Who'd be a NHS whistleblower?

Margaret Haywood worked undercover on a Panorama documentary

Undercover Nurse Margaret Haywood put a 20-year career on the line to help Panorama expose serious failings in the care of the elderly at one NHS hospital.

Undercover Nurse aired in July 2005 after Ms Haywood wore a hidden camera to film conditions on an acute care ward at Royal County Sussex Hospital.

Her findings were striking, including nursing basics that were routinely ignored such as pain control, toileting and even ensuring that some terminally ill elderly patients were getting enough to eat and drink.

Ms Haywood then spent four years battling attempts to have her disciplined, even struck off the nursing register for breaching her profession's code of practice.

On 16 April, she lost that fight when the Nursing and Midwifery Council (NMC) struck her off for repeatedly violating patient confidentiality rules.

In Who'd be a NHS whistleblower? Panorama revisits the issues first raised by Ms Haywood, but also delves further into the reality of whistleblowing protections in the NHS.

"I'm absolutely devastated - I just don't know what I'm going to do now," Ms Haywood told Panorama after the decision to strike her off was announced.

I did have an idea that they'd try and shoot the messenger and that's exactly what they've tried to do Margaret Haywood, undercover nurse

"I did have an idea that they'd try and shoot the messenger and that's exactly what they've tried to do."

Ms Haywood explains why she took the decision she did to go undercover.

"I didn't take the decision lightly I did look into it, I did give it an awful lot of thought and I knew that my position would be compromised by doing it. But I think the public needed to be aware of what was going on on the ward."

Petition

While her decision to help Panorama reveal conditions at the hospital cost Ms Haywood, now 58, her livelihood, it also earned her tremendous support from patients and their families, including relatives of those elderly and frail people featured in the original programme.

Response to the decision to remove her from her profession has led to an online petition and hundreds of emails urging the governing body to reconsider.

The registrant could have attempted to address shortcomings by other means Linda Read, Nursing and Midwifery Council

This week, Panorama looks at the reality of whistle-blowing in Britain in light of the punishment handed to Ms Haywood. We ask if the protections put in place a decade ago are effective and if more can be done to ensure there is a fair and transparent route for those who have legitimate concerns about failings in the health care system.

In a statement to Panorama, the Department of Health said whistle-blowing protections are adequate under the Public Interest Disclosure Act of 1998.

"We expect that any member of staff who reports concerns about the safety or quality of care to be listened to by their managers and action taken to address their concerns.

"The new NHS Constitution includes an explicit right for staff who report wrong doing to be protected."

Staff 'protected'

The department also said it has contracted the charity Public Concern at Work to provide a helpline that is manned by lawyers with expertise, who can provide advice and support to NHS staff. Any calls to the charity are confidential, the department says.

In delivering its decision to strike Ms Haywood off, Linda Read of the Nursing and Midwifery Council, said the filming amounted to misconduct that was "fundamentally incompatible with being a nurse".

The hospital has both apologised and instituted key changes

"The registrant could have attempted to address shortcomings by other means. But this was never a course of action which she fully considered."

Ms Haywood had admitted breaching patient confidentiality but denied her fitness to practise had been impaired.

The undercover investigation at Royal County Sussex Hospital - for which the trust has both apologised and instituted a series of measures to address the shortcomings - in addition to being roundly praised by families and friends of the patients who Ms Haywood encountered, also prompted real change.

Following the broadcast of the Undercover Nurse programme in July 2005 the hospital produced comprehensive guidelines called the 'Ward Checklist Post Panorama', which addresses the basic nursing care issues that were exposed.

Duncan Selbie, the current chief executive of the hospital, told Panorama in a letter: "We have worked extremely hard to improve standards in every area of our hospitals.

"We apologised unreservedly that in 2004 we allowed standards to fall. There is never room for complacency and there will always be more we can do in everything that we do.

"I can assure you that we are working extremely hard to deliver safe and high quality clinical care and to ensure we treat our patients and the carers with kindness and compassion."

'Absolutely disgusted'

Panorama also revisits some of the relatives and friends of the patients who fell under Ms Haywood's care during her time undercover.

Stuart Burnham, whose mother Hilda, herself a former nurse, provided one of the most poignant moments of the programme as she spoke eloquently of the duty of nursing, said he was outraged that Ms Haywood was struck off.

"I was absolutely disgusted with the verdict - it shouldn't have been Margy on trial - its should have been the supervisors at the hospital - they were the ones that were wrong because they were the ones that weren't doing their jobs properly."

Panorama: Who'd be a NHS whistleblower? Monday, 27 April on BBC One at 8.30pm.