Scotsman uses tiny, dubious ‘research’ by mysterious researcher to suggest another fake crisis in NHS Scotland

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In the Scotsman yesterday, we read the headline:

‘Scots doctors driven abroad by bullying and lack of work-life balance’

However, in the article below, we find the research sample is only 17 from an unspecified total. I can’t actually find out how many foundation year two doctors’ there are but there are 140 000 staff in NHS Scotland and there more than 5 000, even, of that presumably relatively rare breed, the consultants. In the absence of any context provided by the ‘researcher’, we must assume this tiny group of student doctors, saying they plan to leave, may have little representativeness of the wider population. Only 17 of virtually any NHS staffing category is most unlikely to be representative.

As for the bullying implied in the headline, see this detail:

‘Loneliness at work, in particular a lack of contact with other doctors, was an issue for some, as was bullying.  And Research author Dr Samantha Smith said negative reasons for leaving such as bullying were “very concerning”. “Even if just one person is experiencing bullying in the workplace that is a bad sign and my own experience in the NHS suggests that bullying does exist there,” she said.’

One? Does Dr Smith really think one case of self-reported bullying is enough to suggest a wider problem in a larger NHS staffing group? Also, does she really think her own personal subjective experience is valid data for a credible research study? Is she an MD (undergraduate) doctor or a PhD doctor who might know something about research methods?

Further, who is the researcher? Who is she employed by? Where was the report published? We find none of this in the Scotsman report and when I look for the author, I find only the Scotsman article to confidently connect with her. Needless to say, there are many Dr Samantha Smith’s including one at the Met Office, one at BUPA, a BBC South-West editor and one in Forensic Chemistry at Derby University but none doing research into healthcare that I can find. Wait a minute, is she Sarah Smith’s daughter?

Seemingly unsatisfied with the damage attempted, the Scotsman author drags in these concerns to further worry the readers:

‘The study has been published amid concern over consultant and GP shortages in Scotland.’

I’ve dealt with this before but here it is again:

As of September 2017, there were 5 189.8 consultants working in NHS Scotland. Thought there are still 430.5 vacancies still to be filled, the shortage fell in the last quarter by 9.6% and the annual overall number of consultants rose by 3.5%. Vacancy rates for consultants are also down from 8.3% in 2016 to 7.5% in 2017. More strikingly, consultant numbers have risen by 43.1% under the current government! To put that in context, overall NHS Scotland staffing has risen by 25.4% in the ten years of SNP administration.Also, in 2017, the number of specialists in intensive care increased by 27.5% and the number of specialists in acute internal medicine increased by 49.2%!

https://isdscotland.scot.nhs.uk/Health%2DTopics/Workforce/Publications/data-tables2017.asp

https://news.gov.scot/news/latest-nhs-workforce-statistics

as for GP shortages, just see:

‘Scotland has more GPs per head of population than any other part of the UK, newly released statistics show’

Already the best staffed and least stressed in the UK, Scottish GPs to get better contracts

New Scottish GP contract rated far superior, by BMA, to English equivalent as Scottish GP numbers hold steady and NHS England loses 1 000 in one year!

Overall, the Scotsman piece rivals their worst for lack of required details, sources and context. I know I keep using this final dig but, BA Journalism, year 1, week 1, day 1, writing workshop activity – E minus, see me after class.

https://www.scotsman.com/news/health/scots-doctors-driven-abroad-by-bullying-and-lack-of-work-life-balance-1-4707698

Naked propaganda and pretty rich, when you read these recent headlines in the English press:

‘Patient safety hit by lack of staff, warn 80% of NHS workers’

‘NHS faces year-round crisis over lack of social care, says council chief’

‘NHS crisis worse than last year as patient care deteriorates, doctors say’

I could go on, and on and……………………

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12 thoughts on “Scotsman uses tiny, dubious ‘research’ by mysterious researcher to suggest another fake crisis in NHS Scotland

  1. Alasdair Macdonald. March 18, 2018 / 11:14 am

    “Bullying” is one of these lines of argument that are not permitted to be challenged. In fact accusing people of “not doing anything to deal with bullying” is a very potent way of bullying them.

