and managed appropriately and sound measures are taken to review and resolve the situation, so the need for public disclosure to achieve change may never be required.

It is to be hoped that a suitably upgraded PIDA will increase protection for whistleblowers and restore public confidence.

Dr. Iseult Roche

Links and further reading:

http://services.parliament.uk/bills/2012-13/enterpriseandregulatoryreform.html

http://www.patientsfirst.org.uk/?cat=6

http://www.rcseng.ac.uk/publications/docs/acting-on-concerns/

http://www.gmc-uk.org/Raising_and_acting_on_concerns_about_patient_safety_FINAL.pdf_47223556.pdf

http://www.medicalprotection.org/uk/england-factsheets/raising-concerns-and-whistleblowinghttp://

www.gponline.com/News/article/1163570/GMC-launches-hotline-NHS-

whistleblowers/http://services.parliament.uk/bills/2012-13/enterpriseandregulatoryreform.html