National Health Service: Bullying

Question

Asked by

To ask Her Majesty’s Government what assessment they have made of the level of bullying, harassment and abuse in the National Health Service in England.

My Lords, the NHS staff survey shows that the level of bullying, harassment and abuse in the NHS is too high, so we are tackling these issues through the national Social Partnership Forum’s collective call to action; the interim people plan, which, through its new offer for our people, will create a healthy, inclusive and compassionate culture where bullying, harassment and abuse will not be tolerated; and our alliance of healthcare organisations, which is promoting civility and respect throughout the NHS.

I thank the Minister for her Answer. As she said, the latest survey shows that over 25% of NHS staff had personally experienced bullying from fellow employees in the previous 12 months. Does she agree that that is appalling and intolerable, and that in most other organisations it would simply not be tolerated? I accept that the problem is exacerbated by the chronic staff shortages, but bullying can be reduced by firm and proper management practices. That is within the Government’s power, so will they get on with the action of reducing the intolerable level of bullying in the NHS?

I thank the noble Lord for his question, which is a follow-up to a recent Question on this. This is exactly why the Government have brought out a manifesto commitment to tackle violence and abuse against staff, including legislation that has already brought forward one conviction. NHS Improvement and NHS England have reviewed what central support arrangements should be provided to support NHS organisations in their responsibility to protect staff from unacceptable violence and abuse. In addition, we are bringing forward a plan that will pilot and evaluate the use of body-worn cameras by paramedics, who experience the worst of the violence and abuse, so that we can ensure that they have evidence for prosecutions that is sadly often lacking for convictions where they are appropriate.

My Lords, as we have heard, levels of abuse and bullying are unacceptably high in the NHS, and whistleblowing is not a universally trusted or successful route to resolution. The Scottish Parliament is investigating using the Scottish Public Services Ombudsman to investigate unresolved NHS whistleblowing cases. Does the Minister consider the use of the English Parliamentary and Health Service Ombudsman a sensible route for English NHS whistleblowers? If not, what would she recommend for frustrated NHS whistleblowers?

I thank the noble Baroness for that proposal; I shall certainly look into it. A number of measures have been put in place to enable a safe space for whistleblowers to come forward, including a number of regulations ensuring that they are protected and that non-disclosure agreements do not inhibit them from coming forward, but I will certainly consider her proposal.

My Lords, does my noble friend accept that the rights that we all enjoy with the National Health Service also come with commensurate responsibilities: the responsibilities of patients not to abuse staff and to turn up to their appointments, and the responsibilities of staff to ensure that the National Health Service is being used honestly and responsibly? Does she agree that the BMA’s recent announcement that charging health tourists is “fundamentally racist” is not only bonkers but financially disgraceful, and deeply damaging to the people and the patients the National Health Service was set up to protect?

I certainly agree that charging those who come from other countries and use the National Health Service is perfectly sensible and appropriate, and by no means racist. I also believe that, as the call for action on bullying says, it should be perfectly straightforward to get out messages on safety from senior leaders and staff voices. It should be a positive message about how it is a natural extension of the social contract between the NHS and those who use it.

My Lords, if a member of staff is being bullied by their senior, who should they go to for help?

The noble Baroness asks an important question. There are structures built into the NHS to enable those people to speak up. There is a “freedom to speak up” champion and a system of champions, so that it is perfectly clear to those experiencing bullying by senior managers who they can speak to.

Does what the Minister suggests apply to the actions of Ministers? She will recall, from when he was Secretary of State, Mr Jeremy Hunt’s practice of insisting on a weekly Monday morning meeting with the key national regulators, at which the sacking of chief executive officers was often discussed. Bullying starts at the top. If Ministers take a bullying attitude towards the NHS, they can hardly be surprised if that behaviour is followed at local level.

I am afraid I do not recognise the characterisation set out by the noble Lord. One of the key characteristics set out by the former Secretary of State in his leadership was that the NHS should be open and not have a culture of blame, and that people should feel free to speak up, so that when mistakes are made they should be corrected.

My Lords, the NHS is the biggest employer of people from black and minority ethnic backgrounds. They face bullying and harassment from within—from co-workers—but also from members of the public and patients. There is considerable anecdotal evidence that some patients refuse to be treated by a clinician or a nurse from a minority ethnic background. What is being done to protect these workers and ensure that the NHS has a much more inclusive environment and culture?

The noble Baroness is quite right. Bullying faced by those in the BAME community is more significant, and data supports that. That is why the NHS is implementing the workforce race equality standard, which is a requirement for NHS commissioners and healthcare providers—including independent organisations with an NHS contract —to track and ensure that employees from BAME backgrounds have equal access to career opportunities and receive fair treatment in the workplace, and to ensure that this is properly recorded and published. This will drive through the improvements she seeks.