Sexual Harassment of Surgeons and Other Medical Professionals

Wednesday 13th December 2023 Westminster Hall

11:00

[David Mundell (in the Chair)]

I will call Rosie Duffield to move the motion. I will then call the Minister to respond. There will be no opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

[Rosie Duffield (Canterbury) (Lab)]

I beg to move,

That this House has considered the matter of sexual harassment of surgeons and other medical professionals.

It is a pleasure to serve under your chairship, Mr Mundell. I am grateful for the opportunity to raise the issue of sexual assault against surgeons, nurses, doctors and other healthcare professionals and patients in clinical settings. In April, I used my Prime Minister’s question to mention the report commissioned by the Women’s Rights Network and written by my friend, the sociologist and criminologist Professor Jo Phoenix, entitled “When we are at our most vulnerable”. The report revealed some truly shocking statistics about violent sexual assault, and everyday inappropriate and unwanted acts intruding into the work lives of professionals and disrupting the recovery of the most vulnerable and ill. How dare we call ourselves a civilised society if we turn a blind eye to this and do not do everything possible to support those women, and some men, who are brave enough to come forward, as well as those who do not feel that they can and suffer in silence?

Professor Phoenix found that more than 6,500 rapes and sexual assaults had been committed in hospitals in England and Wales over a period of nearly four years. Some were against children under 13, yet in a mere 265 cases—a minute 4.1%—was anyone known to have been charged. In total, 2,088 rapes and 4,451 sexual assaults—6,539 cases—were recorded by police forces from January 2019, and one in seven of those, or 266 a year, took place on hospital wards. As the researchers at the Women’s Rights Network sent freedom of information requests to 43 police forces across the UK and 35 responded, the figures are, in truth, even higher and even more shocking.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing this debate and on what she does. Those of us who are here have a particular interest. A recent survey of 2,500 doctors by the British Medical Association found that 33% of female and 25% of male respondents had experienced unwanted physical contact in the workplace. Worse still, these are only the figures for those medical staff who felt confident enough to come forward, so unfortunately the figure is probably much larger. Does she agree that provision must be put in place in the NHS and other, private healthcare facilities to ensure that staff members feel not only safe and protected, but encouraged to come forward and discuss instances of sexual abuse and rape within the workplace? In other words, there must be somewhere to go, someone to talk to and someone to sort it out.

[Rosie Duffield]

Absolutely, and I thank the hon. Member so much for raising that important point, which is supported by all the work that the BMA has done, including the report that he mentioned.

The rape of a female child under 13 was included in those shocking statistics, alongside the rape of a female over 16 by multiple offenders in west midlands hospitals, three rapes of a female under 16 in Cambridgeshire, and six rapes of girls under 13 in Lancashire. It is important to note that although the FOI responses do not record the sex of the victims, national data shows that less than 5% of rape victims are men, so it is reasonable to assume that most victims are female. The investigation uncovered 13 rapes of males over the age of 16, however, including one incident involving multiple offenders, and the sexual assault of a male child under the age of 13 in a Cambridgeshire hospital.

We know that hospitals are, of course, monitored by many CCTV cameras, and individual wards usually have safe-door entry systems, which prompts the question of why only a tiny percentage of cases—4.1%—resulted in a charge or a summons. Indeed, five police forces did not issue a single summons or charge a single suspect for any of the 334 reported sexual assaults in their areas. Why not? The WRN report says:

“The damning figures are probably ‘the tip of an iceberg of indifference’ around the safety of NHS patients and staff”,

as some forces gave inadequate information. For example, Police Scotland did not provide any figures, citing cost constraints, and of those forces in England and Wales that did respond, seven forces provided incomplete responses, five did not give information on the number of assaults that occurred on hospital wards, and three did not provide information about the number of people charged or summonsed.

As Heather Binning, founder of the Women’s Rights Network, says:

“These statistics are jaw-dropping. We began this investigation because a number of members raised concerns about the safety of women and children on NHS wards, but we are horrified at what we have uncovered.”

I am grateful to the WRN for highlighting this problem and shining a light on something that has gone almost completely unnoticed in this place before.

The BMA represents doctors and medical students across the UK. It also produced a briefing for today’s debate, as we heard earlier from the hon. Member for Strangford (Jim Shannon). It states:

“The BMA is deeply concerned by the overwhelming number of doctors who have experienced sexual harassment at work.”

Its “Sexism in medicine” report of September 2021 found that 91% of women doctors in the UK have experienced sexism at work, with 42% feeling that they could not report it.

[Caroline Nokes (Romsey and Southampton North) (Con)]

The hon. Lady is highlighting a very important issue. She made a point about reporting, which is certainly an enormous challenge. The Women and Equalities Committee heard from Chelcie Jewitt of Surviving in Scrubs, who made the point that when doctors tried to report harassment, they were often told by the General Medical Council that it was a trust issue, yet the trust would say that it was a GMC issue. Does the hon. Lady think that goes some way to explaining why there is a lack of reporting and that, when there is reporting, it seems nothing gets done?

