Scotland's NHS is still not as open as it should be. There have been some recent improvements, such as the creation of a whistleblowers' phoneline and a plan for whistleblowing champions in every Scottish health board, but there remains serious concern that, instead of encouraging a realistic conversation about the crisis facing the NHS, health boards are working to suppress evidence of problems and discouraging staff from speaking out.
One board that has been at the centre of these concerns is NHS Grampian. Last year, the board was less than open about an investigation by NHS Healthcare Improvement Scotland (HIS) into care at Aberdeen Royal Infirmary and it was only a freedom of information request that revealed the full details. There has also been controversy around the suspension of Professor Zygmunt Krukowski, the Queen's Surgeon in Scotland, and his colleague Wendy Craig, with claims that the suspensions followed attempts by the doctors to raise concerns about issues at ARI.
Now there is fresh concern over figures which show that NHS Grampian has referred more doctors to the General Medical Council in the last 17 months than NHS Greater Glasgow and Clyde, which is the largest health authority in the UK. The figures obtained by The Herald also show that a third of the investigations conducted by the GMC into doctors from NHS Grampian since the start of last year came from complaints made by the health board itself.
We do not know the specific details of each of the cases referred to the GMC by NHS Grampian, but at the very least it looks like the board may be behaving in a heavy-handed way in dealing in its relationship with staff by referring a relatively high number of cases to the GMC. Referral to the GMC should be a last resort and a health board should never be, in the words of one source who spoke to The Herald, outsourcing disciplinary matters to another organisation rather than dealing with them in a robust and mature way.
The fact that a high number of the investigations conducted by the GMC into doctors from NHS Grampian came from complaints made by the board itself is also of serious concern. In his independent review into whistleblowing earlier this year, Sir Anthony Hopper said that employers might complain about a doctor to the GMS as a reprisal against a whistleblower and if this has happened in the case of NHS Grampian, it would be of serious concern and further evidence of the need to change the culture in Scotland's NHS.
The truth is that, whatever the details of the cases in Grampian, the NHS in Scotland has still not got to grips with the issue of openness. Staff should have the right to raise concerns without the fear of reprisals, which in turn would encourage a wider debate about how to run and fund our health service. Some parts of the NHS still struggle with this idea, but a properly functioning health board should encourage its staff to raise concerns no matter whose feathers are ruffled – for the sake of the health board, but also for the sake of the whole NHS.
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