Belfast Trust under fire: Health Minister vows accountability for Cardiac Unit failing

A damning report exposing a toxic workplace culture in the Cardiac Surgery Unit at the Royal Victoria Hospital in Belfast has prompted a robust response from Health Minister Mike Nesbitt, who has vowed to hold the Belfast Health and Social Care Trust accountable for immediate and measurable action.

The report, which detailed allegations of bullying, verbal abuse, and surgeons throwing instruments during operations, has sparked widespread concern about staff welfare and patient safety in Northern Ireland’s only cardiac surgical facility.

Following a “frank discussion” with the Belfast Trust Chair on Friday, 30 May 2025, Nesbitt condemned the behaviours outlined in the report as “appalling and bring shame on our health service.”

In a statement, he announced plans to finalise a series of departmental interventions, including accountability measures and external support to help the Trust rebuild confidence among staff and the public.

“I will be holding the Trust’s senior management accountable for its response to the report,” Nesbitt said, emphasising the need for a health service culture that is “welcoming for all those who work there.”

He added, “I want assurance that any employee with concerns about bullying or other unacceptable behaviours is properly listened to and supported.”

The minister is set to meet with health service trade unions early next week to discuss the planned interventions and will provide a further update following those talks.

A Call for Demonstrable Action

The report, commissioned by the Belfast Trust in January 2025 after staff complaints and recently leaked to UTV, revealed a breakdown in relationships within the Cardiac Surgery Unit, with “clear tensions” and an “apparent power battle” among senior doctors.

It highlighted shocking incidents, including verbal abuse and instrument throwing in operating theatres, with nursing staff bearing the brunt of the bullying.

The report warned that these cultural issues pose a “significant risk to patient safety,” with operations cancelled due to four heart surgeons refusing to attend theatre and four consultants working from home citing safety concerns.

Ulster Unionist Health Spokesperson Alan Chambers MLA welcomed the minister’s proactive stance but stressed that the Belfast Trust’s response must go beyond words.

“The ability of the Belfast Trust to respond to this week’s damning report will be measured in demonstrable actions and not words alone,” Chambers said.

He described the report’s findings as “both disturbing and completely unacceptable,” particularly the reports of bullying in operating theatres where “life-and-death surgery is being performed.”

Chambers praised Nesbitt’s demand for answers from the Trust’s leadership and expressed confidence that the minister would take “whatever actions necessary” to ensure urgent improvements and a cultural overhaul if the Trust fails to deliver.

“I’m glad that the Minister and his Department have demanded answers from the Chair of the Belfast Trust and have already received assurances that the recommendations of the leaked report are being acted upon at pace,” Chambers said.

“Immediate actions and improvements, however, and not words alone, will be the yardstick deployed by the Minister to ensure the welfare and well-being of every member of our health service, and those that they treat.”

Protecting Staff and Patients

The report’s revelations have raised broader concerns about workplace culture across Northern Ireland’s health service. Nesbitt acknowledged that the findings could encourage other healthcare workers to report similar issues in different settings.

“The Minister has already acknowledged that the content of the report may give others working in the health service the encouragement to come forward and report any toxic culture in other health settings,” Chambers noted, echoing Nesbitt’s call for staff to speak out.

As a member of Stormont’s Health Committee, Chambers urged healthcare workers to come forward with concerns, assuring them that the minister would address such reports with urgency.

“If such reports are forthcoming, I am confident that the Minister will address these with the concern and urgency that he has expressed in relation to the events in the RVH Cardiac Hub,” he said.

Despite the troubling findings, Chambers highlighted a silver lining: patient care has not been compromised.

“If the report has provided any level of comfort, it is that patient care was not compromised by the actions of those responsible for the disgraceful contents of the report,” he said.

“It is a testament to the dedication of our overall health staff that despite what they were having to endure behind the scenes, they did not let this interfere with the pleasant and professional care they give to those patients under their care. Care for which they are rightly renowned.”

Urgent Reforms and Accountability

The Belfast Trust has stated it is “appalled” by the behaviours outlined and insists the Cardiac Surgery Unit remains “clinically safe with excellent outcomes.”

However, this claim has been met with scepticism given the report’s conclusion that cultural issues pose a significant risk to patient safety. The Trust now faces intense scrutiny to implement the report’s recommendations and address the toxic culture decisively.

Nesbitt’s interventions aim to restore trust in the unit, which performs nearly 1,000 surgeries annually, and ensure a supportive environment for staff. His focus on accountability and external support signals a commitment to systemic change, not only within the Belfast Trust but across the wider Health and Social Care (HSC) system.

As the fallout from the report continues, the public and healthcare workers alike will be watching closely to see whether the Trust delivers the “demonstrable actions” demanded by Chambers and Nesbitt. For patients relying on the Cardiac Surgery Unit and the dedicated staff working under challenging conditions, the need for urgent reform could not be clearer.