NHS Highland medics blast 'culture of fear and intimidation' silencing concerns over patient care

They even allege that, if allowed to continue, the risk has shades of the Mid-Staffs hospital scandal in which hundreds of patients eventually died because of appalling care despite warnings, prompting senior staff to speak out.

Read more: Highland radiologist crisis means patients must travel to Grampian and Tayside 

In a letter to the Herald today they say the "practice of suppressing criticism, which emanates from the very top of the organisation...has had a serious detrimental effect on staff at all levels of NHS Highland, but equally importantly, has had an adverse effect on the quality of care we are able to provide for patient".

The medics, who represent GPs and hospital clinicians, said a damning external report on NHS Highland's governance in July, which said the board needed "mentoring" to improve their leadership, had triggered staff to come forward with personal experiences of bullying.

It also comes as NHS Highland's current chief executive, Professor Elaine Mead, prepares to step down in December. 

Dr Iain Kennedy

Dr Iain Kennedy, an Inverness GP and medical secretary for the Highland Local Medical Committee, said: "In some parts of the organisation there is a culture of fear, our clinical staff and some managers have told us that when they have raised concerns they have felt intimidated and marginalised.

"We have had a number of people come forward with examples and we believe that there are many more yet to come forward.

"When people speak out about the impact for patients, they are very quickly put down a grievance route to silence them.

"They are very quickly invited into a room with the senior leadership of the health board and accused of having made serious allegations and they are put on the spot to justify their allegations, rather than being welcomed to share their concerns in an open and transparent manner.

"Everything seems to get done behind closed doors."

The impact has been felt directly in radiology which has been hit by a string of resignations and early retirements, including the departure of its last two remaining interventional radiologists this summer meaning patients in need of emergency care for haemorrhage, sepsis and some cancer treatments must be transferred to Grampian or Tayside instead.

Professor Elaine Mead

The health board now has fewer general radiologists today than it did in 2010 despite a 30% year-on-year increase in the workload, with serious implications for cancer patients.

Read more: Report claims 'extremely murky goings'on' at NHS Highland

Dr Alastair Todd - the former head of service for radiology - said he was blocked by NHS Highland's chief executive Elaine Mead and chairman David Alston from making a presentation to the board last year, when the scale of the radiology crisis became clear.

"The response from David Alston was 'there won't be a presentation by radiology to the board, not now and not ever'," said Dr Todd.

Dr Todd, the health board's sole remaining interventional radiologist until he took early retirement last month, said there were echoes of the Mid-Staffs scandal where hundreds of avoidable patient deaths were linked to mismanagement and whistleblowers were threatened.

"The bullying culture is a symptom of incompetence, of a dysfunction organisation which is not looking after the interests of patients or the interests of its staff," said Dr Todd.

"A lot of people are worried about their careers and their mental health if they stand up and take the flak. But what you end up with is staff who think 'I'm going to do my job, go home, and close my eyes to anything else'.

"Staff turning a blind eye because they are afraid to speak up and say 'this isn't right'. That's how you end up with a Mid-Staffs situation, and we're not that far away in NHS Highland."

Read more: Junior medic at NHS Tayside 'committed suicide due to culture of stress and bullying'

It comes days after claims that a junior doctor in NHS Tayside committed suicide amid a culture of stress and bullying plaguing trainee medics. 

And a report earlier this year into the fudging of A&E waiting times at NHS Lothian also blamed a culture of "bullying and harassment" for the practice.

Dr Eileen Anderson, a consultant radiologist at Raigmore hospital in Inverness who chairs NHS Highland’s Area Medical Committee, as well as the hospital’s sub-committee, said there was a pattern of sidelining staff that was harmful to patients.

She said: "Doctors raise concerns about clinical matters and if these issues are not acknowledged, if they're not listened to and taken seriously then the quality of patient care can diminish.

"This might relate to insufficient consultant cover, nursing cover, radiographer cover, or even more access to timely reported scans, investigations or therapies often with more cost up front but better for patients and potentially with savings in healthcare use in the future.

"It's also very demoralising for the clinicians when their concerns are not taken seriously."

Dr Jonathan Ball, a GP and chair of the Highland Local Medical Committee added: "We have a high turnover of non-executives on the board, we have a high turnover of consultants, managers, nurses and no one's asking why?".

The representatives wanted their concerns aired publicly yesterday at NHS Highland's board meeting, but have been offered face-to-face meetings with management instead.

A spokeswoman for NHS Highland: "The board was made aware through their representatives of an accusation of a ‘bullying culture’ within NHS Highland. Prior to the board meeting members of the board had offered to meet with some of the representatives. A further offer to meet has again been made today.

"The board takes such allegations extremely seriously and any complaints made will be fully investigated through appropriate procedures."

A Scottish Government spokesman said: “With the Cabinet Secretary having spoken with the chair of NHS Highland, we understand that they hope to meet the signatories this week.”