Monday, 12 April 2010

ORGANISED MOBBING: A BRITISH OPPRESSIVE REGIME



Mobbing

Definition

• Mobbing is a term referring to a type of animal behaviour. A newer use refers to a group behavioural phenomenon in workplaces.

Mobbing as a human bullying behaviour

Mobbing in the context of human beings either means bullying of an individual by a group in any context by (Governmental Department, or Professional Regulatory Bodies, Judiciary, Police etc…), or specifically any workplace bullying.

• Though the English word mob denotes a crowd, often in a destructive or hostile mood, German, Polish, Italian and several other European languages have adopted mobbing as a loanword to describe all forms of bullying including that by single persons. The resultant German verb mobben can also be used for physical attacks, calumny against teachers on the Internet and intimidation by superiors, with an emphasis on the victims' continuous fear rather than the perpetrators' will to exclude them. The word may thus be a false friend in translation back into English, where mobbing in its primary sense denotes a disorderly gathering by a crowd and in workplace psychology narrowly refers to "ganging up" by others to harass and intimidate an individual.

• Research into the phenomenon was pioneered in the 1980s by German-born Swedish scientist Heinz Leymann, who borrowed the term from animal behaviour due to it describing perfectly how a group can attack an individual based only on the negative covert communications from the group".

• In the book MOBBING: Emotional Abuse in the American Workplace, the authors say that mobbing is typically found in work environments that have poorly organized production and/or working methods and incapable or inattentive management and that mobbing victims are usually "exceptional individuals who demonstrated intelligence, competence, creativity, integrity, accomplishment and dedication".

Mobbing in Scots law

• Under the law of Scotland, mobbing, also known as mobbing and rioting, is the formation of a mob engaged in disorderly and criminal behaviour. The crime occurs when a group combines to the alarm of the public "for an illegal purpose, or in order to carry out a legal purpose by illegal means, e.g. violence or intimidation”. This common purpose distinguishes it from a breach of the peace.

THEORY

For any organisation enjoying a certain empowering status over a group of people and wishes to establish a regime to practice Mobbing over them, it has to secure a circle of similar authorities in support of such a regime [e.g. other Government Departments, Professional Regulatory Bodies, Judicial System through Courts, Police etc…]; because if that regime is restricted to one Hierarchical Department it would not be able to survive to apply that Mobbing Regime because it would be exposed and be defeated if challenged for example by the Judiciary.

Therefore, the most dangerous confrontation a Mobbing Regime would have to face is with the Legal Judiciary System; the 2 main reasons for that are:-

That such regime could be defeated by hefty damages and consequently made public. This would act as a deterrent for others.

A precedent legal case would occur and make such regime a vulnerable practice for the organization where mobbing occurred.

Consequently for such a regime to survive it is essential for it to secure a circle of other Authorities which will continue to support it.

If the Legal System has been successfully alienated from justice, this should be the biggest achievement of that regime enabling it to survive; having secured that side the practice of such regime becomes not only unopposed but would enjoy the support by coercing other authorities to practice the same; and if an authority refuses to be coerced into such policies it risks isolation and marginalisation.

GOVERNMENTAL BODIES

E.g. the Department of Health in United Kingdom, Europe

One of the instrumental policies which has been deep rooted in the Department of Health is the Alert Letter System which has been abused on innocent doctors. This system, of Alert Letters which is still in existence is a live example of the Mobbing Regime that the Department of Health is practising. When an employee has been issued with an alert letter system or threatened by it, it would not only means to him the extermination of his career but the system serves as a deterrent to others in the profession that fails to challenge it.

PROFESSIONAL REGULATORY BODIES
E.g. General Medical Council

This organisation is influenced by NHS (National Health Service) Trusts Administrators, Postgraduate Deaneries, and Primary NHS Care Trusts Administrators and government. With the power to discipline, restrict or suspend the practitioner and in particular to label its practitioners with Mental Health Issues is a part of the Mobbing Culture and Practice.

ADMINISTRATION OF JUSTICE

In a biased system, claimants face hefty financial penalties when they lose in courts as all the huge legal fees have to be paid.

The CPR [Civil Proceedings Rule] which has been altered since 1999 reflects the Mobbing Culture successfully reaching the Courts; because they are fundamentally flawed. This has been highlighted in 2 Parts:-

In Part 1: The Overriding Objectives

This overriding objective of these CPR applied only to Judges and to Solicitors and does not apply to the victims.

