Cause and effect — the insidious reasons for bullying in the health service

The recent Your Training Counts report from the Medical Council made for stark reading for anyone interested in the wellbeing of young doctors starting their careers. According to the survey, 41 per cent of trainees experienced some form of bullying or harassment in their roles, an increase from 34 per cent in 2014.

The data, which was collected in 2017, also showed that doctors represented 58 per cent of perceived perpetrators of bullying behaviour, while nurses and midwives represented just under one-third of perceived bullying perpetrators (30 per cent).

The Medical Independent (MI) recently reported how the RCSI has added new areas to its training syllabus for radiology on how to deal with bullying and “difficult interactions” with superiors and colleagues. The decision was based on a survey, which found that bullying was a problem within the specialty. Bullying within radiology, in particular, had been identified in a previous Medical Council Your Training Counts report. The Faculty of Radiologists survey replicated the Medical Council’s findings and indicated that one-third of trainees and consultants had experienced difficult interactions, including bullying in the workplace. A spokesperson for the RCSI told MI that the College has added “significant areas to the training syllabus for all years in radiology” to address these concerns.

The steps taken by the RCSI are positive, but wider action is required. While it is good that students and trainees are given the tools to cope with bullying, these do not address the root cause. A feature in this newspaper last November examined the issue of workforce bullying within the HSE. A memo from HSE National Director of Human Resources Ms Rosarii Mannion was sent to all staff on preventative measures in relation to bullying and harassment. The memo acknowledged that environment factors and resource shortages contributed to bullying behaviours. However, Ms Mannion said this did not alter the requirement for all staff to be treated with dignity and respect, as set out in the Dignity at Work Policy. In addition to multidisciplinary training workshops and online training modules, the HSE also established a taskforce intended to look specifically at the problem of bullying and harassment.

The point raised in the memo about the effect of resource shortages is especially pertinent. The problems the HSE has experienced in filling posts over the last number of years has resulted in stressed, overworked staff. Within this environment, toxic behaviours, such as bullying, are more likely to be found.

Staff shortages within the health service should not serve as an excuse for poor behaviour between colleagues, but it is a systematic issue that needs to be recognised as such by health management and policy-makers. While bullying is a multifactorial problem, and may be impossible to eradicate entirely, it can partly be seen as another example of the knock-on effect the recruitment and retention crisis is having on the health service.