Cultural issues related to allegations of bullying and harassment in NHS Highland: independent review report

14. Unwillingness to Raise Concerns

Introduction

14.1. It is relevant and important to discuss why people felt unable to report their experiences and the adverse effects if and when they did.

14.2. It is said that, in general, the main barriers to reporting allegations of bullying or other inappropriate behaviour are the perception that nothing will change, not wishing to be seen as a troublemaker, the seniority of the bully, the fear that bullying will get worse, and the fear or real risk of being dismissed or side-lined. The legal and other remedies are not easy to pursue, often leaving a choice between leaving the job (with all that entails) or continuing to suffer.

14.3. Sir Robert Francis identified a number of factors which may lead to fear of speaking up as being:

• blamed or made a scapegoat
• discriminated against
• disbelieved
• seen as disloyal
• seen as disrespectful in a hierarchical system
• bullied
• fear of wider consequences for a career.^[33]

14.4. As noted already, these have been the experience in NHSH. In this short chapter, I offer some more illustrations of reasons for people feeling unable to raise their concerns.

Themes

14.5. A consultant told me of a variety of impediments:

"Potential repercussions – need to keep my job, pay my bills. I've watched what happens to others who challenge. People's careers sabotaged – cannot work again- will never work again – no pension…If I were to go and make a complaint – who would I go to? I don't have an answer – I won't turn up at the new CEO's door…"

14.6. This is a recurring theme:

"People are unwilling to step forward and say this is a problem. I've spoken to a number of colleagues who, when I told them I was coming, they said, "good for you" and when I asked if they thought about it, the majority of responses were "I've got a mortgage, I've got children.""

14.7. A senior staff member wrote in these terms:

"Those who have gone to formal grievance have come away feeling like they are in the wrong, that this manager is having to deal with them and their faults. This tends to give the message to others that going down this route puts them at risk of being deemed as either a trouble maker, not coping with their work and therefore at fault themselves. Until this bullying behaviour is acknowledged, staff supported, and communication improved I can see many experienced staff leaving if they can't hold out till x retires. This is not my impression of a supportive forward-thinking organisation who cares for the wellbeing of their staff...

That really summed up how I feel about Bullying within NHS Highland and in particular in the [x] department. Before putting in my grievance I had been warned that "management stick together so don't expect your grievance to have a very good outcome" and I have unfortunately found this to be my experience."

14.8. A former local MSP told me:

"I had many cases of NHS bullying over the years. The one conclusion that I reached was that there was a common denominator in the vast majority of cases. Generally speaking, most of the staff who had been bullied had 'dared' to raise concerns regarding patient care or suggest ways to improve patient care. They tended to be well qualified, experienced and conscientious in their professional capacity. Having raised an issue, they were often redeployed to a post with lesser responsibilities or taken from specialised posts to general work. It was not only bullying that was involved, but a fair amount of humiliation was also used, often in front of patients and particularly with other staff present."

14.9. These views echo the observation of Sir Robert Francis that workers who are bullied, or who see others bullied, are much less likely to raise their concerns (see paragraph 10.18 above), as the following passages underscore.

14.10. A former manager in a support role told me:

"What NHS Highland fails to recognise is that most people who are bullied will not report it and perhaps don't even realise that they are being bullied until they have left that situation. If someone does eventually raise a complaint... they will quickly realise that a record has been kept of things that you've done and said that can be skewed to seem negative and, as you haven't kept an equivalent record (not knowing that you needed to), you can't counter the negativity."

14.11. From a care worker in Argyll and Bute:

"My case is not isolated, I have met many people who have raised a concern and been shunted from post to demoted post until they leave. There is a fundamental lack of understanding by NHS Highland of the nature of bullying, it is generally secretive and there is little evidence. People who witness bullying will rarely corroborate a complaint for fear that they will be the next target. When people see what happens to someone who raises a complaint it is little wonder that bullying goes unchallenged. Senior and Middle management close ranks and say there is no issue."

14.12. The feelings of a number of those who came forward are summed up here:

"It is common knowledge that this particular manager openly boasts in the staff dining room about the number of grievances against them and has said that it doesn't matter because "nothing ever happens about them". Staff …. feel that this manager is "untouchable" and are afraid to complain further due to the poor outcomes of previous complaints & the open victimisation of those who have previously complained. Several members of staff have actually resigned their posts as they felt unable to continue working under these conditions."

14.13. There seems to be a strong theme around victimisation, a fear that, if someone raises an issue, the person complained of will use their power to harm the person raising the issue further. Staff fear reprisals.

14.14. I was asked to note that doctors are less likely than other staff to report incidents of bullying and harassment; trainee doctors are among the least likely to speak up. They fear repercussions if they do. They believe that nothing will change by raising concerns. There is also a mistaken perception that doctors do not suffer bullying. They are often seen as powerful, successful and self-confident people, and therefore somehow immune. I was told that this is not the case.