AN organisation described as "autocratic, intimidating, closed, suppressing and defensive", where workers encountered "fear" and "intimidation" sounds more like the mafia than the NHS.
Yet those are just some of the words used to describe NHS Highland in the Sturrock report.
But claims of bullying, harassment, pressure to put targets before clinical priorities, and victimisation of whistleblowers have surfaced - with telling similarity - in numerous health boards.
So how did we get here?
Read more: Highland bullying report warns suspension were 'used as punishment'
Dr Sukhomoy Das, a stroke physician who twice won settlements for unfair treatment and was the only Scottish whistleblower invited to give evidence at the landmark Francis Review, said his reputation as someone who raises patient safety issues saw him sidelined by one Scottish health board.
Instead of a permanent contract he was employed on three month rolling contracts for three years before complaining directly to the chief executive and lodging an official complaint of bullying.
Eventually his own claim was rejected and a groundless investigation launched into his clinical performance instead after colleagues concocted "trumped up" complaints in retaliation.
Dr Das said: "If these doctors had concerns about my performance, why did they keep renewing my contract every three months for three years instead of just kicking me out?"
In another health board, Dr Das said he came under pressure to record new patients as returning patients to help fudge waiting times data and cut appointment times to 10 minutes, increasing patient turnover.
Read more: NHS Ayrshire row as overworked radiographers 'suicidal' and 'scared to speak up'
Dr Iain Kennedy, a GP and one of the leading whistleblowers at NHS Highland, said it was clear 562 bullying complaints was far short of reality given that 340 people gave evidence in the Sturrock review into Highland alone.
He said that official staff surveys such as iMatter masked the scale of "toxic" bullying by limiting comments to immediate line managers, and providing "no opportunity to comment on the overall culture of an organisation".
Dr Kennedy added: "We know from our own personal experiences from speaking to victims in Highland that people are terrified of coming forward to report bullying, and the reason for that is simple - often the bullying escalates."
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