In Part 2:

That it did turn the table on a fundamental security the Public had if costs were awarded against the victims.

Before the 1999 alterations were made to the CPR (Civil Proceeding Rules) all solicitors bills were subject to a Judiciary Taxation [detailed justification of every penny the winning solicitor claimed]. The Bill of Costs of Solicitors requested that Solicitors do disclose all the evidence regarding their costs which details of has been concealed up to the moment the Judgment was given.

Despite this, the Solicitors Rules are that there is no valid bill of costs until that bill is taxed by the Taxation Judge; under the new CPR, the Judge who attended the trial of the case orders the costs without going through any of the motions of Taxation. This puts victims of claims under serious threats to lose excessive monies if they lost in the courts . It is well known that Perjury is rife in negligence claims.

Another issue that may influence the justice are variable factors eg religious affiliations, freemasonry etc. It is known that religion is politics dressed in drag and yet no religious affiliations are declared by those in judicial positions or sitting at tribunals or fitness to practice hearings. Even when extreme religious views are present and barristers ask for the panellist to recuse himself, they do not do so.


POLICE AND THE CROWN PROSECUTION

It appears that the Police are integrated in that policy of Mobbing . The Mobbing Regime could be used in a criminal act e.g. Committing Perjury in Courts.The fact that Perjury is known to have been committed by the Police for the last 30 years in the British Courts [as stated by the Judge in Cinpress v Melea] proves that the theory is correct.

Because the Police are the first door of call in “Perjury” which is essentially a criminal act it is crucial that the Police should be integrated in that Mobbing Regime.

For civil cases, the Attorney General has refused to intervene in allegations of perjury unless the judiciary reports it.

WHISTELBLOWING

Any attempt to alert an organisation of wrongdoings by its members results in organisational reprisals. We will be fooling ourselves to believe that any system of Whistleblowing could be fair and adequate to protect the person unless organised Mobbing is recognized for what it is and cultural attitudes are changed.

CONCLUSION

If Organised Mobbing has succeeded to coerce the Judiciary and the Police, this would abolish any challenges to its practice and it would prevail. Unless both the Judiciary ( rule with confidence imposing hefty fines to Mobbers); the Police and Crown Prosecution Service ( reprimand with jail sentences perjurers) have been successfully detached from the circle of the Practice of Mobbing, all efforts to address justice for whistleblowers would fail and the Mobbing Culture will continue to spread to all corners of the land with serious repercussions to the Tax Payer and a continuous oppression to the British People.


Written by Dr Mohammad Al Ruby for Doctors4Justice.net

14 comments:

Anonymous said...

The only way that organisational mobbing can persist in this Country is with the authority of the Prime Minister - Gordon Brown and Tony Blair before him.

King's College with it's war Studies department appears to have perfected the art of psycological warfare by mobbing. It appears that mobbers, who are under the instruction of senior management, are employed to infiltrate staff and students to home in on target individuals on instruction and drive them out or even to suicide.
Organised mobbing should be made a criminal act with a jail sentence as it destroys lives.

Anonymous said...

Well, though the article, undoubtedly raises real issues being faced by hard and conscientious members of an organization, the problem i feel is, how to take practical measures to overcome this ongoing problem of 'Silence Culture'. The main stakeholders viz. GMC,Department of Health, Defence Unions, Trade Unions etc.should be forwarded this article and ask their view point how to make appropriate changes in the system.

Another issue which i feel is of paramount importance, is the multi-souce feedback required by the GMC for the forthcoming revalidation process. Whistleblowers will never get a positive response as its confidential and the managers will influence other colleagues not to give a positive feedback. Though these hardworking doctors, are really better than many of their peers and hardly there will be any complaint from patient, with poor 360 degree feedback, how can they remain registered with the GMC.

I suggest, we all need to raise this issue as well.

Anonymous said...

Well, though the article, undoubtedly raises real issues being faced by hard and conscientious members of an organization, the dilemma is, how to take practical measures to overcome this ongoing problem of 'Silence Culture'. The main stakeholders viz. GMC,Department of Health, Defence Unions, Trade Unions etc. should be forwarded this article and ask their view point how to make appropriate changes in the system.

