NHS staff who raised the the alarm over poor patient care were driven to the brink of suicide, a major review into the treatment of whistleblowers has found.
The report's author, Sir Robert Francis QC, said he repeatedly heard horrific stories of workers' lives being destroyed because workers had tried to do the right thing for people in their care.
He said the health service must undergo a "major change of culture", warning that: "Failure to speak up can cost lives."
Action has been urged at "every level of the NHS" to make staff raising their concerns the norm.
Sir Robert's proposals include:
:: Action at every level of the NHS to make raising concerns part of every member of staff's normal working life
:: Freedom to Speak Up Guardian in every NHS Trust - a named person to give independent support to whistleblowers and hold board to account if it fails to focus on the patient safety issue.
:: A National Independent Officer to support the Guardians an intervene when cases go wrong.
:: A support scheme to help good NHS staff who are without work after raising concerns to get another job.
:: Sets out 20 Principles and Actions which aim to create the right conditions for staff to speak up.
Some 600 staff spoke to the review team, with another 19,000 responding to an online survey.
Many staff said they did not speak up because they felt their concerns would not be listened to, while others feared victimisation.
The report said student nurses and doctors believed the problem to be "endemic" within the health service.
Sir Robert wrote: "I heard shocking accounts of the way some people have been treated when they have been brave enough to speak up.
"I witnessed at first hand their distress and the strain on them and, in some cases, their families.
"I heard about the pressures it can place on other members of a team, on managers, and in some cases the person about whom a concern is raised.
"Though rare, I was told of suicidal thoughts and even suicide attempts."
Sir Robert wrote: "The genuine pain and distress felt by contributors in having to relive their experiences was every bit as serious as the suffering I witnessed by patients and families who gave evidence to the Mid Staffordshire inquiries."
Announcing the raft of measures, Sir Robert stressed that a change in culture was more important than regulation in bringing about the much-needed change.
"What I heard during the course of the review from staff, employers, regulators and unions and others leaves me in no doubt that there's a serious problem in the National Health Service," he told reporters.
"Taking into account all the evidence obtained by the review, I have come to the conclusion there must be a change of culture.
"No amount of legal or regulatory change will make it easier for staff to raise issues that worry them unless there is a culture which encourages and supports them to do so."
He added: "Too often, honestly-expressed anxieties have met with hostility and breakdown of working relationships.
"Worse still, some people suffer life-changing events, they lose their jobs, their careers and even their health."
Health Secretary Jeremy Hunt ordered the review last June after Sir Robert led two inquiries into failures at Mid Staffordshire NHS Foundation Trust, which the QC said had shown the "appalling consequences for patients when there is a 'closed ranks' culture".
Mr Hunt said he was accepting all Sir Robert's proposals "in principle".
He told MPs: "The message must go out today that we are calling time on bullying, intimidation and victimisation which have no place in the NHS."
The Government would also fast-track a new law protect whistleblowers against discrimination.
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