Content warning – This article includes mentions of sexual harassment, abuse and male violence against women.

Recent events have thrown a spotlight on violence and sexual harassment against women. Natasha Matthews, a clinical fellow currently working with the GMC’s case examiners team, reflects on what can be done to address the workplace behaviours and attitudes that can surround the abuse of women, as well as the GMC’s response to dealing with sexual misconduct cases.

Like most women, it has been impossible for me to navigate recent weeks without some earnest reflection on my position as a woman. The murders of Sarah Everard and sisters Nicole Smallman and Bibaa Henry has made us all stop and think about our own experiences.

And, years after the #MeToo movement, more women and girls moved by these cases have come forward with their experiences of sexism, sexual assault, and feeling unsafe in our communities, schools and universities. Of course, this isn’t about telling other women there’s a problem – we literally all know. This is about shining a spotlight on the systemic issue that women still experience sexism and gender-based violence regularly.

Disappointingly, a quick look online demonstrates the abundance of resentful ‘not all men’ tropes that wholly miss the point. In fact, it’s more damaging than that. Of course, it’s true that not all men harm women, and not all men are safe from abuse either. But deflecting attention from a meaningful conversation about women’s safety to suit one’s own narrative (NB violence against men is overwhelmingly carried out by other men) contributes to the problem. Instead, we need to listen and learn from one another and ask what can I do to make women feel safer?

I read with interest my colleague Clara Munro’s BMJ piece about starting at work: ‘While #notallmen are perpetrators of violent crime against women, can #allmen say that have not stood by while an inappropriate comment is made about a female colleague?’

A 2019 report on fitness to practise cases in health and social care found that of 275 cases reviewed, 232 related to sexual harassment or sexual abuse, the predominant target groups being patients and colleagues at 59% and 32%, respectively. Moreover, the majority (88%) of perpetrators were male. So yes, let’s start there.

As a doctor identifying as female, I am passionate about the need to strengthen processes to tackle all forms of sexual misconduct in the health workplace. Specifically, there is a need to address more poorly understood gender microaggressions, as well as widely accepted forms of unacceptable behaviour, including bullying and sexual harassment. Only then can we truly take pride in our profession as one that wholeheartedly supports gender equality and a safe workplace for patients and colleagues and alike.

As Dame Clare Marx, the first female Chair of the GMC, since its establishment 163 years ago, has said: ‘Inequality is insidious. Throughout my career as a surgeon, I’ve seen it take many forms. Sometimes it’s as ostentatious as a sexist slur or a hand on the knee. But most of the time, it creeps quietly into our professional lives, undermining confidence and the care we provide. That’s why combatting inequality of any kind is not a distraction from delivering first class care. It’s an essential part of it.’

As a current clinical fellow at the GMC, I was pleased to learn the extent to which this issue is taken seriously by our regulator, and it has formed a large part of my ongoing work. While allegations of sexual abuse may be rare, this has not held back the GMC from launching, in 2019, the Embedded Learning from Sexual Abuse cases (ELSA) programme to address all forms of sexual misconduct in the health workplace.

The programme has three main aims:

  • Assurance – to improve how it identifies, evidences and progresses cases involving sexual misconduct and sexual harassment.
  • Supporting others – to improve support for complainants and vulnerable witnesses to understand and participate in investigations of sexual misconduct cases, as well as support for doctors, employers, and GMC staff in identifying and raising concerns about sexual misconduct and sexual harassment.
  • Raising awareness – to raise awareness of the GMC’s professional guidance and how it deals with cases involving sexual misconduct and sexual harassment.

To appropriately progress and evidence cases involving sexual misconduct and harassment, the GMC is developing targeted resources to help identify and manage sexual misconduct in the healthcare workplace. This will improve the support for all those involved in these cases, including witnesses, complainants, doctors and employers, and enable learning to be shared with other regulators.

One such resource is aimed at doctors and will be published on the GMC’s Ethical hub, a resource exploring how to apply guidance in practice. Throughout this reverberates the subtext of my earlier question: In the healthcare workplace, what can I do to make women feel safer?

Colleagues, we have a critical role that may be summed up according to these fundamental principles:

  • We must take a firm and consistent stand on all forms of sexual misconduct – challenge any uninvited or unwelcome behaviour of a sexual nature, or which can be reasonably interpreted as sexual, that offends, embarrasses, harms, humiliates or intimidates an individual or group.
  • We must take swift action to report perpetrators and support victims of sexual misconduct – report all incidents of sexual misconduct we see or to which our attention is drawn to a person or organisation able to investigate the allegation.
  • We should familiarise ourselves with local policies addressing different aspects of sexual misconduct – the severity and nature of the misconduct in individual cases will determine the responses that we might take. If a doctor has committed a sexual assault, this needs to be reported to the police.

To quote Lieutenant General David Lindsay Morrison: ‘If you become aware of any individual degrading another, then show moral courage and take a stand against it. The standard you walk past is the standard you accept.’

Note: Help and support is available for anyone affected by sexual misconduct in the workplace.

GMC Outreach advisors can provide information and support in identifying and managing sexual misconduct in the workplace. Please refer to our page on Who can help in your area.

Our ethical hub pages on Speaking up provide advice and tools to help you follow the processes set out in our guidance, as well as a list of organisations who can support you, including our confidential helpline 0161 923 6399 (open Monday to Friday, 9am to 5pm).