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Low pay, job insecurity, bullying and harassment all contribute to academic researchers reporting above-average levels of anxiety and depression. Institutions can improve working environments by looking at best practice elsewhere. Low pay, job insecurity, bullying and harassment all contribute to academic researchers reporting above-average levels of anxiety and depression. Institutions can improve working environments by looking at best practice elsewhere.

A survey suggests that many research misconduct incidents in the United States go unreported to the Office of Research Integrity. Sandra L. Titus, James A. Wells and Lawrence J. Rhoades say it's time to change that. Scientific misconduct: Tip of the iceberg? A survey of US researchers suggests that scientific misconduct is greatly under-reported. The Office of Research Integrity was told of only 201 instances of likely misconduct relating to work funded by the Department of Health and Human Services in three years. Yet extrapolation from the survey predicts that over 2,300 observations of potential misconduct are made yearly. Sandra Titus, James Wells and Lawrence Rhoades argue that science can and should clean up its act, and recommend six strategies to that end.

Despite the law in the UK (Employment Rights Act 1996, amended as Public Interest Disclosure Act 1998), Bristol Royal Infirmary anaesthetist Stephen Bolsin had to leave for Australia, 2 although progress may have been made more recently. 3 Even in the US, although whistleblowing has been deeply culturally ingrained since the Lloyd-La Follette Act of 1912, individuals remain vulnerable to bullying and gagging.

The authors interviewed 26 whistle-blowers who had initiated qui tam cases against pharmaceutical companies that were successfully prosecuted for health care fraud. The whistle-blowers reported undergoing substantial personal hardships during their legal cases, which lasted an average of 5 years. They were paid a median of $3 million. The authors interviewed 26 whistle-blowers who had initiated ̶0;qui tam̶1; cases against pharmaceutical companies that were successfully prosecuted for health care fraud. Prosecution and prevention of health care fraud and abuse are essential to reducing U.S. health care spending. 1 – 3 A number of recent high-profile cases have uncovered suspect business practices and led to substantial recoveries; in September 2009, for example, Pfizer paid $2.3 billion to settle allegations that it marketed its drugs illegally to physicians, leading to unnecessary payments by the government. 4 Currently, 90% of health care fraud cases are “qui tam” actions in which whistle-blowers with direct knowledge of the alleged fraud initiate the litigation on behalf of the government. 5 Qui tam derives from the Latin phrase qui tam pro . . .

A combative legal process is not the inducement NHS workers need to encourage them to speak up about threats to patients. [...]talking about safety is seen and believed to be a safe thing to do, we will continue to fail patients needlessly.

Asked whether the RCVS could find a way to obtain information from witnesses but also protect identities by, for example, commissioning external investigators (as it did for its recent probe of council members for leaking confidential information to third parties), Ferguson replied: ‘I’m afraid not, no. On the subject of whistleblowing, the RCVS spokesperson said: ‘The term has a defined meaning within statute (The Public Interest Disclosure Act 1998) and is generally made to an employer where various protections for that employee are available. In these sorts of cases, witnesses will be intimidated from giving evidence if required to do so publicly Crossbench peer Lord Trees, chief veterinary adviser to this journal said: ‘I welcome the RCVS’ inquiry, but the sad situation we are in is unusual and I am concerned that the college’s normal processes are not fit for purpose to investigate allegations of this type.

Whistleblowing is regularly identified as corporate control mechanism to prevent and uncover fraud. We review and compare the legal situation for whistleblowers in the People’s Republic of China and India. In a survey of 942 employees from private companies in both countries, we take a look at the status quo of whistleblowing system implementation, explore preference of channels to disclose fraud or corruption, and analyze under which conditions and what kind of employees prefer external over internal whistleblowing. We find that provisions for mandatory whistleblowing systems can be found in the law of both countries. In China in particular, protection is scattered across many different laws in the private sector. Indian companies seem to have systems in place more often, although this difference becomes smaller the larger the company. The general preference of internal over external channels is similar across countries. Our regression models suggest that external channels are preferred over internal ones when fear of retaliatory measures is higher, the company is smaller, and the whistleblower is female. In line with prior literature, the effect of fear of retaliation is moderated by gender: women are less influenced by retaliation. All in all, implementation of whistleblowing systems seems ubiquitous in both countries; legal protection and comprehensive measures to decrease retaliation are lacking. Additional implications of findings are discussed.

Speaking of the public response to the deaths of children at the Bristol Royal Infirmary before 2001, the BMJ commented that the NHS would be ‘all changed, changed utterly’. Today, two inquiries into the Mid Staffordshire Foundation Trust suggest nothing changed at all. Many patients died as a result of their care and the stories of indifference and neglect there are harrowing. Yet Bristol and Mid Staffordshire are not isolated reports. In 2011, the Health Services Ombudsman reported on the care of elderly and frail patients in the NHS and found a failure to recognise their humanity and individuality and to respond to them with sensitivity, compassion and professionalism. Likewise, the Care Quality Commission and Healthcare Commission received complaints from patients and relatives about the quality of nursing care. These included patients not being fed, patients left in soiled bedding, poor hygiene practices, and general disregard for privacy and dignity. Why is there such tolerance of poor clinical standards? We need a better understanding of the circumstances that can lead to these outcomes and how best to respond to them. We discuss the findings of these and other reports and consider whether attention should be devoted to managing individual behaviour, or focus on the systemic influences which predispose hospital staff to behave in this way. Lastly, we consider whether we should look further afield to cognitive psychology to better understand how clinicians and managers make decisions?

To dismiss the role of research misconduct is mistaken and unfortunate. At best, ignoring deliberate misconduct in efforts to reduce irreproducibility is a wasted opportunity, like tilling a field without clearing it of rocks. At worst, it permits destructive behaviour to persist and flourish.