Who protects whistleblowers?

Bradley Manning, the baby-faced US soldier now in the dock after months of incarceration for publicising a raft of internal embassy memos. And, of course, Julian Assange, non-paying guest of the Ecuadorian embassy, following the Wikileaks affair and allegations of sexual misconduct in Sweden.

The message their fate sends would-be whistleblowers is that spilling the beans on perceived wrongdoing can be seriously bad for your long-term health. And, sadly in the current climate, that applies as much to minor league disclosures as to big ticket scandals.

In theory, legislation protects any UK citizen who flags up bad practice or unacceptable behaviour if the information they disclose is in the public interest. And nothing, you might imagine, is more in the public interest than learning about catastrophic errors of judgment in the health service.

Yet at the just concluded national BMA conference in Edinburgh, junior medical staff insisted criticising hospital procedures was literally more than their job was worth, citing colleagues whose careers had suffered strange accidents following their speaking up on behalf of poor patient service.

Life at the top of the NHS in England is hardly more secure. Gary Walker was fired from his chief executive role at the United Lincolnshire Hospital Trust for refusing to meet targets for non-urgent operations to progress the essential variety. His payoff included a gagging clause.

And, when he broke cover to tell his story to the BBC, his erstwhile employers threatened to take him to the financial cleaners unless he pulled out of the interview. He didn't; and because his was a high-profile case he will probably face no penalty.

More junior colleagues, raising concerns in less public arenas, may be more fearful of the consequences. If you get fired as a doctor, where do you go from there?

In his interview, Mr Walker talked of a culture of fear, one he believed, had permeated the ethos in other health authorities such as Mid Staffs with its truly awful litany of avoidable deaths.

He said: "And if you consider that the people who have been running the NHS have created that culture of fear, they need to be held to account or new people brought in to change that culture."

Spooked by that affair, the UK government in the shape of health secretary Jeremy Hunt suggested gagging clauses would be outlawed.

But fear of dismissal and financial disaster aren't the only problems with would be whistleblowers.

They, and we, live in a world where blame is apportioned and fingers pointed with a speed which allows little room for measured investigation or reflection.

The same Jeremy Hunt threatened to remove the pensions from those at the top of the Care Quality Commission (CQC), accused of covering up another scandal involving maternal and infant deaths at Morecambe Bay hospitals.

Yet, as the story unfolded, it emerged the fledgling CQC – created from bolting together three previous organisations all opposed to merger – had been tasked with monitoring the performance of 40,000 medical providers with 1000 ill-trained non-specialist staff.

It doesn't excuse a cover-up, if one took place; it does offer some perspective to the risks implicit in repeatedly re-organising and partially privatising a supposedly national health service.

Another difficulty lies within the legislation notionally set up to protect whistleblowers which promotes trying to resolve difficulties in the first instance with the management involved, rather than running to the courts or the media.

A plausibly rational suggestion you might suppose, except that in so many of these recent cases the management have proved to be the problem rather than the solution.

And, as ever, enter stage left those folk who can smell the opportunity of a fast buck at 50 paces. There is now a small niche industry of companies – often staffed by ex-police or press personnel – who urge you to tell them your story and they will find a way to publicise it in the media.

Some of them nobly suggest they will not take any of your fee for a story being sold. Maybe not, but safely bet next month's mortgage on the deal they do include a handsome cut of any proceeds from the publication concerned. Be sure too, that any such agency will have your privacy and future job prospects well down on their list of priorities if either consideration appears at all.

It was partly in response to what they saw as exploitation of genuine whistleblowers from some of these quarters that WBUK (Whistleblowers UK) was set up last December in an attempt to offer support from lawyers and others who had trodden the same difficult path on a pro bono basis.

The interviews they filmed and publicised to accompany the launch were a touching, if dispiriting, account of ordinary people who had risked reputation and livelihood to publicise something which had gone badly wrong in the way their organisations went about their business.

Many of them had paid a high price, their lives essentially on hold for months and years as they fought the good fight against hostile employers engaged in risky, callous, and sometimes downright illegal practices. Yet their concern for the service users, often vulnerable, had trumped concern for their own welfare.

That brand of well-motivated, public-spirited intervention should be something attracting gratitude and reward rather than, too often, character assassination and loss of prospects.

And the game should never be won by those with deep pockets and shallow principles.