The fear of speaking out

David Vine

David Vine, business development manager at Allianz Legal Protection

Posted by David Vine, business development manager at Litigation Futures Associate Allianz Legal Protection

I am sure that many of us read with horror the findings of the review into the Liverpool Community Health NHS Trust by Dr Bill Kirkup.

He reported that every part of the system failed, leading to patients suffering “significant harm”, and this happened as the trust was considering what it could learn from the Mid Staffordshire scandal.

I don’t want this blog to be yet another hammering of the NHS, but rather highlight the need in whatever industry we’re in, public or private, for an open, no-blame culture to exist. It is the only way to learn and improve.

Time and time again we read of the fear of speaking out. Whether it is nurses and doctors in the NHS or actors in Hollywood, there appears to be a real fear of the repercussions that follow.

This got me thinking about the excellent book by Matthew Syed, Black Box Thinking, which amongst other things highlights the tremendous differences in two safety critical industries, aviation and health.

In one, lessons are learnt after every event and improvements put in place to avoid the same thing happening again. In the other, mistakes are seemingly brushed under the carpet and the all-pervading fear of speaking up permeates throughout.

Robert Rose, a partner at Lime Personal Injury, shares the view that “we have a duty of candour in this country”.

He explains: “It is a statutory duty to be open and honest with patients and families when something goes wrong that appears to have caused or could lead to significant harm in the future.

“Far too many of my clients, injured by medical mistakes, have had to seek legal advice because they are not told about when something has gone wrong , and are not told what if any action will be taken to prevent such a mistake being made again.

“If the NHS is truly going to become ‘an organisation with a memory’, it needs to ensure that it encourages an open and honest culture, where patient safety is always the first priority.”

So how will things ever change? Perhaps we need to stop thinking about our own immediate business challenges and start calling for an open and transparent NHS that isn’t afraid to admit mistakes, but learns from them with the goal of preventing them from happening again.

This doesn’t mean that the great work claimant lawyers in the clinical negligence arena should stop. One would hope that the work they do highlights the issues.

The NHS could learn from corporate business and its efforts to become more open, actively encouraging whistleblowing when it is right and proper to do so. It could also listen to those at the sharp end rather than dismissing their challenges out of hand.

Without a spirit of openness and inclusivity, we will likely continue to read about further scandals and sit on our hands squirming, thinking we must do something. By then I fear it might be too late.

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