Category Archives: Gagging

Tere is a toxic culture, and disengagement everywhere in Health and Social Care. Also in the CQC …

GP list sizes in England can be found here. 

Standards are falling in most areas because of the pressure of work both in Hospital and General Practice. Occasional well respected and popular training practices are the least under pressure. In social care standards are also falling, and one inspector (Greg Hurst reports in the Times 13th June 2019) has quit citing a toxic culture in the Care Quality Commission. He should be listened to, as there is a toxic culture, and disengagement everywhere in Health and Social Care. Of course there will always be examples of individuals who break the mould, but in general NHSreality says it as it is. The Times report is below..

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Mary MacCarthy in Pulse December 2018: Cappling GP lists would make GPs and patients safer: 

Nick Bostock in GPonline 12th December 2018 reports that since 2004, there has been a 50% increase in GP list sizes.

and earlier that year, he reported with Teni Oluwunmi  that the number of GP practices had declined by 263!!

and last year, according to the Mail by 138

Emma Bower for GPonline 5th June 2019 also suggests that Scotland needs a new target for the GP workforce. With increasingly elderly population with multiple pathologies and complexity, 15 minute appointments are also needed. (BBC News)

Anal Carcinoma needs prevention with HPV vaccine? A nurse comments on her own illness…in Healthonline

Research in the US has discovered what the drug manufacturers should have found: drugs for shrinking enlarged prostates cause delay in the diagnosis if the prostate goes malignant. Another case of Big Pharma and overtreatment.

Barry Stanley-Wilkinson gives his exit interview from the CQC. (Greg Hurst reports in the Times 13th June 2019) has quit citing a toxic culture in the Care Quality Commission.

Waiting lists are getting longer, even for cancer diagnosis and treatment. Nick MacDermott in the Sun12th June 2019 so keep up the private insurance payments as long as you can, especially if you live in Wales.

An inspector whose report highlighting failings at a scandal-hit hospital was never published resigned from the regulator, protesting that some of its staff were too close to the private company that ran the hospital.

Barry Stanley-Wilkinson also complained of a “toxic” culture at the Care Quality Commission and said many of its inspectors felt that they worked in a “bullying, hostile environment”.

Mr Stanley-Wilkinson resigned six months after he led an inspection in 2015 of Whorlton Hall, a private hospital in Co Durham for adults with learning disabilities or autism. Police arrested ten carers at the hospital last month after Panorama on the BBC broadcast footage of staff appearing to mock and intimidate patients.

The inspector reported in 2015 that some patients had accused staff of bullying and inappropriate behaviour. He said patients did not know how to protect themselves from abuse and recommended that the hospital should be given a rating of “requires improvement”.

His report was never published and a new CQC team that inspected Whorlton Hall in 2016 gave it a “good” rating. Mr Stanley-Wilkinson’s resignation email, sent to the CQC in January 2016, was published yesterday by parliament’s joint committee on human rights, which took evidence from two CQC executives. He expressed frustration that his report on Whorlton Hall had not been published “despite significant findings that compromised the safety, care and welfare of patients”.

He referred to a complaint about his report by the hospital, which was then run by the healthcare company Danshell, and pointed out that it had previously been run by Castlebeck, which ran Winterbourne View, a care home where there had been an abuse scandal in 2011. Whorlton Hall was taken over by Cygnet Health Care this year.

“I am concerned about the relationship managers have had with the service,” Mr Stanley-Wilkinson wrote. “Discussions had taken place without my involvement despite me being the inspector.”

Paul Lelliott, deputy chief executive of the CQC, said the 2015 report had had inconsistencies and lacked evidence. Ian Trenholm, its chief executive, said the CQC planned to develop a new way to monitor institutions.

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Scottish Highlands: Bullying continues as endemic

 “Last year, a group of senior clinicians claimed there had been a culture of “fear and intimidation” at the board for at least a decade.” What is needed is exit interviews on all staff, in all four dispensations. Hundreds of staff may have been harmed by bullying and harassment in NHS Highland BMJ 2019;365:l2166

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BBC News reported 9th May: ‘Hundreds’ faced bullying at NHS Highland

The review led by John Sturrock QC said staff had described suffering “fear, intimidation and inappropriate behaviour at work”.

