the independent view

We must eradicate the culture of racism and sexual harassment in the ambulance service

Editorial: A secret review into the treatment of trainee paramedics by the NHS, revealed by The Independent, outlines a depressingly sexist and oppressive culture – one NHS chiefs don’t want the public to know about

Monday 18 March 2024 20:24 GMT
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The discoveries made by the investigators cast a sinister light on a frontline service
The discoveries made by the investigators cast a sinister light on a frontline service (Getty)

Whoever forms the next government, one of the greatest challenges that will confront them from day one is how to return the NHS to the condition that the public rightly expect – free at the point of use, high-quality care, short waits, and value for money for the taxpayer.

All of these will cost money, require careful reform (it is generally held), and need the cooperation of a hard-working professional workforce.

Balancing these tasks will be an awesome responsibility, overlaid as they are by the constantly growing demographic pressures on the service. However, one reform that can be introduced immediately to great benefit and at little cost is to eradicate the culture of racism and sexual harassment that has apparently taken hold across the ambulance service.

A secret review into working practices and the treatment of trainee paramedics by the NHS, revealed by The Independent, outlines a depressingly sexist and oppressive culture – and one that NHS chiefs don’t want the public to know about. The discoveries made by the investigators cast a sinister light on a frontline service that gave exceptional help to the nation during the Covid pandemic.

These include: trainee female paramedics facing widespread sexual harassment which goes unchallenged by employers; complaints about sexual behaviour “closed down”; racist behaviour not challenged as ambulance stations are “set in their ways”; and trainee paramedics feeling “untrained” and not ready for the job.

Such deeply corrosive habits reflect those that have in recent years been brought to light in the police and the fire service – and it is especially reprehensible that those who are supposed to be guardians of people’s welfare and placed in a position of high trust should be betraying that trust in ways that damage both the welfare of those working and training as paramedics and indeed of patients themselves.

Intolerable, life-threatening waits for a response to a 999 call are grievous enough, without the unnecessary added jeopardy that those attending don’t feel like they know what they’re doing.

Only the other day, the NHS ombudsman, Rob Behrens, felt obliged to make public his concerns about the way that NHS trust managers are concealing evidence in instances where patients suffer harm. Mr Behrens stresses how ministers, NHS executives and board members of NHS trusts are not doing enough to end the health service’s “cover-up culture”.

He condemns the “dreadful” way some try to prevent bereaved families from finding out the truth, with documentation going missing after death, and those in charge generally putting “reputation management” first. It would appear that our paramedic services and those running them are not immune from such faults.

Of course, all institutions have a tendency to self-defence. It is an almost instinctive reaction, and it pervades politics, banking, media organisations, business more generally, the churches, the public sector, the royal family, and even charities. All have found themselves in denial before eventually capitulating to the truth, leaving those who run them mired in scandal and having done enormous harm to the public in the process.

Inevitable as it may be, though, that is no reason to indulge it. It is right that such investigations as this one into the ambulance service are placed into the public domain as a matter of law, a presumption under revised freedom of information legislation to publish unless such reports are plainly not in the public interest for reasons of national security.

The health regulators also need to be reformed if they haven’t the powers or the inclination to challenge NHS trust managers; and managers themselves need to be held accountable, with adequate sanctions to deter secrecy.

It is the public that funds the NHS and has a right to know whether it is performing in a professional and ethically acceptable manner. The cover-ups need to be outlawed, and the culture of these quasi-corporate trusts tilted from their bureaucratic ways into a more democratically answerable culture. It is, in fact, a reform that need not wait for a change in government.

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