BMA Scotland warns against victimising whistle-blowers

The BMA in Scotland today [Thursday 13 May 2010] called on the Government to ensure that doctors who raise concerns about patient safety are not victimised by their NHS employers.

The calls came as the BMA published findings of a survey of members Standing up for Doctors; Speaking out for Patients. The survey found that the majority of hospital doctors have, at one time, had important concerns about patient care or staff behaviour. However almost half of these doctors didn’t report their concerns, many because they don’t believe it will make a difference or feared the consequences of doing so.

One in ten doctors who did raise concerns was given some indication that speaking out could have a negative impact on their employment.

Commenting on the survey results, Dr Charles Saunders, Chairman of the BMA’s Scottish Consultants Committee, said:

“As clinical leaders, doctors have a duty to speak out when they have concerns. However, as the results of this survey bear out, this is not always possible or effective.

“We have concerns around the culture of many NHS organisations. Doctors tell us they fear their careers can be affected by speaking out. This is completely wrong. We must move to a culture where every individual in a health organisation can raise concerns that are looked at and acted upon appropriately.

“The Scottish Government is promoting the concept of a mutual NHS where the patient is at the heart of decision making. But NHS organisations also need to value the staff who are there to deliver and improve patient care. Such a culture change needs to come from the very top. Ministers and NHS Board members need to send a clear message that they want to hear about things they can do better.”


Dr Sue Robertson, Chairman of the BMA’s Scottish Staff and Associate Specialists Committee, said:

“Most doctors know and understand that they have a contractual right and an ethical duty to speak out. But many NHS employers make speaking out difficult or dangerous for an individual doctor. Ultimately this will result in staff failing to raise concerns. That is why we are calling for a concerted effort by the NHS to improve on the awareness and implementation of whistle-blowing policies.”


Dr Gordon Lehany, Chairman of the BMA’s Scottish Junior Doctors Committee, said:

“Doctors at the very beginning of their career should have confidence in a system that supports them to raise concerns about patient care or staff behaviour. It takes a huge amount of courage and if doctors believe that their career progression could suffer as a consequence, they are less likely to want to speak out"

The BMA is therefore calling on the Scottish Government and NHS employers to:

* Raise awareness of whistle-blowing policies
* Protect the right of doctors to speak out without risk to their employment
* Provide feedback to staff who have raised concerns about what has happened as a result
* Involve the medical profession in reviews of national and local guidelines
* Conduct a retrospective review of responses to cases where doctors have spoken out
* Encourage and develop a culture of openness within NHS Scotland.


Ends

Note to editors

The survey is available online at: http://www.bma.org.uk/ethics/doctor_relationships/speakingoutforpatients.jsp

The survey was issued to a representative sample of 3000 doctors in Scotland (Consultant, Staff Grade and Associate Specialists and Junior Doctors). The response rate was 12% (384).

Almost 80% of doctors were not aware of the whistle-blowing policy for employees in the NHS Board where they worked.

62% of doctors reported that there had been an occasion when they have had important concerns about practices or behaviour of staff. Of these cases, 44% had been about standards of patient care, 37% regarding the behaviour of fellow staff member(s) and 19% of cases related to NHS Board targets or strategy.

Of those doctors who had experienced concerns, only 60% reported them. Of these, one in ten stated that it was indicated to them that their employment could be negatively affected. Almost half reported a negative outcome, in that they were not aware of any action taken, and one fifth said they would not be prepared to report concerns again in the future.

Of those who did not raise concerns (40%), the reasons stated included that it would not make any difference, or their concerns would not be acted upon (69%). They were also fearful of alienating themselves from their colleagues or that their career prospects could be harmed.