Another issue which i feel is of paramount importance, is the multi-source feedback required by the GMC for the forthcoming revalidation process. Whistleblowers will never get a positive response as its confidential and the managers will influence other colleagues not to give a satisfactory feedback. Though these hardworking doctors, are really better than many of their peers and there will hardly be any complaint from patient, with poor 360 degree feedback, how can they remain registered with the GMC.

I suggest, we need to come up with a concrete solution!!!!!!!

Anonymous said...

Another example of 'Mobbing' is to include unfounded allegations in the enhanced CRB dislosure under 'OTHER RELEVANT INFORMATION'
section. The Chief Police Officer has discretion to include all these allegations even though unfounded or charges dropped or led to no conviction/caution.

Do you think anyone will dare to speak up if his CRB shows up malicious allegations?

Do you think anyone would employ a whistleblower with this kind of CRB disclosure?

The only way to be genuine in supporting the whistleblowers, is to make changes in the legislation such as 'Data Retention Act'.

Anonymous said...

Mobbing and Organizational Reprisals:

Mobbing was first described by Heinz Leyman in Sweden in the early 1980's. Kenneth Westues reported in At the Mercy of Mob as, “an impassioned, collective campaign by co-workers to exclude, punish, and humiliate a targeted worker”. The behaviour generally include social conflicts such as defaming a person, isolating them, spreading rumors leading to major conflicts, such as preventing employment, lack of promotion and even threats of physical violence. It may be deliberately coordinated, or may develop through the influence of a copycat atmosphere in the workplace. Ramage explains that its often insidious and hard to detect (1).

There are various forms of bullying. One of them is organized mobbing whereby members of an organization team up against an individual who dare to challenge wrongdoing. Sometimes sham peer review is used to destroy the medical career with improper motive.(2) Whistleblowers are most often subjected to organizational reprisals and various research has replicated these finding that its still hazardous to speak up.(3). A number of NHS staff have faced dire consequences because of whistleblowing which is , in fact, their professional obligations. Sadly they are perceived as troublemakers rather than a solution. Sometimes they are accused of inappropriate behaviour, misconduct and even mental illness (4,5). Martin & Rifkin clearly highlighted their concerns about managers saying 'managers often appear to be deeply threatened by whistleblowers, who are subject to severe reprisals, including ostracism, petty harassment, threats, punitive transfers, referral to psychiatrists, formal reprimands, demotion, and dismissal. Management's response, when perceived as excessive, can generate sympathy for the whistleblower. Many observers see an injustice when a lone individual reports a problem that needs fixing or investigation and management responds with a massive attack on the credibility, working conditions, and livelihood of the individual' (6).

Normally management justifies such official actions by claiming that the employee is a "difficult personality," incompetent, inadequately trained, or has made some serious error. It is not unusual for an outspoken employee's file to be scrutinized and old complaints or allegations pulled out - sometimes from many years earlier - and used to justify actions'.(6). Coull (2004) believes 'many whistleblowers find that their career, physical health, and mental health all suffer' and sometimes 'false allegations of sexual impropriety, financial irregularities, drug abuse, or other criminal activity can be made against the whistleblower'.(7). Sadly, at times, whistleblowers are reported to police and subsequently the CPS press criminal charges despite having no clear charging criteria for whistleblowers. This is contrary to the Government pledge to provide 'ROBUST NEW SAFEGUARDS FOR NHS WHISTLEBLOWERS' as can be seen in the following links,

http://www.dh.gov.uk/en/MediaCentre/Pressreleases/DH_116650

http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_120349


References:
1.Price.M: Campaign on bullying needed with rise of mobbing. Hospital Dr. 29
0ct 2009.
2. Huntoon. L.R. The psychology of sham peer review. Journal of American and Surgeons. Vol 12, number 1, 2007
3.BMJ: Changing the face of whistleblowing. 2009; 338:b2090 doi: 10.1136/bmj.b2090 (Published 27 May 2009)
4.Campell.B:The persecution of NHS Whistleblowers. guardian.co.uk, Friday 11 December 2009 10.00 GMT
5.Lakhani.N: NHS is paying millions to gag whistleblowers. The Independent Sunday 1 Nov 2009
6.Martin.b & Rifkin.W: The dynamics of employee dissent: whistleblowers and organizational jiu-jitsu. http://www.bmartin.cc/pubs/04por.html
7.Coull.R:studentBMJ 2004;12:45-88 February ISSN 0966-6494
http://archive.student.bmj.com/issues/04/02/careers/64.php

