Abuse in the Healthcare Sector

This week we discuss the headline that a former porter from Great Ormond Street Children’s Hospital has been accused of 84 sex offences between 1985 and 2018, including rape, attempted rape, and sexual assault of a child under 13.

A link to the article can be found here.

This is not the first-time concerns have been raised regarding safeguarding in public areas of hospitals, volunteers or in regard to moving patients around the hospital. Following the shocking disclosure of abuse by Jimmy Savile at Leeds Teaching Hospital amongst many other hospitals, an investigation report published by the Trust in 2015 made 31 recommendations to prevent similar incidents happening again. The full report can be found here.

Sadly, the new allegations of abuse are not the first for Great Ormond Street, who also hit the headlines previously for child sexual abuse involving Jimmy Savile who was accused of abusing a dying child in the 70’s at the hospital. In 2012, Great Ormond Street also commissioned an investigation in regard to this. Therefore, despite their investigation and further recommendations in the report by Leeds Teaching Hospital, the Great Ormond Street porter continued to abuse children until 2018.

To many, Great Ormond Street Hospital is well known for the fabulous work and care for very sick children. This further headline will shock  due to the period an employee went undetected and begs the question how could children be put at risk in this way?

This recent headline sadly follows further concerns regarding Great Ormond Street after government minister Steven Barclay called on the health secretary to commission an independent investigation into an alleged cover-up of a child’s death in 2011. Great Ormond Street has admitted that crucial medical evidence about the child’s condition when she arrived at the hospital’s intensive care unit was not provided to a coroner’s inquest Minister demands investigation into Great Ormond Street Children’s Hospital ‘cover up’ | The Independent.

In any medical situation whether it be that of a child or an adult, we expect those who are looking after us when we are our most vulnerable to be appropriately vetted and trained. We put our lives in the hands of medical staff. Safeguarding is paramount as there is a clear position of trust we rely upon.

Heath care professionals include but are not limited to, doctors, nurses, healthcare assistance, carers, support staff and therapists.

Physical and emotional abuse may be easier to identify, whereby sexual abuse can at times be more difficult.  The guidance states “A breach of sexual boundaries occurs when a healthcare professional displays sexualised behaviour towards you. Sexualised behaviour is defined as acts, words or behaviour designed or intended to arouse or gratify sexual impulses or desires.” Breaches of sexual boundaries do not just include criminal acts such as rape or sexual assault, but cover a range of behaviours including the use of sexual humour or innuendo, and making inappropriate comments about your body. It can include comments made in your presence, even if not about you. clear-sexual-boundaries-information-for-patients-and-carers.pdf (professionalstandards.org.uk)

A google media search for the last year alone brings up numerous concerning entries for abuse in the health sector and these are only the reported cases we know of.

• In February 2020, GP Manish Shah was convicted of committing 90 assaults against 24 female patients whom he persuaded to undergo unnecessary intimate examinations for his own gratification. He did not always wear gloves to carry out examinations and in one case he left a woman entirely naked on an examination table. His victims were aged between 15 to 39. Shah, is to serve a minimum of 15 years prison sentence. This followed a previous hearing in 2018 for similar offences. GP who sexually assaulted 24 patients jailed for life | Crime | The Guardian.
• Cambridge paramedic Andrew Wheeler was found guilty of rape of two women and sexual assault of a minor. 18 offences were committed between 2002 and 2018. He is to be sentenced in February 2021
• NHS Gynaecologist Dr Jomo Mathurine was struck off after secretly filming himself having sex with unsuspecting women

The Independent Inquiry into Child Sexual Abuse has now published a report having spoken with 109 victims focusing on the period between 1960-2000. The report found healthcare practitioners who committed child sexual abuse commonly did so under the guise of medical treatment, which went unchallenged by other staff even when unnecessary or inappropriate because of their position of trust. The full report can be found here.

Inappropriate Relationships

Abuse in the health sector has also come up repeatedly in regard to inappropriate relationships. This can be between doctors and patients, nursing staff and treating psychiatrists or mental health practitioners to name just a few scenarios.

Personal relationships with former patients may also be inappropriate depending on the individual circumstances such as whether the patient sought medical attention for mental health concerns. Other factors include; the length of time since the professional relationship ended, the nature of the previous professional relationship and whether the patient was particularly vulnerable at the time of the professional relationship, and whether they are still vulnerable

The General Medical Council, the organisation that regulates doctors in the UK, makes it clear that doctors “must not pursue a sexual or improper emotional relationship with a current patient”. Any doctor caught ignoring this rule is likely to face professional sanction, including being struck off. Doctors must not end a professional relationship with a patient solely to pursue a personal relationship with them.

Guidance can be found here.

As outlined above, of particular concern, is a patient who has engaged treatment for mental health. Therapists can be provided with very intimate and vulnerable details from a client. The client may form a strong bod with their therapist. This could lead to an abuse of power and makes a sexual relationship which such patient highly unethical.  It is the doctor or therapist’s responsibility and duty to ensure that his or her relationship with the patient remain as professional as possible.

Anyone who has concerns regarding a health care professional can report this to the manager on site, the General Medical Council and police. All NHS organisations will have a formal complaints procedure which should be readily available to all patients on request.

If an NHS employee has committed abuse, it is possible to make a civil claim against the NHS Trust for who the employee works, under the term ‘vicarious liability’ if it can be established that the abuse occurred during the course of employment or in a relationship akin to employment.

In the private sector, civil claims can be made against the individual practitioner’s indemnity insurance.

We encourage anyone who has concerns about sexual abuse to get in touch. You can contact Alan Collins at Alan.collins@hughjames.com or Danielle Vincent at  Danielle.vincent@hughjames.com.