    Having been involved in schools for close to 40 years, bullying was something which I had to deal with throughout that time. Undoubtedly bullying has been something that we humans have engaged in since Adam and Eve and will probably continue until the ‘rocks melt in the sun’. The are few of us who at some time in our lives have not been bullies and have not been the victims of bullying. In most cases these things are short term and most of us stop doing it and seek to stop others doing so, too. To a large extent it is resolved by social learning.

    However, for some people, bullying is their modus operandum and they see no reason to change. The media are full of such people. Indeed, a purpose of the media is to bully groups and individuals who challenge the status quo. And, there are many people who are victims of persistent bullying and whose lives are seriously blighted. So, bullying is something that has to be dealt with …… and, bullying the bully is NOT the way to do it!

    The victims of bullying, like the victims of violence, are often reluctant to come forward. Partly this is because they often blame themselves, so low has their self-respect become. It is also because they are often not believed or, more likely, the person to whom it is reported, often know from experience that they will be “damned if they do and damned if they don’t”. But, unpleasant as that is it is not a reason, for not investigating the claim.

    In order to bring about a change in that reluctant attitude, the policy in most organisations became that if someone makes a claim that they have been bullied, that claim should be treated seriously and investigated properly. However, some people distorted that into asserting that “because the person has said he/she is being bullied, he/she IS being bullied”. This led to the emergence of the anti-bullying zealots, who used bluster and rabble-rousing to bully people in authority. They used bullying to attain power.

    In my experience, what the person who was being bullied (i.e. it had been established after a sensitive and sympathetic investigation that bullying had taken place) wanted was for the bullying to stop. Usually, they did not want retribution or severe retribution. They just wanted to be able to get on with their lives and, often, to have a reasonable social relationship with the bully. It was people who were family or friends of the victim who wanted the condign punishment of the bully, but, seldom was that punishment seen as adequate and often the investigator was the object of the spleen, too. The other group were those whom I call the ‘professionally outraged’. They see themselves as the mouthpiece of the oppressed, they go around looking for things that can allow them to express outrage. In all probability they started off well-intentioned about dealing with something which caused unhappiness, but it then segued into something which gave them authority and power, and, finally they came to identify themselves as the only bulwark against this. Sadly, egos are pretty demanding of gratification.

    The Scotsman article is an example of this misuse of reported bullying, not to resolve the bullying, but to attack something else; in this case NHS Scotland and the SG.

    Dr Smith is basing her arguments on the false premise that because someone alleges he or she is being bullied, he or she is, in fact, being bullied. Common justice and good researching requires that we make efforts to establish the truth.

    Liked by 2 people

  2. johnrobertson834 March 18, 2018 / 12:12 pm

    Fascinating and insightful thoughts A. Had a similar experience myself when I told a bully to eff off and they reported me for bullying.

    Liked by 1 person

    • Alasdair Macdonald. March 18, 2018 / 5:10 pm

      Sky has recently published a wholly non-propaganda piece about ‘Putin’s Russia’ and how it has a huge military expenditure but ‘cannot provide for the basic needs of the population’, such as housing. Of course, we know, courtesy of Mr Portillo that homeless people in this country ‘have shoes’. The Russian people interviewed for vox pops had, as far as I could see, shoes, too.

      Liked by 4 people

  3. Contrary March 19, 2018 / 8:53 am

    Good food for thought there on bullying Alasdair; people being bullied just want it to stop, they don’t want some kind of retribution. I have always thought it interesting how it is so prevalent in schools – from a nature/nurture argument point of view – do children learn the behaviour at home, or is it an in-built behaviour to establish pecking order? In adults, questions spring to mind, are the majority of people carrying out less aggressive bullying unaware of what they are doing, and just need to be made aware? I’m probably being naive there!

    Just listened to Ian Blackford being interviewed on the radio there re. Russian stuff: I was wondering (and still am) where all the widely publicised nerve agent attack was going – I am sure all sorts normally go on at that level that we don’t hear about, so it would seem there is some kind of agenda behind the reporting and faux outrage of Westminster and instant condemnation of Russia without proof. Anyway! Ian indicated they were going to start trying to clamp down on money laundering, and doing something about the SLPs (Scottish limited partnerships? Those things that allow shell companies ,,,), and hopefully force the uk gov’ts hand to do something about it – good move, to my mind, using this for beneficial manoeuvring.