Anonymous said...

http://www.palvgmc.blogspot.com



What Dr Pal is 100% correct that two different set of criteria are used to investigate complaints and harsh action is taken against doctors from ethnic minorities. Liam Donaladson, the former CMO said that ethnic minority doctors face systemic prejudice, racism and harassment (Donaldson.L; Chief medical officer calls for action against racism in NHS, BMJ, 19 July 2008). These doctors are 12 times more likely to face allegations of indecent behaviour and subjected to GMC Fitness to Practise Hearing. GMC has assassinated livelihood of a number of bright doctors and its so sad that there is no accountability for them (Esmail.A. Asian doctors in the NHS: service and betrayal, British Journal of General Practise, October 2007). In a latest article published in the BMJ,it has emerged that black and ethnic minority are more likely to face Stream I (more serious) investigation (Sandhu B: Alarm over ethnic profile of disciplinary statistics. BMJ 24 May 2011). Unless regulatory bodies change their attitudes and be fair in their proceedings, patients’ care will never improve.

Anonymous said...

Its so disgusting that the GMC is so racist against minority doctors. The most encouraging factor is that people have trust in the court.

The following quote is alarming for the GMC

http://www.sundaymercury.net/news/tm_objectid=16203725&method=full&siteid=50002-name_page.html

Judge Charles Harris raged: “It is like a totalitarian regime: anybody who criticises it is said to be mentally ill – what used to happen in Russia.”

RE

Anonymous said...

GMC guidelines on rasing concerns are sketchy as they don't provide any platform of support when a whistleblower is subjected to complaint and reprisal as the NHS Managers and Trusts will never admit that its retribution or anything to do with whistleblowing. Even the CPS has no charging criteria when the Trusts press criminal charges. So who dares to speak up and ends up losing his good name, livelihood and almost impossible to work again in the NHS. Even regulatory bodies take drastic action when referred by the NHS Managers and whistlbleblowing issue is not taken seriously. How to prove that its part of mobbing and whistleblowing if the evidence is in the form of written complaints and the NHS Managers use malicious allegations through other staff or known patients. If the whistleblower is from ethnic minority, he/she is unable to produce any witness as NHS Managers threaten any potential witness of dire consequences of supporting a whistlebower.

Its not easy to raise concerns. A robust screening process is vital and if a whistleblower provides written evidence of raising concerns before reprisal and subjected to referral to regulatory bodies, he/she should not be investigated and the matter must be closed as soon as possible. It will encourage other NHS staff to speak up and will minimise culture of silence and fear as many NHS staff feel, regulator bodies are part of mob culture.

Anonymous said...

GMC has two different set of criteria to investigate concerns and some people are justified to say that its not less than a double standard. The following article written by a British Cardiologist Dr.Peter Wilmshurst provides evidence of racial bias despite GMC's claim that its not due to ethnicity but the place of work which brings more International Medical Graduates to Fitness to Practise (FtP). A British Professor who claimed false qualification was given only PRIVATE WARNING . Seven Black and Ethnic minority doctors claiming false qualifications and/or making false job applications were treated harshly; three were erased, one suspended and another reprimanded. Is it fairness in this most civilized nation.

You can find full article in the following link

http://palvgmc.blogspot.com/

under

A Personal View. Dr Peter Wilmshurst


'....Some may ask why the Professional Conduct Committee publicly suspended or erased from the Medical
Register a number of doctors, all of whom had African or Asian names, for claiming qualifications that they had not been awarded, but the GMC decided that in the case of a white British professor at a major academic institution only a private warning not to do it again was required.....'


Not to mention that Dr Pal, an ethnic minority doctor who raised concerns on patients' safety was labelled as mentally ill and the judge branded GMC as a 'STALANISTIC REGIME'. Its unfortunate that the GMC has assassinated the career of a brilliant doctor and the NHS has lost an eminent professional merely because of racial bias. GMC has been and will be used to silence and prosecute whistleblowers and drastic action will be taken against ethnic minority doctors. There is still hope if the GMC and other regulatory bodies change their attitudes and stop taking dictations from NHS Managers and stick to their primary duty of patients' care and not to punish genuine whistleblower.

Anonymous said...

