Perspective: The trouble with good intentions

12 November 2009

By Joanne Curran, associate editor MDDUS

IT’S been a long road for whistleblowing nurse Margaret Haywood.

Just when she thought her 25-year career was over for secretly filming sub-standard care for the elderly at a Brighton hospital, the High Court has decided she can now go back to work. The court approved a settlement between Haywood and the Nursing and Midwifery Council (NMC) that means the striking-off order imposed on her in April will be replaced by a one-year caution. The ruling means she can now work as a nurse again.

Haywood’s case has generated strong opinions from both sides. Some agreed with the NMC’s decision to strike her off for secretly filming patients in the Royal Sussex Hospital for a 2005 BBC Panorama programme. The footage revealed the extremely poor conditions in which the patients were being cared for. The council found her guilty of misconduct and ruled she had breached patient confidentiality, despite Haywood’s defence that she was acting in their best interests. Others also argued that she had failed to follow due process by not reporting her concerns to her most senior management before going down the media route.

But there was also anger from many in the medical profession who viewed Haywood’s treatment as harsh. They feared it could deter other healthcare professionals from raising concerns in the future as Haywood is just the latest in a series of high-profile whistleblowers to have suffered after raising the alarm. And while politicians continue to urge clinicians to report concerns, is it any wonder that some healthcare professionals may look at Haywood’s treatment and wonder if whistleblowing is really “worth it”?

The Royal College of Nursing, who ran Haywood’s appeal, received more than 40,000 signatures for a petition supporting her. And the then health minister Ben Bradshaw also described the decision to strike her off as “unduly harsh”. Remarkably, none of the managers responsible for the neglect Haywood highlighted were disciplined – only she was. In the end, Haywood’s case ended relatively well for the nurse, who said she is now “looking forward to putting this behind me and getting back to nursing.” The RCN said it considered the matter satisfactorily resolved.

The NMC said it was now developing guidance on how nurses and midwives should raise and escalate concerns which would be published next summer. But the council also made a valid point when it said: “One of the lessons of Margaret Haywood's case is that nurses and midwives need clearer information about how to appropriately raise and escalate concerns in a way that is safe for patients and in a way that will not bring them into conflict with their code of conduct.”

It seems fair to say that good intentions should not be used as a reason to disregard key considerations such as patient confidentiality when whistleblowing, but it should go without saying that those who raise concerns also need to be supported.