Listen very carefully

Regular devotees of this column (maybe even both of them if I am lucky) will know that where I am concerned, the rest of this famous quotation ‘…I will say zees only wernse’ rarely applies. After 30-plus years of penning a fortnightly or monthly column such as this, in a field such as dentistry, I am likely to have made the same or similar points many times.

The fact that I seem to get away with it most of the time, is both gratifying and depressing.  Depressing because it could mean that nobody reads the stuff first time around, or that they don’t read it second time around, or that they don’t read it at all.

Or perhaps that it is such rubbish that nobody remembers it anyway.

Undeterred by any of this, let me tell you a story. A fellow passenger on my daily 200-mile round trip commute to my place of work, was having trouble getting the promised – and much publicised – wi-fi connection on the train. The guard listened attentively, expressed his profuse apologies and reassuringly confirmed that he would be right back. And so he was, this time armed with a leaflet explaining what to do if experiencing problems with the on-train wi-fi connection. Minutes later my travelling colleague descended into peals of laughter because the leaflet provided an email address through which to access the wi-fi helpline. Priceless.

Sometimes I wonder if there is so much ‘stuff’ coming at us all day, every day, that there is no longer enough time to filter it and activate the bull**it and ‘do you really want to say that?’ detector. On the morning when William and Kate woke up in Malaysia to the news that topless photographs of Kate were circulating on the internet and were about to appear in the French press, a BBC commentator started a sentence with ‘they were reported to be….’ and then he paused. For a split second I held my breath, thinking that we were about to be treated, over our cornflakes, to an assessment of Kate’s upper body strength.

But then he continued  ‘…saddened’.  Panic over. But, in a year when Harry’s lower body strength and credentials at naked billiards, and the derriere of Kate’s sister P Middy have come under such sustained public scrutiny, I was reminded that things often happen in threes. (Now that would have been a story).

You may have noticed the recent juxtaposition of the publication of the damning findings of the Hillsborough Independent Panel, and a piece on the detention of terrorist suspects by coalition troops in Afghanistan. In both cases, although chronicling events separated by over 20 years, reference was made to the culture of solidarity and loyalty to colleagues, without which the police and defence forces could not exist. Around the same time, several national newspapers brought together stories about a surprising number of high-flying head teachers who were under investigation over financial and management irregularities.

Nobody would question, I am sure, the appropriateness of listening to the background noise, rumours and whispers about what really happened at Hillsborough all those years ago.  Unfortunately, this was hardly a case of ‘listen very carefully… I will say this only once’ because those poor families had to tell their story over and over again before anyone was prepared to listen; how different today in healthcare where the ‘raising of concerns’ has been turned into something of an art form. It has become an institutional means of removing unwelcome colleagues, of advancing one’s own career, of settling scores, and other dark arts.

Super snoopers
I think we can all understand the case to be made for breaking ranks if we are aware of someone who is placing members of the public at serious risk. But this now sits within a wider culture of everyone keeping a close eye (and ear) on everyone else, whether in relation to their financial administration, or tax affairs, or neighbours claiming state benefits or using hosepipes, or some other aspect of their life that might be suggestive of criminal activity or something suspicious, improper or simply irritating. As citizens, we are expected to become mobile CCTV cameras and listening devices and we are encouraged to put aside those time-honoured British characteristics of ‘keeping yourself to yourself’ and ‘letting other dogs live’ and instead become unpaid supersnitches.
But has the pendulum swung too far?

The principle of whistleblower protection and immunity is certainly understandable and important, but it should not be absolute. In healthcare, in the teaching profession and elsewhere in the public services I fear that whistleblowing has replaced normal, open communication channels, grievance procedures and dispute resolution. In anonymity rests enormous power and control, and the ability to influence the course of events in one’s favour. The NHS is grinding to a halt because of the empowerment of the whispering classes, with ridiculous numbers of key people either suspended or paralysed into inactivity and indecision.

There are even ridiculous situations where, in order to protect the identity and privacy of the informant(s), the person on the end of the accusations can face really damaging and sometimes career-threatening smears and broad allegations without being told the detail which would allow him or her to refute the allegations and defend themselves. It is in the nature of these things that people in senior and more influential positions are the ones exposed to being discredited in this way, rather than the reverse. Employers are required to proceed with extreme caution when contemplating or investigating any similar allegations about employees and the weight of the law exists to protect the employee, not those higher up the feeding chain.

As soon as there is a statutory or professional obligation to raise concerns, and the looser the parameters for this (as is the case here in the UK, but quite the reverse in Australia as far as dentistry is concerned), the easier it becomes for determined and serial whistleblowers to ply their trade with impunity and, in particular, free from any realistic prospect of successful defamation actions being brought against them.

Surely the time has come where, if there is any question of information being passed on, or concerns being raised in bad faith or vexatiously, the informant becomes accountable for their own actions. For as long as the present carte blanche remains in existence, we perpetuate and continue to expose to public gaze one or the murkier and least admirable facets of our profession and indeed of healthcare generally.
Rather like Kate and Harry’s recent experiences, some things are actually best kept under wraps and, what has really been exposed, is not Kate and Harry’s assets but the shabby behaviour of other parties under the pretence of public interest and/or the freedom of the press. Do they take us for idiots?

Kevin Lewis is renowned for his vibrant and influential writing, where he imparts his insight into UK dentistry. In his 20 years in full-time general practice, Kevin developed special interests in preventive dentistry and practice management. He has been involved with Dental Protection since 1989, and was appointed dental director in 1998. Kevin is also a popular speaker, lecturing on a variety of issues at many different events worldwide. He has contributed to two CD-Rom training programmes on infection control, and a BDA A12 Advice Sheet. In 2003, he became a member of the Council of the Medical Protection Society.

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