Thursday, 27 October 2016


Somebody I know who was a senior nurse told me that she once wrote a memo to her manager pointing out that some planned changes in the hospital were not in patients’ best interests. The memo was returned with just four letters on it: “J-F-D-I”.

It took some time to establish what the manager meant. And it was a shock when the clarification came:

“Just F***ing Do It!”

That kind of unacceptable bullying is apparently widespread in the NHS. The Guardian has carried out a survey which shows a widespread bullying culture.

After the Mid-Staffordshire Hospital scandal and the Francis Report of 2013 - which talks of “… a culture of fear in which staff did not feel able to report concerns; a culture of secrecy in which the trust board shut itself off from what was happening in its hospital and ignored its patients; and a culture of bullying, which prevented people from doing their jobs properly” (page 10) – we could have all reasonably expected that this was a problem that was being addressed throughout the NHS. But apparently it is not.

Everybody has to wake up and realise that bullying cultures are not just facts of life that have to be tolerated. Not only are they morally unacceptable but they are, as the Francis Report demonstrates, systematically unsafe, nay dangerous.

People who question actions and policies and orders should never be silenced with JFDI. They should be respected and listened to and congratulated for expressing their concerns. Not to do so sows the seeds of disaster. In civil aviation they learnt this long ago, not least because the world’s worst aviation disaster seems to have occurred because nobody wanted to challenge the bad decision of an authoritarian captain. But in British public services – of which child protection is still an important part – we have, apparently, a long, long way to go. 

It’s not just sad, it’s scary.