STEPHEN DAISLEY: Sadly for patients, the NHS has gone down with the sickness of secrecy… a malady that starts at the very top
Columnist Stephen Daisley argues that the Scottish NHS is being undermined by a culture of secrecy that prioritises institutional reputation over patient safety, warning that this makes patients less likely to trust the healthcare system with their lives. He cites senior figures including BMA Scotland chief Dr Iain Kennedy and patient safety commissioner Karen Titchener as evidence that concerns raised by staff and patients are routinely dismissed or suppressed rather than addressed.
Dr Kennedy has warned of a "culture of cover-up" in which doctors and staff who raise safety or capacity concerns face scrutiny rather than action, while Titchener describes a "nothing-to-see-here culture" in which complaining patients are branded "a pest" or "aggressive". Daisley traces this secrecy to the Scottish Government itself, citing examples such as undisclosed WhatsApp messages from pandemic decision-making, an unreported Covid-19 outbreak in Edinburgh, and withheld documents relating to an unlawful investigation into a former first minister, arguing that Dr Kennedy is right that such a culture is set "at the very top" by ministers and MSPs.
- Columnist says secrecy culture harms NHS Scotland patient trust and safety
- BMA Scotland and patient safety commissioner report suppression of concerns
- Writer blames Scottish Government's broader lack of transparency and accountability
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Scotland's NHS relies on staff and patients speaking up when something goes wrong, whether that's a safety failure, a lack of beds, or poor treatment. The concern being raised is that, instead of acting on these warnings, parts of the system are more focused on protecting its reputation, which can leave problems unaddressed and patients at greater risk.
Key figures named in this debate include Dr Iain Kennedy, who leads BMA Scotland, the doctors' professional body, and Karen Titchener, Scotland's patient safety commissioner, a role created to give patients an independent voice when raising concerns about care. Both have described a pattern in which complaints or warnings are brushed aside rather than investigated, with staff facing pushback for speaking out and patients sometimes dismissed as difficult.
The wider argument links this to how the Scottish Government itself has handled sensitive information, pointing to past controversies such as undisclosed pandemic-era messages, an unreported Covid outbreak, and withheld documents from an unrelated investigation. This matters because trust in how the NHS and government handle information can affect whether people feel confident coming forward with concerns about their own care.
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