Support for whistleblowing nurse struck off by NMC

[antijen]

http://www.gopetition.com/petitions/support-for-whistleblowing-nurse.html

This petition is for members of the nursing profession and the general public who want to show their support for nurse Margaret Haywood.

Margaret was struck off the nursing register by the Nursing and Midwifery Council for taking part in a television programme which highlighted instances of poor patient care.

We believe that Margaret was justified in exposing the worrying conditions at her hospital and that the documentary shed light on matters that the public deserved to know about.

Isn't the hippocratic oath about integrity and healing, this woman would have broke this oath if she done nothing,this is scapegoating of the worst kind. This woman is not the problem, questions should be asked about the real problems she highlighted. The system and people who made this decision to strike this nurse off should hang there heads in shame, and maybe take some advice from her, she is being penalised for caring. Any support would be appreciated, the link takes you to online petition.

[PeckhamRose]

Done.

[antijen]

Thanks Pechamrose.

[georgia]

Have signed

[tinylittledan]

Done too.

[Sherwick]

done

[Huguenot]

I'm not sure about the details of the situation, and feel uneasy about signing up to such a political agenda.

Are there any details about the NHS position?

[annaj]

As far as I know, Huguenot, she was struck off, not for whistle-blowing, but for breech of confidentiality, because she didn't take consent from the patients she secrectly filmed in order to expose poor practice.

I don't know enough detail of the case to know if her actions were justified I'm afraid, but it would be the NMC position not the NHS that you would need to research to come to a decision. The NHS employs doctors and nurses and handles local disciplinary procedure, but registration is regulated by the GMC or NMC.

[JetSetWilly]

breach of patient confidentiality, big, big error in the eyes of the nmc, and along with accountability its drummed in to you from day 1.

personally they were within their rights to strike her off the register for this breach, however i feel they could have looked at the case with a little bit more compassion and understanding of the situation, however i have no doubt that she knew what she was getting herself into and what the possible consequences could be, and if she thought that the nmc would take this into consideration, then it shows quite a bit of naivety on her behalf.

sorry but not signing.

[Marmora Man]

Signed.

The technical breach of failing to obtain the patient's consent to the filming was, to my mind, required to expose a greater damage to the patient's safety. Has any patient complained about the situation?

[annaj]

I think I probably agree with you, Jetsetwilly. Confidentiality is one of the absolute certral principles of medical and nursing professionalism. She must have know that she was getting into something very serious and had a responsibility to think about the implications not just for herself, but also for the patients that she involved. #

Is the greater good of exposing poor practice worth the risk of exposing individuals without their consent? And was secret filming the only way it could have been done? I don't know the answer to those questions in this case, but I'm afraid I won't be adding my support without knowing a lot more about it.

[annaj]

Crossed posted MM, but I have to say confidentiality is far more than a technicality. It is fundamental to the work that doctors and nurses do and everyone who works in the professions should understand that.

Was it definitely for the greater good? Was there no less drastic action that could've acheived the same thing? Did she have the right to decide that exposing those patients was in their best interest? I'm not sure she did. Or at least I think when she took that decision she should have known that she ran the risk of loosing her registration, because she breeched a fundemantal professional and ethical responsibility.

[Brendan]

What about the ethical responsibility she would have been breaching by not exposing things?

I would think a medical professional?s loyalties lie with their patients first and the trappings of the profession second.

[Marmora Man]

annaj,

Like you I work in healthcare (but on that ghastly management side!) I acknowledge that the need for confidentiality is paramount in healthcare - tho' such high minded aims are often confounded on wards, in treatment and consulting rooms by casual comment, poor storage of records, transmission of results etc. It's not as if she revealed the patient's illness, treatment plan or prognosis.

As to whether she had other avenues possibly - but I'm sure you have experienced, as I have, the blanking that can go on if senior NHS or other health management is informed of poor / dangerous actions that will cost money and effort to rectify.

[annaj]

I would think a medical professional?s loyalties lie with their patients first and the trappings of the profession second

Absolutely, but that's the point. Confidentiality isn't a trapping of the profession it is the foundation on which the doctor-patient relationship is based. It is part of what creates the trust that allows us to do what we need to do for the patient. A doctor's (and I'm talking about doctors now, because that's what I know) first duty of care is to their patient, not the population at large (although we do have wider responsibilities in certain circumstances) or the greater good.

The circumstances in which a breech of confidentiality is justified are fairly clear cut. You have to believe that the patient poses an immediate danger to themselves or others or has commited certain serious crimes, such as murder or acts of terrorism (the addition of terrorism is quite a new thing) There are grey areas, where you could argue that a breech was in a patient's best interests, which I assume is what this nurse believed, but the regulatory body may disagree.