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    • Alasdair Macdonald. March 19, 2018 / 9:31 am

      Contrary,

      Bullying is, I think something children do unintentionally from infancy when the see something that they want and over time with sensible parenting they learn not to do. However, a fair number of us do not get out of the habit and, indeed, find that it can bring personal gain and so they continue with it, A lot of ‘Statesmen’ throughout history have been appalling psychotic bullies. I think, also, that sometimes we do bully and are unaware of it. Looking back I sometimes wonder if some of the things I considered to be ‘bantering’, etc, with women was, in fact, bullying.

      I am not sure where this nerve gas thing is going. I do not know whether the UK Government, or intelligence services, has been involved or if they are being opportunistic about it for a variety of reasons. There is always a bit of calculation and opportunism in politics – ‘Don’t let a good crisis go to waste’. Politics is a complex and nuanced thing which is why I am not a politician. Maybe, Mr Blackford is being opportunistic in seeing the crisis as an opportunity to tackle an outrage like money laundering. If so, it is this kind of ‘realpolitik’ which leaves me with an uneasy feeling even if it is for a ‘good’ purpose.

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  4. mike cassidy March 19, 2018 / 1:10 pm

    Here’s the study in question.

    http://bmjopen.bmj.com/content/8/3/e019456

    And its worse than you thought.

    If the abstract is accurate, ONLY 17 people were interviewed.

    And if the conclusions abstract is accurate, there is no story at all!

    Happy reading.

    Like

  5. macgilleleabhar March 19, 2018 / 2:35 pm

    Thanks for providing a link Mike. I have had a quick look through it and I think this sentence from the section headed, “Strengths and limitations of this study”,speaks volumes,

    “This study fills a gap in the literature, as there have been few studies exploring the subject, and no previous qualitative studies examining this issue.”

    They are not doing urgent research into a critical problem within our health service but doing some research out of curiosity and finding mundane reasons for people making career changes or, not in the majority of cases, as they are taking a career break.

    Sighs and shakes head.

    Like

  6. Ludo Thierry March 19, 2018 / 8:29 pm

    Thanks for the link Mike – had a wee read. Quite interesting. Particularly of note was that the researchers specifically recruited a group of Scotland based FY2s due to their concern that the NHS England contract changes would unbalance the responses: see below:

    Research aims
    The aim of this interview study was to explore F2 doctors’ reasons for leaving UK medicine, in order to better understand how they might be encouraged to stay.

    Data collection
    Participant recruitment
    At the time of this research, there were contentious proposed changes to junior doctor contracts in England resulting in strike action by junior doctors.These recently proposed contractual changes would inevitably have been the focus of conversation had the study recruited doctors currently working in England. For these reasons, this study focused on F2 doctors currently working in Scotland.

    The occupational perspective
    The proposed changes to junior doctor contracts in England provoked mixed emotions among the F2s. The changes were first proposed in July 2013, but negotiations stalled on multiple occasions, with the result that junior doctors in England undertook industrial action in December 2015, March 2016 and April 2016. Further negotiations in May 2016 led to a proposed change in the contract. These proposals made many of the Scottish F2s in this study wonder if they would return to the UK, due to fears that the changes would affect Scottish contracts in the future, and availability of specialty training jobs in Scotland due to competition from English trainees.

    (Note how ‘..fears..’ that the NHS England contract changes would be imposed on NHS Scotland in future made “..many of the Scottish F2s…wonder if they would return to the UK..” ie Scotland’s NHS is suffering due to FY2s being concerned that there would be contagion from NHS England policies).

    SEE: Occupational perspective

    Junior doctor contracts: The proposed changes to junior doctor contracts in England provoked mixed emotions among the F2s.

