Why do people find it so hard to speak out in the interests of patients?

Why do people find it so hard to speak out in the interests of patients? Health care staff are usually motivated to enter their professions by a desire to make a difference for patients and service users. Why then, do they find it so hard to speak up for patients when they see care that does not meet satisfactory standards? And when they do, why do they find it so hard to be heard? asks Bev Fitzsimons. The Health Foundation