Concerns raised by a group of clinicians prompted the review.

Health Secretary Jeane Freeman apologised and said other health boards should learn lessons.

At Holyrood, Ms Freeman said the culture at the health board had been unacceptable, and she supported the review’s recommendations.

These include educating all staff on the effects of bullying and providing a “properly functioning, clear, safe and respected wholly independent and confidential whistleblowing” mechanism.

NHS Highland runs services in Argyll and Bute, and another recommendation was that a separate review be done of the “functioning of management” in this area, partly because of its geography……..

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Peter Gregson in an email to me asks “if only the BBC could take it up” and it has but it wont be sustained:

The Minister has not changed position on anything relating to whistleblowing apart from in one regard. In future she will choose the whistleblowing champions in each board herself. Therefore if any particular champion is getting nowhere with any particular board they just go to her for help. Simples!

She rejects the idea of a whistleblowing hotline again, but gives no indication as to how any whistleblower might be assured that somebody somewhere will register their concerns. “We believe that it is right that Boards, as employers, have the responsibility to initially respond to a concern and that this is key in improving local culture. Where a whistleblower remains concerned about a Board’s approach they will have the ability to raise the issue with the INWO”. [Independent National Whistleblowing Officer].

So we continue to be lumbered with the useless PCAW helpline, the use of which continues to fall. (I calculated in my last email to MacDonald that our helpline sees one-twentieth of what we should be seeing, if conditions in hospitals here can be compared to England [if you missed that, see www.kidsnotsuits.com/nhs-staff-whistleblower-hotline-parliamentary-petition])

How will she know when whistles are blown? Through annual “Duty of Candour” reports from each Board. Which at the moment are not standardised, so for at least the next year, Boards can say as little as they like.

It feels to me that she and her Dept have learnt little from the recent Tayside and Highland shenanigans.

If only we could get the BBC to take up this matter.. Any other ideas?

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Whistleblowing protection is important, but exit interviews that prevent the need for whistleblowing are more important.

Whistleblowing protection is important, but exit interviews that prevent the need for whistleblowing are more important.

Clare Dywer in the The BMJ reports Whistleblowing: Government tries again to ban “gagging clauses” in NHS BMJ 2019;365:l2052

England’s health secretary has revived the government’s unfulfilled 2013 promise to ban non-disclosure agreements in the NHS. Clare Dyer considers the legal implications and hears why NHS whistleblowers are often still fearful of recriminations

Matt Hancock is “determined” to end the use of gagging clauses that stop NHS staff speaking out. The health and social care secretary for England told the Daily Telegraph last week that whistleblowers provided “a vital and courageous service” for the NHS.1 “Settlement agreements that infringe on an individual’s right to speak out for the benefit of patients are completely inappropriate,” he added.

The determination to end the use of non-disclosure agreements that ban staff from airing patient safety issues is not a new one. Back in 2013 Hancock’s predecessor, Jeremy Hunt, announced that the “era of gagging NHS staff from raising their real worries about patient care” would end,2 after Robert Francis QC called for such a ban in his report on widespread failings at Mid Staffordshire NHS Foundation Trust.3

Yet only days before Hancock spoke, lawyers for Sue Allison, a radiographer who signed a settlement agreement after raising concerns about missed cancer diagnoses and standards of care in a breast cancer unit, were arguing that her agreement should not prevent her bringing a whistleblowing claim. A judge ruled that the agreement, which she signed in 2015 without legal advice, was invalid. Her case that she suffered a detriment as a result of blowing the whistle will now go ahead.

In the wake of a series of scandals over poor care in which staff failed to blow the whistle for fear of reprisal, the NHS has been aiming for a culture of greater openness. Guidance on the duty of candour requires trusts to explain honestly to patients when something has gone wrong with their care, and the Care Quality Commission now inspects providers on their compliance with the duty of candour, as well as other aspects of their care.