[Rosie Duffield]

Absolutely. I thank the right hon. Lady so much for raising the work that Surviving in Scrubs does. I know that its evidence was really important for her inquiry.

The survey found that doctors’ experience of sexism and sexual harassment had prevented them from choosing certain specialities and had affected their career progression. Doctors say that the very structure of medical training creates a power dynamic, where perpetrators can have a significant impact on doctors’ opportunities to progress. The scale and severity of sexual harassment in medicine was further highlighted by the working party on sexual misconduct in surgery survey, which found that a third—a third—of NHS female surgical staff had been sexually assaulted by colleagues in the past five years.

These shocking findings led the BMA to launch its “Ending Sexism in Medicine” pledge in March 2023, which over 60 organisations have signed. The pledge aims to help ensure

“a world where doctors and medical students can work in a safe environment free from discrimination, and where gender plays no role in career progression or how they are treated.”

The pledge commits to ending sexual harassment in medicine and ensuring that structures are in place to enable reporting safely.

The BMA has called for the Government to implement legislation that includes a preventative duty on employers to take all reasonable steps to prevent sexual harassment taking place, including from third parties, and to support the Worker Protection (Amendment of Equality Act 2010) Act 2023, which places an obligation on employers to protect employees from sexual harassment. It stresses that all vital protections, policies at work, legislation and support for staff members must also be applied to students undergoing vocational training rather than just those classed as employees. As someone with a medical school in my constituency, I could not agree more.

I am also grateful to Tamzin Cuming, chair of the Women in Surgery forum at the Royal College of Surgeons, and to Professor Carrie Newlands, co-lead of the working party on sexual misconduct in surgery, for their report “Breaking the Silence”. The foreword is written by Professor Dame Jane Dacre, who says:

“This report shows that we still have a long way to go in demonstrating the respect that our female colleagues deserve in the surgical workplace. The survey findings of sexual misconduct are eye-watering and upsetting. It is difficult to read some of the testimonies, and this work should galvanise all healthcare organisations to make sure the problem of sexual misconduct is eliminated.”

It is an outstanding report that includes shocking data and statistics as well as chilling quotes from those affected. I urge anyone here to read it.

I cannot do justice to this work in such a short debate, but I want to read some of the quotes from those who took part:

“I watched a consultant fiddle with the hair of an industry representative, and kiss the back of her neck, at work. She was in a difficult position and did not want to report the incident.”

Another says:

“He’d frequently rub himself against me repetitively during surgery, grunt and gasp in my ear, then leave the operating theatre before the operation was over. The scrub nurse used to help me close up. She once cried with me after surgery and reminded me that she was powerless to do anything, but that she cared.”

Another states:

“The orthopaedic consultant, during an operation, discussed with his (male) trainee how they like blow jobs. It was my first day in theatre.”

I apologise for the unparliamentary language.

Those accounts are just a small snapshot of some of the report’s findings. It represents a lot of work and I hope that the authors’ recommendations can be given serious consideration by health bodies and the Government, along with the important work of the GMC, which has produced updated guidance on good medical practice and professional standards, which I am afraid I have not had time to give justice to today.

Since entering Parliament, I have focused on women’s health, our experiences of the NHS and maternity healthcare services. The pressures and enormous stress placed on our NHS professionals are well known, but these women who save lives, whether as a surgeon, nurse or a friendly reassuring receptionist, deserve to work in a safe and respectful environment, where they are given the dignity they deserve. Patients must feel and be safe at all times within a clinical setting. I am certain the Minister agrees, and I would be happy to work with him to ensure we get a much better place for all of those who need and love our NHS.

11:11

[The Minister for Health and Secondary Care (Andrew Stephenson)]

It is a pleasure to see you in the Chair, Mr Mundell. I am grateful to the hon. Member for Canterbury (Rosie Duffield) for raising this incredibly important issue. She has been a tireless voice for women in this place, on this and many other matters. Our health service holds a special place in all our hearts. It is appalling that NHS staff face sexual assault. The reports the hon. Lady talked about, “Breaking the Silence” and that from Surviving in Scrubs, make for incredibly difficult reading. I salute the authors for their courage and professionalism.

The first report highlights that up to two thirds of women and nearly a quarter of men had been the target of sexual harassment from colleagues in the past five years. It also states that a third of women in surgery have experienced sexual misconduct in their training, including sexual harassment, sexual assault and even rape. Sadly, there is other such published research about the alarming levels of unwanted sexual behaviour happening to NHS staff and patients, including an investigative report by the Women’s Rights Network, which again the hon. Lady mentioned.

Let me be clear: that behaviour is disgusting and deplorable, and has absolutely no place in our hospitals. Staff who dedicate their lives to helping others need to be able to do their jobs without fear of any kind of abuse, let alone sexually motivated remarks, insults or attacks. NHS leaders have a duty of care towards their staff and patients. Ensuring staff are safe and treated with respect is a crucial part of creating safe and compassionate workplaces.

