Safe spaces: “I’m not a whistleblower, I was doing my duty as a doctor”

Summary

Justice for Doctors is a not-for-profit organisation. Their aim is to provide support and guidance to doctors and other healthcare professionals who have experienced or are experiencing discrimination, harassment, and bullying, and feel targeted because of whistleblowing.

On 16 May 2024, Justice For Doctors held a landmark conference about doctors speaking up for patient safety at the Royal Society of Medicine. This opinion piece by Dr Annabel Bentley is part of a series on “safe spaces”. In it she reflects on the conference and some of the experiences shared by the doctors, journalists and patients who attended. 

Content

The NHS depends crucially on its reputation which is too often protected above all. Doctors say that when they raise patient safety concerns, they are mistreated by powerful trusts who investigate them, rather than the safety issues.  

In some cases, individual Trust reactions to staff raising whistleblowing concerns have been likened to that of a cult, where reputation is protected above all, even patient safety. It is part of a much bigger picture - the exposure of the realities of the institution that is NHS. This week’s publication of the Infected Blood Inquiry is the biggest and most costly NHS scandal. But it is all part of the same thing - the institution being valued above those it serves.

Justice For Doctors conference

Last week I was at the landmark conference held by Justice For Doctors at the Royal Society of Medicine in London. The day was led by Dr Salam Al-Sam, consultant histopathologist. As founder of Justice For Doctors, he’s created a safe space for doctors to talk. The event was chaired by Professor Jane Somerville, an eminent professor of cardiology at Imperial College who was involved in Britain’s first heart transplant in 1968. 

The room was packed, and more joined online - around 100 doctors, plus journalists and patients.

A pattern emerging

We heard stories of how doctors were targeted when they spoke up about avoidable deaths and serious harm in NHS hospitals where they worked. Their tales of being persecuted for speaking up - as is their duty - began to show a familiar pattern. 

One doctor recounted how they were told to come to a meeting with Trust managers. The doctor asked if they could bring their trade union representative with them but was told it was a ‘routine’ meeting and therefore not necessary. However, when they went to the meeting alone, they felt ambushed as managers told them that concerns had been raised about them, to leave the hospital immediately, go off on sick leave, and not talk to anyone about why. 

Feelings of betrayal and bafflement were common themes. One doctor said:

“I feel a bit of an imposter. I’m not a whistleblower, I was doing my duty as a doctor. I felt that if I didn’t stick up for my patients, then no one else would.”

Doctors spoke about how trusts used bullying tactics to silence and isolate them when they raised safety concerns. There seemed to be a common tactic emerging. Instead of investigating the concern, the Trust investigates the doctor who raised the concern. If that, combined with harassing the doctor, doesn’t trigger them to resign, the Trust then launches multiple lines of attacks; retaliatory General Medical Council referrals, maintaining high performance standards (MHPS) investigations, notifying other parties and smearing their reputation. That creates multiple jeopardy for the doctor. 

Doctors say that where this pattern plays out, a culture of fear sweeps the Trust.

Dr Azhar Ansari, said he felt he had no choice but to leave his job after he raised concerns about staffing and deaths.

“They made false allegations, basically that I was a madman,” he said. “They went after me rather than the patient safety concerns I was raising”.

He had raised concerns about a patient who died of starvation.

Dr Ansari said:

“The culture I worked in, the doctors did not want me to come and see the patient. I was prevented from attending the inquest as a witness, despite being the Trust’s lead for inflammatory bowel disease”.

Regardless, the coroner found the death was ‘contributed to by neglect’. The coroner’s report describes the lack of feeding for over a month, from the end June to 10 July 2017;  ‘omission’ of nasogastric tube feed which ‘contributed to malnutrition’. Then from 11 July to the beginning of August 2017 it states; ‘failed to feed’ with total parenteral nutrition.

Another story was shared by Mr Martyn Pitman, an obstetrician, who said he was confronted with retaliatory allegations of bullying and harassment after raising concerns about safety in maternity care. He said his trade union representative told him that trusts “deliberately extend it because they want to break you. They want to absolutely destroy you”.

The founder of Justice for Doctors Dr Salam Al-Sam, who’s brought more than 140 doctors together, is being compared by some to Alan Bates the Post Office campaigner. Dr Al-Sam told me:

“We all want to keep patients safe. Managers - including doctors in managerial positions - are abusing taxpayers’ money by spending it on persecuting doctors rather than fixing the patient safety issues they raised.”

Strength in numbers

More doctors and patients are finding their voices to speak up for patient safety. What was a trickle of stories in the media seems to be increasing - see recent reports in Westminster Confidential, The Times and the Telegraph.

The next wave of action will be patients’ voices combining with doctors. There is strength in numbers and solidarity from banding together. I joined the Justice for Doctors conference with Dorit Young, whose 25 year old daughter Gaia died in University College London Hospital in July 2021 of an unexplained brain condition.

Patient stories joining forces with Justice for Doctors is important. As Dr Al-Sam says “Justice for doctors is justice for patients and vice versa”.

Related reading

• Professor Jane Somerville: Supporting doctors who speak up for patient safety
• Still not safe to speak up: NHS Staff Survey Results 2022 (Patient Safety Learning blog)
• Treated with callous disrespect: A bereaved mother’s tale of institutional apathy from the Coroner Service
• Truth For Gaia campaign

Share your insights

What did you think of Annabel's blog? Have you got insights to share around patient safety and raising concerns as a member of staff, patient or carer? Comment below (sign up for free first) or contact the team at content@pslhub.org