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Thanks to the bravery of people across the world coming forward with their experiences, sexual harassment has recently become a huge topic of discussion. After years of unacceptable behaviour, the tide finally seems to be turning, not only for the individuals affected but for the industries they work in and the societies that have for too long turned a blind eye to the unacceptable treatment that these people have endured.
In the UK, sexual harassment is defined in the Equality Act 2010. A person sexually harasses someone if they engage in unwanted conduct of a sexual nature, and the conduct has the purpose or effect of violating someone’s dignity or creating a hostile, degrading, humiliating, or offensive environment for them. It is also unlawful to subject someone to a detriment because they have complained of sexual harassment or have assisted someone in bringing a complaint of sexual harassment.
With Hollywood producers, politicians and CEOs being toppled from their Ivory Tower careers as a result of the #MeToo Movement, as a profession, we need to be asking the questions: how big a problem is this in the health service? How are we empowering people affected to come forward? How will we respond to such claims? We face difficult truths every day in our workplaces, and communicate these. But how do we do this when the difficult truth may well be us?
This year, the Time Magazine ‘Person Of The Year’ accolade went to ‘The Silence Breakers’, women and men who have spoken out about the sexual harassment they have experienced. On the front cover of the magazine, five women’s faces look into the camera,unflinching in their determination. On the right of the picture, there is an elbow, leant on the table, the rest of the individual it belongs to out of shot. Initially, this caused controversy; was this woman not important enough to be pictured fully? The owner of that elbow is a healthcare worker, from Texas. She chose to remain anonymous, in solidarity, representing ‘all those who could not speak out’. She also feared the loss of her livelihood and ability to support her family if her story ‘came out’.
It would be naïve bordering on negligent to deny that sexual harassment exists in the medical profession in the UK. With cases in virtually every other area, how could we possibly assume to be somehow ‘above’ it? A recent survey in the US found that 30% of women had experienced sexual harassment in their medical careers and, in Australia, in 2015, concerns surfaced in surgery, following comments that sexual harassment was endemic in the speciality.
When trying to understand sexual harassment as a concept, it helps to appreciate that it’s not simply about sex, but about power. In the world of medicine, this leaves junior doctors and trainees, especially women in male-dominated environments, particularly vulnerable. Sexual harassment can be a way of men, whether consciously or unconsciously, making women feel that despite all of their academic or professional achievements, they are little more than objects of sexual gratification.
NHS Staff Surveys show that junior doctors are among the least likely to report bullying and harassment if they experience it. Only 27% of trainees who experienced bullying or harassment in 2016 said they or a colleague reported the incident to their employer. This compares to 33% of all doctors and 47% of all NHS staff who have experienced it. Respondents to the GMC National Training Survey say that the main reasons for not reporting is fear of the consequences for them and their future career or a lack of confidence that it would make a difference.
The BMA is addressing sexual harassment as part of a wider project around bullying and harassment in the medical profession. This follows resolutions in 2016, from the ARM on bullying and harassment, and the medical students conference, specifically on sexual harassment. More information is available here.
As part of this work, in January 2018, we are launching a new BMJ e-learning module to help members understand what bullying and harassment are, what to do if you experience or witness it, and what is needed to create a more positive working environment. We’re looking into what we can learn from our experiences of supporting members in bullying and harassment cases, and will be developing policy recommendations on what needs to be done to improve investigation and resolution of complaints , to encourage reporting and identify issues at an earlier stage, and to prevent such behaviour happening in the first place. We want to hear from you. If there’s anything you wish to share, please contact the BMA’s equality, inclusion and culture team at [email protected].
What has become clear through our project, and experiences across the world, is that for things to change, people need to speak up. To do this is hard, and the individual will need to be supported through the process. Please, if you see bullying or harassment of any kind happening to others, speak to them and offer support. It makes a huge difference for people to know they are not alone. A member who has experienced or witnessed bullying or harassment and doesn’t know what to do about it can always contact the BMA for advice and support. You don’t have to wait until you have got to the stage where you are ready to make a formal complaint. BMA advisers will gladly listen and talk things through with you at any stage - call 0300 123 1233
Find out more about the BMA's bullying and harassment work.
Sexual harassment in the medical workforce is an uncomfortable truth. Let’s face it together, and stand in support of those affected.
Hannah Barham-Brown is the UK junior doctor's committee deputy chair for professional issues
These themes resonate with many other current initiatives, and I am pleased that the issue of sexual harassment is placed in the context of power plays and workplace bullying of all varieties. The British Orthopaedic Trainees Association now has the 'Hammer it Out' programme which is catching attention. 'Bullying' was a major motive for me to found BOTA 30 years ago.
Finding 'someone to talk to' may be difficult, but here, BMA retired members may have a part to play. We will have no conflicts of interest (and would resile if we did), much experience, and a desire to be of continued service to the profession. I will explore what more retired members might do to help.
Chairman, Retired Members Conference
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We came across this excellent blog article by Hannah Barham-Brown when conducting a literature search to identify recent articles on sexual harassment in medicine. We were thinking of submitting an editorial to the BMJ, to summarise international activities in medicine since Me Too. However, as Hannah has included most of the key points we wanted to make, we would like to ask if we may suggest to the BMJ editors that they publish her piece in the main journal? We really think the time is right for the BMJ to publish on this issue. There are some updates which could be included: Louise Stone et al has published on the issue in the Medical Journal of Australia (published on line 18/6/18 and the RCOG has also recently published an article on sexual harassment in their members magazine (Spring 2018). We are based at the University of Otago in New Zealand - we are two academics and a GP - and would be happy to collaborate, but first wish to seek Hannah's agreement that we may approach the BMJ.
Thanks for writing the blog piece and for considering this request.
Associate Professor Mira Harrison-Woolrych (FRCOG and medical writer) email: [email protected]
Dr Katherine Hall (GP)
Professor Mavis Duncanson (public health and epidemiology)