IN theory, Scottish Government policy on both issues is crystal clear.

First, there will be no compulsory redundancies in the NHS. Secondly, NHS staff are free to report concerns about patient safety without fear of reprisals. Health Secretary Nicola Sturgeon repeated that reassurance last December after a survey suggested that 84% of nurses fear victimisation if they report safety worries and 37% have been put off reporting any such issues. "Publicly today I send out a very strong message to all those working in the NHS that patient safety is paramount. It is their responsibility, it is my responsibility and anyone with concerns should be free to raise them," she said.

What are we to make, then, of the revelation that increasing numbers of staff are leaving the NHS in Scotland under "compromise agreements"? As trade union officials agree, there is nothing wrong with these agreements as such. The concept, devised around 20 years ago, involves an employee agreeing not to pursue an employment-related claim, usually in exchange for a sum of money.

However, as The Herald reports, there are fears that in the NHS in Scotland compromise agreements are being used both to gag whistleblowers and to disguise what are in effect compulsory redundancies. There were around 400 such deals last year.

As far as compulsory redundancies are concerned, there appears to be a grey area, especially when services are being redesigned and certain specialists are no longer needed. NHS Greater Glasgow and Clyde recently shed 54 employees in this way, rather than attemp to redeploy them. It seems unlikely that the Health Department is unaware of this practice, which looks like compulsory redundancy by another name. However, if both parties are satisfied with the terms on offer, it is hard to see what is wrong.

Far more serious is the claim that many of these compromise agreements contain non-disclosure clauses that prevent staff members from whistelblowing. Ms Sturgeon must be aware that there is a long history in Scotland of the failure of employers to create a safe environment for staff to raise concerns without fear of reprisal. If compromise agreements are being used to off-load staff who have complained about the safety or welfare of patients and prevent them taking those worries further, then it is a serious matter.

In England the Health Select Committee recently recommended the scrapping of compromise agreements in the NHS if they barred workers from raising complaints or grievances with organisations such as the Care Quality Commission and the Nursing and Midwifery Council. South of the Border there is also a whistleblowing hotline that guarantees anonymity.

It is time a similar facility was introduced in Scotland. This is not merely an ethical issue, as it might be in other organisations. Lives could be at stake. Gagging clauses are both unacceptable and incompatible with the goal of improving patient care and safety. Meanwhile staff who sign compromise agreements must be reassured that they are free to speak out without compromising their remuneration.