Bullet Proof Cardie

Now Is Gossip Put On Trial

Posted on April 27, 2011. Filed under: Dignity at Work, doctors, Gossip, GP, health, Homophobia, NHS, women |

       A few years ago, I was in Boston for a conference, and to escape the stifling heat of the city, took a trip across the harbour to the historic town of Salem.  As most people will know, this was the site of the notorious witch trials of 1692 in which twenty innocent people were judicially murdered for allegedly consorting with the Devil. I visited the memorial to the people who died, and learned that it had only been in 2001 that the last few people had been officially pardoned by the State of Massachussets.  It had taken 309 years for the authorities finally to admit to having been wrong. It was distressing to read some of the trial transcripts carved into the memorial, the desperate words of the accused who knew that there was absolutely nothing they could say or do to prove themselves innocent.  What I had not realised was that the people who died were those who would not  confess  to being witches – even in the face of death they would not compromise their integrity by lying. They wouldn’t admit to being witches because they weren’t. However the court was starting from the supposition that witches really existed and the court could not possibly be mistaken, so the “evidence” could not be contested and the accused were doomed.

                From the twenty-first century viewpoint, of course, it is obvious that the processes were biased and unfair, so much so that the term “witch-hunt” has come to be synonymous with the persecution of innocent people by hysterical  tabloid headlines or totalitarian show trials. However when I read those heart-rending speeches by the martyrs of Salem, I had no idea that I would soon be feeling the same sense of helpless despair, the knowledge that nothing I could say or do would exonerate me because the verdict was already decided.  I was not on trial for my life, fortunately, but for my career and livelihood, my personal and professional reputation and my self-esteem.  I was undergoing an investigation by an NHS employer for “bullying”.

                The aim of “Dignity at Work” policies is laudable – to eradicate bullying, harassment and discrimination from NHS workplaces.  Like most doctors in training, I had certainly experienced my fair share of being shouted and bawled at and terrorised by notorious “characters”, had mentally noted certain behaviours and sworn to myself that I would never get like that.  There was not a great deal of role-modelling of good working relationships, but I do remember with gratitude the few seniors who were understanding and supportive. Working in an exceedingly stressful environment where everyone is stretched to the limit it is difficult to act with perfect courtesy at all times, and only the most dishonest of doctors would fail to admit that they might occasionally have been a bit ratty. I have never yet met a doctor who was perfect. Conflict is inevitable when people work together, and part of the essence of good management is to deal with it as soon as it arises without scapegoating individuals or allowing it to fester.

                Good management, unfortunately, is in short supply in many corners of the NHS. I had witnessed a colleague being put through the witch-hunting process, and had tried to support her, so I had seen how it worked and was semi-prepared for it when it happened to me. The catch-22 about an accusation of bullying is that the only “evidence” required is the feelings of the alleged victim, which of course are entirely subjective and based on their own beliefs, attitudes and interpretations of the alleged bully’s behaviour.  Nobody can argue with someone having “felt bullied” – as the policy states, it is the impact on the victim that matters, not the intention of the perpetrator.  Indeed, the perpetrator does not actually have to have had any harmful intention at all. This means that one may be guilty of “bullying” on the basis of a tone of voice, a gesture, or even a joke taken out of context.  The only way out is to “confess” and promise to modify one’s behaviour, as any protestations are taken as evidence of lack of insight or arrogance.  The fact that one may not actually have done or said the things reported is neither here nor there.

                It is difficult to convey in words how devastated and ashamed I felt when I read the witness statements that were sent to me. They were a mish-mash of gossip, hearsay and opinion, and the spite behind them steamed off the pages.  They arrived when I was alone in the house, and the cruel comments embedded themselves into my brain and played over and over again. Was that really how I came across to people?  The conflict hinged around a certain meeting, but many of those interviewed had not been present at the meeting, had never worked with me and in one or two cases had actually not even met me. Others who had been present were not interviewed – presumably because they might have said they hadn’t seen me bully anybody.  The investigation was heavily biased, unfocused and had extended its remit way beyond my personal behaviour and practice – the complainant had been unhappy with the work situation long before I arrived and had indeed shared some of that unhappiness with me in the many workplace chats that were now repeated and twisted in the statement.  Casenotes and diaries that would have exposed the lies for what they were were not examined. All the miseries had been there before I came, and the complainant had had the same issues with my predecessor.

