CQC chief warns of bullying culture in NHS
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- Published: Monday, 03 February 2014 07:26
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David Prior, the chairman of the Care Quality Commission (CQC), writing in the Telegraph (Feb 2, 2014), warns the NHS will “go bust” without radical change to drive up standards and rid hospitals of a “toxic” bullying culture that damages patient care. He says the safety of the most vulnerable patients is being jeopardised by a “dysfunctional” rift between NHS managers and clinical staff.
In an article for the paper Mr Prior warns of an “alarming” culture within the NHS. He discloses that one in four staff have reported bullying, harassment or abuse from colleagues and managers, while whistleblowers are ostracised. The NHS often “delights” in the “ritual humiliation” of those who are deemed to have failed, he adds. Without “transformational change”, he says, including greater private-sector involvement, hospital mergers and an end to pointless targets, the health service risks going “bust”.
In his article, Mr Prior highlights the treatment of whistleblowers, saying the NHS is failing to listen to those who challenge poor care and champion the rights of patients. He says those who try to speak out are too often “ostracised” by their colleagues and managers. Mr Prior, a former hospital chairman, suggests he has found himself “trapped in a paradox” when it comes to the NHS, arguing that while it can be “overwhelmingly kind” as well as skilled, parts of the health service have created a culture “that stigmatises and ostracises those who raise concerns or complaints”.
He writes: “Too often, it delights in the ritual humiliation of those deemed to fail, tolerates and institutionalises outdated working practices and old-fashioned hierarchies and can almost encourage “managers” and “clinicians” to occupy opposing camps. I love the NHS – am often overwhelmed by the kindness, care and skills of those who work in it – and yet am too often shocked by some of the behaviour I see.”
He says he wants to see more successful hospitals taking over failing counterparts, closer integration with community services and more use of the private sector for NHS-funded care. “We need serious transformational change; without it the NHS will deliver poor care, and ultimately, go bust,” he writes. “We need more competition to drive up standards of care; more entrants into the market from private-sector companies, the voluntary sector and other care providers. Perhaps most crucially, we need to change the culture.” In this article, he suggests that the NHS would perform better if the waiting targets which were introduced by Labour were discarded entirely. He writes: “We need the Government to change the way it holds the NHS to account: an end to trusts being blind-sided by waiting targets that miss the point, skew priorities and have unintended consequences.”
However a Department for Health spokesman told the paper: “We are clear that targets must never come before clinical need – and based on clinical advice, we have scrapped a number of them. However, it’s right that patients have certainty about how long they can expect to wait for medical treatment when they are ill. In fact, despite the NHS treating more people than ever, waiting times are low and stable and there are 35,000 fewer patients waiting longer than 18 weeks than in May 2010. We are focusing on poor care like never before.”
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