This blog is prompted by a recent newspaper crossword in which one of the clues, quadruplicated, was 'Whistle-blower'. The four answers were, respectively, 'canary', 'snitch', 'telltale' and 'betrayer'. The blog draws attention to negative perceptions of whistleblowers in the eyes of some people. It emphasises how wrong these perceptions are and how damaging this can be, with serious patient safety implications.
In this blog I provide a crossword counterpoint (attached below to solve), which seeks to support learning about the realities of hostility against some staff who speak up in the NHS. I will share a follow-up blog which contains the solution to this crossword and seeks to provide further education on this topic where there is so much confusion and misunderstanding.
A recent blog I wrote for the hub, 'What is a whistleblower?', discusses different interpretations of 'whistleblowing'. Broadly speaking, there is a divide between those who regard whistleblowers as good guys, and those who consider them to be treacherous villains. Hero or traitor?
In that blog I suggested that how you view whistleblowers depends on your viewpoint and the lens through which you view them. An evidence-based lens combining personal experience and rigorous analysis may bring your image of whistleblowers into sharp focus. An opinion-based perspective prejudiced by hearsay and myth may create an inaccurate blurred image. Insight or groupthink?
The blog refers to definitions of whistleblowers from a number of referenced sources (read the definitions document here). Those in section A of the definitions document support the 'hero' interpretation. In contrast, references in section B are more aligned to the 'traitor' doctrine. A or B?
Revealing answers to 'Whistle-blower' crossword clue
By coincidence, shortly after that blog was submitted for publication on the hub, a leading newspaper published a crossword puzzle with 4 iterations of the same single word clue: 'Whistle-blower'. Two of the answers (1 across and 22 across) were six-letter words; the other two (7 down and 11 down) were eight-letters.
As confirmed when the solution was published a week later, the respective answers for each clue are: 'Canary', 'Snitch', 'Telltale', and 'Betrayer'. A revealing reminder that some people have very negative conceptions of whistleblowers. No sitting on the fence in the eyes of the compiler of the newspaper crossword – he/she clearly sees whistleblowers as 'traitors'!
The 'What is a whistleblower?' blog pays particular attention to NHS healthcare professionals. Registered healthcare professionals are required to report, and if necessary escalate, any concerns they have about the safety or care of patients.[5-7] It is ludicrous if they are then subjected to detriment by their employers, or if organisational culture causes staff to be afraid to speak up. Sadly there is evidence of both detriment and a climate of fear in parts of the NHS.[8-12] This needs to change.
In my experience healthcare professionals do not see themselves as whistleblowers when first speaking up – they are simply doing their job. It probably does not occur to them that in speaking up they may be putting their careers at risk. However, case after case show organisations responding by channelling 'whistleblowers' into protracted processes and employment disputes, with sanctions which may include career-ending dismissal. Those who have spoken up are wrongly seen as disloyal troublemakers. I am not the only one who believes that the 'whistleblower' term and related processes can be profoundly unhelpful.[1,8,13]
Healthcare professionals who raise patient safety concerns are not snitches!
It should be patently obvious that healthcare professionals who raise valid patient safety concerns are not 'snitches', 'telltales' or 'betrayers'. However, as illustrated by the recent newspaper crossword, that is how whistleblowers are seen by some people.[3,4] This is the reactionary 'section B definitions' view of whistleblowers, as promulgated for example in Roget's Thesaurus. Fortunately there are others who have a more enlightened view of whistleblowers in general and in particular, for the purposes of this article, of staff who raise patient safety concerns.[15-17]
Does it matter?
Does any of this matter? Well, yes, it does. Words can be powerful in shaping attitudes, beliefs and behaviours, including negativity towards and retaliation against staff who raise concerns in the public interest. Orwell knew the power of language; 'Newspeak' is central to the setting of his book '1984'.[18,19] Similarly Burgess's 'Nadsat' in 'A Clockwork Orange'. The term 'dogwhistle politics' refers to coded language described as a powerful form of speech enabling people to be manipulated, overtly or covertly, intentionally or unintentionally. Negative perceptions of whistleblowers are a component of dysfunctional cultures that tolerate and enable reprisals against staff who speak up.
