Staff shortages and referral backlog ‘fuelling abuse against doctors’

Three-in-five doctors (60 per cent) have experienced or witnessed verbal or physical abuse from patients or their relatives within the past 12 months, with 37 per cent saying the incidents resulted from staff shortages and 39 per cent saying it was due to the referral waiting list.

In the Medical Protection Society (MPS) survey of nearly 900 doctors in Ireland, 86 per cent of those who have experienced or witnessed abuse in the past 12 months said it negatively affected their mental health, and over a quarter (26 per cent) said an increase in abuse and intimidation from patients has made them reconsider their career in healthcare.

A quarter of doctors (25 per cent) also feel that abuse against healthcare professionals is not taken seriously by the Garda.

MPS is calling upon the Government, Garda, and HSE employers to take “every possible step” to address this issue.

Dr James Thorpe, Deputy Medical Director at MPS, said: “While long referral waiting lists and staff shortages understandably cause stress to patients and their families, healthcare professionals are doing their best under challenging circumstances. While most patients are respectful, it is troubling that so many healthcare workers face aggression and intimidation.

“Experiencing and witnessing abuse can have profound effects on the mental health of healthcare professionals, which can be detrimental to both the individual and to patient care. It can also result in healthcare staff needing time off work or even contemplating leaving the healthcare profession altogether.

“Healthcare professionals – whether working in primary care, HSE or private clinics – must feel their safety is a priority and be encouraged to report all abusive behaviour.”

Dr Thorpe continued: “All healthcare settings should provide an appropriate forum where those who witness or experience any kind of abuse from patients can talk about it and seek appropriate wellbeing support. Peer support networks can also help to foster a supportive environment where experiences can be shared and reflected on, and staff should be offered practical advice on de-escalation techniques.

“The Garda could also consider how they can support healthcare settings, for example, by encouraging reporting of abuse and better communicating to the public the consequences of abuse.

“More broadly, there is a need for research to ascertain the additional training needs for HSE staff for dealing with conflict and protecting themselves from violence.

“The Irish Government, Garda, and HSE must take every possible step to address this issue and help raise awareness of the importance of treating all healthcare workers respectfully. Failure to act may result in the loss of many more skilled and dedicated staff at a time when the profession can least afford it.”

Healthcare professionals who participated in the MPS survey commented anonymously:

• “Aggressive and disrespectful language used to healthcare professionals due to patients having to wait for investigations or appointments out of our control. Physical abuse from patients to staff on wards.”
• “Held at gun point by drug seeking patient.”
• “A patient and their relative disagreed with medication a patient were prescribed and had been on for some time and wrongly thought it caused them issues. They were extremely aggressive to the doctor and threw a chair in their direction.”
• “I examine incident forms in the hospital where I work. About two-thirds of the incidents are in the category of violence, harassment, and aggression. Racist and homophobic abuse is common.”
• “The work environment, especially for nurses, is brutalising. Nursing colleagues have been head butted, bitten, spat at, kicked, and punched. I have been spat at and verbally assaulted.”
• “Many times, it’s the relatives becoming abusive; this can continue into the clinic discussions or will often be by complaint letter into the hospital.”
• “It’s as though we are the cause of their problems rather than helpers.”
• “Threats of violence, calls to radio stations, threats of litigation and of referral to the Medical Council.”