Every trust is required to appoint a “freedom to speak up guardian,” and the National Guardian’s Office said in its first report in November 2018 that more than 7000 workers had contacted the local guardians.4

Gagging clauses still widespread

But use of settlement agreements with non-disclosure clauses is still widespread, says Arpita Dutt, an employment solicitor who has acted for several NHS doctors. The law makes it clear that a settlement is unenforceable unless the worker has had legal advice and that a gagging clause cannot stop an employee making a “protected disclosure”—passing on information, for example, revealing a criminal offence or danger to someone’s health or safety.

Guidance from NHS Employers, updated in February 2019,5 recommends a clause making it clear that nothing in a non-disclosure agreement will prevent a worker speaking up about concerns relating to the quality or safety of care. “This includes, but is not limited to, matters relating to patient safety, bullying and harassment, and cultural issues that may affect quality of care or the wellbeing of workers,” says the guidance.

Dutt, a partner in the law firm BDBF, told The BMJ that almost every settlement agreement she had seen in whistleblowing cases contained some form of confidentiality clause. Although the law allows whistleblowers to speak about a protected disclosure, they may be barred from talking about their treatment by the trust after their disclosure and therefore be unable to tell the real story of what happened to them as a result, she noted. “Because of that blurry line, once employees have settled they’re too afraid to jeopardise it by saying the wrong thing in the wrong way.”

Andrew Pepper-Parsons, head of policy at the whistleblowing charity Protect (formerly Public Concern at Work), echoed Dutt’s comments. “When it comes to public interest issues, such as a patient safety concern, no agreement can prevent a whistleblower from escalating concerns to a regulator, their MP, or the media. Where it’s less clear is when a whistleblower wants to raise their own treatment in the workplace as a worrying example of workplace culture. This could be seen as falling foul of a non-disclosure agreement, as it reveals details about the potential claim that is being settled.”

Protect is not in favour of an outright ban on non-disclosure agreements. NHS trust leaders argue that sometimes they need non-disclosure clauses, not to prevent staff speaking out about patient safety but where they are balancing the rights of different staff members who may be in conflict with each other and the trust has a duty of care to staff members whom it still employs.

Dutt acknowledged that settlement agreements with non-disclosure clauses may be appropriate in some cases—for example, if both parties genuinely agree and want to put things behind them and move on. But she said that NHS trust lawyers told her it was difficult to settle whistleblowing cases because “we won’t get authority to settle a whistleblowing case unless there’s a public hearing and we get a judgment.” She added that whistleblowers’ lawyers were told, “If your client can withdraw the whistleblowing element, we can settle the rest of it.”

Dutt doubts that the duty of candour has made any difference to the way whistleblowers are treated, “because the culture of most organisations is still quite toxic against whistleblowers.”

She added, “The first thing trusts try to establish is that you are not a whistleblower at all. Most trusts I’ve dealt with don’t operate whistleblowing policies effectively.”

References

Halfhearted support from Scotland. English Whistleblowers: “promises of protection are repeatedly broken”, meeting hears.

In Scotland the “whistleblower blast” is on 19th June, but there is no funding for the room Peter Gregson needs. For fundraising go here

He ends his message: “Please chuck in a few £. Then I’ll be able to afford to feed my children this month”. The petition is here

and the Scots are also looking at the Independent Contractor Model (GPs) after it has been cleaned out by understaffing and underfunding.

The health services are too proud and mean to contract out their human resources, but this is what is needed, along with a whole dose of repeated honesty, exit interviews, removal of targets, and giving the profession more powers over their own destiny..

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The BMJ opines: Whistleblowers: promises of protection are repeatedly broken, meeting hears BMJ 2019;364:l1482

There has never been a more dangerous time for frontline NHS staff to consider speaking up in defence of patients, a consultant surgeon who lost his job after reporting concerns about an avoidable death has told a meeting on whistleblowing at the Royal Society of Medicine.

All three levels of supposed protection—the NHS itself, regulators, and the law—are failing whistleblowers, Peter Duffy said.

