A study of doctors in Scotland with experience of whistleblowing in the NHS has revealed “shocking” repercussions including bullying by managers, being blacklisted, marginalised and having their sanity questioned.
An online survey of BMA Scotland members, which attracted 436 responses, found that that vast majority (87%) of medics had encountered challenges when speaking up about safety concerns.
Fears around disciplinary procedures and a detrimental impact on their career were raised as issues by potential whistleblowers.
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One doctor said their health board had made up false complaints, referred them to the medical regulator and blacklisted them as a result of speaking up.
Another said that the backlash to raising concerns about a manager or patient safety would ruin a doctor’s career and mental health, while one told of complainants being “interrogated while in tears”.
The confidential survey also found that clinicians who were white and older were more likely to be whistleblowers, with one ethnic minority doctor saying that raising concerns is equal to “digging the grave”.
The findings were gathered as part of an MBA thesis conducted by BMA Scotland chair Dr Iain Kennedy, supported by the University of Warwick and University of Aberdeen.
Dr Kennedy was among a group of medics who blew the whistle in a letter to the Herald in 2018 over an alleged culture of bullying and victimisation at NHS Highland.
It ultimately led to the Sturrock inquiry, and more than £3.4 million being paid out in compensation to affected staff.
Dr Kennedy said the research reveals a "shocking picture" of what can happen to those who "bravely" speak out when things go wrong.
He added: “We need urgent action to change this and better support to encourage whistleblowers, particularly for younger and non-white doctors.
“NHS boards, with the clear support and backing of the Scottish Government, must do more to implement whistleblowing procedures which guarantee anonymity and protection for anyone speaking up and they must encourage reporting without fear of retaliation.
“We also need to see a wider shift in the NHS to a culture which is based on feedback and learning, not blame and finger pointing.
“Such a change needs to start at the very top and the Scottish Government must focus on fostering a culture which prioritises patient safety and staff well-being over health boards instead simply trying to do everything they can to manage their reputation.”
Dr Iain Kennedy, a Highland GP, has personal experience as a whistleblower (Image: BMA)
The research found that fewer than one in five (17%) of respondents were satisfied with their organisation’s response to whistleblowing.
Concerns over patient safety were the most common reason for whistleblowing, but 56% of whistleblowers said they experienced bullying by managers as a result and 39% said their mental state had been questioned - a practice known as "gaslighting".
More than one in three (36%) whistleblowers said they experienced workplace marginalisation or a negative response from peers for speaking up.
The most common fears described by whistleblowers included disciplinary procedures, bullying, detrimental career impacts, and referral to the General Medical Council - the doctors' regulator - as a punishment.
One consultant - a doctor who had qualified overseas and came from a ethnic minority background - said that "hardly anyone takes you seriously, raising concerns is equal to digging the grave".
A GP said their health board "made up false complaints about me, referred me to the GMC, and blacklisted me" after whistleblowing.
One specialist said they were "not listened to", adding that in their opinion the NHS management "were more concerned about their reputation than patient safety".
International medics, particularly those from ethnic minorities, can be particularly vulnerable to retaliation, said the BMA (Image: PA)
Several other consultants described feeling "dismissed", having whistleblowing raised during a review of their sick leave, and experiences of "systemic bullying" by managers.
One added: "I know both complainants [whistleblowers] and both were made to sit in meetings where they were interrogated whilst in tears.”
Another said raising concerns about patient safety or the behaviour of certain managers would trigger a backlash that "[ruins] your career and mental health".
Dr Sajid Farid, Chair of the BMA’s Scottish Race Equality Forum said doctors from ethnic minorities - particularly those from overseas - tend to experience more ‘dignity at work’ issues.
He added: "Ethnic minorities are subject to more GMC referrals and often feel that they are not regarded as part of the NHS but rather just used until they are no longer needed.
“The working environment in the NHS is becoming worse day by day, and the staff shortage is adding to the workplace stress."
Dr Chris Smith, Chair of BMA Scotland’s Junior Doctors’ Committee, said that medics at the beginning of their careers perceive whistleblowing as "a threat to progression".
He added: “When junior doctors rotate into different departments, we can provide a fresh set of eyes to identify an issue, but we can also too easily be cast as the troublemaker rocking the boat and causing problems where none had been raised before.”
Health Secretary Neil Gray said: “All Health Service workers should have the confidence to raise any concerns they may have.
"When a whistleblower raises a concern, I expect Boards to treat it with the utmost seriousness and ensure it is thoroughly fairly and appropriately investigated, ensuring no individual suffers any repercussions.
“The National Whistleblowing Officer is independent of Government and reviews how health boards, primary care and independent providers handle whistleblowing cases.”
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