A LONG-term culture of bullying, secrecy and cover-up led to NHS Lothian health board rigging its waiting time figures, according to a damning report by independent consultants.
The report by David J Bowles and Associates reveals a "blame culture" where the board's anti-bullying policy has been breached; where bad news is buried and a "gloss" put on reports; and where staff are told "just fix it" with no questions asked.
It said the management styles described by staff, and a number of alleged incidents highlighted during interviews and focus groups, could be described as "creating an undermining, intimidating, demeaning, threatening and hostile working environment for some staff".
This culture has "lasted for some time" with some middle management following their bosses' lead on bullying – "emulating inappropriate management styles" – and with staff afraid to use whistleblowing procedures because of concerns about reprisals.
Last month, shortly after Health Secretary Nicola Sturgeon announced the independent report, NHS Lothian's chief executive Professor James Barbour, 59, announced he was stepping down from his £195,000 post with immediate effect.
The health board's crisis came to a head when it was caught manipulating its statistics by making last-minute offers of treatment in England to patients, in order to hit targets.
An initial investigation by PricewaterhouseCoopers spoke of a culture which involved the suppression of information and an "oppressive management style" – prompting demands for a fuller investigation.
The new report demands full-scale retraining of the upper echelons of the body, stating: "As part of the change programme we recommend that senior and middle managers and staff be provided with training and development to clearly distinguish the difference between bullying and firm management.
"The 'blame culture' as reported to us can sometimes result in an environment where incidents are suppressed and there is a lack of openness."
The report included 57 one-to-one interviews with employees and five focus groups with another 56 staff from a cross section of roles and disciplines.
Dr Charles Winstanley, chairman of NHS Lothian, has now been asked to produce a single integrated action plan to improve waiting-time information reporting.
Dr Winstanley said it had been a difficult time for the organisation, but the review had been necessary and had given NHS Lothian a clear way forward. He said: "Our focus is now on implementing the recommendations and ensuring NHS Lothian never finds itself in this position again."
Ms Sturgeon said: "I want to be clear there is no place in any part of the NHS for a management style or culture of this type and it will not be tolerated."
Her Labour opponent Jackie Baillie said: "This explosive report casts a light on the ugly culture of bullying that has been allowed to evolve at this health board. It is clear NHS Lothian was under huge pressure as a result of SNP budget cuts and an aggressively target-driven culture.
"NHS Lothian might be the health board that has been found out, but the pressures on all boards are the same. I fear this is just the tip of the iceberg."
Tory health spokesman Jackson Carlaw said: "We have long championed the right of NHS staff to be able to communicate privately and securely concerns they may have."
Theresa Fyffe, Scottish director of the Royal College of Nursing, said: "We have to question whether this is happening at other boards and is being swept under the carpet."
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