GMC needs to change its mind set that the NHS Medical Managers' concerns are always credible. The reality is that most of them are really corrupt and biased against ethnic minority doctors particularly locum doctors. If anyone raises concern, they report him to GMC with spurious complaints and sometimes play dirty and the concerns remain under the carpet. They don't investigate fearing reality as it will imply they are poor managers and historic arms of the GMC are used to silence and punish whistleblowers. GMC now says its role is not to punish doctors but to protect patients and public but the evidence shows completely different.

Its just a lollypop that PIDA protects whistleblowers as Trade unions will almost never support PIDA claim and a whistleblower can't afford hefty fee and even if he wins, he will not get back his legal cost and will be subjected to further reprisal. GMC encourages to speak up but many whistleblowers say its professional suicide. In other words, GMC ask doctors to commit suicide after raising concerns. GMC just want to satisfy public that they are protecting patients but when a whistleblower faces reality, financial, emotional hardship and almost unlikely to work again in the NHS, he will advise others to keep your head down and never whistleblow. GMC destroys career by investigating a whistleblower and bringing him before a Fitness to Panel (FtP) hearing and seek dictations from DH/NHS Managers to prosecute whistleblowers with harsh punishment for ethnic minority doctors. Even if the allegations are unfounded, the doctor will have a life long sentence as he will have to disclose it in all future job applications and the employers will be reluctant to offer him a job. This is direct contrast to GMC as well as DH pledge to support whistleblowing. In other words, GMC as well as the NHS/DH send a clear message to other staff to keep their mouth shut and in theory encouraging them to raise concerns on patients' safety. I believe, its all hypocrisy and nothing is going to change.

Free adviser to GMC said...

The best way for the GMC to build up its rapidly damaging reputation is to start being honest and fair by investigating NHS Medical Managers under Stream 1 (more serious) allegations and bring them before the Fitness to Panel (FtP) hearing when they refer genuine whistleblowers to GMC with spurious complaints. If the whistleblower provides evidence of raising concerns before being referred to GMC, the case must be closed at the investigation stage (Registrar stage). This will send a clear message to all doctors to raise concerns and discourage NHS Managers' gang culture. GMC must NOW stop taking dictations from the NHS/Department of Health although we still believe its an uphill task for the GMC.

Anonymous said...

http://www.bmj.com/rapid-response/2011/11/03/gmc-encourage-whistleblowing-anyone-believe-it

"The GMC to encourage whistleblowing" - anyone believe it?
Mon, 2011-08-22 14:47
The House of Commons Health Select Committee believes that the GMC
should send a clear signal to doctors that they must report concerns about
a fellow doctor.[1] My experiences suggest that the GMC itself has been
involved in concealing misconduct.
As chair of the medical committee of a government recognised national
organisation, I reported a group of doctors, because the committee had
concerns about their research.[2] It involved injecting a radioactive
isotope into patients suffering from a neurological illness. Before
investigating the allegations, the GMC investigated me for the counter-
charge of disparaging the doctors. The GMC investigated the allegations
against the doctors only after clearing me, but allowed the two most
senior doctors to voluntarily remove their names from the Medical
Register, which meant that the charges that they had covered up misconduct
could not be investigated. The GMC then confirmed that ethics committee
and ARSAC approvals had not been obtained. No consent forms were
available. It was stated that patients were only asked to give verbal
consent. The GMC decided that it was unable to adjudicate on allegations
of data fabrication because the authors failed to produce the data. Many
might consider failure to produce data at the request of the GMC prima
facia evidence of falsification. The GMC held no public hearing and issued
no public statement. The senior doctors involved, including a medical
professor and a consultant in nuclear medicine, who told the GMC that they
did not understand the requirements for ethics approval and for
administration of radioactive isotopes, were given private warnings and
advice.
In 2002, Dr Clive Handler was suspended from the Medical Register
after I reported him to the GMC for financial misconduct.[2,3] Dr Handler
had left Northwick Park Hospital in 1998 after an inquiry there revealed
the misconduct. The GMC was informed that a severance agreement between
the hospital and Dr Handler included an agreement not to inform the police
or the GMC. The hospital trust board, including the Medical Director,
Professor Peter Richards approved the agreement. At the time Professor
Richards was a GMC member. When Dr Handler appeared before the
Professional Conduct Committee, Professor Richards was the Committee's
chairman and I was amazed to witnessed the bizarre conduct of a
dysfunctional organisation. Professor Richards had to stand-down from
hearing the case because of his involvement in the cover-up. Despite that,
Professor Richards returned to chairing subsequent PCC hearings.
The messages from these cases are clear. Ordinary doctors who report
misconduct may be victimised by the GMC and the GMC tolerates its own
members concealing crime.
The Health Select Committee should be asking "quis custodiet ipsos
custodes?"
References
1. Jacques H. Doctors should be held to account for behaviour of
colleagues, say MPs. BMJ 2011;343:d4794.
2. Wilmshurst P. Dishonesty in medical research. Medico-Legal Journal
2007;75:3-12.
3. Dyer C. GMC hearing reveals how doctor won deal to have earlier inquiry
documents destroyed. BMJ 325 : 1189 doi: 10.1136/bmj.325.7374.1189/a
Competing interests: I have reported concerns about conduct of other doctors.
Peter T Wilmshurst, Consultant Cardiologist
Royal Shrewsbury Hospital

