In the UK, the conviction of neonatal nurse Lucy Letby for the murder and attempted murder of newborns in her care has shaken the healthcare industry. Co-workers have since spoken publicly about how their suspicions, although raised, were dismissed by the institutions meant to prevent harm. Across Europe, there are similar concerns.

Investigations into the Letby case will take years, but there are immediate concerns about culture and the processes around transparency – and particularly whistleblowing. 

In the UK, it is the job of the healthcare watchdog the Care Quality Commission (CQC) to enforce standards, but as one HBI speaker told delegates at HBI London 2023, the onus should lie first with providers: “The regulators are doing your job.” 

For-profit providers are often running organisations far less bureaucratic that the NHS with which they compete, perhaps relying on external and/or part-time staff, and this can lead to a culture where workers are less inclined to raise the alarm bell. Sceptics would allege there is an element of self interest at play here too.

Closing ranks is not the answer. French nursing home group Orpea may still be picking up the pieces following the fallout from the expose in the book ‘Les Fossoyeurs’, but it has made significant strides towards more transparency and improving pathways to raise concern. 

Spire Healthcare had to recall 1,500 patients after breast surgeon Ian Paterson was jailed on 17 counts of wounding with intent. A 2020 independent inquiry ruled that “a culture of avoidance and denial” was a contributing factor.

According to 2023 data from Freedom to Speak Up Guardians (FTSU), an initiative that works to tackle barriers to whistleblowing, independent providers make up 21% of all healthcare organisations but only report a measly 3% of cases. NHS Trusts are reporting 92% of cases. On the face of it, NHS bodies may be large and unwieldy, but it seems for profits have a way to go to match them for transparency and provide a path for complaints like these to reach the right people, and be actioned.