That's what is going on in the NHS, according to the results of a survey in Nursing Times.
"84% of [nurse] respondents had previously raised concerns about a colleague’s practice or attitude – of which 23% said they had done so “several times” or “regularly”, and 23% “at least once”.
But of those who had raised concerns, 52% said there had been no appropriate outcome as a result of speaking up and a similar percentage said doing so had led to negative consequences for themselves.
Almost 30% of nurses said being viewed as a troublemaker was the biggest barrier to speaking up, with inaction by managers cited by 23%. "
Organisations that don't learn from their own experience suffer calamitious reputational damage when the public learns that they don't systematically learn lessons from experience. Their leaders are branded as incompetent at best. More important, their customers suffer the consequences. In the NHS, that means avoidable harm to patients, as those so disastrously served by the Mid-Staffordshire Hospitals have learned. It's been estimated that between 400 and 1200 unnecessary deaths occurred there between 2005 and 2008.
This is a deep cultural issue, reinforced by incentives and a long history. In the past it's been reinforced by government set targets and the systematic gagging of those who alleged bad practice. Following the Francis Report, the Department for Health says it want things to change, but changing such a deeply embedded, longstanding and seemingly ubiquitious bad practice is exceptionally hard to achieve.