Doctors4Justice said...

No, GMC cannot be motivated to support whistleblowing.

25-12-2011

Anonymous said...

I think the Commons HSC should be careful and vigilant during its annual investigation of the GMC as it may be misleading the committee as did the CQC. You can the evidence in the following news clip,
http://www.telegraph.co.uk/health/healthnews/9045478/Whistle-blowers-are-the-unsung-heroes-of-the-NHS.html
Whistle-blowers are the unsung heroes of the NHS
Everyone working in the NHS should be free to criticise bad working practices without fearing for their livelihoods.

All NHS employees should feel free to speak out against bad practice  Photo: ALAMY
By Max Pemberton
7:30AM GMT 30 Jan 2012
It takes bravery and courage to stand up and speak out when the stakes are high. While many of us like to think we are possessed of that fortitude, in reality, few of us are. We therefore owe a considerable debt of gratitude to those NHS whistle-blowers who have publicly denounced malpractice, corruption or poor care, often risking their jobs in the process.
They are the unsung heroes of the health service, who often receive appalling treatment at the hands of furious managers. Behind closed doors, there are attempts to strike deals with such staff, forcing them to keep quiet. Healthcare workers are frequently required to sign confidentiality agreements if they quit their job over a dispute with their NHS trust. For fear of ruining their careers entirely and receiving no severance package, many capitulate and sign on the dotted line.
Last year, an investigation by the Bureau of Investigative Journalism and Channel 4 found that doctors routinely had to sign contracts forbidding them to talk publicly about the trust they worked for. Furthermore, three trusts were found to have made clinicians sign contracts specifically banning them from talking to the General Medical Council, the organisation responsible for regulating doctors.
These gagging clauses have no place in a public institution such as the NHS, where being forced to keep silent puts patients’ welfare at risk. The public has a right to know if there are problems in the NHS, and managers have a duty to ensure that this information is freely available.
For a while now, politicians have been saying that NHS whistle-blowers must be protected, but little has been done to ensure this. Although a helpline was launched at the end of last year for NHS employees who had concerns, there seemed no way of ensuring that those who spoke out would be protected. It appears, however, that at last the problems are being taken seriously, in some quarters at least. The GMC last week announced that it will be writing to every doctor, advising that they never sign a contract that contains a gagging clause to prevent them speaking out against bad practice.
The GMC is rightly emphasising that such clauses interfere with a doctor’s duty of care towards a patient. But while this move must be applauded, it seems that this focus on openness and patient welfare hasn’t reached every corner of the NHS. It has emerged that the Care Quality Commission (CQC)– the health watchdog responsible for protecting whistle-blowers – has, itself, asked at least six former employers to sign confidentiality agreements. The CQC offered six individuals severance packages on condition that they signed a contract promising that they would not ''make or repeat any statement which disparages or is intended to disparage the goodwill or reputation of the CQC or any Specified Person’’.
This is the same CQC that has been dogged by controversy and claims that it is failing patients in its role as regulator for NHS hospitals and care homes. A damning report by the Health Select Committee last September accused the CQC of not doing enough to protect patients and focusing on bureaucracy instead. It has also been found to have misled Parliament over the number of inspections it has undertaken, and, in 2009, a leaked letter revealed that employers had complained of a “bullying culture”.