More needs to be done to encourage whistleblowing within the National Health Service, according to an editorial published on bmj.com. It says more statutory protection, the support of regulatory bodies but above all a change in culture are needed to ensure patients and clinicians are protected.

The article, written by Peter Gooderham from Cardiff Law School, says it is ten years since an anaesthetist at Bristol Royal Infirmary exposed information about the avoidable deaths of children having heart surgery. Whistleblowing, however, is still hazardous even though most patients would expect doctors to protect them. He adds that the General Medical Council also stipulates the professional ethical duty for doctors to raise their concerns.

Mr. Gooderham says NHS doctors often have a contractual duty to be part of clinical governance procedures which should include a system for raising concerns and information on what to do when appropriate action is not taken. But, he says, whistleblowers can be made to feel that they are the problem and may become the subject of retaliatory complaints and disciplinary action. There is limited protection for whistleblowers under the Public Interest Disclosure Act but some people believe this does not go far enough.

The editorial points to the recent investigation into poor care standards at Stafford Hospital. Staff there were criticised for operating a culture of silence but such criticisms “may worsen the situation by exacerbating a culture not just of silence, but of fear.” In calling for the change of culture he suggests a start would be for those in official positions to recognise the risks of whistleblowing so that they might begin to limit the damage brought about by scandals which are probably already happening.