THE culture of the NHS in Scotland must be overhauled to make it more transparent and accountable to patients, with greater help for whistleblowers, MSPs have said.
Holyrood’s health committee said it was unacceptable that a third of staff still felt it was “unsafe” to speak up about problems in case of reprisals and blacklisting.
In a wide-ranging report on NHS governance, the committee called for a new confidential hotline to initiate investigations, in addition to the current service, which largely gives advice.
“Ultimately there needs to be a culture of openness and transparency,” the committee said.
The report follows the publication last week of an independent probe into NHS Lothian which uncovered a culture of "bullying and harassment" at the board.
The committee said Scottish Government oversight of NHS boards was “inadequate”, and it needed to improve an annual review system that seemed to have little follow-up.
MSPs also recommended ending the current conflict of interest where NHS board members act as trustees of board-related endowment funds.
It follows the Herald revealing NHS Tayside board members used £2.7m from a charity they controlled for routine spending, money which later had to be repaid.
MSPs also said patients and families felt health boards erected barriers to complainants, and these had to come down, to make the process simpler less defensive.
There was also scepticism among patients that complaining would make any difference.
Committee convener Lewis Macdonald said: “At the heart of the NHS are the patients it serves. The whole purpose of this investigation is to ensure that the culture of the NHS allows for the delivery of the highest quality of care to patients.
“We heard directly from staff, patients, NHS Board members and senior NHS managers. We heard that patients want more and greater involvement in their care and how it is delivered. When things do go wrong, there should be greater transparency allowing patients and their families to feel confident lessons will be learned.
“There are also significant measures that need to be taken to ensure staff feel able to speak up about concerns. There needs to be a more open culture that values staff.
“While there are checks and procedures in place it remains inevitable that on occasion things go wrong and it is important these can be quickly identified and not repeated.”
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Labour MSP Anas Sarwar MSP said: “It is deeply troubling that more than a third of NHS staff still feel they cannot raise concerns about what is going wrong. Given events at NHS Lothian, it is clear far more needs to be done to address staff concerns.
“The culture of secrecy that has become part and parcel of SNP government cannot be allowed to infest our NHS too. Our hardworking doctors and nurses deserve support - not a culture that makes them too afraid to raise concerns.”
Tory MSP Miles Briggs added: “The success of any organisation is often the culture it had and develops for staff and patients.
"After 11 years of SNP control, staff have felt unable to speak out about professional problems and patients are kept out of the loop when decisions are being taken about their care or when things go wrong.
"Sadly NHS health boards themselves seem forced to cover up the truth of the challenges they often face and are reluctant to speak out before problems turn into a crisis.
"I hope that this report’s recommendations are followed by SNP Ministers and we look to build an open and transparent culture in our NHS that will benefit everyone who works in and uses the service.”
A Scottish Government spokesperson said: “We have already taken steps, alongside the BMA, to introduce new legally binding protections for doctors in training and other postgraduate trainees who are whistle-blowers.
“That builds on a range of measures already in place across NHS Scotland, including the whistleblowing alert and advice service. We are also working to have the new role of Independent National Whistleblowing Officer in place as soon as possible. We anticipate this will be by the end this year.
“All of this is contributing to an increasingly honest and open reporting culture within our NHS, because it is crucially important that people at all stages of their NHS careers feel able and confident to raise their concerns without fear of punishment or retribution.”
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