Whistleblowers are often in the news, especially in the National Health Service. It is reported for example (the i, 19 April 2014, p. 7) that Dr Raj Mattu, the heart surgeon who exposed the unnecessary deaths of patients in University Hospital of Coventry and Warwickshire NHS Trust, was unfairly sacked after nine years of harassment, but finally vindicated by a tribunal on 16 April. The system is such that whistleblowers usually have to complain to their superiors in the hierarchy, who then become defensive (or offensive) – and all the more so if the whistle-blower then goes to the media. The situation is made worse by the fact that anyone found to be at fault is liable to be disciplined, sacked or even prosecuted. Professor John Braithwaite describes how he and his colleagues acted as consultants on evaluating nursing homes in Australia (Restorative justice and responsive regulation, OUP 2002, pp. 17-18). Criminal prosecution for breaches of the long list of regulations wasn’t working. In consultation with the indistry and major stakeholders such as consumer groups, unions and those concerned with care of the elderly, the old regulations were scrapped and a list of just thirty-one outcome standards was compiled. Performance against each of these was discussed at a conference of the inspection team, management, staff, relatives and relatives, and sometimes outside advocacy groups. The aim was not to blame, but to discuss how care could be improved. It was found that inspectors who treated nursing homes with trust, and used praise when improvements were achieved, achieved higher compliance with the standards two years later than those who did not.
Hospitals are admittedly much more complex institutions than nursing homes, but is it not possible to manage them on similar restorative, patient-centred lines?