Demand for full truth on NHS ‘bullying’ – the culture of fear

Chris Smythe in the Times reports 7th November: Demand for full truth on NHS ‘bullying’

“Doctors, MPs and whistleblowers are demanding to know the full extent of NHS  bullying after it emerged that staff at a second hospital felt pressured to  “stop the clock” on waiting times.

Those who spoke out over the Bristol heart scandal, Stafford Hospital and Baby  P will join the president of the Royal College of Physicians and Tory MPs  today to call for an urgent inquiry into “retaliation” by bosses against  staff who raise concerns. There is an “immediate risk of patient harm”  because so many staff are bullied to stay silent over problems and the  Government needs to root out the problem, they say.

The call comes amid concern over staff being pressured to fiddle data to make  it look as though NHS targets have been hit. Cancer patients were put at  risk at Colchester General Hospital after managers ignored the protests of  staff who were bullied into changing waiting times, inspectors claim. Mark  Aitken, a doctor and governor at the Colchester Hospital University Trust  until he was removed last spring, said that problems had been endemic.

“If you have a hospital driven by targets and the targets reward people  financially, you’re going to get people saying, ‘Oh, we missed this target,  I’ll just change that number, and everything will be all right’. You don’t  get the resources you need to meet the targets by fiddling the figures,” he  added….”

In a letter from Sir Peter Bottomley MP and 12 other signatories, (Whistleblowing and the NHS culture of fear. letters in The Times) they call for an “urgent enquiry” and blame the “poor leadership from NHS management”. They seem blind to the problem of the political philosophy; the enquiry should not get at the monkeys but at the organ grinders…. The Politicians. Time for a Health Service bureaucracy licensed to ration and one step removed for the politicians?

Another letter from Alan Burns, from Nassington, a former CEO (also in letters above) reads:

Sir, As a former Health Authority chief executive of 21 years experience I am fascinated by the tribal nature of the debate on whistleblowing (report, Nov 5, and letters, Nov 6, 7 & 8). When I first became a district general manager in 1985 I was appalled by cases in which the whistleblower was pilloried by the medical establishment or told not to worry because the problematic junior was “moving on” in a few weeks.

In time responsibilities shifted from regional medical officers to health trust CEOs, and in the case of GPs to primary care trust CEOs. Some issues were tackled but old habits die hard, and defending the indefensible once again became normal among all groups of staff, or at least enough of those groups to deter proper action.

Now we find managers being pilloried even where the CEO is himself a doctor, as in Chelmsford. The chairman of the Care Quality Commission, David Prior, is correct to ask “where were the doctors at Stafford Hospital?” — or indeed any other professional group, particularly those with corporate responsibilty as directors. The point is that this is not a disease of management but rather a disease of the NHS, all groups being responsible at one time or another for taking the “easy” option of burying or moving on the problem.

The solution requires a systemic cultural change with real leadership from all levels and professions, including our political leaders. Alan Burns, Nassington, Northants

I would agree, and I recommend the first step should be for politicians to allow CEOs and Chairmen to say what they really think, to use the word rationing, and to ungag their staff by recommending exit interviews, job change interviews, and in post interviews to be made immediately public – without sanction and in the case of managers they should be encouraged to expose the perverse incentives in an excess of financially backed performance indicators.

In other words exactly what NHSreality stands for.

This entry was posted in A Personal View, Community Health Councils, Gagging, Patient representatives, Perverse Incentives, Political Representatives and activists, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

1 thought on “Demand for full truth on NHS ‘bullying’ – the culture of fear

  1. Pingback: Open Letter to all Ministers and the Prime Minister – with their replies | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

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