NHS Scotland needs culture change on whistleblowing, says senior doctor

Scotland’s NHS needs a “complete culture change” to encourage whistleblowing, a senior medical figure has said.

The call came as a survey indicated nearly half of doctors who responded are not comfortable or unsure about calling out malpractice.

The British Medical Association (BMA) unveiled figures from a survey, in which 24% of doctors said they would not feel comfortable raising a concern around patient safety or malpractice at work.

A further 24% said they were not sure if they would report the same concerns, and 52% said they would raise concerns with their superiors.

The survey examined 592 doctors across Scotland, and Dr Iain Kennedy, chair of BMA Scotland, said the results prove the NHS in Scotland needs “a wholescale shift to a culture based on learning, rather than blame and finger-pointing”.

The figures were released ahead of BMA’s annual representative meeting on Tuesday.

Dr Kennedy, a former whistleblower who exposed bullying and intimidation at NHS Highland, is among those speaking at the meeting.

He is expected to say: “As a former whistleblower on bullying in NHS Highland, I know all too well what it’s like to stick your head above the parapet.

“I want all my colleagues in Scotland to feel they can raise concerns without fear of being labelled a troublemaker.

“In 2021/22 across Scotland’s 14 territorial health boards, a total of 96 whistleblowing concerns were officially raised.

“But I fear that we still aren’t doing anywhere near enough to support Scotland’s doctors to speak up.

“Our recent snap survey of doctors suggests almost half – 48% – are frightened to raise concerns around patient safety or inappropriate behaviour.

“It’s shameful that we work in an NHS where some doctors feel they can’t speak up on behalf of patients without repercussions for themselves and their careers.”

Dr Kennedy stated that doctors should “feel free to speak up without fear or favour”.

He added: “We have seen some positive changes – such as the introduction of whistleblowing champions. But that’s not enough. We need a complete culture change.”

Some doctors also left anonymous feedback, with one saying there will be no improvement on whistleblowing “until senior management’s entire ethos changes to one which values staff”.

The same doctor also said the “Scottish Government cannot dodge responsibility” as “the NHS acts under their instruction”.

Dr Kennedy said: “If we can work in a system where we are genuinely listened to, in well-staffed supportive services, then working conditions will improve and, crucially, patient experiences and outcomes will too.

“We need a wholescale shift to a culture based on learning, rather than blame and finger-pointing.

“An NHS where everyone feels free to speak up will be safer for patients and doctors. If that happens, we will save lives.”

A Scottish Government spokesperson said: “It is vital that everyone who works in our Health Service has the confidence to raise any concerns they may have. Policy measures are in place to support this and staff should raise a concern with their line manager or team leader, or with a more senior manager if circumstances mean this is more appropriate.

“There are also a dedicated whistleblowing champions in each health board to ensure staff are encouraged and supported to speak up.”