Duffy, who reported his worries to the Care Quality Commission in 2015, won his case for unfair constructive dismissal at an employment tribunal last July. He was awarded £102 000 (€120 000; $135 000), which related to a dispute over pay, not his disclosures.

He told the meeting, opened by the RSM’s president, Simon Wessely, that he had been forced to resign from University Hospitals of Morecambe Bay NHS Foundation Trust in 2016 “for my own protection” and was “unemployed and, it seemed, unemployable.”

Since 2017 he has worked outside the NHS as a consultant surgeon at a hospital on the Isle of Man, living alone, while his wife, family, and friends still live in the Morecambe Bay area. “It really does feel like being two years into a 10 year prison sentence,” he said.

His case showed, he added, that “we have NHS promises of whistleblower protection repeatedly broken, leaders who don’t show leadership, regulators who don’t regulate, guardians who don’t hold organisations to account, and a law which simply exposes whistleblowers to more hate, threats, intimidation, and allegations.”

He said that the law failed whistleblowers in at least three critical areas. First, the whistleblower was the one on trial, not the NHS trust and managers. Second, whistleblowers were “threatened with costs if they don’t drop the case.” Finally, for success in a claim of sacking on the ground of whistleblowing the law demanded an evidential link or “smoking gun” to link the whistleblowing and the sacking. “This evidential link is an almost impossible task, particularly with the NHS conducting a scorched earth policy to evidence right from the start,” said Duffy.

He advised potential whistleblowers, “If you speak up as a group, you are infinitely more powerful. My mistake was to go it alone.”

David Nicholl, consultant neurologist with Sandwell and West Birmingham Hospitals NHS Trust, asked how far the NHS had come since the report of Robert Francis’s Freedom to Speak Up review in 2015.1 “Not very far,” he answered.

Nicholl said that one hopeful sign was that the CQC had fined Bradford Teaching Hospitals NHS Foundation Trust in January for breach of the duty of candour because it had failed to tell a family within a reasonable time that there had been delays and missed opportunities in treating their baby, who had died.2

Peter Wilmshurst, consultant cardiologist at Royal Stoke University Hospital and a whistleblower who has reported several research misconduct cases to the General Medical Council, said that there was an inequality of arms because “the individual can never match the resources of the trust.” He added, “There are no effective sanctions for those who treat whistleblowers badly.”

Several speakers and delegates called for reform of the whistleblowing legislation the Public Interest Disclosure Act, which Duffy described as “full of loopholes.”

Nicholl said, “There are fundamental problems with the legislation. If there’s anything we can do to press on that, it’s absolutely vital.”

David Walker, medical director of the Morecambe Bay trust, said in a statement, “We strongly encourage staff to come forward if they think patients may be in any way at risk, so we can investigate and learn from any mistakes. He added that the concerns raised by Duffy had been thoroughly investigated at the time and that “the employment tribunal found there was no evidence that he was ill treated or suffered a detriment for raising those concerns.”

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Changing a culture of fear, bullying and gagging…… Start again with local pride….

NHSreality feels that the culture in Westminster reflects the culture in the nationalised industries as a whole, and the health service being the biggest. It is also the biggest bully, with most fearful staff, and who feel most gagged… Starting again using local pride may help, but some areas may fail to recruit… Perhaps these should be the first to be released from the shackles of Political Interference. Co-payments should be allowed.

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We cannot address the culture of fear without better management and it cannot come from inside. Even if the skills were there, which they are not, the staff would not trust them. We need an outside provided HR company to do “Exit interviews” on all staff and board members, and to report dispassionately and in a depersonalised way, at regular intervals. Somehow this needs to be amalgamated into an annual public report for localities, and regionally, and nationally. We need to hear the views of all staff who leave a job, move departments, or retire, or emigrate.

But then, you and I know what the result will be….

So at the same time, because we know the outcome, we need to be planning the changes necessary to reverse the decline. I admit that I cannot see the way forward, especially when the official line is “everything for everyone for ever” and no overt rationing applies. We are creating a dependency culture. We are discouraging autonomy. In work with the GIG economy we are creating a slave culture. I see several “Spartacus” like revolts ahead, and the destruction of the whole state health and social care empire unless we have much more honesty and much better leadership.

