A GP who helped expose a “culture of fear and intimidation” at a health board has voiced fears that increased pressure on the NHS after covid could lead to a rise in staff being mistreated and bullied.

Dr Iain Kennedy, who was one of the four NHS Highland whistle-blowers who sparked the process that led to the 2019 Sturrock review, told healthandcare.scot: “We know – particularly those of us who are GPs – that there is a treatment backlog, and we are already beginning to see very worrying waiting times.

“I am therefore fearful that when we come through covid and the light is shone on non-covid patients, those with cancer for example, that the pressure could mount up again on the NHS in Scotland.

“It’s when pressure is applied that there is always the risk that behaviours deteriorate.”

Dr Kennedy was speaking to healthandcare.scot about progress that has taken place at NHS Highland since the 2019 Sturrock review.

Some of the first people to come through the system had described it as “broken” after receiving “shocking” pay-out offers, it was revealed this week.

But Dr Kennedy said for the vast majority of people the healing process had been a “major success”.

“The main success in Sturrock has been the healing process, and also the change in senior leadership.

“We are very impressed and optimistic about our new chairman – Professor Boyd Robertson – who has certainly set the right tone, and we continue to meet regularly with the chair and the chief executive officer.

“The change in leadership has been significant, and we know that culture is set at the top so that has been so important.

“In terms of the healing process, that for the majority of victims of bullying who have registered has thus far been a major success. 173 people have signed up to the healing process so far and over 40 have already been through the process and received their resolutions.”

The Inverness GP paid tribute to the conflict resolution and mediation company, CMP Solutions, that helps staff navigate the process, and psychological support provider Validium.

“There are a lot of people engaging with psychological therapies at the moment, and we have to remember that a lot of people have suffered fairly severe psychiatric injury – we are talking about people with post-traumatic stress disorder, severe anxiety disorders, depressive illness, and we know that many have had suicidal ideation over the years.

“Validium are providing a free psychological service to these individuals and all the reports that I am getting are extremely positive.

“The other thing about the healing process is people have been able to go in front of a panel of five medical experts – so these are former medical directors, directors of HR, a lawyer, an expert whistle blower from England, and a former trade union individual – and everyone that has spoken to me that has gone through the panel has found it an extremely positive experience.

“They have been heard and believed, and I think the panel, from the feedback that I have had, have been impressed by what they have heard but also very concerned by what they have heard.

“One of the really positive things about the healing process is the panel is feeding back organisational learning to NHS Highland and I think that will be very valuable in filling some of the gaps in the Sturrock report.”

However, Dr Kennedy believes there is still more to do – pointing out that it can take years to change culture in an organisation.

“NHS Highland has a culture where people in positions of power tend to look upward to their boss; there is a boss-watching culture.

“The tendency in Highland has been to recruit and appoint individuals who are easy to control and who are unlikely to challenge those who they perceive to be more powerful than them.

“We still have a by-stander culture. There is almost no challenge that we witness within NHS Highland and the whistle-blowers still feel there is far too much onus on us to challenge and point out problems, whereas the culture should be moving to one where people feel free to, and want to, speak up.

“That’s not there yet – the bystander and boss-watching culture remains very prevalent and indeed has probably become a little worse with covid because there is such a command and control culture in the country at the moment, and indeed NHS Highland is in command and control mode, despite tiny numbers of covid patients.

“That may well be justifiable in some health board areas but I don’t believe its justifiable in Highland where we have tiny numbers.”

Overall, however, the GP is confident things will continue to improve. He praises the “positivity” of the new Chair Professor Boyd Robertson, appointed in February 2019, and Chief Executive Pamela Dudek, who took on the role on a permanent basis in October – as well as the role of Health Secretary Jeane Freeman.

The hope is, Dr Kennedy says, that NHS Highland “can be the board that shows the way forward for all health boards in Scotland.”

 

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