A Sick Culture
Health Secretary Andrew Lansley may have promised to protect and support whistleblowers but the NHS culture he has inherited is so bullying and defensive that many staff won’t risk raising concerns. Doctors are the most powerful and trusted NHS employees but a recent survey of 384 doctors by the BMA in Scotland found that 40% did not report concerns about standards of care and staff behaviour, for fear of reprisal. And a study last month in the British Medical Journal found that the content of the whistle-blowing policies of 118 NHS trusts was ‘overly cautious and negative.’
But it’s the experience of whistle-blowers themselves that puts most people off. John Watkinson, the former chief executive of the Royal Cornwall NHS Trust (RCNT) was sacked in 2008 for raising concerns about the lack of proper public consultation in a decision to amalgamate cancer services. (Eyes passim). He is still on the dole and his house is up for sale. Last month, an industrial tribunal unanimously found that he had been unfairly dismissed, concluding that his removal ‘was a travesty of anything approaching basic fairness’. Lansley has ordered an inquiry but RCNT has now appealed the decision, using more public money to stall further media scrutiny, delay any compensation for Watkinson and bump up his legal costs still further (£200,000 and counting). Now Rose Woodward, highly-respected chair of the Cornwall and Isles of Scilly Cancer Patient and Carer group, has resigned citing ‘bullying and intimidation from regional health organisations.’
Lansley has already announced the winding up of Strategic Health Authorities by 2012, but he must ensure that whatever replaces them creates a culture of listening to patients and staff, rather than shouting at them. But his review of the Cornish debacle is unlikely to achieve anything if it remains in-house. Last year David Bowles, the chairman of Lincoln Hospitals NHS Trust, resigned over what he perceived to be bullying by East Midlands SHA. A consequent review commissioned by NHS chief executive David Nicholson found ‘no evidence’ to support the allegations.
David Hands, a professor in Health Policy, retired NHS chief executive and a former governor of Northamptonshire Healthcare NHS Trust, also reported to Dame Barbara Hakin, the Chief Executive of East Midlands SHA, a range of very serious concerns about bullying and other improper management practices in the Trust which had been reported to him by many of the Trust’s staff. He also complained about the failure of the SHA to ensure that consultation about service cuts was undertaken properly within NHS and employment law. This eventually led to another whitewash ‘review’ by the SHA.
In May 2009 Professor Hands compiled a detailed, evidence-based analysis of the many inadequacies in the way the SHA Review was commissioned and conducted in relation to the issues he had originally identified. He sent a copy of this paper to the Chairman of the Trust, John Peet, requesting that it be considered by the Board of Governors. It has still not reached the agenda. Professor Hands subsequently sent his paper to David Nicholson complaining about apparently improper practice by East Midlands SHA and the Trust. He again appears to have been stonewalled.
Professor Hands has now written to Andrew Lansley asking for a properly established independent inquiry into the reasons why his legitimate complaints have apparently been systematically suppressed by the Trust, East Midlands SHA and the Department of Health. He has also suggested that the Lansley should ensure that the Cornwall inquiry is truly independent and its terms of reference be broadened to incorporate an assessment of the ‘appropriateness of the current management culture in the English NHS to enable the highest quality of patient care’. Don’t hold your breath.
MD