If we apply zero budgeting and allow local trusts to run themselves without any government interference, restraints, or banal performance indicators, we will get large differentials in health care, but morale will rise. Staff can feel involved and “begin to enjoy themselves”.  After a time best practices will emerge, and convergence of standards, but this will take a decade(s). Meanwhile we need to lift the restriction on medical school and nursing training places, so that we have an excess of staff, even allowing for the dropout rate. We need to acknowledge that no state cannot keep up with the advances in medical science, (see The NHS is being impeded by greedy drug companies ) and therefore we need to ration health care. Cradle to grave, without reference to means,……? The drug companies are out to make a profit, and it is not drugs which improve the health of populations. (See the USA) They do improve the outcome for individuals, but that is different. 

How we do this is the big debate which has not even started. NHSreality suggests means related co-payments, both for health and social care. Then there is the litigation…. without no fault compensation, the combination of reduced resources, short termism and declining standards (see baby death rate) will ensure more and more opportunities for citizens to litigate. Reducing tax relief on pension contributions is another tempting short term fix…  

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Frances Gibb in the Times 15th October reports: NHS payouts to disabled children reach £100m in a day

Sofia Lind in Pulse 20th September reports: GPs should expect to be sued every 10 years, says defence organisation.

Tim Ship man reports in The Times 14th October 2018: Budget pensions threat to raise £20bn for NHS

Chris Smyth on October 15th reports in the Times: Baby death rate could soon be double that of western nations

 

 

The Blame and the bullying culture in the UK Health Services. Sometimes you cannot change from within. Scotland equally bad..

Sometimes a culture cannot be changed from within, because it is so “ill” that none of the people with the power to change it have the tools to do so. This is the case for the 4 UK Health services. The “Blame Culture”, is not the only issue, because free speech is denied staff, and punishments are withheld only for non interference or not rocking the boat. There are big incentives to keep quit, and minimal commitment and involvement are rewarded. If the culture is to change an outside Human Resources agency needs to come in, and start with exit interviews. These should be on all staff, and board members, the chair and the CEOs. When doctors are afraid to be honest in their portfolios, and reluctant to speak out the public needs to know why, and what is being done about it. So far – nothing constructive.  We need “zero budgeting” equivalent in HR, and trust can only be restored by a completely new system.

Jacqui Wise  and/or Peter Blackburn in the BMJ (2018;362:k4001( Blame culture and safety fears on the rise, finds survey published 20th September 2018 reports. On line:Survey of UK doctors highlights blame culture within th e NHS.  

A major survey of UK doctors reveals a bleak picture. Many feel they work in a dangerous and toxic environment with a blame culture which jeopardises patient safety and discourages learning and reflection.1

The survey of 7887 doctors—including GPs, junior doctors, and consultants—was carried out as part of a BMA project, Caring, Supportive, Collaborative, aimed at finding solutions to the challenges faced by the NHS.

Most doctors (78%) said that NHS resources are inadequate and that this significantly affects the quality and safety of patient services. Patient services have worsened, including waiting times for patients and staffing levels, they said. Around three quarters said that national targets and directives are prioritised over the quality of care…

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On line: Doctors are increasingly expected to provide patient care in unsafe environments where a persistent culture of blame stifles learning and discourages innovation.

Those are the findings of a BMA survey which is part of an ambitious project aiming to find solutions to the challenges faced by the NHS.

The project, ‘Caring, Supportive, Collaborative’, has seen almost 8,000 doctors provide accounts of their working lives across the NHS – and will go on to look at how working life can be improved.

BMA council chair Chaand Nagpaul said: ‘It is vital that the Government and policy makers heed the views of all doctors who provide care at the coalface; they are in the best place to know the problems the NHS faces on a daily, hourly basis.

‘They know the scale of impoverishment in the NHS is staggering and they are working in a culture which has improved little since the publication of the Francis and Berwick reports following the tragedies in Mid-Staffordshire five years ago.’

