Peggie vs. NHS Fife Tribunal: What it tells us about organisational failure

Gender ideology is an idea that is entirely fictitious. There is no evidence for the existence of a ‘gendered soul’. Individuals of course have feelings but the feeling that an individual may have that he or she is the opposite sex, does not make it real. An ideology that insists that such a feeling is real and insists that others must agree with it, is by definition, authoritarian. What can happen to any organisation steeped in an authoritarian ideology?

An organisational culture steeped in authoritarian ideology, is characterised by centralised control, rigid hierarchies, and the suppression of dissent (Schein,2023). Such an organisational state has profound implications for the vitality and longevity of the organisation. This type of culture stifles critical thinking and undermines innovation. It will likely precipitate a decline in organisational performance. This is exactly what we appear to have witnessed this week in the Sandie Peggie v NHS Fife tribunal. What we appear to have witnessed is a labyrinth of processes and procedures gone wrong; a complete lack of impartiality; scant accountability, and the application of common sense in short supply. How can this have happened?

Authoritarian organisational cultures prioritise compliance. They demand strict adherence to directives issued by those at the top of the hierarchy. This approach often manifests in unilateral decision-making, and a lack of tolerance for individuals questioning established norms or policies. Employees are discouraged from voicing alternative perspectives or challenging the status quo. An environment is created where critical thinking: the ability to analyse, evaluate, and synthesise information to make reasoned decisions, is systematically suppressed. Critical thinking thrives on open dialogue, diverse perspectives, and the freedom to question assumptions. In an authoritarian setting, these elements are replaced by fear of reprisal, conformity, and a culture of silence.

The suppression of critical thinking has cascading effects on organisational health. It stifles innovation. Critical thinking is the bedrock of problem-solving and creativity, enabling employees to devise novel solutions to complex challenges. In an authoritarian culture, employees are less likely to propose new ideas or take risks because they fear punishment or ridicule. This leads to stagnation.

A lack of critical input from employees can lead to obsolescence. Authoritarian cultures erode employee morale and engagement. When workers feel their insights are undervalued or dismissed, they become disengaged, leading to reduced productivity and higher turnover rates. Disengaged employees are less likely to invest mental energy in critically analysing problems or seeking improvements. This entrenches a cycle of mediocrity. Research from organisational psychology, such as studies by Gallup (2023) consistently show that low employee engagement correlates with diminished organisational performance. In authoritarian environments, the lack of psychological safety— where employees feel secure in expressing ideas—exacerbates this disengagement, draining the organisation of intellectual capital. The recent perfomance of NHS Fife would suggest the existence of a culture where employees, even those in fairly prominent positions, have felt it necessary to follow an delusional ideology rather than reality, simply in order to survive..

Organisational authoritarianism also fosters groupthink, a phenomenon where conformity overrides independent thought, leading to flawed decision-making. Without critical thinking to challenge assumptions or evaluate alternatives, organisations risk making strategic errors. Groupthink in such environments blinds organisations to risks and stifles the ability to course-correct before decline sets in. This, we are arguing, looks to be exactly what has happened in NHS Fife for some time; the pinnacle being Friday afternoon's bizarre press release, not the mention all six of them, or was it seven?

Moreover, authoritarian cultures create a feedback vacuum. Leaders insulated from criticism or alternative viewpoints, are prone to overconfidence and misinformed decisions. Without critical feedback, leaders may pursue strategies misaligned with the law or societal norms. This disconnect can lead to resource misallocation, missed opportunities, and, ultimately, financial and operational decline. Again we think that is exactly the impact that the promotion of gender ideology has had on NHS Fife.

To function effectively, organisations must foster environments where critical thinking and open communication is valued and constructive dissent is welcomed. By enforcing compliance, fostering groupthink and beliefs in magical thinking, it would appear that NHS Fife has facilitated an erosion of intellectual rigour resulting in disengagement, poor decision-making, and strategic missteps. It should never have come to this but NHS Fife will not be the last organisation to end up in disasterous mire of controversy and failure.

NHS Fife has failed

Until gender ideology is rooted out of all our public services, we will continue to witness ridiculous arguments made by professionals who have lost their way. It is essential that our governments and leaders step up and put on their big boy pants to stop the nonsense and public spectacle that this phenomenon has become.

Carolyn Brown ScotPAG Convenor

Gallup, (2023), State of the Global Workplace: 2023 Report

Schein, E.H., (2010), Organizational Culture and Leadership, Jossey-Bass.