Although ministers may talk about making the NHS more transparent, staff are still finding it difficult to voice concerns over poor care.
Workers at the Stafford Hospital at the centre of the recent care scandal have said they experienced bullying and were silenced after attempting to raise the alarm, the BBC reports.
When he was removed from his post as chief executive of United Lincolnshire Hospitals Trust in 2011, Gary Walker was forced to sign a confidentiality agreement.
His case, and that of Margaret Haywood - who was dismissed as a nurse for filming examples of neglect in 2009 - give examples of reasons why staff may be reluctant to come forward.
Although the majority of hospital trusts have whistleblowing policies, a study by the British Medical Journal has found the majority are written in a way that discourages the practice.
British Medical Association leader Dr Mark Porter said the legal policy is clear, but it serves to make people concerned about the consequences if they come forward.
"Lawyers may be involved and they are facing this big organisation and feel they can't speak out. We have to change that," he explained.
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