Poor communication

The stark survey reveals the damaging effect of asking doctors to provide care without enough funding, staff, beds or equipment to meet the needs of patients. The results also suggest that poor lines of communication and organisational divisions between general practice and hospitals is undermining patient care. The accounts from doctors also reveal a lack of IT support is holding back efforts to encourage collaboration and greater innovation in our health services.

Dr Nagpaul said: ‘Doctors experience challenges of trying to provide safe patient care when there is poor staffing, gaps in rotas, lack of adequate facilities and where a persistent culture of blame stifles learning and improvement.

‘The BMA’s Caring, Supportive, Collaborative project aims to understand and find solutions to these challenges.’

The survey also reveals a significant number of doctors are fearful of making a medical error and that the level of fear has increased over the past five years. Nine out of 10 doctors say one of the main reasons for making errors is pressure and lack of capacity in the workplace.

Inclusivity lags

As well as a culture of fear and blame, the survey also showed that BAME (black and Asian minority ethnic doctors) remain disadvantaged by the NHS. Only half of BAME doctors feel respected or culturally included in their place of work.

They talked of experiencing unconscious racism in everything from job progression to training and patient interaction.

Dr Nagpaul said: ‘BAME doctors make up more than a third of the medical workforce and play a vital role, day in day out, delivering care to patients across the country. Yet despite their commitment they’re more likely to face referral to the GMC, are more likely to have their cases investigated and are more likely to face harsh sanctions following an investigation. Only 7 per cent of very senior managers are from BAME backgrounds.

‘BAME staff in the NHS workforce as a whole are more likely to experience bullying, harassment or abuse from other staff. Differential achievement in exams and poorer career progression are another worrying factor, and with independent research showing that this is not related to any lack of ability. In the 21st century, that is not acceptable.’

Read the report

In Scotland Peter Gregson has the bit between his teeth, but has been meeting resistance:

Dear Lewis Macdonald MSP,

I’d like to draw your attention to this article in Health Service Journal by Shaun Lintern of 27/9/18 “Thousands of NHS staff use speak up guardians“. As you may know, NHS staff in England can take reports to their Board’s “speak up guardian” – a beefed up version of the “whistle-blower champions” we have in Scotland. All their reports are then collated by the Freedom to Speak Up National Guardian, Dr Henrietta Hughes (whose office might correspond to our INWO if there were a hotline in Scotland in place for staff to use). She counts 7,000 reports in the year ending March 2018.

There are 1,200,000 NHS staff in England, so therefore 0.58% have filed reports.
There are 162,000 in Scotland. If we had the same response rate in Scotland as England, we could expect 945 reports pa. 

Last year the NHS Scotland helpline received in the period to 31st Jan 2018 just 48 reports.*

Could it be that Scotland’s health service is 20 times better than England’s? I doubt it, if recent reports from Tayside and the Highlands are anything to go by.
Yet our Health Minister believes current arrangements and plans for an INWO to be perfectly adequate.
I beg you to reconsider her claims in light of this data from south of the border.

Best wishes

Pete Gregson

* This is bad, but worse is that the numbers using our helpline have decreased significantly since its introduction five years ago. Even more worryingly, looking more closely at the data reveals that the correct number and/or email address was provided for re-contact in just 11 (65%) cases. That means 35% either did not leave their details or left the wrong ones. This figure begs the question as to why whistle-blowers have so little confidence in the helpline that they would do such a thing.. 

