Surgeons threw instruments and bullied nurses - report

The health minister has faced questions over a leaked inspection report which found cardiac surgeons threw instruments during procedures and bullied junior staff.

Mike Nesbitt told Stormont's health committee he was treating the report's findings about the Royal Victoria Hospital's cardiac unit "extremely seriously".

Committee member Alan Robinson, of the DUP, said reports of what had happened were "more akin something you'd see in a wild west bar than a surgical unit".

The Belfast Health Trust, which runs the cardiac unit, said it was "clinically safe with excellent outcomes".

The report said that an "apparent power battle" has been unfolding between some senior doctors in the cardiac unit of the Royal Victoria Hospital in Belfast.

Nesbitt was questioned about the controversy when he appeared before Stormont's health committee on Thursday.

He said he would meet health unions as a "matter of urgency" to explore to what extent the behavioural issues were representative of units in other trusts

The minister also told assembly members he wanted to be assured the report's recommendations were being implemented.

He said while he initially committed to publishing the review in the assembly's library, he now needed to take legal advice around identifying individuals.

Nesbitt is expected to meet the chair of the Belfast Trust on Friday.

Earlier the Royal College of Nursing (RCN) executive director, Rita Devlin, said the report was damning and the behaviour nurses had to deal with was "shocking".

An independent review of the service was undertaken last year following long-running concerns about the culture in the cardiac unit.

Earlier in May, UTV reported the review had concluded that behavioural issues were creating a significant risk to patient safety.

BBC News NI has now seen a leaked copy of the report, which lays bare bullying allegations and claims of a lack of trust among staff.

Some 70 staff spoke anonymously and the report states there are "clear tensions" between different groups of staff.

The report also detailed the throwing of instruments during surgery as well as "verbal abuse".

The report added that while there was one consultant "particularly prone" to throwing instruments in theatre, the behaviour was not unique and nursing staff were bearing the "brunt of the bullying".

Earlier the Royal College of Nursing (RCN) executive director, Rita Devlin, said the report was damning and the behaviour nurses had to deal with was "shocking".

She said the behaviours "have gone unchecked and unchallenged".

Speaking to BBC Radio Ulster's Talkback programme, she added: "We would have experienced behaviours like this from surgeons maybe 20, 30, 40 years ago".

"What shocks me is that it's still going on and what shocks me is somewhere like the Belfast Trust allowing it to happen, turning a blind eye and a deaf ear to the complaints that were being raised."

In one section of the report, one occasion was outlined where a management decision resulted in a brief period of unannounced absence by four of the cardiac surgeons.

Staff described the unit as being in "chaos" and said patients who were already prepped for theatre had their surgeries cancelled.

In its conclusion, the report says the department is safe based on metrics, such as mortality data.

However, it goes on to say that cultural issues in the unit represent a significant risk to patient safety "as a result of tensions, poor behaviours and a severe reluctance amongst staff to raise concerns".

The Belfast Trust said: "We are reassured that the independent external review contains a universal recognition of the technical competence and clinical skills of all staff who work there.

"However, the trust fully acknowledges that the details in this independent review are appalling and the behaviour described within it is shocking and indefensible."

The former chief executive of Northern Ireland's Health and Social Care Board John Compton told Good Morning Ulster the report raised "questions about leadership".

"The danger that this report has pointed out is that patients no longer become the centre of the unit, the centre of the unit becomes the personal, interpersonal relationships between senior staff, the behaviours that occurs between senior staff and junior staff in the middle of all of that and that carries with it an undoubted risk of patients' safety."

He said the implications were "profound" for the unit itself, the Trust and the Northern Ireland health and social care system.

"This is as difficult a read as you could possibly ask in terms of those sorts of reports", he said.

Unison's Patricia McKeown said for the people working inside the cardiac surgery unit "the very idea that you cannot face going to work because of a toxic atmosphere is utterly unacceptable".

She told Good Morning Ulster that "this is not new, it's not confined to one department, one hospital or indeed one Trust".

"It's a cultural problem that needs to be seriously tackled from the top and it hasn't been," she said.

She added that unison has experienced 20 years of "serious grievances" front line and support staff aimed at the "behaviour of some senior clinicians".

"This behaviour includes bullying, harassment and quite a lot of it is rooted in misogyny and in racism...a statement we can back up with evidence," she said.

The cardiac unit is a regional service for patients across Northern Ireland, with almost 1,000 operations carried out every year.