Almost one in three female surgeons working in the NHS have been sexually assaulted and two-thirds have been sexually harassed, according to researchers.
A paper in the British Journal of Surgery published today analysed survey data from more than 1,700 members of the NHS England surgical workforce. In a weighted analysis, it found that among women, 63.3% reported being the target of sexual harassment versus 23.7% of men, while 89.5% of women and 81.0% of men reported witnessing such behaviour.
Additionally, 29.9% of women had been sexually assaulted versus 6.9% of men (35.9% witnessing versus 17.1% of men), with 10.9% of women experiencing forced physical contact for career opportunities versus 0.7% of men. And one in 125 female surgeons (0.8%) reported being raped by a colleague.
Sexual assault in the NHS
The Royal College of Surgeons of England described the findings as “truly shocking”.
The researchers, from the universities of Exeter and Surrey, also found that respondents’ evaluations of various organisations’ ability to handle sexual misconduct were significantly lower among women than men.
Only 15.1% of women felt the General Medical Council (GMC) was adequate in their handling of sexual misconduct, compared to 48.6% of men, while a similar number (15.8%) regarded NHS trusts as adequate (44.9% of men). Royal Colleges fared better with 31.1% of women regarding them as adequate.
Tamzin Cuming, chair of the Women in Surgery Forum at the Royal College of Surgeons of England and one of the researchers, described it as a “MeToo moment” for surgery.
Writing in The Times she said: “No one should need to call for a code of conduct that says, in essence, ‘please do not molest your work colleagues or students’ and yet this is one of the actions our report recommends. The report is measured, its recommendations achievable, but this shouldn’t disguise the anger and frustration felt by many in our profession.
“This is no time for hand-wringing. Action is needed. Although our data is from the field of surgery and specific to staff, it has implications for all healthcare. Whatever the healthcare role of a perpetrator, their actions mean they simply should not be working with patients and vulnerable people.”
The research paper is accompanied by a report from the Working Party on Sexual Misconduct in Surgery (WPSMS) titled Breaking the Silence: Addressing Sexual Misconduct in Healthcare. It made 15 recommendations including:
- reform of reporting and investigation processes of sexual misconduct in healthcare
- reform of healthcare regulators’ professional guidance to include sexual misconduct towards colleagues
- learning to be integrated in recognising and taking appropriate action on sexual misconduct at all stages of a career in healthcare
- and, every NHS Trust and healthcare provider to have an appropriate, specific and clear sexual violence/sexual safety policy in place.
An investigation in May 2023 found that fewer than one in 10 NHS trusts has a dedicated policy to deal with allegations of sexual assault and harassment, despite more than 35,000 sexual safety incidents being reported to 212 NHS trusts in England between 2017 and 2022.
A breakdown in the WPSMS research of the types of sexual behaviours witnessed by women and men included:
- Jokes with sexual content (89.0% women, 80.6% men)
- Physical advances, unwanted/sexual (38.4%, 14.9%)
- Unwanted/sexual talk (61.8%, 29.5%)
- Uninvited comments about body (67.3%, 38.3%)
- Deliberately infringing body space (44.9%, 17.8%)
- Forced contact for career opportunities (16.6%, 2.2%).
The paper states that the normalisation of sexualised behaviour leads perpetrators to perceive tacit support for it, “undermining a doctor’s means of self-regulation” and allowing “inappropriate sexualised behaviours and misconduct to flourish, where perpetrators target not only colleagues but are more likely to transgress sexual boundaries with patients”.
A statement from the Joint Royal Surgical Colleges said: “The findings of the working party’s survey on sexual misconduct in surgery are shocking. As leaders of the four surgical royal colleges, we want to send a strong message: these utterly unacceptable behaviours have no place in surgery.
“We would like to thank the working party for having the courage to speak out on this very serious problem. We will work with the group and colleagues across healthcare to ensure that surgery is the safe and welcoming profession it should be.”
Last month, the GMC announced that zero tolerance of sexual harassment, including clear definitions of what constitutes it and an expectation that doctors who see such behaviour will act, will be included for the first time in its new professional standards.
The regulator published its first major update in 10 years of Good medical practice, which outlines the principles, values and standards expected of doctors working in the UK. It comes into effect on 30 January 2024.
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