Waiting times: Holyrood committee hears health chiefs deny 'bullying culture'

Senior NHS officials in Scotland have "unequivocally" rejected suggestions that there was a "bullying culture" in relation to waiting list management.

Health board heads spoke at Holyrood's audit committee, which is examining NHS list manipulation.

A number of witnesses, including Robert Calderwood from NHS Greater Glasgow and Clyde Health Board, said they did not recognise the bullying description.

The chief executive of the NHS, Derek Feeley, has also been facing questions.

He told MSPs that any manipulation of figures were "unacceptable", but there was no widespread evidence of the practice across the NHS in Scotland.

Mr Feeley said that there was "no hidden waiting lists".

The session was called following the discovery of list manipulation by NHS Lothian and a national Audit Scotland report which found "poor" information-keeping.

The health board heads denied that hidden waiting lists existed and insisted that all figures were open to public examination.

During the first part of the committee's evidence session, Tory MSP Mary Scanlon asked the health board representatives about the bullying of NHS staff.

Prof Fiona Mackenzie - representing Forth Valley, which was commended in the Audit Scotland report - said that while workers felt the pressure of being busy, they were "certainly not" pressured to "behave in an untoward way".

Glasgow and Clyde's Mr Calderwood rejected the premise of Ms Scanlon's question.

He said: "I don't recognise issues of a bullying culture and a fear of reporting an inability to deliver a target.

"I think the board of Greater Glasgow and Clyde can demonstrate at public meetings that waiting list information and other patient quality information is debated very publicly every month."

Staff workshops

However, Ms Scanlon continued to press the NHS bosses.

Holding the Audit Scotland report aloft, she said: "You all seem to be in denial about this report. Do you think this is an accurate report to Audit Scotland?"

Gerry Marr, from Tayside NHS, responded by explaining that following the publication of the Lothian report, a series of workshops took place with staff involved with waiting times management.

He told the committee: "The findings from the series of workshops is absolutely the opposite of what you [Mary Scanlon] describe.

"I can quote from them, and it says: 'How do you feel to be working in Tayside' - 13 of 26 in one workshop said proud, and in another 13 said busy.

"The other quotes that we get from that report, which we made available to our internal auditors, was that staff appreciated the fact that the chief executive, the chief operating officer, and senior management took the personal time to enquire of the wellbeing of staff, whether they felt pressurised, whether they felt indeed bullied to do something inappropriate. The answer was an unequivocal no."

Audit Scotland carried out its investigation after irregularities came to light in NHS Lothian.

The health board was criticised for removing patients from the 18-week waiting list when they refused to travel to England for treatment, marking them as "unavailable for social reasons".

In its report on the wider status of waiting lists, Audit Scotland concluded that in a small number of cases patients had been inappropriately marked as unavailable for treatment, but it could not say whether these were deliberate.

It stated: "Due to the poor information, it was not possible to determine whether these were due to human error, inconsistent interpretation of guidance, or deliberate manipulation."

No problem

During Mr Feeley's evidence session to the committee, he defended waiting list targets.

He explained: "We think it is important to try and reduce waiting times for patients and one of the means we have chosen to try and reduce waiting times for patients is setting a target because all of the evidence shoes you is that is a way of getting people engaged.

"If you set a target for something, people pay attention - they allocate resources accordingly, they allocate the time accordingly, they see it as a priority."

When asked by Labour MSP Jackie Baillie whether the chief executive should have picked up on the rise in social unavailability logging before it was identified as an issue in Lothian NHS, Mr Feeley said "no."

He added: "I think the rise in social unavailability was largely in the period 2008-10, and was largely for the reasons we explained today at the committee.

"It was not an unexpected rise, it was a gradual and steady rise where there was a a peak, a spike in social unavailability we looked at the spike and we took appropriate action. So, I think there was no reason for us to act in any other way."