Jeremy Hunt said the blame culture in the NHS must change to avoid more scandals like those tragically exposed at Gosport War Memorial hospital (Report, 21 June). Of course, there must be consequences where neglect or deliberate actions have caused harm, but to shift to a “learning culture” he must incentivise accountability among staff to foster a culture of openness and honesty. Lessons are only learned through honesty, transparency and an acceptance that accountability doesn’t necessarily lead to blame and punitive measures. Staff are the NHS’s biggest asset and by getting its workforce culture right, not only will Hunt improve patient safety and prevent future scandals such as the one at Gosport hospital, he will reduce the burden on staff that is making so many want to leave the NHS after so many years of service.
Executive chairman, Pulse UK, Norwich
• Safety is disaster-led. After the Herald of Free Enterprise ferry sank in 1987, killing 193, marine safety regulations were tightened. Shipping companies were made responsible for safety of life at sea, in addition to the duties of captain and crew. Safety improved. Working as a ship’s doctor from 2003-15, I witnessed a new development. A monthly prize was awarded to the crew member who reported the most significant safety concern leading to learning or a change of practice. A volte-face in the NHS would be to reward whistleblowers, especially those whose testament led to an increase in safety. We need to fundamentally change the current situation in which staff are still nervous about the personal consequences of whistleblowing, and are often unsupported or worse. How about an annual prize for the NHS organisation which has made the most safety improvements as a result of staff-reported concerns? Carrot and stick.
Dr Ruth Taylor
• Bribing or gagging well-intentioned whistleblowers, who have the interests of the patients at heart, is no way to improve quality control in the NHS, a matter which in my opinion has never been adequately addressed. The main problem is that the whistleblower feels they have no one to turn to. The post of matron has largely been abolished, and the medical profession has become the servant of managers, who are lay people, rather than the other way around, a fact which is reflected in their respective salaries.
Surely NHS staff should be given a statutory right to complain to management if they find it necessary, and have their complaint recorded and acted upon in a transparent manner, instead of having to endure the present culture of victimisation.
I recall as a junior doctor, working at a hospital in the south of England, complaining that when I was on call for cardiac arrests – a very urgent matter requiring immediate attention, obviously – no on-site accommodation was provided for me. The outcome? I was hauled up before the hospital manager and senior surgeon and accused of being a communist. Presumably communists have higher standards of care and compassion.
Dr Andrew Norman
• In her article Call for action against senior officials over hospital deaths (22 June), Sarah Boseley refers to “life-shortening drugs” such as diamorphine. It is important to stress that although overdosage can be fatal, as long as they are given in appropriate dosage, carefully titrated against the patient’s need for pain control, these drugs do not shorten life. The common perception that they do can be very unfortunate if consequent reluctance to prescribe or accept them results in inadequate pain control in advancing but non-terminal cancer.
Dr Peter Wemyss-Gorman
Lindfield, West Sussex
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