Surgery
Tackling bad behaviour in the operating theatre
Future Surgery recently cast a light on bullying, discrimination, and sexual misconduct in the NHS, and discussed the efforts required to foster an inclusive culture to support staff wellbeing. Louise Frampton reports.
An impassioned debate at the Future Surgery conference recently highlighted the distress experienced by surgical staff arising from bullying, discrimination, and sexual misconduct taking place in operating theatres in the UK. The debate followed a number of high-profile surveys, studies and court cases, in recent years, which have revealed the extent of unacceptable behaviours in the surgical setting and wider NHS. This thought-provoking session brought to
the fore the experiences of individuals who have raised concerns that they have been the victims of bullying, discrimination, or sexual misconduct, and these personal accounts underscored how this may lead to feelings of distress, fear, and suicidal thoughts. Such behaviour is detrimental to staff wellbeing and retention, jeopardises patient safety, leaves Trusts exposed to legal action and absenteeism, and undermines efforts to create inclusive, cohesive, and effective teamworking. So, how can we challenge the behaviour of others and, also, how can we challenge our own unconscious biases?
Bullying and racism: a whistle-blower’s account The discussion opened with an account by Mr Omer Karim, now a Consultant Urologist with the Royal Marsden Hospital, who had previously fought a high-profile case against the GMC, which was widely reported on in the press.1-4 For those unfamiliar with the case, Mr Karim,
previously worked as a consultant urological surgeon at Heatherwood and Wexham Park Hospitals NHS Foundation Trust, (now the Frimley Health NHS Foundation Trust), and had engaged in ‘whistle-blowing’ activity. In 2013, Mr Karim and other doctors at the hospital raised concerns with the Care Quality Commission that ethnic minority doctors were being subjected to workplace bullying and, although the matter was referred to the GMC, no action was taken.1-4 The same year, the GMC received allegations about ‘Mr Karim’s behaviour’ and, although the case was dismissed, the hospital launched further investigations into Mr Karim and his department. He was referred again to the GMC and suspended from work.1-4
After almost four years of investigations, the GMC subjected him
to a Fitness To Practise (FTP) tribunal, which eventually determined that Mr Karim had done nothing wrong.1-4 Mr Karim argued that, while the investigations
into his conduct continued for years, similar complaints against a white colleague were quickly dropped. In August 2018, he brought claims against the GMC, including a claim of direct race discrimination. An employment tribunal found in his favour. Reporting on the outcome, Mr Karim’s solicitors summarised5 that the tribunal had found: l There was less favourable treatment of Mr Karim in the way that he was treated, compared to a white doctor.
l The GMC undertook an investigation into Mr Karim when the same allegation was made against a white doctor, whom they decided not to investigate, and looked for material to support allegations against Mr Karim, rather than fairly assessing matters presented.
l The GMC continued the investigation against Mr Karim where the investigation into the white doctor was terminated and referred back to the Trust.
l Taking into account all the evidence, including the statistical evidence about race, which shows a higher proportion of adverse outcomes for BME doctors, the Tribunal found that the difference in treatment of Mr Karim in comparison with a white doctor and the significant delay in the investigation of him were on the grounds of his race.
In the ruling vindicating Mr Karim, the tribunal judgment said that it was concerned there was “a level of complacency about the operation of discrimination in the work of GMC or that there might be discrimination infecting the referral process”. The tribunal also pointed out that “UK graduate ethnic minority doctors are 50 percent more likely to get a sanction or warning than white doctors.”1-4 However, in June 2023, the GMC successfully appealed the ruling with regards to direct race discrimination.6,7
Following the appeal ruling, the April 2024 I
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