A FORMER NHS Highland neurologist said a targets-driven culture led to one patient being harmed after she was left on an immuno-suppressant drug 10 months too long, while another woman with motor neurone disease lost the ability to speak while waiting for an appointment.
Dr Bethany Jones, who quit the health board in 2013 and now works in New Zealand, said she faced a “constant fight” with senior managers who wanted doctors to prioritise new patients over follow-up cases, resulting in potentially hazardous delays.
Dr Jones also claimed senior managers “plundered” the department’s endowment fund to buy medical equipment and that administrative staff at Raigmore hospital were “punished” if they left unused paper in the photocopiers.
Read more: NHS Highland medics blast ‘culture of fear and intimidation’
It comes amid an ongoing row over an alleged culture of bullying and intimidation at NHS Highland, with clinicians claiming in a letter to the Herald in September that the problem stems from the very top of the organisation and was silencing concerns about patient care.
On Friday, the health board’s chairman David Alston confirmed he has written to Paul Gray, chief executive of NHS Scotland, to request external help to manage the crisis after around 100 current and former staff came forward to back up the claim.
Dr Jones said: “As a result of health targets we were under pressure to focus on new patients. It was a constant fight to allow my clinics to have enough follow-up slots.
“Things slipped again and one day a patient walked in to my clinic who had been on a high dose prednisone for 10 months longer than she was supposed to be. She was suffering from severe side-effects.
“Another patient with motor neurone disease had her appointment with me delayed. She had lost her ability to speak by the time she finally saw me and couldn’t communicate her questions with me anymore. There are more examples.
“I was shocked and managed to arrange with my outpatient clinic booker that such patients’ appointments wouldn’t be delayed anymore. This was a constant fight with the senior managers.”
Read more: Under fire NHS Highland deny ‘systemic culture of bullying’ as more victims come forward
Dr Jones said she loved and still missed providing healthcare in the Scottish Highlands, but that she felt compelled to speak out after NHS Highland rejected claims that there was a widespread culture of bullying and harassment.
She said: “Admin staff [were given] a quota of copying paper. They were expected to remove their own unused paper from the copying machine once finished.
“People were requested to inform their manager if colleagues accidentally left paper in the copier so they could be duly punished.
“We had departmental endowment funds. Patients donated money into these funds and they could be used by the department to buy study books but also spend on an end of year Christmas lunch for example.
“These funds were plundered by senior management to buy hospital equipment so even that was taken away from the hard working nurses and paramedics.”
The Herald has also spoken to a former consultant physician at Caithness General, Dr Inte Malik, who said the bullying culture was “very rife”.
Read more: Claim NHS Highland executive raised bullying concerns in 2012
He was one of three consultant physicians when he joined but said he saw his colleagues driven out, and ended up off sick with stress.
“I was alone and the workload was too much,” he said. “Two of my other colleagues they resigned before me because of bullying.
“In my case the bullying was coming from middle management level. They were trying to undermine me and micro-manage me and that really caused so much stress for me that I went off sick between December 2009 and April 2010.”
Dr Malik said the resulting staff shortages “had a huge impact on patient care” as consultant vacancies were plugged by locums, including two Greek doctors.
He said: “One of them said to me ‘I’m so scared – I basically applied for the job of a junior doctor, I don’t have consultant experience’. I raised it with the managers but they said ‘no, it’s fine, it’s just culture shock’ and sent these two locums to Raigmore for a month to get used to the NHS structure.
“They found a junior doctor position for this locum in Raigmore, so he never came back to Caithness.
“The other chap worked there for two years. After a year they gave him a substantive post but ultimately resigned because they changed his job plan unilaterally – they scrapped on-call surgeons and said to him ‘you will also see the surgical patients out of hours’.
“He said: ‘I’m not trained as a surgeon and I don’t feel I am providing a safe practice to these patients – if a patient with a surgical problem comes to emergency with a pain in their tummy, I don’t know whether this patient has appendicitis, or constipation, or cancer, I’m not trained’.
“You cannot ask a mechanic to fix the furniture. He didn’t feel safe, so he resigned and left.”
David Alston, chair of NHS Highland, said: “Since the allegations were brought to the attention of the board, despite significant effort, we have been unable to fully understand the nature, extent and causes of the concerns being raised.
“What is clear, however, is there are a growing number of staff feeling distressed and concerned about their working environment.
“In view of the situation we find ourselves in, it would not be in the board’s interest to now attempt to manage this on our own.
“The board has said all along that we have nothing to hide and, therefore, in order to understand and address the underlying issues, we would welcome external input to determine what is required.”
Source : HeraldScotland