Freshfields whistleblowing survey 2023: Spotlight on trends in the healthcare sector

In October, we published the results of the Freshfields whistleblowing survey 2023, which gathered the views of over 2,500 individuals across five jurisdictions (the US, the UK, Hong Kong, France and Germany) and thirteen sectors. The survey was designed to gauge respondents’ attitudes towards whistleblowing and how these attitudes may have changed since the last iteration of the survey in 2020.

In recent blog posts we have examined, amongst other topics, the impact of remote and hybrid working on speak-up culture (see here), as well as trends emerging from the survey data in the US, Hong Kong and the EU (see here, here and here).

This blog will cover key trends in the healthcare sector, and how they compare to the overall survey responses. Specifically, the healthcare sector saw a significant increase in the number of respondents who were involved in whistleblowing since the last iteration of the survey, as well as a lack of internal reporting of wrongdoing and poor awareness of whistleblowing procedures. These trends highlight the continuing importance of strong speak-up cultures for employers in the healthcare sector, and the need for consistent training and awareness campaigns regarding internal whistleblowing policies and procedures.   

Increased involvement in whistleblowing 

The healthcare sector saw a significant overall increase in the number of respondents who reported being involved in whistleblowing – either through having a whistleblowing claim reported to them, experiencing a colleague whistleblowing, being the subject of whistleblowing or being a whistleblower themselves. 40 per cent of respondents in the healthcare sector reported being involved in whistleblowing in some way (up from 29 per cent in 2020) and 16 per cent of respondents reported being a whistleblower themselves (up from 10 per cent in 2020). 

While this figure is consistent with the data from the overall survey population (43 per cent of respondents overall reported being involved in whistleblowing, up from 32 per cent in 2020, and 17 per cent of respondents overall reported being whistleblowers themselves, up from 12 per cent in 2020), involvement in whistleblowing in the healthcare sector varied by jurisdiction. Respondents in Hong Kong were the most likely to be involved in whistleblowing (46 per cent, up from 20 per cent in 2020) and respondents in the US were the least likely (38 per cent, up from 11 per cent in 2020). However, all five jurisdictions saw an increase in respondent involvement in whistleblowing since the 2020 iteration of the survey.

While it is difficult to pinpoint factors contributing to a rise in whistleblowing, extremely high demands on employers and individuals during the COVID-19 pandemic and the subsequent increase of remote and hybrid working are consistent themes across the healthcare sector and may be contributing factors (see below for more analysis of the impact of remote and hybrid working). 

Lack of internal reporting 

While there was an increase in respondent participation in whistleblowing in the 2023 survey, there was no corresponding increase in respondents’ desire to report wrongdoing internally. 42 per cent of respondents in the healthcare sector said that they would report wrongdoing to their direct bosses (the same as in 2020), whereas this figure has decreased when looking at the overall survey population (40 per cent, down from 46 per cent in 2020). 

Just as with involvement in whistleblowing, the percentage of respondents in the healthcare sector who would report wrongdoing internally varied across jurisdictions. Respondents in France were the most likely to report internally (63 per cent, up from 52 per cent in 2020) and respondents in Hong Kong were the least likely (15 per cent, down from 34 per cent in 2020). This figure may be concerning for employers in Hong Kong, as respondents in this jurisdiction were also the most likely in the healthcare sector to turn to social media to report wrongdoing in the first instance (22 per cent, up from 7 per cent in 2020). 

Whistleblowers turning to social media could be a sign of a disconnect from, or lack of trust in, their employer. Regardless of the reason, the encouragement of internal reporting is clearly important in the healthcare sector, as whistleblowing reports may entail disclosures relating to intellectual property, confidential information or sensitive data. Regular whistleblowing training for all employees and supportive messaging from the top down can be effective ways for employers to foster greater trust in their employee populations and to encourage them to raise any concerns internally in the first instance. 

Low awareness of / training on whistleblowing procedures

Our survey also studied another key topic for whistleblowing – employee awareness of whistleblowing procedures. Respondents in the healthcare sector (39 per cent in both 2023 and 2020) were less likely than the overall population (47 per cent, up from 43 per cent in 2020) to think that the average employee would be aware of their organisation’s whistleblowing policy and know what to do should wrongdoing occur. Awareness in the healthcare sector varied across jurisdiction, with respondents in non-EU countries like the UK (66 per cent, up from 60 per cent in 2020) and Hong Kong (39 per cent, up from 37 per cent) being more likely to think that employees would know about whistleblowing policies than respondents in Germany (20 per cent, down from 30 per cent in 2020) and France (28 per cent, up from 24 per cent in 2020). 

In addition to employee awareness of procedures, training for managers within organisations is key to building a strong internal speak-up culture. Respondents in the healthcare sector (46 per cent) were significantly less likely than respondents overall (61 per cent) to think that managers in their organisation were adequately trained on whistleblowing procedures. Again, respondents in non-EU countries like the US (77 per cent) were more likely than their European counterparts in Germany (39 per cent) and France (28 per cent) to believe that managers in their organisation were adequately trained. 

The lack of awareness and training in EU countries is at odds with the significant reforms in the EU following the implementation of the EU Whistleblowing Directive (read more here). Organisations in the healthcare sector in particular may have significant responsibilities towards patients and consumers, including in relation to health and safety, and so proper escalation of concerns is especially crucial. Healthcare employers should therefore consider how regularly and effectively they inform their employees about their whistleblowing procedures as well as the type and frequency of training that they are providing – not just to managers, but to all levels within the organisation. 

The impact of remote / hybrid working on whistleblowing

Our survey also captured respondent opinions regarding the potential impacts of wider societal movements, including the increasing prevalence of remote and hybrid working following COVID-19. There has been an increase in the number of respondents in the healthcare sector who believe that remote and hybrid working has had some impact on whistleblowing (81 per cent, up from 74 per cent in 2020), although this remains lower than the overall population of the survey (85 per cent of respondents overall, up from 76 per cent in 2020). There was agreement amongst the respondents that there has been some impact of hybrid and remote working on whistleblowing, but opinions were divided as to what this impact was. Some respondents reported that employees in their organisations are now more likely to feel comfortable blowing the whistle in the privacy of their own homes (30 per cent, up from 20 per cent in 2020) and others felt that employees are more likely to report externally or on social media because they feel less connected to the organisation (22 per cent). In contrast, some respondents felt that workers will be less likely to be exposed to instances where whistleblowing is required (24 per cent, up from 21 per cent in 2020). 

These results show how important it is for employers to engage with their workforce and understand feelings regarding whistleblowing on the ground. However, remote and hybrid working may only be relevant for a portion of a healthcare workforce as many roles will require physical attendance at the workplace. Striking the balance between different groups of individuals will be a particular challenge. 

To access our full whistleblowing survey report, please click here. The Freshfields team would be very happy to discuss any of the themes in the report in more detail.