MM, I agree entirely that confidentiality is poorly maintained on a day to day basis and it's something I am passionate about improving. As someone who works in the area I live in, in front line healthcare, confidentiality has to be improtant to me and I am extremely careful to maintain it in my own practice.

[bignumber5]

Marmora Man Wrote:

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> The technical breach of failing to obtain the

> patient's consent to the filming was, to my mind,

> required to expose a greater damage to the

> patient's safety.

Not her decision to make, though, and that's the point.

I don't know the full details in this situation, but retrospectively stating that the end justified the means does not, in the eyes of the NMC, excuse doing something that you know to be inappropriate at the time. As for the general principles of confidentiality, what they do/should mean and how they are fleshed out in reality, what annaj said.

[Keef]

Marmora Man, am I not right in saying that you're against all the CCTV, cameras going up and invading our privacy? If so, then I'm surprised you're so supportive of this lady.

I initially wanted to get behind the whole thing, but then hearing about the filming of patients without consent, I suddenly lost some sympathy, even if it was for a "greater good".

Wouldn't some argue that keeping the streets safe is a greater good, over your personal right to privicy?

[Sherwick]

The need for confidentiality is paramount in healthcare?

No it isn't.

The need for healthcare is paramount in healthcare.

Joyce Robins, co-director of Patient Concern said: "This just demonstrates the priorities of the regulators - rules come before patients every time. The message that goes out to nurses is: however badly you see patients treated, keep your face shut.

"This makes total nonsense of all the talk about openness and transparency in the NHS. Cover-up is the order of the game."

Ms Haywood's actions were also defended by Gary Fitzgerald, chief executive of Action on Elder Abuse.

He said: "We know that we're seeing older people suffering the most appalling care and neglect too often in our care environments.

"In that context I believe what Margaret Haywood did and what Panorama did was right and proper."

Elizabeth Bloor, the BBC programme's producer, told the hearing there had been "an over-arching public interest" to produce the Undercover Nurse documentary because Panorama had received up to 5,000 complaints about conditions.

http://news.bbc.co.uk/1/hi/england/sussex/8002559.stm

[Sherwick]

I'll just add that my gran is in a care home. If she was being abused I would want to learn about it asap from any possible outlet.

I wouldn't give a rat's ar*e about her 'patient confidentiality' or 'due process', which could mean that I would only find out when she's dead.

[annaj]

Sherwick, of course patient care is vitally important and of course any of us would want to know and take action if a relative of ours was being abused or not recieving the care they should, but you simply can't dismiss confidentiality as unimportant or trivial.

The message, to my mind, is not "shut up", but report failures of care through the process of adverse incident reporting, the due process that you are so scathing of, which in many places is actually quite effective, but sadly underused, because people share your belief that it'll be ineffective.

[Ted Max]

What if you do complain and it is ineffectual? Here's a piece I read a while back on this case, which is quite enlightening (*yes, it's in the Guardian).

"The judgment starts off well, by dismissing the complaints made against Haywood by the Royal Sussex Hospital. The trust had complained that Haywood had broken their own rules by going public, instead of complaining internally.

The panel was scathing about this. Haywood had in fact reported her concerns to a ward manager. In any case, her actions were justified because so many relatives and staff had complained, with no apparent effect. In a rather fine paragraph the panel writes that what Haywood did was defensible because "the concerns were of an exceptionally serious nature. The failure to deliver basic nursing care to these patients, many of whom were in the last stages of their lives, rendered many of their lives miserable. It was so serious because it was so fundamental. There was a failure to meet basic human needs."

The judgment goes on to make clear that it was only the broadcast that forced radical reform. Until then, internal complaints had produced a sluggish and "not very impressive" response. So far, so good. But then the judgment takes a bewildering turn. Before the film went out, Panorama obtained the retrospective permission of every patient - or their relative - whose cases were featured. One elderly man is not featured, but is glimpsed in the background in a handful of shots. Suddenly the panel decrees that the fact that he is on a ward is confidential information, and that therefore Haywood has contravened the nursing code by betraying patient confidentiality. Moreover, she cannot be excused for it because "she should not have gone public until she had explored and exhausted, with management and senior management ... all other avenues of addressing the inadequacies on the ward." The result? She may not work as a nurse again.

What? What? Only a few paragraphs earlier, Haywood is fully justified in forcing change. Now an anodyne background shot of a man in pyjamas means she must lose her livelihood. I read the nursing code. There is nothing in it to back up the panel's preconditions on whistleblowing. They seem to have been plucked out of the air. But the sense of official relief at a reason to ban her rises off the page."