Needless to say, there was no mention of the fact that I had recently returned to work after a life-threatening illness, having been “redeployed” after trying to raise concerns about a dangerous colleague.  No doubt my card was marked. The team were hostile and suspicious from the start, greeting my questions about how things worked extremely defensively, and in the case of one colleague, losing control to the point of shouting and screaming at me.  I just wanted to go to work, do my job, and go home, but they clearly felt immensely threatened.  The one person who had spoken in my defence had not been interviewed because, as the report stated, “it would have made no difference to the outcome”.  There had been no attempt at mediation because the “victim” had refused to attend.; nobody thought to tell me that, so I waited patiently for a mediation process that never happened.  The team had simply decided that they were not prepared to work with me and wanted me out, and they got their wish. They had been gathering the “evidence” for months – before any of my terrible “mistakes” had actually happened, in fact! I was happy to move – they had made it extremely clear from the beginning that I wasn’t welcome and had made my day-to-day work very difficult in all those subtle ways that unco-operative colleagues can, culminating in sending me to Coventry and the silent treatment.  It was, in fact, a textbook example of the form of workplace bullying known as “mobbing” or “ganging-up”, where an individual is targeted by the group, harassed and driven out.  Most of us have witnessed or experienced this sort of thing at school, and there have been cases of children driven to suicide by the severity of the social injury at a time when they most desperately need to fit in with their peers. It is no less devastating to have it happen to you as an adult.

The irony is that I am one of the very kind of people that Dignity at Work and equality and diversity policies are intended to protect – gay and carrying a disability – so to have the legislation twisted round and used against me was almost beyond belief.  The investigation did not examine the attitudes, prejudices and beliefs of the complainant, even in spite of evidence from another witness of homophobic joking and gossip going on behind my back. Most of those involved were in breach of their professional codes of conduct as well as the employer’s policies and the law of the land, but none of them were brought to account. I could have counter-complained, of course, but since every single thing I said and did was twisted round and used against me I knew it would just be taken as further evidence that I “lacked insight” and was “unwilling to change”.  And having experienced the “investigation”, I could not actually bear the idea of putting another doctor or nurse through the same thing.

The role of the BMA appeared to be to sit and watch all this happening and do nothing, so I had no effective defence. Abuses of process were not called to account, so the Trust had carte blanche to drag the process out for months and months, mess with my salary, ignore its own policies, breach confidentiality and generally make the rules up as it went along.

The quotation in the title is from Benjamin Britten’s opera “Peter Grimes”, an ambiguous work that tells the tale of an outsider hounded to death by a small community – the irony being that the gossip is not put on trial, Peter is convicted by the “court of public opinion”.  The Salem trials were ostensibly based on religious belief but actually on personal grudges and spite, neighbours accusing each other for fear of being the next one accused.  Until word began to leak out to the outside world of what was going on, residents of the small community were faced with the awful choice of either joining in with the accusations or becoming one of the accused.  

I survived.  No doubt these things have always happened in the NHS, they were just happening to someone else.  The victims changed speciality, or emigrated, or left the profession, or just disappeared.  These witch-hunts can go on for years and leave the subject so damaged that they never return to work – what athletes call a “career-threatening injury”.  For me, the most devastating thing was discovering that the standards and principles of the NHS to which I had devoted my professional life were meaningless, that I had for 20+ years paid money to a “trade union” that just sat there and watched all this and offered no effective support, being apparently completely powerless to hold the employer to its own policies or even recognise that the complaint was malicious.

It took a long, long time to recover. Naturally I thought it was my fault, and wondered what I had done to make these people hate me so much.  The involvement of someone I had considered a close friend was the most painful blow of all, but when power and ambition are at stake, personal loyalty and compassion are not on the agenda. Now I know that it wasn’t actually about me – somebody somewhere had decided I was persona non grata and on my way to the door, no doubt for financial or political reasons, and I was just collateral damage.  I will be eternally grateful to the friends – mostly non-medical – who supported me and were horrified by the blatant injustice of the process. I was not the only one whose faith in the ethics of the NHS was severely shaken. I will certainly be contributing to the ongoing discussion on revalidation for doctors and the danger to minority doctors  of such tools as “multisource feedback” when the feedback is not reciprocal and is not validated against equality and diversity legislation.

We do not need huge public inquiries to find out why NHS staff do not blow the whistle on poor practice.  We already know. It’s because we’ve seen what happens to those who do.  We are trying to work in a hideous blame culture that is a greater risk to patient safety than MRSA. 

 It has been reassuring to meet other staff who have been through this kind of thing and realise that there’s a pattern. You lose your job, but you keep your integrity; most of those you thought were friends run for the hills or join in the backstabbing,  but some do not, and they are worth their weight in gold.  With their support you recover your self-worth and confidence – perhaps enough to get another job if the bullies haven’t gone so far as to damage your registration.   You notice that there are a few former colleagues about who don’t seem to be able to look you in the eye.  Some of the things you tried to raise concerns about begin to change, although the changes do not have your name attached to them.  Life goes on…………………..another colleague rumoured to be a bit “difficult” or “outspoken” suddenly disappears, suspended or on sick leave, and you worry a bit about what’s happening to them but they now have the professional equivalent of leprosy so nobody makes contact with them and they never come back…………………..

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