A stain on the reputation of the NHS – ongoing implications for patient safety
I am not fundamentally opposed to the 'whistleblower' word. Some who have experienced retaliation after reporting wrongdoing embrace it. But it can create misleading prejudice, which is particularly concerning from a patient safety perspective in the context of healthcare staff raising valid concerns. The pejorative connotations associated with a 'section B' interpretation (in which the whistleblower is portrayed as a 'sneak', 'snitch', 'rat', 'telltale', 'betrayer' and other derogatory terms [2,14]) has serious adverse consequences: for the individual concerned, workforce morale and patient safety.[8-11]
The House of Commons Health Committee reported as long ago as 2015 that:
"The treatment of whistleblowers remains a stain on the reputation of the NHS and has led to unwarranted and inexcusable pain for a number of individuals. The treatment of those whistleblowers has not only caused them direct harm but has also undermined the willingness of others to come forward and this has ongoing implications for patient safety".
That statement is as true now as it was then.
Crossword: Glimpses of NHS Whistleblowing terrain
In an attempt to convey a more accurate understanding of the whistleblowing landscape, particularly in respect of the NHS, I have compiled a new crossword: Glimpses of NHS Whistleblowing terrain. It can be accessed from the following links, in either PDF or Word formats.
Glimpses_of_NHS_Whistleblowing (blank crossword and clues).pdfCROSSWORD (Glimpses of NHS Whistleblowing Terrain) questions.docx
(Click the above links to download the crossword. The PDF option is best for writing the answers by hand on printed sheet. Try the Word file if you prefer to enter answers electronically.)
This crossword is offered in a spirit of education and learning (though of course it is not legal advice). I appreciate that it is as susceptible to author's bias as any publication but I have tried to be fair, and have supported my views with authoritative sources of reference where possible. It is an attempt to redress the balance that sometimes operates against healthcare professionals who raise concerns in the public interest. This imbalance also has adverse consequences for patients, taxpayers and organisational culture.
I hope the crossword provides some light-hearted entertainment, and contributes to better understanding of these issues.
The solution, with explanatory comments and accompanying blog, are now available on the hub here.
- Wilkins H. What is a whistleblower? Patient Safety Learning; 2 February 2022.
- Wilkins H. What is a whistleblower? Definitions document. Patient Safety Learning, the hub; 2 February 2022.
- CONCISE CROSSWORD 1767. The Sunday Times; 30 January 2022: p.28
- CrosswordGiant, Crossword Puzzle Clues and Answers: CONCISE CROSSWORD 1767. The Sunday Times; 6 February 2022: p. 27.
- Health and Care Professions Council. Standards of conduct, performance and ethics; 2016.
- Nursing and Midwifery Council. The Code; 2015.
- General Medical Council. Ethical guidance for doctors. Raising and acting on concerns about patient safety; 2012.
- Robert Francis. Report of the 'Freedom to speak up' review; 2015.
- Holt K. Whistleblowing in the NHS. BMJ 2015; 350: h2300.
- Outram C. West Suffolk Review; December 2021.
- NHS Improvement and Care Quality Commission. Monitor and CQC review into whistleblowing concerns at the Christie NHS Foundation Trust; 2022.
- BBC News. Hinchingbrooke Hospital patient sent 'whistleblower' letters; 8 March 2022.
- National Guardian's Office. What is speaking up?
- Roget's 21st Century Thesaurus, third edition. Whistleblower synonyms.
- Gov.uk website. Whistleblowing for employees.
- UNDOC. United Nations Convention against Corruption: Resource guide on good practices in the protection of reporting persons; 2015.
- UNODC. Speak up for health! Guidelines to enable whistle-blower protection in the health-care sector; 2021.
- Orwell G. Politics and the English Language. Horizon No. 76, April 1946. The Orwell Foundation.
- Cliffs Notes study guide: Critical Essays. The Purpose of Newspeak: Orwell (1949). Nineteen eighty-four; Appendix.
- The International Anthony Burgess Foundation. A Clockwork Orange and Nadsat.
- Saul J. Dogwhistles, political manipulation, and philosophy of language. In New Work on Speech Acts, chapter 13. Oxford Scholarship Online; 2018.
- House of Commons Health Committee (2015). Complaints and Raising Concerns, chapter 5 (Treatment of staff raising concerns).
- Wilkins H. Glimpses of NHS whistleblowing terrain (blank crossword: PDF format, Word format). Patient Safety Learning; March 2022.
There are no comments to display.
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!Register a new account
Already have an account? Sign in here.Sign In Now