Sir, Sir Robert Francis, QC, has identified in recent years a top-down NHS culture characterised by fear and bullying. This has resulted in widespread victimisation of whistleblowers by senior management. Henrietta Hughes, the new national guardian for speaking up, does a disservice to this analysis by blaming “grumpy doctors and nurses” for compromising patient safety (report, Oct 8). Her only reference to management suggests that holding them to account for the bullying would be “punitive” and not her style. The platitudes and wishful thinking she offers to effect NHS culture change will not work. Tough love is what we need, not the syrupy Love Actually that she mentions.
Dr David Drew
Sutton Coldfield, W Midlands
Sir, If Henrietta Hughes wishes to be tough on unhappiness in the NHS she must be tough on its causes. Simply ordering people to be happy will not wash. Team spirit has been destroyed by shift-working, goodwill sacrificed by threats of imposed contracts and safety compromised by financial stringency. As a critic of my own health trust I was marginalised and harassed to the extent that colleagues decided, as often as not, to lead an easy life by keeping their heads down. Being proved right after my retirement (which restored my happiness levels to normal) resulted in no credit, only schadenfreude. However, that is not the sort of happiness that is needed.
Dr Andrew Bamji
Rye, E Sussex
Sir, Your report highlights an important point about patient experience. These are difficult, pressured times for those working in the NHS, and much more must be done to address the underlying causes of unhappiness in the health service.
Past evidence has shown that cancer patients are up to 18 times more likely to receive poor care where staff have suffered high levels of discrimination or poor leadership; this link between happy staff and happy patients is strong but too often underappreciated. How somebody is treated is just as important as how successful their treatment is.
Macmillan Cancer Support
Sir, Henrietta Hughes says that the NHS needs more of the trust, joy and love hormone because staff are grumpy. When I am reuniting families it is often because I am telling them, for the third time, that their operation has been postponed because of lack of beds/equipment/resources. This strikes me as less Love Actually and more Groundhog Day.
Dr S J Ward
Consultant anaesthetist, St Mary’s Hospital, London W2
Sir, There are plenty of reasons to be grumpy: the National Health Service is rife with bullying and harassment by managers; there are severe shortages of doctors and nurses, with big rota gaps; the nurses training bursary has been withdrawn; overseas medical staff could be excluded post-Brexit; and there are massive funding difficulties which are getting worse every week.
But if frontline staff can withstand all this, happiness does come when patients say: “Thank you all for making me better.”
Some patients actually do.
Dr David E Ward
Ret’d cardiologist, London SE22