Two incidents come to mind from my own experience working in private-sector Care of the Elderly. In two separate institutions I was severely concerned about the care being given, health & safety, staffing levels, hygeine, you name it. So I did what the NMC says we should do: I approached my line manager, formally, with written documentation of failings observed. To take some examples, unqualified staff left in charge all shift, unlocked drug and instrument cupboards, broken or inadequate equipment, used inco pads left in heaps on floors, broken toilets left unmended for weeks, inappropriate food (how's a woman with no teeth supposed to eat the salads that were the only food offered day after day?), overdosing of patients with powerful tranquillisers to disguise the inadequate staff levels......In both cases, I was not the first nurse to raise concerns, but the others contented themselves with grumbling quietly, all except for one brave CA who had unwisely contacted Social Services direct, and when that didn't work, the local Press. She was vilified and stitched up. In both cases, immediately after the managers received the concerns, my contract was terminated, for specious reasons. Now get this. In one case, the Home was closed some months later, by Social Services who up to that point had been turning a blind eye because, I think, it was cheap. Reason given: patients discovered to be at risk. In the second case, the Matron of the Home was removed from post by the owner some months later. Reason given: incompetence. I like to think my protests did some good, if only in gingering up those who could make a difference, but these were small operations with simple chains of command and accountability. I have every sympathy with Ms Haywood, who found that "nothing was done" when she tried the tangle of official channels. But I would say, to anyone contemplating doing the same, Watch Your Back. Ms Haywood left herself vulnerable, as was said in previous post. In my experience, managers facing this kind of scandal pull strokes that would gain the admiration of Damian McBride.