    “I think if I worked down there [in England] I’d be totally disheartened and wouldn’t really want to continue. Sometimes I think I probably wouldn’t want to do this job if I was paid any less… And it’ll definitely change my perception if I come back and Scotland’s gone the same way, what will I do?” (P2)

    (Also note that Scotland based FY2s were forecasting that England based F2s would be actively seeking to move to Scotland ((due to the superior contract conditions) and thus increase ‘..competition..’ for specialty training jobs). ie NHS England Junior Doctor contract policies are anticipated to improve recruitment of CMT1s to Scotland – Another benefit of SNP Scottish Govt policies!

    Also interesting to note how UK Govt policy on visas/immigration had impacted on the participants’ decision making processes: see below:

    Structural perspective

    Visas: F2s reported that Australia and New Zealand made it relatively easy for them to navigate the process of obtaining a visa. However, F2s who were non-UK citizens reported that UK visa made it more difficult for them to stay in the UK:

    “…if I wanted to do that [locum for six months in the UK], I couldn’t, I need an actual job that I’m doing for the whole year to be able to stay.” (P12, a non-UK citizen).

    These concerns about NHS England’s contractual changes were influencing the career development choices of some participants in a way that has potential to cause collateral damage to future recruitment in Scotland (because the participants are considering going much further afield eg Australasia – and wouldn’t necessarily be making their way back to the UK (including Scotland) any time soon, if at all: see below:

    “I always wanted to work in London, so if I was applying for CMT1 (Core Medical Training), I would have liked to have apply down South. [But] there was a lot of uncertainty and there’s still a lot of uncertainty now about what the contracts are going to be like. I think they have started releasing the provisional contracts now and they look terrible. You’ve been paid less and you’re working a lot more and you’re working one in two weekends. It didn’t seem like a good thing to trade rather than working somewhere where there is a good work life balance and sunshine and people appreciate what you do for a living in Australia—why would I want to move to England?” (P12)

    I would have thought The Hootsmon might have been teasing out these rather important nuanced strands from the decision-making process being studied by the researchers – after al they seem to impact on Scotland somewhat – oh – I forgot….it’s The Hootsmon we’re talking about.

    Like

  7. Ludo Thierry March 19, 2018 / 8:42 pm

    Hi Contrary – like you I heard the Ian Blackford interview re. the Russian stuff on radio this morning. I too was a lot happier after hearing the interview and the apparent ratchetting up by Ian and the SNP Westminster Group on the Tory UK Govt’s policy (absence of policy) on Scottish Limited Partnerships and their abuse by money-launderers and other nefarious types (from Russia and beyond). SNP probably gave a bit too much carte blanche to May and Co – and probably a bit too soon off the blocks to do so. However, now that the Tories have gone so hard on the general illegal activities of the Putin elite in Russia they lay themselves open (yet again) to the charge of rank hypocrisy if they continue to stymie reform of the SLPs and other similar legal loopholes elsewhere in UK/Crown Dependencies/Overseas Territories. If we manage to force them into some bits and pieces of reform all to the good (they will only do it if carried kicking and screaming to the voting lobby – and wholesale reform – although badly needed – is simply beyond hope whilst we remain within the UK cesspit).

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    • Contrary March 21, 2018 / 8:22 am

      That was my thinking, Ludo. Though Aliasdair is right about opportunism being a bit meh; while still part of this so-called Union I think it has to be the only way things might change for the better.

      (Where is clydebuilt? I’d like congratulations on brevity of comment 🙂 )

      Like

  8. bigjon999 March 21, 2018 / 1:53 pm

    BBC article : http://www.bbc.co.uk/news/health-42653542
    Some highlighted sections:
    * More than 10% of the nursing workforce have left NHS (England) employment in each of the past three years
    * Leavers outnumbered joiners by 3,000 last year, the biggest gap over the five-year period examined by the BBC
    Meanwhile its a different story in other parts of the UK:
    Other parts of the UK are also experiencing problems retaining nurses. (?!)
    In Northern Ireland and Scotland, the leaver rates are rising. In the most recent years, 7.5% of nurses left NHS employment in Northern Ireland and 7.2% did so in Scotland. But in both nations, the number of joiners outnumbered leavers.
    In Wales there were more leavers than joiners, according to Freedom of Information reports.

    Like

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