NHS organisations also have clear policies to deal with reports of harassment or bullying. We know that raising and reporting sexual harassment and misconduct is never easy, particularly when the perpetrators are in positions of authority or are patients. However, victims need to feel confident to raise such issues and be reassured that appropriate action will be taken by their employers.

[Caroline Nokes]

I thank the Minister for giving way, and welcome him to his new role, appreciating that he has only been in it a few weeks. I gently say to him that there is a real challenge in our NHS when 10% of women in one study reported unwanted sexual conduct in return for career opportunities. That is absolutely about power, and it is going to take a step change to break down those structures that enable such harassment to continue, behind a veil of silence, so that women are still afraid to speak out.

[Andrew Stephenson]

I pay tribute to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), who is the Chair of the Women and Equalities Committee, for her work in this area. I completely agree with her point; there needs to be a serious culture change. We would all recognise that over many years the NHS has been fantastic in treating patients. However, quite often the same clinicians, in many regards, have not been as compassionate when looking after each other.

The workplace culture that has developed in parts of the NHS need addressing. Even though I am new to my role, with only three weeks in post, as part of the NHS long-term workforce plan, I am looking at that culture and the staff leaver rates across a whole range of different parts of the profession. That is important because we must ensure that people have a safe and enjoyable working environment. At the moment, reports such as those detailed by the hon. Member for Canterbury show that in far too many trusts, employers are falling well short of providing that supportive environment, which is the least people should expect.

Turning to what has been happening, most NHS organisations now have trained staff to help colleagues raise concerns in this area. That includes a network of more than 1,000 local freedom to speak up guardians across all trusts, supported by an independent national guardian to help drive positive cultural change. We have also established a confidential helpline for staff who want to speak up but need guidance about what to do and where to turn. That, again, goes to the point made earlier by my right hon. Friend the Member for Romsey and Southampton North about the experience of people complaining but being passed from pillar to post between the GMC and trust. I hope that the confidential helpline will help make a difference.

NHS organisations must do everything they can to stamp out the unacceptable behaviours at all levels across the health and care system. In April, the former Secretary of State, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), convened an urgent meeting with NHS England to ensure that NHS organisations are doing more to tackle such behaviours. We have made some progress, although I acknowledge that there is much more to do.

This year, NHS England broadened and strengthened the remit of its domestic abuse and sexual violence programme, which was established in 2022, to address sexual harassment and misconduct on NHS premises. All trusts and integrated care boards were asked by NHS England to appoint an executive and operational lead for domestic abuse and sexual violence. Those leads are reviewing their policies, training and support systems to enhance support for staff and patients.

In September, NHS England launched the first ever NHS sexual safety charter across the healthcare system. There are now 200 signatories, including NHS employers and the Royal College of Surgeons. Signatories commit to taking a zero-tolerance approach to any inappropriate or harmful sexual behaviours in the workplace by implementing all 10 charter commitments by July 2024. The commitments include establishing clear reporting mechanisms, implementing training programmes and providing essential support for those involved in investigations. NHS England will use the new network of domestic abuse and sexual violence leads to share and promote good practice and develop practical solutions in implementing the new charter.

Data capture is also a key commitment in the charter and to gauge the charter’s impact, the NHS staff survey now includes a question related specifically to sexual safety. That systematic approach reflects a commitment to transparency and accountability in creating a safer working environment. The Equality Act 2010 has also been amended this year to include a new duty on employers to take steps to prevent the sexual harassment of their employees. Implementation of the charter will assist NHS employers with meeting the duty when it comes into force next October.

The GMC is unable to consider complaints about registrants that relate to matters more than five years old unless it considers it to be in the public interest to do so, which has been raised during the debate. We are modernising the legislation that governs professional regulators, which includes removing the five-year rule as part of the reforms to regulatory legislation for doctors. It will allow the GMC greater discretion to consider whether a concern should be investigated. Introducing those changes remains a top priority for the Government.

I hope that these measures show that we are committed to addressing the problem with targeted action. However, I acknowledge that there is more to do, and I would be happy to work with the hon. Member for Canterbury and Members across the House to ensure that we get it right. We will not be satisfied until the number of staff facing sexual harassment is down to zero. There must be a collective effort across our health service to enact change. Strong and effective leadership is crucial, and it starts from the top. The Government, with NHS England driving this work, are calling upon all NHS boards to sign the sexual safety charter and ensure that their healthcare settings are safe places for our current and future workforce.

I will close by acknowledging the bravery of all those women and men who have come forward with their experiences of sexual harassment and misconduct in the healthcare workforce. That includes the testimonies in the report from Surviving in Scrubs, some of which the hon. Member for Canterbury read out. It takes incredible bravery and selflessness to come forward. Thanks to those brave women, and some men, we are getting ever closer to ending the scourge of sexual assault in our health service. I thank the hon. Member for putting a spotlight on the issue today. We must not tolerate it.

Question put and agreed to.

11:21

Sitting suspended.