Case Study Radiologist Whistle Blowers

Introduction

In order to protect patient safety and deliver a quality patient outcome, healthcare workers have the responsibility of raising concerns whenever they experience any cases of illegal conduct or unethical practices. However, empirical evidence has shown that in most cases, those who raise these concerns are often victimised or treated badly by their employing organizations, or senior colleagues, despite these bodies having the responsibility of protecting their interest. According to Wilmshurst (1), whistle-blowers have such experiences because their concerns often embarrass their seniors, the organization or powerful individuals considered ‘untouchable’. Indeed, several cases, within the UK’s NHS, have emerged revealing the plight of whistle blowers in the healthcare sector. In this article, we highlight some of the cases in an attempt to unpack the problems or risk faced by whistle blowers – albeit with a specific focus on the radiology department.

In the UK, various organizations (e.g. patientfirst.org.uk) have highlighted the risks that whistle blowers undergo when trying to raise their concerns about unprofessional patient treatment, a majority revealing that most whistle blowers have experienced unfair treatment and loss of jobs (2). Particularly, Dyer argues that in most cases, the whistle blowers face difficulties in overcoming such risks because whereas they mostly have limited financial resources, they compete against employers who spend massive resources in litigations in an attempt to conceal their unprofessional actions or to protect their senior individuals (3).

Whereas some whistle blowers are not genuine and only claim to be whistle blowers when allegations have been raised against them, Wilmshurst (4) observe that after genuine whistle blowers have raised their concerns, the authorities, or the accused parties often try to look for any reason to victimise or dismiss them – through small mistakes that are magnified to warrant a case that can prevent them from making proving their concerns. This was particularly eminent in the case of Sharmila Chowdhury. In fact, Wilmshurst (5) mentioned some cases where the NHS Trust employed detectives to trail a whistle blower access his computer and audit his mileage so as to make a claim that he tried to defraud the Trust.

The case study of Sharmila Chowdhury

A typical example of the risks faced by whistle blowers in the radiology department is that of Sharmila Chowdhury. According to Chowdhury (6), she had worked in the UK NHS since 1980, before she qualified as a radiographer three years later. She was later employed at Ealing Hospital as deputy imaging manager before she was promoted to the position of an imaging manager. The radiology department she used to manage comprised of 60 employees; some of them being consultant radiologist. Her whistle blowing journey began when she became the budget holder and in charge of the attendances and additional work for all staff including those of the consultant radiologists. In her reflections, she mentions that she became concerned about two consultant radiologists who were being paid large sums of money yet they were also working in other private hospitals. When she sought confirmation from the managers of those private hospitals, it was indeed confirmed that these two consultants had been working in those private hospitals for several years while also receiving payments from the Trust. Additionally, she observed that the consultants were also claiming overtime pay yet they never used to work overtime. After raising her concerns to the authorities, no action was taken against the practice and instead, she was dismissed based on what she termed as ‘false counter-allegations.’

This case study confirms literature by Wilmshurst (7) that in most cases, whistle blowers are distrusted because they are never trusted to remain silent about a colleague’s misconduct, or a threat against patient safety, when the only thing needed is a cover up to for the sake of the organization or senior members of the organization. In fact, according to Wilmshurst (7) some NHS organizations might not employ known whistle blowers due to the fear that they might not ‘cooperate’ when a cover-up is required, or for the fear that they might not be good ‘team players’. Nonetheless, those considered to be cooperative are often appointed to senior positions like regulatory commissions to protect the interest of their accomplices. According to Wilmshurst 2017 (8), this is the reason why whistle blowers are often not treated well by regulators e.g. the UK’s General Medical Council (GMC).

Apart from losing their jobs, whistle blowers also face the risk defamation and threat. Sometimes, when they refuse to comply with the demands of perpetrators; they face several threats including the threat of litigation. For instance, Wilmshurst (9) narrates that when he refused to be bribed by Streling-Winthrop over their demand do falsify research results he had on the amrinone drug, he was threatened with legal action. Particularly, Wilmshurst had published a research finding revealing that the drug was unsafe and ineffective for its purpose. In another case, Wilmshurst was sued for libel and slander by a scientific trial’s sponsor (MIST) when he expressed concerns at a scientific meeting over incomplete and inaccurate trial data (10). In fact, according to accounts by Wilmshurst, the trial went on for three years, where he incurred legal costs amounting to 300,000 pounds trying to win a case that only ended when MIST went into liquidation.

Way Forward

Existing literature has identified various whistle blowers who, despite the suffering they have undergone as a result of whistle blowing, are still continuing with the practice either directly or indirectly by assisting others to do the same. For instance, accounts by Chowdhury (11) indicates that Sharmila Chowdhury, despite losing her job out of whistleblowing, is still continuing to rally support for whistle blowing through various channels such as websites (e.g. sharmilachowdury.com). Worryingly though, Chowdhury (12) indicates that despite Sharmila Chowdhury’s case having received much attention from the media, a permanent solution has never been realised. Nonetheless, she is currently working with the NHS, in collaboration with Department of Health, in a project that helps develop effective ways through which whistle blowers can find their ways back to work (13).

However, it is eminent that there is still much to do in improving the current situation faced by whistle blowers. For instance, according to Chowdhury (14), no commission of inquiry has ever been raised to investigate the case of Sharmila Chowdhury, neither have any managers at the trust been held accountable for the way she was treated as a whistle blower.

To conclude, the plight of whistle blowers within the NHS perhaps is a tip of the iceberg of what other whistle blowers are facing in other countries. This speculation is especially true considering observations by Wilmshurst (15) that in some countries, whistle blowers have received death threats for exposing unprofessional conducts. We can only conclude by speculating further that whistle blowers often face worse treatment that the people they expose.

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References

• 1. Wilmshurst P. whistleblowing in healthcare, HealthManagement, Volume 17 - Issue 4, 2017
• 3. Dyer C. Migraine doctor loses appeal against finding of dishonesty. BMJ, 2015; 351: h6351.
• 4. Wilmshurst P.Dishonesty in medical research. Medico-Legal Journal, 2007;75(1): 3-12.
• 5. Wilmshurst P. whistleblowing in healthcare, HealthManagement, Volume 17 - Issue 4, 2017
• 6. Chowdhury S (2016) An open letter to Jeremy Hunt from a whistleblower. Health Service Journal, 4 January. [Accessed: 22 August 2017] Available from hsj.co.uk/patient-safety/an-open-letter-to-jeremy-hunt-from-a-whistleblower/7001361.article
• 7. Wilmshurst P. whistleblowing in healthcare, HealthManagement, Volume 17 - Issue 4, 2017
• 9. Wilmshurst P.Dishonesty in medical research. Medico-Legal Journal, 2007;75(1): 3-12.
• 10. Wilmshurst P. English libel laws and scientific research. Significance, 2012; December: 37-9.
• 11. Chowdhury S (2016) An open letter to Jeremy Hunt from a whistleblower. Health Service Journal, 4 January. Available from hsj.co.uk/patient-safety/an-open-letter-to-jeremy-hunt-from-a-whistleblower/7001361.article
• 12. Wilmshurst P. whistleblowing in healthcare, HealthManagement, Volume 17 - Issue 4, 2017
• 13. Chowdhury S. why I became a radiology whistle blower HealthManagement, Volume 17 - Issue 4, 2017
• 15. Wilmshurst P. whistleblowing in healthcare, HealthManagement, Volume 17 - Issue 4, 2017