situation, and if the hospital in which she works operates a complaints procedure,
then she would be advised to follow that procedure and voice her concerns
accordingly. If no response is forthcoming, or if such complaints are swept aside,
then W may wish to raise the matter with persons further up the management
ladder even through to the chair of the health authority or Trust where that
appears to be appropriate. Alternatively, at some point W may wish to report to the
Royal College of Nursing /RCN).
On a strict interpretation of confidentiality rules it could be argued that the
passage of information even between those in the health care system should take
place only to serve the treatment of the patient. However, if this principle was to be
followed rigorously, investigations into medical accident might be inhibited. The
General Medical Council allows that doctors must judge whether it is appropriate
to pass on patient information to others within the health care system so that they
can perform their duties. Here the permission of the patient cannot be obtained,
and public disclosure might cause distress to relatives. Arguably, however, dis-
closure within the health care system ought to be permissible. However, further
problems may arise, where, instead of effecting any remedy, the disclosure by W
leads to further problems at work. If W finds herself the subject of formal
disciplinary proceedings, or indeed victimised in some way by line managers as a
result of the complaint, how should W react? Prior to the 1998 Act there were few
available remedies here. Section 27B of the Employment Rights Act 1996 /as
amended by the Public Interest Disclosure Act 1998) allows that W should suffer
no detriment as a result of her actions. If W can show any element of detriment as a
result of her actions she will be able to bring a claim for compensation.
This course of action may also invite press comment, whether or not W actually
instigates this. At this point, W will have to take care to avoid breaching profes-
sional confidentiality rules in any statements to the press. However, insofar as W
and those giving evidence on behalf of W need to give evidence as to the particular
events which led to the complaint, the disclosure will generally be permissible
under professional conduct rules. Under the UKCC Code, disclosure is allowed
`where required by the order of a court'. This does not exactly cover the situation of
atribunal which will not generally proceed by witness summons or the sub-poena
of witnesses. Nonetheless, it is difficult to see that a health authority or Trust would
have much success in seeking to restrain by court action the disclosure of infor-
mation, where that information is being legitimately used to pursue a remedy in an
industrial tribunal. Indeed one in-built advantage of the 1998 Act is that it is in the
long-term interests of employers to ensure that internal complaints are dealt with
in a speedy and responsible manner.
8.10 Conclusion
The continual pressures to meet targets and to cap spending have had a dramatic
and radical impact not only on the methods of service delivery but also on the
demands and expectations placed on various health care professionals and the
allocation of resources. The development of responsibility on all levels, financial,
administrative and professional, down the line from the hospital administrator to
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