Free speech punished by senior NHS doctors

The NHS is just another nasty bureaucracy

A junior doctor made a rude comment on a doctors' only forum about one of the top bananas who masterminded the plan to 'improve' doctors' training and 'career paths'. 'Modernising Medical Careers', as it's called, is very widely disliked. Its benefits seem to be mostly for employers and the government - not doctors or patients.

Our Dr Scot Jnr, who works in a Highlands hospital, made some forthright comments (which included some 'Anglo-Saxon' words) about one of the MMC architects who is a career medical politician.

He was immediately suspended from work: a high-powered London close friend of the top banana architect had seen the comment and called another chum, another big tamale medical woman, up in the Highlands. A plot - allegedly unlawful - was hatched between them, Chinese-whisperish, to silence and punish Dr Scot Jnr forthwith.

This summary activity has deep implications for the freedom of doctors to speak out against diktats they don't agree with, and it demonstrates how bullied and harassed clinical staff are. One in four junior doctors report being bullied and intimidated by senior doctors (figure from BMA report). Ultimately it has deep implications for the quality of care and treatment doctors are allowed to give patients.

Fundamentally, this silencing and intimidatory activity is an onslaught on freedom of speech for all of us. In the NHS particularly, this toxic culture is so deeply entrenched that it goes barely noticed by most, it's part of the environment like targets or management suite shagpile. This hidden culture of intimidation and fear is also the reason that so many patients are not able to get the treatment they need or the apologies they deserve when things go wrong.

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Australia: Senior doctor quits 'dangerous' public hospital

A SENIOR emergency department doctor has quit one of Queensland's busiest public hospitals because it is "too dangerous and too dysfunctional". Dr Michael Cameron, senior staff specialist in emergency medicine at Logan Hospital, on Brisbane's southern outskirts, said the Bligh Government continued to ignore the problems in the health system.

He said doctors, nurses and other medical staff were under extreme pressure and patients' lives were at risk - but the Government was doing nothing to solve the crisis. "Everyone is overworked and overwhelmed . . . it had got to the point where I dreaded going to work each day, to a job I loved and was good at," he said yesterday.

Dr Cameron first spoke out about problems in Queensland's besieged health system in a frank open letter published in The Sunday Mail in May. At the time, he asked to remain anonymous, fearing that going public could have severe ramifications for himself, colleagues, patients and Logan Hospital. In his letter, Dr Cameron, who has worked for 25 years in the state's public hospitals, revealed the chaotic life in a typical hospital emergency department at Logan. His insightful words about sickness, accidents, drunken abuse, overdoses, death and miracles touched many Queenslanders.

The letter also drew an immediate response from Premier Anna Bligh and Health Minister Stephen Robertson, who met with Dr Cameron and discussed the most serious issues. Ms Bligh said at the time Dr Cameron had much to offer the Government as it continued to implement its $10 million health action plan and she vowed to turn to him for help as her special adviser. But Dr Cameron has been largely ignored since the May meeting, with neither Ms Bligh nor Mr Robertson speaking to him since.

He said one of Ms Bligh's staff had contacted him and sought his comments on proposed health funding and spending outlined in the June State Budget. Dr Cameron told him there was inadequate funding for Logan Hospital - but no extra money was provided when Mr Robertson announced a $1.2 billion boost for health for 2008-09. The doctor had also asked the Government to urgently address mental health issues at the hospital, but measures were put off for several years.

Dr Cameron said another flu-hit winter - with Logan's emergency department inundated with sick and elderly patients - was the straw that broke the camel's back. "We have seen it for eight years . . . the winter crisis. Every year the Government promised they would fix it. They said it again this year, but nothing was put in place. "It all fell over again. Every year it starts earlier, it lasts longer and is more intense. "The pressure definitely got on top of me. I just could not go through it again. I could not go through another year of that."

Dr Cameron said he decided it was time to quit, which went against all his beliefs. He even contemplated leaving the public health system altogether and finding another career. "Logan Hospital has become the dumping ground. Hospitals on the Gold Coast and in Brisbane are overflowing . . . if they are blocked they just send them to Logan. "We were overwhelmed. We could not cope. Logan (Hospital) needs to be twice the size with twice the number of staff."

Dr Cameron said other senior staff had also resigned from Logan and he felt shame for leaving the hospital in the middle of a crisis. "I felt it was personal failure . . . I should have been able to take it." He spoke to colleagues who had worked at other public hospitals in Queensland, interstate and overseas and they offered their support. "Everyone there recognises that Logan is under extreme pressure. It is too intense, too dysfunctional, too dangerous. "They had all experienced the same pressures as me. I have been there for nine years . . . I felt I could move on without any shame."

Dr Cameron confirmed reports of a system in crisis: of patients left hours without being treated, left on trolleys in corridors because there were no beds, and people dying. "The Government needs to address these problems urgently . . . but that is never going to happen, at least not in my working lifetime," he said. Dr Cameron said there had been a major recruitment program at Logan this year "but it has not had a very good response".

He has decided to stick with public health and take his emergency medical skills to Redlands Hospital, which has just undergone a $20 million upgrade. "It has a new emergency department . . . it is the right size with the right numbers . . . with limited population growth in the Redlands, it is more controlled . . . it is more closely aligned to demand. "I am looking forward to it," he said of the senior role that he will start in January.

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