The healthcare industry, whether in the public or private sector, is not immune to the effects of the #MeToo movement. Despite being centred on providing care, the healthcare industry has increasingly faced the urgent need to address sexual harassment and misconduct. Numerous studies have highlighted the troubling frequency of such incidents in medical settings, which not only affect the individuals but also hinder effective teamwork and communication, thereby posing risks to patient safety.
Although concerns about workplace harassment are longstanding, the 2017 #MeToo movement has intensified the focus on this issue. Underscoring the importance of strong policies and clear institutional responses to prevent and address harassment. Healthcare organisations must implement comprehensive strategies that define harassment as unacceptable and establish systematic methods for investigating complaints. When substantiated, these complaints should result in fair and consistent corrective actions.
This article examines the extent of the issue, its repercussions for healthcare professionals and patient care, and the evolving legal and organisational approaches for combating sexual harassment and misconduct in healthcare.
The scale of sexual misconduct in healthcare globally is staggering. Women, particularly in the field of surgery, are disproportionately affected, with recent UK research uncovering that a shocking 63.3% of female surgeons have experienced sexual harassment, while 29.9% have been subjected to sexual assault[1], [2] This study reveals an environment where misconduct is widely observed, both male and female colleagues report witnessing it firsthand. Yet only 16% of those impacted come forward to file a formal report, exposing the immense silence surrounding this pervasive risk. Global publications mirror these findings[3], with an alarming 55% of surveyed female doctors in Australia reporting they had experienced sexual harassment[4]. Similarly, the nursing profession faces equally high rates of sexual harassment[5], with a study highlighting that 60% of female nurses and 30% of male nurses worldwide had experienced sexual harassment.[6], [7]
These statistics underscore the urgent need for comprehensive strategies across all healthcare settings, including both public and private institutions.
Evidence highlights that organisational characteristics, rather than individual traits, are the strongest predictors of whether sexual harassment occurs within a given setting[8], [9], [10]. Environments where management is indifferent or inattentive to harassment contribute to a culture where perpetrators expect little to no consequences while victims feel discouraged from speaking up[11], [12]. Effective leadership and a strong, respectful workplace culture are essential; when leaders model respectful behaviour and prioritise a zero-tolerance approach to misconduct, they set a standard that permeates the entire organisation, reinforcing a culture where harassment is actively prevented and swiftly addressed. Clear policies, transparent grievance procedures, and consistent enforcement are critical organisational controls that equally deter harassment and create a safer, more accountable workplace[12]. Training further supports this by clarifying what constitutes harassment, reducing ambiguity, and fostering respectful behaviour among employees[10].
Experiences of sexual misconduct and poor sexual safety within healthcare are linked to deteriorating mental health for both men and women. The demanding nature of healthcare professional roles already puts a strain on mental health, and environments that tolerate harassment can exacerbate these effects. Poor mental health has been shown to negatively affect overall well-being and is associated with lower job satisfaction, reduced safety and increased intentions to leave the profession. Workforce retention challenges in healthcare lead to significant costs for organisations, including recruitment, training and lost productivity. Decreased job satisfaction is also connected to increased absenteeism, burnout and risk-taking behaviours, all of which can compromise patient safety. Research in other professions has similarly linked sexual harassment to performance declines, suggesting that it may undermine both medical staff performance and the quality of care provided to patients[13].
Monitoring and documenting the direct impact of sexual misconduct on patient care is challenging due to the underreporting of incidents and the silent suffering of victims. Nonetheless, evidence demonstrates a clear connection between sexual misconduct and power imbalances within healthcare environments, particularly between healthcare providers and patients or between senior and junior staff members. These imbalances can create a "slippery slope," where misconduct directed at employees increasingly leads to harmful actions against patients[14]. Working in an environment where sexual violence is normalised undermines the health of the workplace and disrupts the trusting relationships that targeted individuals have with patients. Research consistently shows a link between dysfunctional teams and poor patient outcomes, emphasising how a toxic work culture can affect employees, and the quality of care provided to patients. [15]
In response to the growing awareness of sexual misconduct in healthcare, various legal and institutional measures have been implemented to address the issue.
The NHS Sexual Safety Charter establishes a framework to prevent and address sexual misconduct, emphasising a zero-tolerance policy and a commitment to creating a respectful, safe environment for all staff and patients[16]. Signatories pledge to ten core principles, including promoting transparency, fostering inclusivity, supporting affected individuals, enforcing clear behaviour standards, providing training, and establishing robust reporting mechanisms. Key initiatives supporting the charter is the new NHS England Sexual Misconduct policy[17], and the Royal College of Surgeons of England’s Code of Conduct, which outlines severe consequences for misconduct, and NHS England’s anonymous reporting process, providing a safe channel for reporting incidents[18].
The Worker Protection (Amendment of Equality Act 2010) Act 2023 came into effect in October 2024[19]. This amendment builds on the existing Equality Act 2010, which already holds employers liable for sexual harassment by employees under section 26(2).
The new law introduces a mandatory duty for employers to take reasonable steps to prevent sexual harassment in the workplace. If an Employment Tribunal finds an employer failed to meet this standard, they may impose an additional compensation uplift of up to 25% on top of the original award. To apply this uplift, the Tribunal must first confirm that harassment occurred and award initial compensation. The uplift applies regardless of whether harassment was the primary claim.
The amendment does not specify what constitutes "reasonable steps," giving the Tribunal discretion to assess this based on each employer's resources and circumstances.
This shift in the law makes the duty preventative rather than reactive. It aims to reduce workplace harassment of employees by encouraging employers to create safer environments and imposing significant financial consequences for non-compliance.
Sexual misconduct doesn’t require dark corners; it can occur openly in any environment where boundaries, respect, and accountability are compromised. Ending sexual misconduct in healthcare will require more than social media awareness and superficial gestures. This problem requires a multifaceted and collaborative effort from all stakeholders in the healthcare sector.
Our Global FINEX Healthcare team are one of those stakeholders. Our Clinical Risk Consultancy service can support your organisation in:
