Dani Garavelli: Duty of care neglected

Published on Saturday 18 April 2009 20:02

Four years ago, Panorama produced a documentary that exposed the appalling neglect of elderly people in the Royal Sussex Hospital in Brighton.

Using hidden cameras, it captured a catalogue of failings on an acute medical ward: blood stains on curtains, faeces on floors, food for patients who were too frail to feed themselves left lying on bedside tables. Some of the scenes were painful to watch: one woman told of her agony after staff failed to give her pain relief; another was left to die alone.

It was – by any standards – a superb piece of investigative journalism, which led not only to improvements in the hospital concerned, but to an opening up of the debate on the care of the elderly. And who could deny it was in the public interest? If your ageing relatives were being treated like pieces of meat, then you'd want to know about it, wouldn't you?

Yet last week, Margaret Haywood, the nurse who filmed the incriminating footage, was struck off by the Nursing and Midwifery Council (NMC) for "a major breach of the code of conduct". Now campaigners are rallying round, outraged that she should suffer for highlighting a problem which appears to be almost endemic in the NHS.

As a member of a profession which relies on whistleblowers, my natural instinct is to jump on the bandwagon and back calls for her reinstatement, and yet I can't help feeling that – for all the good she did – Haywood crossed a line that does make her position as a nurse untenable.

In order to highlight the way in which the dignity of her elderly patients was being stripped away, she filmed them at their most vulnerable, thereby compounding the abuse. More culpable than Haywood, though, it seems to me, was the BBC for hiring her in the first place. If programme-makers wanted proof of what was happening, why didn't they get a member of their own team to join the hospital as an auxiliary? Why did they expect her to put her own job on the line by effectively doing theirs for them?

The decision to become a whistleblower is never an easy one. Contrary to the impression given in All The Presidents' Men, the role of Deep Throat is not particularly glamorous, and those who take on their bosses rarely escape unscathed.

I write as someone who learned this the hard way. Years ago, I was taken to court for trying to protect the identity of a police officer who came to me after trying and failing to raise his concerns about malpractice with his own superiors. The issue at stake was not as significant as the abuse of elderly patients – it revolved around the alleged massaging of crime figures. But given the energy the force expended trying to root out and destroy the whistleblower, you would have thought he'd jeopardised national security.

In the end I won the case. I didn't have to name my source but the chief constable went ahead and sacked the senior officer he believed to be the mole regardless. The whole affair left me with an admiration for those prepared to put their jobs on the line and a cynicism about the willingness of large bodies to acknowledge and address their own inadequacies.

With this in mind, I don't need convincing that Haywood turned to the BBC as a last resort. What woman approaching retirement age would put her career at risk unless she believed it was her only option? The fact the documentary team had received 5,000 complaints about patient care certainly suggests no one inside the hospital was interested.

I have no problem with workers breaching their employment contracts to expose wrong-doing and if Haywood had merely given the BBC an interview telling of her own experiences, then, in my opinion, she would have been acting entirely legitimately. Nor do I have reservations about clandestine filming per se. The BBC's documentary The Secret Policeman in which reporter Mark Daly went undercover to expose racism in Greater Manchester Police force posed few ethical problems because it embarrassed only those who made derogatory comments on camera.

The difficulty with shooting undercover footage in a hospital, however, is that in order to expose wrong-doing, you have to use subterfuge against the very people you are seeking to protect. And the difficulty of getting a nurse to do it is that you're asking her to breach not merely her contract with her employers, but with her patients.

There will be those who insist the liberties Haywood took with their human rights were for the greater good, but – unlike her – the elderly people she filmed had no real opportunity to decide whether they were willing to sacrifice their right to privacy for the future benefit of others. And yes, I know the programme-makers subsequently obtained permission to use the footage, but having witnessed the confusion of these patients, you have to wonder if they were capable of giving informed consent.

Worst of all, Haywood's decision to make the BBC documentary while working as a nurse represents an unacceptable conflict of interests. If, in the course of her job, she found an elderly woman lying in her own filth her first priority should surely have been to clean her up – not to record the fact for the BBC. To my mind, the moment she took possession of the camera, Haywood ceased to be a nurse and became a reporter, which perhaps explains why the National Union of Journalists has been more vocal on her behalf than the Royal College of Nursing has.

On balance, then – though I salute her courage and her tenacity – I think the NMC had no choice but to strike Haywood off. I just hope it has been as tough on those individuals whose dreadful failings she risked her livelihood to highlight.