THE Chief Executive of NHS Scotland has admitted too many staff feel they can't raise valid concerns about the service amid fears they will be victimised.
Paul Gray, who took on the top job three years ago, says staff have told him they fear consequences if they speak up or believe it would be pointless, as nothing would change.
He revealed he asked a senior Scottish Government official to intervene in one case where he felt a problem raised by a member of staff had been ignored by managers and trade unions.
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In an outspoken article and interview, Mr Gray said he wants every NHS Scotland employee to feel they can raise issues with confidence knowing "any genuine concern will be considered and acted on".
Mr Gray, who is also Director General of Health and Social Care for the Scottish Government, said: "...when I speak to staff, there are still too many who feel that they can’t speak up about a valid issue. Some say that they don’t think that there would be any point – nothing would happen if they raised a concern. And others say that they fear that there could be consequences for them – perhaps in terms of their career, or a fear of being victimised. That tells me that there is still something we need to tackle."
There have been a number of high profile cases involving NHS Scotland whistleblowers who felt victimised after raising the alarm. These include Dr Jane Hamilton, a consultant psychiatrist, who voiced fears over the safety of a Scottish specialist psychiatric service in NHS Lothian linked to two deaths. There are also examples in NHS Grampian where Malcolm Loudon, a surgeon turned whistleblower, was accused of bullying but was subsequently cleared of all allegations by the General Medical Council.
The Scottish Government has responded to criticism about the way whistleblowers have been treated in a number of ways, setting up an independent helpline for people who feel the need to speak to a third party and moving to appoint a national officer for whistleblowing to oversee how cases are handled.
They also subscribe to Patient Opinion Scotland, an online forum where the public can share their experiences of the NHS. Mr Gray said staff could use this to highlights concerns they have anonymously.
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Nevertheless, Mr Gray said travelling around the country he had encountered NHS staff who had seen "things that could be better" but were uncertain what to do about it.
He said he wanted to assure people that if they had a genuine concern it would be properly investigated: “If you have a transparent health service where it is safe to raise issues, that is safe for patients. It is better for patients, better for staff, better for families, better for carers...
"This is really about assuring people, if you have got a concern it is not just OK to raise it, it should actually be welcomed.”
Asked why people continue to fear repercussions, he suggested that this was a "perception" he was keen to address.
Mr Gray said: “Of course the concerns that come to me eventually are inevitably the most difficult and intractable issues that have a high profile. What I have found in the ones we are able to resolve is that the start of many complaints is people have felt dismissed or unheard. That to me is what I am really keen to get across. There is some absolute understanding principle in the NHS and we want people to be listened to when they describe what is going well but we also want them to be listened to when they describe what should indeed be better.”
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He described one case where a member of staff had turned to their MSP after feeling their legitimate concerns were not being addressed on the ground. Mr Gray said a leading government official ultimately took the issue up with the health board and it resulted in improvements not just to the individual's working conditions but also ultimately to patient care.
The importance of staff feeling able to raise concerns, he said, is something emphasised in his discussions with NHS managers and during leadership training.
Dr Donnie Ross, a former medical director in NHS Grampian, has spoken out on behalf of staff with grave concerns in the region. He congratulated Mr Gray for taking a different approach to whistleblowing, but warned " recent events demonstrate very clearly how difficult it will be to achieve a working environment where employees can feel confident that raising concerns about patients safety will not have terrible repercussions on their professional and private lives." He called for a "root and branch" review of how the NHS responds to well founded criticism.
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