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Can Mandela’s model for restorative justice work in healthcare?

February 25, 2014

Restorative justice now has a significant role in the criminal justice system in England and Wales. According to the Ministry of Justice’s evaluation of its early pilot projects, restorative justice was associated with an estimated 14 per cent reduction in the frequency of reoffending and 85 per cent of victims who participated in face to face meetings were satisfied with the experience.

The principles of restorative justice have also been applied to education, where it is more commonly referred to as restorative practice. Here it is being used with some success to resolve conflict and tackle bullying, helping children understand the way their behaviour affects others and how to deal with conflicts which arise in the playground.

Restorative practices have also been used in workplace environments to settle grievances and disputes between staff members.

Given that restorative practice has achieved success in resolving conflict and repairing harm in other contexts, it is worth considering whether it could work within the NHS.

As events at Mid Staffordshire and University Hospitals of Morecambe Bay foundation trusts have clearly demonstrated, failings in the health service can cause tremendous harm and a legacy of mistrust. Adverse incidents and surgical complications can also cause real distress to the doctors involved in turn affecting their performance.

A recent study, published in The British Journal of Surgery, investigating the personal and professional impact of major clinical incidents on surgeons at two large NHS teaching hospitals in London found that most participants described the support they received from their employers as inadequate.

They said that debriefing or effective mentoring following serious incidents was rare, and organisations often reacted punitively while blame passing and personal rivalries dominated morbidity and mortality meetings.

…By contrast, a restorative approach provides an opportunity for those most affected by these events to talk about their experience in a process which is focused on rebuilding trust rather than punishment.

The person harmed can find out what happened and (ideally) receive some reparation while those involved in the incident can show they recognise the gravity of what happened and make amends. 

Clearly, the advantages would need to be carefully considered on a case by case basis.

Read the full article.


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