Is inadequate response to whistleblowing perpetuating a culture of silence in hospitals?

Linda Moore (Health Policy and Management, Trinity College, University of Dublin, Dublin, Ireland)
Eilish McAuliffe (Health Policy and Management, Trinity College, University of Dublin, Dublin, Ireland)

Clinical Governance: An International Journal

ISSN: 1477-7274

Publication date: 10 August 2010



The reporting of incidents or “whistleblowing” occurs when a member of staff within an organisation discloses that an employee has acted in a way that is a cause for concern, and the person it is reported to has the ability to do something about it. Surveys in the UK and the USA have shown that errors in healthcare are unacceptably high. It is also known that under‐reporting of errors is the norm. There is a need to understand why people fail to report so that systems and more open cultures which support staff in reporting poor practice can be introduced. Research that captures the experiences of those who have observed poor care and what they experience if they report an incident is critical to developing such an understanding. This paper aims to address this issue.


An exploratory quantitative research design, based on a similar study in the NHS UK, was utilised to answer the research questions of this study. Data were collected in eight acute hospitals in the Health Services Executive (HSE) regions in Ireland. Two hospitals were selected from each of the four regions and nursing staff on three wards within each hospital provided the sample. A total of 575 anonymous questionnaires were sent to all grades of nurses working on these 24 wards.


A total of 152 responses were received, a response rate of 26 per cent. This study found that 88 per cent of respondents, i.e. nurses working in acute hospitals, have observed an incident of poor care in the past six months. The findings indicate that 70 per cent of those that observed an incident of poor care reported it. Nurse managers are more likely to report than staff nurses (reporting rates of 88 per cent and 65 per cent respectively). The study findings indicate that only one in four nurses who reported poor care were satisfied with the way the organisation handled their concerns.


Health professionals have a responsibility to maintain standards of care and this responsibility includes taking action to report poor care. The paper shows that reporting of poor care is hampered by a fear of retribution and lack of faith in the organisation's ability to take corrective action.



Moore, L. and McAuliffe, E. (2010), "Is inadequate response to whistleblowing perpetuating a culture of silence in hospitals?", Clinical Governance: An International Journal, Vol. 15 No. 3, pp. 166-178.

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