FOR the hundreds who saw their careers and even their mental health left in tatters by bullying at NHS Highland, the long-awaited Sturrock report offers vindication - but probably few surprises.
Many of the findings also echo patterns all too familiar across the NHS.
Mr Sturrock describes failures and delays in how staff concerns have been investigated at NHS Highland, and victimisation of whistleblowers.
Read more: 'Many staff suffered serious harm and trauma', says Sturrock review
An unnamed former Highlands MSP, quoted by Mr Sturrock, told the QC that in his experience the common denominator in bullying cases was that the target was an employee who had "dared" to raise concerns regarding patient care or to suggest improvements.
The MSP added: "They tended to be well qualified, experienced and conscientious in their professional capacity.
"Having raised an issue, they were often redeployed to a post with lesser responsibilities or taken from specialised posts to general work."
Mr Sturrock highlighted as a particular concern the "apparently peremptory, inappropriate and inconsistent use of suspension as a disciplinary tool".
One witness quoted in the report told how they ended up suspended from work and banned from entering any NHS Highland premises or contacting any other members of staff pending the outcome of an investigation into complaints against them.
The process lasted two years.
The witness said: "I understand this practice of long-term suspension was a regular occurrence and staff often left in the process.
"Not only is this a cruel and unfair process it is also a complete waste of valuable skills and taxpayers' money."
Cases of NHS staff who describe how speaking out was turned against them, with their conduct or clinical capability questioned and suspension on dubious grounds swiftly following, are all too common.
The circumstances are often complex, but health boards should be required to publish data on the number of staff suspended or redeployed on non-clinical grounds to ensure that these processes are less likely to be misused.
The Sturrock report also sheds some interesting light on how the past decade of austerity and increased targets may have ramped up a culture of workplace bullying.
Mr Sturrock said he heard from witnesses how Scottish Government policies on waiting lists and the treatment time guarantee put pressure on health boards to deliver "without enough regard for affordability" and "can lead managerial staff to pressurise clinical and other staff to improve performance".
One witness told Mr Sturrock how budget pressures had eroded relations between clinicians and their managers, adding that "at some point, the staff become the enemy".
The witness said: "They've stopped listening to us as professionals. If I have a professional judgement and it's not what wanted to be heard, it's closed off and you feel that you've done something wrong."
This leads Mr Sturrock to call for an "honest conversation [with the general public and employees]...about realistic expectations and the perhaps inevitable tensions between clinical delivery and financial reality" in the NHS.
Read more: Fife cancer doctor 'bullied out of job' says whistleblowing ruined her career
While the report provides no definitive answer to the original claim that NHS Highland was blighted by a "culture of bullying" per se, he is satisfied that the problem was sufficiently widespread that the whistleblowers who wrote to the Herald last September were right to sound the alarm.
He said: "I am satisfied that those involved genuinely felt they had no option but to do so and that this was the only way to address matters".
"Many of the concerns expressed in the letter have a sound basis," he added.
In particular, Mr Sturrock acknowledges in his report - a wide-ranging 176-page document - that "one of the more significant issues of concern brought to my attention has been how some respondents viewed the apparent influence over a period of time of the recently departed chief executive".
Elaine Mead stepped down in December.
Of medical director Dr Rod Harvey, who stepped down as an executive in March, Mr Sturrock said "a number of specific concerns were expressed by a number of respondents about the way [Dr Harvey] has handled matters over a number of years".
However, Mr Sturrock said it was not "useful" or "necessary" to go into any detail given that board executives had left their roles.
He does, however, question the failure of the Scottish Government to intervene sooner.
In autumn 2017, officials were notified of problems stemming from NHS Highland's leadership team by a number of non-executive directors charged with hold the board to account.
He adds: "It seems likely that that more active intervention at that time would have avoided such as public and arguably more damaging process now.
"Indeed, I am satisfied that senior people in the Scottish Government were aware of the dysfunctioning situation with the Board and at senior leadership level for a considerable period of time prior to matters becoming more public in the autumn of 2018...
"In particular, the resignation of a number of non-executive directors and other events and information provided to the Government over a period of time ought to have signalled the seriousness of matters and could have prompted more decisive action at an earlier stage."
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