[Sherwick]

annaj Wrote:

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> Sherwick, of course patient care is vitally

> important and of course any of us would want to

> know and take action if a relative of ours was

> being abused or not recieving the care they

> should, but you simply can't dismiss

> confidentiality as unimportant or trivial.

>

> The message, to my mind, is not "shut up", but

> report failures of care through the process of

> adverse incident reporting, the due process that

> you are so scathing of, which in many places is

> actually quite effective, but sadly underused,

> because people share your belief that it'll be

> ineffective.

I don't think you understand me.

Patient care is not "vitally" important. It is of PARAMOUNT importance.

Going through the formal process whilst people are being abused is not satisfactory.

As Ted pointed out above: "Before the film went out, Panorama obtained the retrospective permission of every patient - or their relative - whose cases were featured.".

I really cannot believe some on here are defending the panel that struck her off.

[antijen]

Thanks everyone for support on this injuctice.

Huegonot The nhs position is brought about by individual trust policy and goverment legislation, meaning the trust (that she was working for) is acting on behalf of the nhs.

I have a few friends who are nurses and from what Ive heard the official process is corrupt, in the instance of incident reporting, issues (including the welbeing and safety of patients) can take years to investigate and rectify, if they are rectified at all due to staff turnover, red tape and 'cover up's'. It is also important to bear in mind that no individual trust likes to have bad press. While all this is going on, people are literally dying as a result, you only have to look at your closest ,major emergency a&e department to see that patients are cueing in corridors often without adequate pain relief or a basic standard of care such as adequate toileting facilities, what does this say about the confidentiality of patient? Also, how many people are dying or suffering as a result in the community when paramedicas have to wait in hospital corridors for bed spaces to become available to offload their patients?

Staff have become disillusioned and very often complaicent about their jobs because they are mentally and physically drained by working within a system that cannot live up to the expectations of the wider community due to inadequate funding and utilisation of resources.

I have learned first hand from two friends, who happen to be senior nurses, of instances of abuse and neglect that they have reported and on numerous occasions proceeded to 'go down the official route' but due to the individual stress and bullying that they have been subjected throughout this process, they are both considering leaving the nursing profession. Is this what we want, the people who actually care about the patients and the name of the profession to be hounded out to allow practices like this to continue?

I think you gotta ask yourself who would you rather have caring for you or your family especially with this case, if your old, and may not have the capacity to report complaints yourself and no-one else to do it for you.

For anyone who wants to find out more about the case of Margaret Haywood or wants to know more about the real goings on within the NHS, check out the NMC's fitness to practice website page via the link below to check out some current and recent cases. The NMC's code and policies can also be found here. I have also included a link underneath for the GMC's (General Medical Council - Governing Body for Doctors) fitness to practice website with recent cases for your information.

http://www.nmc-uk.org/aSection.aspx?SectionID=7

http://www.gmc-uk.org/concerns/hearings_and_decisions/fitness_to_practise_decisions.asp

[Keef]

Sherwick, I don't think you are being fair to Anna, someone who definitely doesn't need telling about the importance of patient care!

I also wouldn't say anyone has defended the panel, people have just raised a couple of details that are relevent and worrying.

The question is, do the ends justify the means? In this case I'd say the answer is yes. However, it is a slippery slope, and if everyone decides that they are going to make a judgement call on the confidentiality rules, based on what they think is right, then it's all going to go to sh!t.

[bignumber5]

Sherwick Wrote:

-------------------------------------------------------

> I don't think you understand me.

> Patient care is not "vitally" important. It is of

> PARAMOUNT importance.

> Going through the formal process whilst people are

> being abused is not satisfactory.

> As Ted pointed out above: "Before the film went

> out, Panorama obtained the retrospective

> permission of every patient - or their relative -

> whose cases were featured.".

>

> I really cannot believe some on here are defending

> the panel that struck her off.

And whilst panorama did what they are obliged to do in order to broadcast the footage, the nurse in question did not do what was required to obtain it. It's a less than ideal situation, for sure, but as annaj has explained, there are some basic principles of healthcare that must remain sacrosanct in order for it to occur, and confidentiality and informed consent are amongst them. In registering with the NMC (or the GMC) you agree to that, as stated in the code of conduct. You do not sign a contract and then quibble about the special circumstances when you breach it. You do not stand in the dock and explain to a judge and jury that, actually, you had to take a vital journey and that's why you were drink-driving, and you do not breach the NMC code of conduct because you think that, rightly or wrongly, there are special circumstances.

For the record, I think it's a pissing shame that the act of whistleblowing backfired on the whistleblower, but it has not backfired because she blew the whistle, it backfired because of a significant breach of the code of conduct, and an NMC committee (of her professional peers) decided that this was unacceptable. This you accept when you register with the NMC. I did, so did she. She fuct up.