Why do staff report high levels of bullying in the NHS?

As mentioned in the previous post, Ian Kennedy has finished at the Healthcare Commission, which has now been taken over by the Care Quality Commission. In a farewell interview for the Heath Service Journal (HSJ), he talked about bullying "permeating the delivery of care in the NHS". He, at least partially, comes to this conclusion because 1 in 6 staff say in the NHS annual surveys that they have experienced bullying, harassment or abuse from either their line manager or other colleagues.

Why should this be the case? In the HSJ interview article, Sian Thomas, joint acting director of NHS Employers is quoted as saying that chief executives needs to take a lead in encouraging an open culture. Why have CEOs not been doing this?

NHS Trusts have been measured by targets. Believe it or not, it's only recently that reporting requirements have put quality at the top of Board agendas. It remains to be seen whether this intervention from Monitor will change the target culture, but at least they've got the focus right.

Professional staff have found it difficult to get their voice heard in a culture centrally driven by business notions and targets, which do not always relate to patient care. To speak up about how such manageralism is affecting health services is not welcomed. The Royal College of Physicians has produced a report Doctors in Society: Medical professionalism in a changing world. At least the most recent Darzi review Our NHS, our future includes a focus on clinically led services.