The man behind a damning inquiry into mental health services in Tayside has dismissed the health board’s attempts to defend itself by hiding behind budget problems.
Addressing its findings Dr David Strang, the inquiry chairman, said the board had “lurched from crisis to crisis” in recent years.
And he also said that it was wrong for the board to use financial difficulties as an excuse for a string of failings identified in the report.
“I do not believe they needed more money. The issue was more what they were doing with their resources,” he added.
He also added that the most disappointing thing for him was that none of the recommendations he made in his interim report had been implemented.
Mr Strang, was appointed chairman to the inquiry in July 2018, and produced an interim report in May 2019 with initial recommendations.
“I thought that by the time I came to producing the final report that some of my initial recommendations would have been implemented.
“It was a big disappointment for me that none of these had been put in place.”
Mr Strang said that he had been disappointed that NHS Tayside appeared to not have listened to earlier recommendations and did not learn from previous incidents.
He said: “On too many occasions, Tayside has adopted a defensive position, giving the impression of wanting to protect its reputation at all costs.
“Frontline staff feel that the organisation is more interested in identifying who is to blame and attributing fault than genuinely learning in a supportive environment.
“Patients, families and carers were told that they would be invited to contribute to a review following an adverse event, but were then not involved.”
Mr Strang said the task he was given was challenging but he was happy with the report that had been produced.
He said: “I have come up with 51 recommendations but quite honestly I could have come up with 50 more.
“NHS Tayside lurched from crisis to crisis. They dealt with short-term problems as they arose to the exclusion of forming long term plans to deal with issues.”
He added: “Long-term planning is required to address the changing shape of the mental health services workforce.
“There needs to be a fundamental service re-design which will take into account the much-reduced level of consultant psychiatrists and focus on the wider needs of the whole community, with an emphasis on prevention and early intervention.”
Mr Strang said that there was also a culture of blame with nobody being prepared to accept responsibility for mistakes that had been made.
“He said: “There seemed to be no clarity over who was in charge or who was responsible.
“Part of the problem was that there were issues with senior staff and leadership.
“Since April 2018 there have been four heads to the board, three chief executives and three heads of mental health.
“These people were all in their posts for short terms .”
Mr Strang said he had been very concerned at the culture of bullying among staff.
He spoke about the “hierarchical” nature of staffing with many members of staff afraid to speak out about issues that were concerning them.
He said: “There are many committed and dedicated staff working in mental health services in Tayside, but whose potential is not being realised.
“Many of these people felt frustrated that their voices were not being heard and felt that they were undervalued by some of those leading the services.
“Patients and carers too felt that they were not listened to or, worse, that they were not respected nor taken seriously. ”
Dr Strang said that while he couldn’t make any promises that NHS Tayside would act on his recommendations he was confident that there would be strict monitoring of what they were doing in the future.
He said: “The Scottish Government and Scottish politicians are paying very close attention to what NHS Tayside does now.”
The Evening Tele asked NHS Tayside for an interview with a senior member of management.
A spokeswoman said: “I’m afraid our chief executive has been called away and is unavailable for interview.”
The board was asked to respond to Dr Strang’s comments.