The NHS has ‘pockets’ and ‘islands’ of a positive culture. However, my research concluded that the NHS is institutionally and systemically deaf, bullying, defensive and dishonest (Pope 2017). The dishonesty is seen in a number of ways. It can be the overarching pretence that things are what they are not, and the promotion of ‘good news’ and spin. It can be the blatant lying and ‘cover up’ in the face of failure. Often records and notes ‘disappear’. The NHS is very defensive and is exquisitely sensitive to anything that dents and threatens to tarnish its reputation and image of perfection.
Scandal of infected imported blood products: A news item on the Radio 4 programme (11 Feb 2019, 1.53:45) was about the scandal of the importation of infected Factor 8 in the 1970/80’s. There have been 1500 confirmed deaths. Jason Evans describes the situation as a “cover up that’s been going on for decades”. There was a recent internal government audit which showed that 1000 files relating to the cases were removed by civil servants. The DH has now apparently said that many of these have been found. Morecombe Bay: The KIrkup Morecombe Bay report (2015) identified collusion and concealing of the truth. ‘Many of the reactions of maternity unit staff at this stage were shaped by denial that there was a problem, their rejection of criticism of them that they felt was unjustified…We found clear evidence of distortion of the truth…events such as the disappearance of records, although capable of innocent explanation, concerned us. We also found evidence of inappropriate distortion of the process of preparation for an inquest, with circulation of what we could only describe as ‘model answers’...Where individuals collude in concealing the truth of what has happened, however, their behaviour is inexcusable, as well as unprofessional.’ (p.8). ‘The Inquiry into Hyponatraemia-related Deaths’: This report by O’Hara was published in January 2018 following the investigation into the deaths of five children in Northern Ireland. ‘…concealment and deceit’ was identified. The Northern Ireland inquiry found that it was difficult to ‘…persuade some witnesses to be open and frank with the work of the Inquiry. All too often, concessions and admissions were extracted only with disproportionate time and effort. The reticence of some clinicians and healthcare professionals to concede error or identify the underperformance of colleagues was frustrating and depressing, most especially for the families of the dead children’ (p.25). There was a ‘…culture which concealed error’ (p.18), a failure to learn from the initial deaths and a great reluctance to admit fault. There was a ‘…underlying institutionalised reluctance to admit major shortcomings’ (p.111). ‘I am compelled to the view that clinicians did not admit to error for the obvious reasons of self-protection and that this defensiveness amounted to concealment and deceit’ (p.222) ‘…the unfortunate truth to be drawn from this Inquiry is that there are too many people in the Health Service who place reputation before honesty and avoidance of blame before duty’. (p.74). ‘The failure by senior clinicians to address the issue with appropriate candour suppressed the truth and inhibited proper examination of what had gone wrong.’ (p.98). Alison’s Story: This is a very tragic story. It is a very clear case of abuse of position and trust by a nurse. There is the inevitable ‘cover up’, and a catalogue of failures. There were people who should have taken action to protect Alison, but didn’t. Typical of many other situations in the NHS (e.g. deaths at Gosport hospital) some people did raise concerns, but nothing was done; classic NHS behaviour. Medical records were so-called ‘lost’ and the NHS organisation concerned did not share information with the police. ‘The truth was hidden to protect reputations’. lick here to edit.
0 Comments
|