Is it worth it?

Alice Figueiredo’s parents were interviewed this week, after a 10 year battle to establish why their daughter had died in Hospital. Their immense pain was obvious. They had suffered personal, professional and financial loss - both had quit their jobs to work full time on Alice’s case, and twice they had sold their home to fund litigation.

The trial of NE London NHS Foundation Trust (NELFT), and the Ward Manager Benjamin Aninakwa, lasted 7 months. The verdicts were given this week but they were not a complete victory. The Trust and the Ward Manager were found guilty of health and safety failings, with the jury deciding that not enough was done by NELFT, or Aninakwa, to prevent Alice from killing herself. However, NELFT was cleared of the charge of corporate manslaughter, and Aninakwa was cleared of gross negligence manslaughter.

Its hard to keep on challenging the system even when it has clearly failed. Those like the Figueiredos experience career loss, financial instability, and psychological trauma. Alice’s mother Jane said ‘You can't underestimate or even find the words to say, the toll that that takes on you. It's profoundly re-traumatising’. No victory could have removed the pain that continues to devastate Alice’s parents but the not guilty verdicts on the manslaughter charges must be a bitter pill for them to swallow.

After the verdicts their focus was on the potential positive impact of Alice’s case, with Jane anticipating major changes to psychiatric care. ‘You need to do far, far better to stop failing those people who you have a duty of care to’, she said.

Why is it challenge difficult?

Whistleblowers like Mr. Martyn Pitman & Dr. Chris Day demonstrated incredible resilience in calling out inadequate patient safety, and holding the NHS to account. Both encountered fierce institutional resistance, organisational self-preservation, obfuscation, misdirection and general inertia.

I wrote about Martyn Pitman last year after the conclusion of his Employment Tribunal case and you can find my article here.

Professional ruin

Whistleblowers are often professionally ostracised and many are dismissed. Obstetrician Martyn Pitman raised Midwifery safety concerns at Royal Hampshire County Hospital, but lost his 20-year career despite the hospital acknowledging his warnings were justified.

Dr. Chris Day exposed ICU safety lapses which were linked to patient deaths, and spent a decade battling Lewisham and Greenwich NHS Trust, enduring vilification and the destruction of vital evidence by Trust officials.

In both cases the Employment Tribunal (ET) offered little assistance to either Doctor. They dismissed Mr Pitman’s case. They accepted the Trust’s argument that his behaviour after 20 unblemished years in post constituted reasonable grounds for dismissal, even though the Trust agreed that his safety concerns had been justified.

The ET also initially accepted the Trusts argument that Dr Day was not a ‘worker’ and therefore not entitled to whistleblower protection. Thankfully this rather strange decision, essentially barring Doctors from whistleblowing protection, was reversed at the Court of Appeal.

Dr Day’s case was remitted back to the ET, but the process has been protracted and complex, with ongoing legal battles and procedural disputes. The lack of ET support, and the financial cost, will inevitably deter professionals from continuing their cases against employers.

Protect, which provides support for whistleblowers, indicates that 85% of whistleblowers experience severe professional repercussions from their actions. Many professionals will prefer to walk away from these possible repercussions rather than continue with what is inevitably a costly, negative and damaging process.

Mental Health

The psychological impact of challenging the system is staggering. Alice Figueiredo’s parents describe their 10-year legal battle as “devastating” and “life-altering”. A staggering 52% of whistleblowers suffer severe anxiety or depression, and their families report fractured relationships and identity crises.

Retaliation

Organisations often use their complex bureaucracy as a retaliatory weapon against challenge.

The Figueiredo family faced resistance, obstruction, misreporting and opacity while investigating Alice’s death. They experienced delays, misdirection, incomplete review of information and incident reports that failed to find the truth. The financial cost of challenging a large organisation with superior resources, means that many cannot continue the fight.

Martyn Pitman was dismissed over ‘communication style’ rather than his safety message. It had not appeared to have been raised as an issue in the first 20 years of his employment. Chris Day’s Trust destroyed 90,000 emails during litigation and were prepared to deprive him, and all other Doctors, of their right to raise concerns under whistleblowing legislation in order to defend their position.

Why do organisations resist challenge?

Whilst it would be reasonable to think that concerns raised by employees would be investigated, and appropriate changes made to improve care and patient safety, the default position of most organisations is to prioritise self-preservation. Mr Pitman’s Trust dismissed him, focussing on his apparently ‘disruptive behaviour’ rather than addressing his concerns, which they later admitted were legitimate. They chose to target the messenger whilst ignoring the message.

Organisations love the status quo and fear uncertainty. Resistance comes from leadership anxieties about loss of control (e.g., Day’s case exposing management deceit), cultural change (e.g., improved Midwifery staffing post-Pitman) and Financial liabilities (e.g., the Horizon scandal that has, to date, cost £1.1 billion). It is easier to fight the challenger than to admit that your organisation needs to change.

Finally, hierarchies – like NHS Trusts – make accountability difficult. As in Alice Figueiredo’s case, corporate manslaughter charges against large organisations often fail, because responsibility for errors is widely spread. The ET’s generally supportive attitude towards employers gives organisations a sense of impunity and reinforces their sense of immunity to challenge.

Personal cost vs society benefit

For those who persist, the calculation is relatively stark. Challenge rarely benefits the challenger but might improve the system and, in the NHS, the standard of care.

The Figueiredo family emphasised their fight was about ‘justice, truth, and accountability – not vengeance’. Martyn Pitman lamented ‘losing the career I cherished’ even though his concerns were justified. Dr Day’s persistence despite destroyed evidence highlights the ethical imperative many feel, to ‘prioritise truth over corruption’ even if that comes at considerable personal cost, and eventually brings little if any personal benefit.

Is challenge worth the trauma?

It clearly takes a special person to follow the path of the Figueredo family, Martyn Pitman and Chris Day. The individual costs can be catastrophic. Collectively, however those who challenge also drive reforms, including improvements in hospital safety and corporate accountability. We should cherish and support those who persist; they benefit all of us.

Conclusion

As Protect’s research shows, whistleblowing failures have cost UK taxpayers £2.3 billion in three scandals alone. Yet for those who put themselves in the crosshairs, the choice between bearing unsustainable personal costs or to walk away and allow harm to continue, is agonising. These cases of Alice Figueiroa, Martyn Pitman and Chris Day demonstrate, in different ways, the grim reality that systemic change often demands individual sacrifice. It should never require the sacrifice of our children.

It may be that in your professional life, you have felt it necessary to challenge the system, including becoming a whistleblower. If so you will probably feel unsupported, undervalued, and probably marginalised by your colleagues.

If you are at odds with your employers, and feeling unsupported, please seek help from an Executive Coach who can help you navigate thought these difficult times. You can book a free no obligation 30 minute on-line conversation with me here. If I am not the right Coach for you, I will recommend somebody else who might be.

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Challenging the system is hard