Culture of blame deterring medical whistleblowers
It is unacceptable that staff still feel afraid to speak out about failures in the health service, a senior civil servant has admitted.
Andrew McCormick said a culture was needed where workers are protected and supported in raising concerns.
Last month, a report by the Audit Office found 83,000 adverse incidents occur in Northern Ireland’s health service every year.
It noted the persistence of a perceived “blame culture” which can undermine willingness to notify managers if errors happen.
The report’s findings were discussed by the Public Accounts Committee (PAC) yesterday.
Appearing before MLAs, Mr McCormick, the permanent secretary of the Department of Health, admitted errors will always happen because of the risks linked with complex medical treatment.
He also expressed concerns at comments that staff are reluctant to come forward and report mishaps.
The report referred to a staff survey which noted 12% of respondents felt their organisation blamed people involved in errors.
Less than half — just 41% — said they felt there was no blame attached.
The Audit Office asked the Royal College of Nursing (RCN) in Northern Ireland whether its members felt comfortable raising concerns about patient safety.
The RCN reported that “a certain level of reluctance” remains amongst its members.
PAC vice-chair John Dallat said he was shocked by the remarks: “That is very serious coming from a prestigious organisation like the Royal College of Nursing.”
In response, Mr McCormick said he shared those concerns.
“We do all that’s possible to promote a culture where every individual should feel free, protected and supported in raising concerns,” he said.
“I react with considerable concern over what’s reported here.”
However, Mr McCormick admitted he has yet to speak with the RCN to discuss its concerns.
The Audit Office found 633 negligence claims were lodged during 2011/12, with 3,304 cases submitted in the last five years.
The total cost of settling claims in that period topped £116m, including £39m spent on legal and admin fees.
However, the Department of Health estimates another £136m will be spent covering cases which have still to be settled.
Mr McCormick referred to a comment that medicine used to be simple, ineffective and relatively safe but is now complex, effective and potentially dangerous.
“There will always be adverse incidents and there will always be avoidable deaths — I would be wrong to say otherwise,” he added.
Five findings from the report:
- £28.5m was paid out in negligence cases during 2011/12.
- Over 500 serious incidents were reported to the health board in the last two years.
- Cases are dragging on with one claim for damages lasting 27 years and 36 still outstanding after 15 years.
- Legal and admin costs are adding to the spiralling bill, accounting for a third of the £116m paid out since 2007.
- Half of all staff — including 93% of paramedics — had not been appraised in the previous 12 months.