Harmful cultures putting mothers and babies at risk, GMC warns

Mothers and babies will continue to be at risk if maternity services fail to tackle harmful cultures which put cover-up over candour and obfuscation over honesty, General Medical Council (GMC) Chief Executive Charlie Massey will warn in a speech today.

He will tell an audience, at the HSJ Patient Safety Congress in Manchester, that ‘something must have gone badly wrong’ in workplaces where trainee doctors are fearful of speaking up to raise concerns.

Mr Massey will say:

‘That doctors are making life and death decisions in environments where they feel fearful to speak up is profoundly concerning. Those are the very factors that lead to cover-up over candour and obfuscation over honesty. And it is in those cultures that the greatest patient harm occurs.

‘Everyone in this room will be aware of the scandals of recent years concerning maternity care. This is one of the most high-risk and high-pressure areas of medicine. One where the consequences of things going wrong can be especially tragic and far-reaching, affecting both a mother and her baby, not to mention their wider family. So the fact that our data point to worse wellbeing indicators in this specialty should sound alarm bells for us all.'

GMC data shows that more than one in four (27%) of obstetrics and gynaecology trainees say they had felt hesitant escalating a patient to a supervising clinician, higher than the average for all trainees. The specialty also has above average rates of workload stress, incivility and bullying, and doctors who feel unsupported by colleagues.

Mr Massey will say:

‘These data suggest a situation where, too often, patient safety is falling victim to unhealthy culture. The unthinkable – harm to mothers and their babies – is at risk of being normalised. And toxic culture is in no small part to blame.’

He will say that mutual respect between health professionals is crucial, despite medicine being ‘notoriously tribal’, and will call on employers to recognise their role in ensuring workplaces promote a sense of belonging and inclusion.

‘Behind these statistics lie real people, real tragedies. I have met some of them and their testimony is searing. So for them, and for all the patients we’re here to serve, we must demand better, and never accept as normal cultures which don’t have safe care at their heart.’