Letby case highlights doctors' concerns being ignored. Scotland's NHS has a similar problem – Dr Iain Kennedy

Instead of a culture of fear and blame, NHS staff must feel free to speak up about problems that affect patient safety

The way doctors and other healthcare workers are treated within our NHS has been thrown into stark review by the tragic events at the Countess of Chester Hospital in Cheshire. This utterly shocking case shone a spotlight on how the doctors who raised their concerns were, quite staggeringly, ignored by senior management, with horrific consequences. The cruel and sadistic way Lucy Letby inflicted untold suffering on babies and their families is, thankfully, incredibly rare and beyond any parallel we could or should seek to make.

It is true though that accounts about the way doctors were systematically mistreated and ignored when they raised concerns suggest an all-too-familiar pattern, one which many of my medical colleagues recognise and tell me also happens across Scotland. Just last month, it was reported that senior A&E doctors in NHS Grampian had raised concerns about staffing shortages that were putting patients at risk, with nothing done by NHS management to mitigate the situation. These doctors felt so worried, and so ignored by those above them, that they felt they had to go to the media as their warnings were falling on deaf ears.

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NHS doctors and other staff are well aware of the risks that come with whistleblowing – knowing that concerns they raise might not be listened to and treated seriously, and that it might result in negative personal repercussions for them and their careers. This should never be the case – the fear of being penalised and targeted for raising concerns that have patient safety at their very heart.

Earlier this year, I highlighted figures from a snap survey of BMA Scotland members that showed almost 50 per cent of those doctors who responded would still not feel confident about raising concerns, despite some of the practical steps that have been taken to enable NHS staff in Scotland to speak up. I have said it time and time again, and I will keep on saying it until we see tangible change – we need a real shift in culture in Scotland’s NHS that means doctors are listened to when they voice their concerns about anything related to patient and staff safety.

As a former whistleblower, this is clearly an issue close to my heart, and I understand how the brave doctors in Grampian must feel to have raised their heads above the parapet. It’s something I will be focussing on in the coming months, and I hope to see some real progress on moving away from a current NHS culture based on “reputation management” and more towards openness, support and learning.

The way things are currently, with a culture of fear and blame, is simply not good enough. Our patients are our number one priority, and all of Scotland’s doctors – indeed all of Scotland’s NHS workers – should feel free to speak up without fear or favour. There will be no improvement over raising concerns until senior management’s entire ethos changes to one which truly values staff. We need to be able to work in a system where we are genuinely listened to, in well-staffed, supportive services. If we can do that, then working conditions will improve and, crucially, patient experiences and outcomes will too.

Dr Iain Kennedy is chair of BMA Scotland



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