With thanks to the editor of the JRSM for publishing this addendum. This has not been supported by the other authors on the paper. Quite frankly, I don't even give a damn. They all opted for the privatisation agenda instead of fighting for what was right. Then they have to live with what they did. The older you get, the less focus you have on the pathway to what is right. Fame wasn't the right way. http://m.jrs.sagepub.com/content/104/7/278.citation/reply#spjrs_el_360 Brief Review dr.ritapal@gmail.com Rita Pal, Medical Journalist It should be noted that this paper was not written for the purpose of supporting groups who align themselves with the NHS privatisation agenda. It is notable that a number of reviews have taken place in the whistleblowing arena following the suggestions we made. These are the Speak Up Review, the Hooper Review etc. It is important to note that none of these reviews investigated the real problems in the NHS. Organisations like the GMC, BMA and the Royal Colleges were not investigated or held to account. Essentially, no file was investigated in any detail and there were no proper conclusions. Where there is no accountability, there will be no improvements in patient safety. This is demonstrated by the ever increasing NHS litigation bill. We have a situation where numerous whistleblowers wrongly believe hanging their linen in the public domain provides some kind of accountability. It may provide some psychological comfort but nothing more will come of this. The negative side effect is that whistleblowers are stereotyped as victims. Is this the message that we want to propagate? Without any detailed investigation into the skeletons in the closets of the medical establishment, there will be no effective solution. The reviews can only be described as a lip-service effort to appease the public and perhaps whistleblowers. Conducted by the government's "safe pair of hands" with advisers failing to declare associations frowned upon by the GMC, its not surprising that most whistleblowers felt that these reviews failed them. The Speak Up Review was not an Inquiry under the Inquiries Act. Its methodology was far from scientific and involved taking each whistleblower's story at face value without any detailed analysis. The fast developing problem of vexatious whistleblowing plaguing Trusts was rapidly glossed over. A kind of mob like fan base for this review resulted in rather greater expectations than it was ever able to deliver. There must be a balance between the rights of the whistleblower and the rights of the Trust. So far, the Trusts are being demonised whether they are right or wrong. This is being done due to adverse media publicity affecting hospitals before court hearings or findings. This will have a negative effect on patient confidence and therefore patient safety. The aim should be to maintain patient confidence and to focus on improvements in patient care rather than playing to media headlines. We must not focus on whistleblowing litigation as the gold standard solution to patient safety or whistleblowers. The emphasis must revert back from the whistleblower "stories" to patient care. At no point are we being told what improvements were made in terms of patient safety in the cases when safety concerns were raised. Without this feedback loop, how will there be any improvement in the NHS? We must go back to the drawing board and focus our minds on the real problems that have existed for decades within the closed doors of medical establishments. These establishments have evaded scrutiny for decades. It is time they opened their doors to a proper inquiry into their methods of handling whistleblowers. We still remain in the days when the infamous Finlay Scott of the GMc stated that "transparency was like a greenhouse - you could look in but not enter the room". Until full transparency is achieved by way of a proper well constructed public inquiry, it is unsafe for doctors to whistleblow and patient safety is currently at risk. The public is not interested in show- trials to appease them. What they now demand is action to preserve the NHS safety profile. Conflict of Interest: I am not associated or affiliated to Patients First or Cure the NHS Published September 13, 2015