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Abstract
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Extensive cultural change is needed in the NHS to tackle sexual violence and prevent further institutional harm to patients and staff, writes Philippa Greenfield
The recent "Me Too in Medicine" investigation by The BMJ and the Guardian1 is an important reminder of the sheer scale of sexual violence experienced by NHS staff--35 000 reports of rape, sexual assault or harassment, stalking, or abusive remarks were identified though a freedom of information request to all NHS trusts and police forces from 2017 to 2022. As highlighted in the investigation, this is likely just the "tip of the iceberg" of sexual violence in the healthcare system. Last week we similarly saw the publication of a report by the Working Party on Sexual Misconduct in Surgery (WPSMS) showing the alarming levels of sexual violence perpetrated by our surgical workforce.2 This shouldn't surprise us--sexual violence persists in every country and culture and mostly affects women and girls but can affect anyone.3
Survivors of sexual violence in the healthcare workforce have been silenced and neglected, and we have failed to acknowledge the devastating harm caused. Public and professional attention brought to this issue by the "Me Too" investigation and WPSMS report has resulted in a welcome call to action against sexual violence to our health organisations, institutions, and regulating bodies.4
Any new initiatives or legislation must confront the headlines clearly stated in the WPSMS report--that the real challenges faced are not tackling external threat, but rather fundamentally changing the culture that lies in the fabric of the NHS. The "Me Too" data show that incidents of sexual violence were mostly perpetrated by service users.1 But they also tell us that 4000 NHS staff were accused of perpetrating sexual violence, with few cases resulting in any repercussions.1 This is particularly concerning because these figures are likely a vast underestimation of the scale of sexual violence perpetrated by staff. Meaningful data on rates of NHS staff perpetration are difficult to find because incidents are rarely recorded. The WPSMS report, however, asked surgeons directly about their experiences of perpetration of sexual misconduct from colleagues. It found that sexual misconduct (ranging from sexual harassment to sexual assault and rape) over the past five years was widespread and disproportionally affected female surgeons.2
No formal NHS systems are in place for staff to safely raise or record reports of staff-on-staff sexual harassment and violence. Most NHS organisations do not have a sexual violence policy, and training to build awareness and expertise in the workforce to respond appropriately to disclosures is woefully lacking.5 We currently do not have a system that supports survivors who disclose their experiences of violence...
Language: en |