Why the blame culture within the NHS needs to change – as quickly as possible

Jeremy Hunt
·3-min read
<p>Jasmine Hughes died at Great Ormond Street Hospital in 2011</p> (Getty)

Jasmine Hughes died at Great Ormond Street Hospital in 2011

(Getty)

The shocking revelations about the apparent cover-up behind why baby Jasmine Hughes died in 2011 at Great Ormond Street Hospital (GOSH) are a grim reminder that even the most prestigious healthcare institutions can get things wrong.

What I find most depressing about this case though is not that mistakes might have been made in Jasmine’s care. All doctors and nurses are, after all, only human and mistakes sadly do happen. In this case, medical experts suggest that mismanagement of Jasmine’s high blood pressure ultimately led to her tragic death.

This is awful enough but I get really angry about the tales of “missing” records, of inconsistent and changing statements from key clinicians, the ridiculous decision to stop talking with Jasmine’s family and above all, the continued refusal to apologise to them for what went wrong.

GOSH has issued a classic non-apology apology of which any politician would be proud. They are sorry Jasmine’s family feel they haven’t got the answers they want but do not accept that any errors caused her death. They clearly disagree with the findings of Dr Malcolm Coulthard and Dr Stephen Playfor but haven’t provided an explanation as to why, despite committing “to being open and transparent when things go wrong”.

So whilst there has been some progress in recent years this all too familiar story goes to the heart of what I believe is still a major issue within some parts of the NHS. Indeed within parts of healthcare systems around the world. It is easy to talk about being in favour of transparency and openness but the current blame culture that exists in healthcare means it is almost impossible for clinicians to actually be open when something does go wrong.

This is not a criticism of any individual doctor or nurse involved but a broader point about how difficult it is for them to be as completely open as they would like about what happened when there is the threat of litigation hanging over their every word.

Patients and their families tell me time and again that they understand how mistakes can happen. But what they don’t understand is how difficult it can be to get a doctor, a hospital or a Trust to say something as simple as, “I’m sorry, we made a mistake, we will do everything we can to make sure we don’t make it again”.

The truth is that until we move from a culture that seeks to blame an individual when something goes wrong to one that seeks to learn from these errors so that the system as a whole avoids repeating them we won’t see clinicians being as open as they’d like. And we’ll never see real progress in reducing the amount of avoidable harm healthcare causes.

When I was health secretary I wanted to tackle this issue by focusing on transparency with the introduction of Ofsted style ratings through the CQC and requirements on Trusts to publish data on the levels of avoidable harm they experience.

This has undoubtedly improved things even if not all Trusts publish data in a meaningful way. But towards the end of my time at the Department of Health and Social Care I realised that you’d never get lasting change until you achieved real cultural change.

That is a challenge that the events at GOSH suggest we have a long way to go in tackling.

Jeremy Hunt is a former health secretary who has been Conservative MP for South West Surrey since 2005

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