Many of the biggest scandals in healthcare have been exposed by whistleblowers.

At the beginning of the Covid pandemic, Li Wenliang, a 34-year-old ophthalmologist working in a hospital in Wuhan, was the first to raise the alarm over a cluster of patients whose respiratory symptoms echoed earlier Sars outbreaks.

In a textbook shoot-the-messenger retaliation, he was criminalised for spreading “false rumours” only to die tragically from the disease in February 2020 – by which point most of China was in lockdown.

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xxxJeffrey Wigand blew the whistle on Big Tobacco. He was later portrayed by Russell Crowe in a movie depiction of the expose, The Insider (Image: Getty)

Then there was Jeffrey Wigand, a former tobacco company biochemist who went public in the 1990s to reveal how executives had knowingly formulated cigarettes to hook consumers.

That directly contradicted the testimonies of the industry’s top CEOs, who told US Congress under oath in 1994 that they did “not believe nicotine to be addictive”.

For his trouble, Wigand said he was fired, harassed, and subject to death threats.

There are the false prophets too, of course.

Plenty of antivax conspiracy theorists still hold Dr Andrew Wakefield up as a hero long after his 'evidence' of a link between MMR jags and autism was debunked.

And sometimes, it’s complicated.

In 2019, when Sir John Sturrock reported on an alleged culture of bullying in NHS Highland - an investigation prompted by whistleblowing clinicians contacting the Herald - he did indeed conclude that many staff had suffered "serious harm and trauma". 

However, he also noted that "a number of those against whom bullying allegations have been made are also, or have been, the subject of inappropriate behaviour themselves".

People can be both victim and perpetrator. 

Dr Andrew Wakefield remains a hero to some despite claims of an MMR-autism linked being debunkedDr Andrew Wakefield remains a hero to some despite claims of an MMR-autism linked being debunked (Image: PA/Press Association Images)

A row over breast cancer chemotherapy in Tayside exposed similar complexity after an NHS whistleblower raised concerns that patients were being prescribed lower doses than other health boards without their consent.

A controversial report in 2019 concluded that this had put women at increased risk of their cancer returning, but a subsequent review found no fault with the treatment which oncologists said was designed to reduce side effects.

A GMC probe cleared the medics of any wrongdoing 2021.  

The fallout was blamed in 2022 for an exodus of cancer specialists who felt unsupported by the health board, and a subsequent recruitment crisis which left patients travelling to Aberdeen, Edinburgh and Glasgow for radiotherapy.   

It led to the peculiar situation where whistleblowing in good faith may have inadvertently resulted in more adverse circumstances for the same people it sought to protect. 

The idea that whistleblowing is not necessarily black and white - or always right - has been highlighted in recent weeks by two hot-button topics: puberty blockers, and Lucy Letby - the nurse convicted of murdering seven newborn babies and attempting to kill seven others (one after a retrial which returned its verdict on July 2).

xxxxxJolyon Maugham KC (inset) has been spearheading a legal fight to reinstate access on the NHS to puberty blockers for under-18s seeking to transition. An outright ban was not stipulated by the Cass Review, but it said existing evidence for their use in gender dysphoria was weak and called for more research  (Image: Getty)

In the former, Jolyon Maugham - a KC and executive director of the Good Law Project, which is challenging the UK Government's ban on prescribing puberty blockers to trans children  - posted on X (formerly Twitter) on June 20 that he had seen evidence of a "huge increase in deaths of young trans people on the NHS waiting list" since restrictions were first introduced in December 2020, in the wake of a High Court ruling that under-16s were unlikely to be mature enough to give informed consent. 

NHS management has "sought to suppress" evidence of these deaths, said Maugham, who said that a whistleblower from the Tavistock - formerly NHS England's only Gender Identity Development Service (GIDS) for children - had disclosed to him that “in the seven years before the High Court decision (December 1 2020) there was only one death of a young trans person on the waiting list but in the three years afterwards 16 deaths”. 

The post, so far retweeted more than 3,300 times, appeared to contradict the findings of the Cass Review, published in April, that there was no good evidence to show that gender-affirming treatment reduces suicide risk. 

There were claims from a second whistleblower that staff had been "threatened with disciplinary proceedings" if they exposed the figures, said Maugham.

It sounded like classic intimidation - but was it? 

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On July 19, a rapid review - commissioned by England's newly-appointed health secretary Wes Streeting and carried out by Professor Louis Appleby, a leading expert in suicide prevention - found no evidence to support the claims. 

In fact, there had been five suicides in the three years prior to 2020-21, and seven in the three years after, said Prof Appleby.

There was "essentially no difference", he said, adding that the claims placed in the public domain "do not meet basic standards for statistical evidence". 

It seems likely the whistleblowers sincerely believed what they said; yet they were wrong, and in the process their claims were weaponised into an already a toxic debate. 

Meanwhile, the lifting of reporting restrictions surrounding Lucy Letby following the conclusion of her retrial has opened the floodgates to speculation that the case against her is flawed.

Much of the evidence in the original eight-month trial came from seven consultant paediatricians - colleagues at the Countess of Chester Hospital's neonatal unit - who became suspicious after noticing Letby was consistently on duty when infants they considered stable suddenly collapsed or died between 2015 and 2016.

A public inquiry is set to examine why NHS managers failed to heed doctors' warnings sooner. 

Police footage shows neonatal nurse Lucy Letby being arrested on July 3 2018Police footage shows neonatal nurse Lucy Letby being arrested on July 3 2018 (Image: PA)

Yet, there is a counter-narrative emerging: that perhaps the medics fell victim to groupthink and confirmation bias as they looked for an explanation and coalesced on the most improbable - medical murder. 

The evidence is entirely circumstantial, no one ever witnessed Letby 'in the act', and there is no proof any babies actually were - as alleged - harmed by air embolisms, insulin poisoning, or tampered equipment. 

Mike Hall, a retired neonatologist and the defence's (unused) expert witness has since spoken publicly to insist that in his view the prosecution case "misrepresented the [babies'] degree of 'wellness' prior to their final collapses".

In other words, the deaths were tragic - but not unusual. 

Statisticians have also poured scorn on a staff roster which shows Letby on duty whenever a "suspicious" death occurred. Deaths which occurred when she was not on duty - and there were several - were not counted.  

It is either the definitive example of whistleblowers vindicated, or the ultimate false alarm.