One year on – what has changed since publication of explosive NHS Highland bullying report?
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The publication of the Sturrock Review “shone a light into bullying within NHS Highland”.
Amid mounting pressure, health secretary Jeane Freeman announced QC John Sturrock would lead a probe into widespread claims of bullying in November 2018. It went on to take the testimony of hundreds of witnesses and was eventually published on May 9, 2019.
The review found 66 per cent of those taking part experienced bullying described as often “significant, harmful and multi-layered, and in various parts, at all staffing levels, and in many geographic areas, disciplines and departments of NHS Highland.”
The chairman of the board, Professor Boyd Robertson, who was appointed just two months before the report and after the bullying crisis began, said Mr Sturrock’s report made for difficult reading.
“What was my reaction to the Sturrock report? I think like most people at the time it was one of just shock at the extent of the problem within the board’s operations. Although we had been prepared for it in some ways it was still very daunting to have it presented in the way John Sturrock did in the report.
“John Sturrock himself said it was important to take time to digest what was in the report and it was important to get things right and I feel that we have now reached that point.
“The first phase was about listening, understanding and learning, that would be about the first six months after the report and in that time we were holding meetings with the whistleblowers group on a regular basis to discuss their response to the report and their requirements of us.
“I was also meeting with individuals who had been affected by the bullying and the inappropriate behaviour that had been perpetrated. I met with approximately 20 individuals and got a much better sense of what had transpired and the hurt and the harm had been inflicted on them.
“That was broadly the first phase of our response before we moved into a more proactive response, certainly a phase I would characterise as responding and acting.”
But in November the board hit a major bump in the road when it unveiled its now aborted plan that called for victims of bullying to get compensation only through court or an employment tribunal – the move sparked outrage.
One of those touched by the development was former NHS Highland director of operations for the Inner Moray Firth Linda Kirkland who later helped develop the healing process after she retired early due to bullying.
She said: “There were a number of papers on the agenda for culture review including the healing process. A number of ex and current NHS staff attended to hear it first hand. What we saw and heard shocked us to the core.
“The most horrific part was that it felt as if you were being bullied, disrespected and abused all over again. It brought back the feelings of helplessness, despair and shame.”
But HR director Fiona Hogg defended the proposals, saying : “We pulled together what I guess was the outline of a process based on the resources that we had available and also the guidance of what was and wasn’t possible.
“I think things moved in that time, both within government and within other areas, recognising that actually we did need to do something different.
The policy everyone except the board and within two months a new chief executive, Paul Hawkins, was appointed on an interim basis after two whistle-stop visits by Ms Freeman at the end of January and start of February restarted the process.
It was a moment of significant change according to Dr Lorien Cameron-Ross, one of the original whistleblowers, who credited the health secretary and the new chief executive with getting things moving again in the right direction.
“Until February it had felt that we were taking two steps forward and then one step back,” she said.
“Just when we thought we were finally on the same page, something would show us that we weren't there yet.
“I think it was the combination of Paul Hawkins arriving and the last visit from the cabinet secretary. They both have a no-nonsense approach and could see things were not moving at an acceptable pace or in an acceptable direction. They both showed great empathy and yet a business-like approach to creating a solution.”
But Professor Robertson suggested much of the groundwork had already been done, saying: “I think it was a matter of timing but I don’t think it was just the advent of Paul and I would certainly pay tribute to Iain Stewart because he did a lot to change the tenor and tone of the organisation and that was one thing that both he and I were intent on doing given what had been found in the Sturrock report.
“When Paul took over we were at the point that we were needing to address the healing process and he is very clear sighted and saw that we would need quite a bit of additional resource and he negotiated that with the Scottish Government.
“That additional resource has enabled us bring in external advisors who contributed heavily and very tellingly to the healing process. It was absolutely critical that we had external people brought in to facilitate that process.”
The need for external mediators was apparent to many including Mrs Kirkland who found the process fraught, she said: “A change in approach was tangible from this point, the whistleblowers were asked to nominate a number of representatives to join the healing process co-production short life working group. The representatives included current and ex staff, all bar one had been victims of the bullying.
“But I felt physically sick walking into Assynt House. I was not alone. I had not crossed the door since I had left in 2016, retiring early.
“The first meeting was during the second week of February. I was one of the representatives. It was almost derailed when we realised that the employee director would be in attendance. A number of us were uncomfortable with this.
“The first realisation that this would be different was that this concern was acknowledged and acted upon. The employee director was asked not to attend the meeting.”
Dr Cameron-Ross, who had not suffered bullying at the health board, also found the meetings difficult.
“There were some really sensitive and harrowing issues discussed, which everyone found hard to hear but they helped shape a process which we are all proud of, so that means it was worth it. There were days when I think we all left emotionally drained.
“If I knew then what I know now, I would have been very frightened and anxious of embarking on the whole ordeal. It has had a heavy toll on all of us and at times it felt unbearable. However, I would do it all again, no question.”
Ms Hogg said: ”We could use specialist lawyers, we could use specialist mediators, and we could look to access specialist psychological services and for those people that was the one piece of work that they had to do, they could come up with the propositions and work really carefully on it.
“But they also had the ability to be seen as independent and I think that level of external confidence and connection just allowed us to move on a bit, we won’t always have the resources or the ability to everything independently but particularly for the healing process that was a big step forward for us.
“It wasn’t the organisation dictating what we were going to do – it was very much about us trying to create the right conditions.”
Mrs Kirkland said: “From start to finish it took six weeks. It was hard, emotionally draining, we had to bare ourselves open so they could understand what it had been like and the scars we still bore.
“All the feelings of trauma and helplessness kept popping-up. We did not always agree about things but we had agreed at the outset that we would remain part of the process until we were able to come to a consensus.
“Only once did we get close to not meeting that. It was hard to accept that the process could only go so far, it would not give total closure to victims, but it was so much better than the starting point.
“We had a few wrinkles along the way. The psychological support needed to be available for longer, we sorted that, the companies engaged by NHS Highland to deliver the process had to convince and demonstrate they had no conflict of interest, we sorted that, the compensation levels were not high enough for the exceptionally horrific cases, we sorted that.
“In the end we got there. We all signed off on the final process on March 26.”
