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Whistleblowing and Ethics in Health and Social Care

Whistleblowing and Ethics in Health and Social Care

Angie Ash

(2016)

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Book Details

Abstract

Those who speak up about poor, corrupt or unethical practice often do so at a great personal cost. This timely book explores our understanding of the ethics of whistleblowing and shows how managers and organisations can support individuals speaking out.

While some professional guidelines formalize duties to speak out where there are concerns about poor or harmful practice, workplace cultures often do not encourage or support this, and individuals frequently find themselves victims of a backlash. This book looks at the social, cultural and systemic reasons that make speaking out about poor care so risky. The book looks at the ethics of whistleblowing, and why some people speak out about corrupt or harmful practice, but many do not. It offers a practical framework for creating ethically driven health and social care organizations that support and protect individuals speaking out.

Whistleblowing and Ethics in Health and Social Care is essential reading for students, professionals and decision makers across health, social care and criminal justice.


Whistleblowing and Ethics in Health and Social Care is more than timely. In-depth and well researched, its themes hit the mark - including organisational culture, paradoxes, corrupt practices, silence, by-standing and blind spots - as do the many disturbing examples given. Ethical leadership may be a solution as good as any, as the book suggests, but ethical leadership seems, in reality, scarce on the ground, thus making the book all the more important to remind us of the magnitude of the problem.
Michael Mandelstam, Author of How We Treat the Sick: Neglect and Abuse in Our Health Services and Betraying the NHS: Health Abandoned
This is a very important and timely publication given all the recent interest in and publicity about whistleblowing in the public sector with a particular focus on health and social care. What I very much value about this book is that it is not simply about the nuts and bolts of whistleblowing in respect of policy and procedure but it seeks to unearth some of the very real and fraught complexities experienced by those who have been involved in whistleblowing scenarios. Ash quite rightly encourages the reader to unpack the various layers that shroud this activity and in my view she has produced a critical analysis that should both provoke debate and be actively referenced in current and future debates. A must read for all health and social care professionals.
Nushra Mansuri, Professional Officer (BASW England)
Dr. Angie Ash FRSA, is a researcher, writer, mentor and consultant and a registered social worker. Angie's career has included social work practice and management, research at the universities of Bristol, Swansea and Bangor, and management consultancy to government, charities and companies. Angie is Principal of the UK-based health and social care consultancy Angela Ash Associates (www.ashassociates.co.uk).
Angie Ash has prepared a text which is readable, relevant and required. It is required and relevant especially at this time when public services, and public sector workers, are being compromised by cuts which are having a damaging impact on those who need to use, especially, health and social care services. Through informed and passionate analysis, this book explores the realities and risks of whistleblowing but also highlights its crucial importance and value.
Dr. Ray Jones, Professor of Social Work, Kingston University and St George's, University of London
This is an excellent account of whistleblowing in the field of health and social care. It is one of the first books to systematically and comprehensively analyse some of the key issues that arise when whistleblowers try to raise their heads above the parapet. It is essential reading for those who wish to understand how to improve the life of the whistleblower and those who wish to make organizations a better place for speaking out.
Narinder Kapur, Visiting Professor of Neuropsychology, University College London and NHS whistleblower who has written articles on patient safety

A highly recommended 'must read' book for not just those in the NHS but for policy makers, governments and the general public, in order to gain an understanding of whistleblowing which has huge implications on patient and staff safety, as well as in some instances on the public purse.

The book is extremely well researched and is unique in its in-depth analysis of whistleblowing in the health sector.

It should be made compulsory for all NHS managers and politicians to read, so that they have a better appreciation and enable appropriate action to be taken when faced with staff raising concerns.


Sharmila Chowdhury, NHS whistleblower, www.sharmilachowdhury.com

Table of Contents

Section Title Page Action Price
Whistleblowing and Ethics in Health and Social Care by Angie Ash 3
Acknowledgements 6
Abbreviations 10
Chapter 1 - The Paradox of Whistleblowing 11
Patterns of paradox 12
Living with paradox 14
What this book is about 17
Terms used 24
Chapter 2 - Whistleblowing 25
Good, Bad and Ugly 25
Fables, fantasies and facts 26
What whistleblowing is 27
Who is likely to whistleblow and about what? 30
Weighing up the pros and cons of whistleblowing 34
Codes and woes 35
UK whistleblowing in law 38
Paradoxes in whistleblowing policy and procedures 40
What happens when people whistleblow? 42
Retaliation and retribution 45
Facing into fear 48
The smell of Salem 49
Ostracism and outcasts 51
Chapter 3 - Organizational Culture and the Whistleblower 53
Organizational climate and culture 54
Layers of culture 55
Undiscussables of organizational life 56
Fragmented cultures 59
Socialization, rationalization, normalization 61
Ethics and human agency 65
People are social animals 67
Groups: Not always your friend 69
Minority influence can make a difference 72
Bad apples, bad barrels 73
Cultures are critical 74
Chapter 4 - Silence and Devices of Denial 76
Keeping quiet 77
The sound of silence 79
Spiral of silence 81
Black sheep and walls of silence 81
Obedience to authority 82
Denial 85
Strategies of denial 86
Doublespeak and denial: Rotherham, England 88
Chapter 5 - Bystanders, Bleach and Blind Spots 93
Bystanders and the aversion of the gaze 94
Self-deception, the slippery slope and ethical degradation 96
Exercising the moral muscle 98
We think we’re more moral than we mostly are 99
The evil that is done 102
Organizational blind spots 106
Health and social care disasters 107
Systematic attention deficit disorder 110
Chapter 6 - How Not to Encourage Whistleblowing 113
Cash for whistleblowing 114
A duty to report 116
Individual autonomy, individual liability 117
Problems of a ‘duty to whistleblow’ 118
Compliance, confidence and codes 120
Trusting the confidence apparatus 120
Prevention is better than cure 123
Chapter 7 - Whistleblowing in Ethical Health and Social Care Systems 126
Defining ethics and morality 127
The whistleblower as ethical canary 128
Integrity and the codes 129
Whistleblowing as ethical right action 132
An ethic of care 134
Whistleblowing and the emperor’s clothes 137
The whistleblower and an ethic of care 138
Embedding an ethic of care into health and social care practice and systems 139
Ethics and care throughout health and social care systems 140
Attentiveness 142
Responsibility 143
Competence 144
Responsiveness 145
Chapter 8 - Ethical Leadership and Whistleblowing 146
The art of leadership 147
Romancing the leader 147
Ethical leaders 149
Ethical leadership and an ethical organizational culture 152
Designing ethical leaders 153
Emotional intelligence and the ethical leader 154
Emotional intelligence in the workplace 155
Chapter 9 - The Ethical Point of Whistleblowing 158
Leadership, Anti-Bathsheba style 159
The virtue of whistleblowing 163
Postscript for the Whistleblower 165
References 168
Subject Index 179
Author Index 182