From: Peter Gregson <postmaster@roseburn32.plus.com>
Sent: 26 September 2018 23:49
To: ‘HealthandSport’ <HealthandSport@parliament.scot>
Cc: ‘Miles.Briggs.msp@parliament.scot’ <Miles.Briggs.msp@parliament.scot>; ‘Alex.Cole-Hamilton.msp@parliament.scot’ <Alex.Cole-Hamilton.msp@parliament.scot>
Subject: RE: Whistleblowing in NHS Scotland
 

Dear Lewis Macdonald MSP, 

Today I read  in the Herald : NHS Highland medics blast ‘culture of fear and intimidation’ silencing concerns over patient care

Amazingly, there is footage in the Parliamentary video archive from 19th September 2017 of the NHS Highland Chief Exec boasting to your Committee of how excellent their measures are. A claim which now rings hollow. The written version is at http://www.parliament.scot/parliamentarybusiness/report.aspx?r=11090&mode=pdf where Elaine Mead from NHS Highland must fair be regretting her words. See page 14:

Elaine  Mead: I  am  sure  that  they  could  feel  frustrated by  that, but  we need to encourage staff to take responsibility for their own work and make the  changes  in  their  own  workplace,  and  we  in NHS Highland are doing that. That    takes    time,    but    we    are    certainly encouraging  local  staff  to  take  every  opportunity they can to do their job and to change their job for the better.  In fact, they feel more empowered and more engaged to do that. I come back to my point about  that  being  an  issue  of  the  culture  in  the organisation.  We  have  to  live  it  as  well  as  saying it.  It  is  really  important  for  the staff  to  know  that they will be listened to and that they can influence the  way  in  which  their  jobs  are  working  and  how their services are run and organised.”

There is some interesting stuff in there from NHS Tayside as well, showing Governance was failing even as fine words were being fed to MSPs.

Please consider what measures can be taken to get the Health Minister to “wake up and smell the coffee”

Yours sincerely,

Pete Gregson

 

Whistleblowing champion quit NHS Tayside board ‘because of failure to probe bullying culture’

Gareth McPherson reports 20th September on the resignation of a “Board Member” in Tayside. This is as near as we get to an exit interview. Would that the media chased every resigning board member to get their opinions. The reason “Failure to probe the bullying culture”.

NHS Tayside faces a fresh crisis after its whistleblowing champion revealed he is quitting over the board’s failure to investigate bullying.

Munwar Hussain said allegations that were brought to him by a junior doctor about the abuse of trainees were among the issues not taken seriously enough.

The suicide of a doctor in training at Ninewells is linked to the bullying culture, Mr Hussain claimed.

His concerns were raised by Labour MSP Anas Sarwar following a ministerial statement by Health Secretary Jeane Freeman in Holyrood on Thursday afternoon.

It emerged over the weekend that Mr Hussain and two other board members were standing down.

Another two non-executive members of the board have also left the board in the last few months.

Mr Sarwar told MSPs that he had seen a letter from Mr Hussain sent to the cabinet secretary explaining his reasons for leaving the board.

In that letter, the whistleblower champion revealed how he was told by an ex-doctor in training that they left the NHS due “to issues of systematic bullying and negative cliques”.

Mr Hussain wrote: “Further there were claims that people were raising issues, but these were not being acted upon by managers, including allegations in the email that a previous trainee took their own life and the stress was unbearable for some.”

Mr Sarwar described it as a “serious set of allegations including a claim that a trainee took their own life due to stress”

“He (Mr Hussain) goes on to say that he asked for this to be raised at a board meeting but was told that he could not.

“He attempted twice to meet the strategic director of workforce in August, but both times the meetings were cancelled.

“And he did eventually raise the matter at a staff governance committee, but felt in his words that this is ‘viewed as an ongoing issue that is tolerated’.”

Ms Freeman, who said she received the correspondence from Mr Hussain on September 3, insisted the matter was being properly dealt with by the health board.

“The specific allegations that were reported via that whistleblowing are currently under investigation,” the SNP minister said.

“This chamber should rest assured – and I will give them my absolute assurance – that I will continue to monitor how these matters progress.

“But it is on the basis of this board responding appropriately in my opinion, to what the whistleblowing issues have been raised with them, that I have the assurance that they are being dealt with.”

An NHS Tayside spokeswoman said: “Bullying in any form is never tolerated and all concerns are taken seriously, with the NHS Tayside medical director taking a lead on matters relating to doctors in training.

“We can confirm that all allegations raised in Mr Hussain’s letter to the cabinet secretary are currently being investigated through the appropriate channels.”