By Adam Brimelow Health correspondent, BBC News A review into the treatment of NHS whistleblowers has heard "shocking" stories about staff who raised concerns being ignored, bullied or intimidated.
Review chairman Sir Robert Francis QC told the BBC a "significant proportion" of health workers were afraid to speak up.
The findings of the Freedom to Speak Up Review are due to be released later.
Health Secretary Jeremy Hunt said there had been "significant changes" to make the NHS more open and transparent.
Speaking exclusively to the BBC, Sir Robert said that in some places staff were reporting concerns as a matter of routine.
But he warned a "significant proportion" of NHS workers would not raise concerns - either because they were afraid of the potential consequences, or because they felt nothing would be done.
Blame cultureOne of the main concerns he identified was the treatment of "whistleblowers" - people who reported problems - with some having been ignored or having encountered bullying and intimidation.
"Time and time again people say to me they either want to complain about the behaviour of others towards them or, when they do raise a concern about the working environment or the way patients are being treated, the reaction to them has been one of being bullied," he said.
Sir Robert, who has already led two independent inquiries into the scandal at Mid Staffordshire between 2005-2009, was last year asked by Health Secretary for England, Jeremy Hunt, to look at how to create an "honest and open" reporting culture in the NHS.
He said the response by NHS staff to his review had been "very impressive".
More than 600 people had communicated directly with their stories and experiences, and about 19,000 answered an online survey, he said.
Sir Robert said he had learned from previous inquiries of the distress caused to patients and their families when their concerns were not listened to. He said the same was true of NHS workers.
Staff who are not supported "can suffer hugely," he said.
"I've heard some frankly shocking stories about [staff] whose health has suffered, and in rare cases who've felt suicidal as a result of their perception of them being ignored or worse," he said.
Organisations needed to hear the truth from staff who knew more than anyone else what was going on, he added.
He also spoke of a need to "normalise" the raising of concerns - something he said should be "welcomed and celebrated". Too often, he said, the reaction was to look for someone to blame.
However, he also applauded changes in the health service to improve accountability and transparency in the last two years.
"I think there's been tremendous progress made since my two reports. I'm not seeking to claim the credit for that, but the conversation that happens in the NHS today is of an entirely different nature to what it was a few years ago."
'Treasured not bullied'Responding to Sir Robert's comments, Mr Hunt said the NHS had changed significantly since the Mid Staffordshire scandal, where hundreds of patients suffered "appalling" care.
But he said "more needs to be done", adding that "this is why we asked Sir Robert to carry out this important piece of work".
"We agree with Sir Robert that listening to patients and staff is absolutely vital and will be responding to this report later today," he said.
In a statement, the campaign group Patients First welcomed Sir Robert's remarks.
"We believe that those staff who are brave enough to raise patient safety concerns should be treasured, not bullied, and look to Jeremy Hunt to decisively act to help change the prevailing culture in large parts of the NHS and protect such staff," it said.
'Persecution'Dr Raj Mattu, a cardiologist who was suspended then sacked after raising concerns about patient safety in 2001, said it was frustrating and depressing that there had been "very few biting changes" to protect whistleblowers.
He said there was still "persecution of whistleblowers on a grand scale" in the NHS.
Asked why this was the case, he said medical staff were in their jobs because they wanted to help patients but many senior staff were there for a "career in management".
"What then happens is the interests of the trusts and the NHS conflict from time to time with those of the patient and many of us who are whistleblowers feel compelled under moral obligation to speak up," he said.
He called for independent assessment of whistleblowers' claims, and "real protections" for those raising concerns.
Have you been affected by the issues in this story? You can email your experiences to haveyoursay@bbc.co.uk
Please include a contact number if you wish to be contacted by a BBC journalist.
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