Over 30 women allege harassment and misogyny in ambulance service

More than 30 women have told RTÉ Prime Time they experienced sexual harassment, misogyny, bullying or intimidation while working in the National Ambulance Service (NAS). An unpublished Health Service Executive (HSE) internal review obtained by the programme also raised concerns about the culture and leadership of the service, including references to bullying and harassment and what it described as a traditional "command and control" management style. The report, carried out by the HSE's Workplace Health and Wellbeing Unit, has not previously been published or reported on. Documents obtained by Prime Time also show that concerns about misogyny, gender discrimination and sexual harassment were raised with the Director of the NAS Robert Morton by senior management. The women who spoke to the programme include current and former paramedics and emergency medical technicians. Many spoke anonymously because they continue to work in the service. They stressed that there are many good people working within NAS, including many men, but described what they believe is a long-standing culture in which inappropriate behaviour was tolerated and complaints were not always properly addressed. NAS is a part of the HSE in which more than 2,400 staff are employed nationwide. 'I didn't want to rock the boat' Hannah, not her real name, told Prime Time that in one instance a senior male colleague made a series of sexual comments while they worked an overnight shift together. "He was asking me about my sexual preferences, asking about positions that I like to have sex in, asking do I like to do anal? Would I ever have a threesome?" She said the colleague asked who she would have a threesome with and suggested himself and another person. "Then, when there was a lull in conversation, he was like: 'I can't stop thinking about bending you over.'" Hannah said he also made a sexual comment about the body of a young female patient after the crew had treated her. "He made a comment about how tight her body was and said that he wondered if her fanny was as tight as her body." Hannah said she felt extremely uncomfortable but feared being labelled a "difficult woman" if she complained. Another woman, Barbara, also not her real name, said the power held by more senior staff over interns made challenging inappropriate behaviour particularly difficult. Interns are assessed regularly throughout their training. She said her experience during her training left her questioning whether she could continue in the service. Barbara said on one occasion a more senior male staff member made comments about her underwear and, during one incident involving a patient being carried downstairs, placed his hand on her backside. She said she felt unable to react because her priority at that moment was caring for the patient. She also described occasions on which she said he touched her or massaged her shoulders in front of colleagues. "He had that power over me, and he knew that he had that power, because I was not going to get through my internship year unless he signed me off." "He had my career in his hands. I felt if I said anything at all, that I would have been penalised for it." Complaints 'fell on deaf ears' A number of women told Prime Time they were discouraged from making formal complaints or feared doing so could damage their careers. Aoife, not her real name, described an incident in which she alleged that a senior colleague had put his hand on her leg and moved it towards her crotch. She said she reported the incident to a supervisor but was discouraged from pursuing it. According to Aoife, she was told: "You’re wasting your time even reporting it, because nobody’s gonna do anything, and he’ll do it again because he’s done it before." She said she felt she was given no support and has since left the service. Several women also raised concerns about the HSE's dignity at work complaints process. Hannah subsequently made a complaint. She said it was deemed inconclusive because there was no witness or documentary evidence, which further damaged her confidence in the complaints process. David Hall, CEO of Lifeline Ambulance Service and a former member of the Pre-Hospital Emergency Care Council, described the NAS as historically male-dominated, with a "semi-militaristic structure" and an "unhealthy culture of dominance". Dr Alan Eustace, Assistant Professor of Private Law at Trinity College Dublin, said it was understandable that employees might be reluctant to complain if they feared consequences for their careers. He said it would be viewed "extremely unfavourably" if managers actively discouraged employees from making complaints. Unpublished HSE review Similar concerns about the culture and leadership of the NAS were also identified in an internal HSE review carried out in 2021. The 2021 review of the service's leadership team identified mistrust, a negative workplace culture and negative leadership styles. The report said, "inappropriate behaviours", including potential bullying and harassment, "had not been called out." It also identified a traditional "command and control culture" and what it described as a tendency to blame. It said some senior managers believed that questioning authority could lead to them being undermined, excluded and eventually forced out. Freedom of Information documents obtained by Prime Time separately show that concerns about gender balance and the treatment of women were raised by senior management. In one area of operations, four new heads of service and eight new general managers had been appointed. All 12 were men. A senior male manager described this as "an unacceptable level of gender balance in a public organisation". The same correspondence said female staff wanted to work in an environment free from "sexual harassment; indirect discrimination and misogynistic behaviour". HSE response In a lengthy statement, the HSE said it regretted the serious concerns raised by staff working in the NAS and said all staff had the right to feel safe, respected and valued at work. "All HSE staff have the right to feel safe, respected and valued at work," it said in the statement. "While significant efforts have been made in recent years to improve the culture of NAS, staff feedback continues to highlight concerns relating to bullying, discrimination, harassment, and levels of trust within the organisation. These behaviours can significantly impact individuals and teams and have no place in our organisation." It said work has begun on a new culture initiative aimed at addressing issues and concerns within the service. The initiative was announced earlier this week, after Prime Time had begun submitting questions to the HSE about allegations of misogyny and sexual misconduct within the NAS. It will be independently chaired by retired Irish Major General Maureen O’Brien. Over the next six months, the initiative will include an organisation-wide survey, workshops, staff interviews, and site visits. 'It was tolerated' Some of the allegations made to Prime Time stretch back over the course of lengthy careers, while many relate to recent or current issues. Nicola, who has worked in the National Ambulance Service for more than 20 years, said she spent years trying to avoid a particular male member of staff because of repeated unwanted physical contact. She said she raised concerns with a manager and the man was spoken to on occasions, but she believed the behaviour was tolerated. "It was anger for a long time. And frustration. It was just so wrong what he was doing. But it was tolerated," she said. The women who spoke to Prime Time said they continue to value the work of the NAS and the role paramedics play in responding to people at some of the most difficult moments of their lives. But several said their experiences had changed how they viewed careers they had once regarded as a calling. Barbara was one of several women who has subsequently left the NAS. "I cried and cried and cried because I worked so hard to get into the ambulance service," she said. If you've been affected by any issues raised in this article, please go to rte.ie/helplines. The full report from Aisling Kenny and Executive Producer Tara Peterman will feature on the Thursday 10 September edition of Prime Time on RTÉ One and RTÉ Player at 9.35pm.