Leaders: The buck must stop with senior NHS managers

BULLYING. Cover-up. Fear. Blame. Intimidation. Just a few of the words to describe the shameful record of “inappropriate management culture” which a damning report published yesterday found was endemic at one of Scotland’s largest health boards.

The report into NHS Lothian, commissioned by health secretary Nicola Sturgeon, lifts the lid on an organisation in which bad news was not passed up to line managers, staff were told to “put a gloss” on reports and ordered to “fix” problems without support.

Such a culture would be inappropriate in any modern workplace, but it is particularly shocking in the NHS, where co-operation and responsive, though robust, management should be central to the delivery of health care. Equally shocking is the fact this scandalous state of affairs, which cannot have failed to impact on patient care, might not have been uncovered had the health board not been caught fiddling waiting list figures.

In her response yesterday, Ms Sturgeon was right to affirm that there was no place for a culture of bullying in the NHS, an approach we are sure the health secretary and her Cabinet colleagues adopt in the government. However, given the scope of the report, her assertion that the report should not been seen as a general condemnation of NHS Lothian appears optimistic, though it would be wrong to tar all health board managers with the same brush.

Pledging her support to the new interim chief executive, Tim Davison, who is charged with rebuilding the trust and confidence in NHS Lothian, Ms Sturgeon also asked the board chairman, Dr Charles Winstanley, to produce an action plan on waiting time improvements, governance and culture. It is obviously in the interests of the NHS patients the board accept there were mistakes and promised the maximum level of transparency in the future. But this is not enough.

It is axiomatic that those in positions of public-sector power are properly held to account. Nowhere in her statement did Ms Sturgeon explain how this would happen in the case of former NHS Lothian chief executive Professor James Barbour who retired last month. At the very least he and Dr Winstanley, who was responsible for supervising the chief executive’s work, should be called before Holyrood’s health committee to the management culture at the board and the manipulation of the waiting times figures.

Fairness demands they should be allowed the opportunity to explain their actions, though if they claim that two members of staff at an NHS trust who have been suspended as part of the investigation into waiting times are to blame, most people would see that as avoiding responsibility.

When they have heard the evidence, MSPs, and the health secretary, can then consider what further action might be taken based on the principle that the buck must stop with senior and highly paid NHS managers.

Our US friends need to loosen up

It’s clear a shocking scene which could scar the delicate and innocent minds of America’s children for life. No, it’s not the latest zombie movie or a sequel to Pulp Fiction, which has offended the US censors. It is, er, Brave, the Highland-set animation from Disney and Pixar, the makers of Toy Story and Finding Nemo, which Scottish tourism bosses are hoping will become a worldwide hit.

And what, pray, has upset the moral guardians of the Land of the Free? Why, it’s a scene in which a kilted Scot lifts up his traditional garb to deliver a Braveheart-style insult to an enemy. A scene in which there is not even any – how to put this politely – posterior flesh on view. As a result of this harmless moment, which has appeared in some trailers for the film, the first official ruling from the Motion Picture Association of America on Brave warns that the film contains “rude humour”.

Rude? We hardly think so. It is, surely, the kind of humour even the youngest children will laugh at and adults, getting the Braveheart reference, will enjoy. It is not, as one film blogger asserts, raising concerns because of the emphasis on the so-called “rude humour”. Last night, a spokeswoman for VisitScotland maintained the Scots were very good at laughing at themselves and that the film captured that sense of humour perfectly. Their verdict: “It all looks harmless fun and the trailer is very tongue in cheek.”

We could not agree more and would urge our American cousins to loosen up a bit, to be a bit less uptight when it comes to fears over the corrupting influence on young minds. It’s a just a very mild joke guys. Even kids will get that – if you let them in to the cinema to see it.