NHS executives should be regulated similarly to medical practitioners, the paediatrician who first raised the alarm on Lucy Letby has said, after clinicians’ concerns about her after years of concerns were “turned on the head”.
The behaviour and accountability of senior officials within the health service “absolutely” needed to be regulated, said Dr Stephen Brearey, who first carried out an urgent review into the nurse sentenced on Monday to a whole-life term for the “sadistic” murders of seven babies.
“Doctors and nurses all have the regulatory bodies that we have to answer to and quite often we’ll see senior managers who have no apparent accountability for what they do in our trusts and then move to other trusts,” Brearey told BBC Radio 4’s Today programme.
“You worry about their future actions and there doesn’t seem to be any system to make them accountable.”
The calls were echoed on Tuesday by the hospital doctors’ union (HCSA), which is asking for an independent national statutory body to be established outside the health service to protect whistleblowers and those who report safety concerns.
“The intolerable cover-up culture by managers that we still see in corners of the NHS is bad for patients and bad for doctors,” said the HCSA president, Dr Naru Narayanan. “For too many doctors, the brave, professionally obligated and morally correct step of reporting safety concerns is rewarded with attempts to silence and force out the individual who reports problems by managers focused on protecting reputations.”
The union, which said it had dealt with “a string of cases affecting members” – with some reporting being left on the verge of suicide after raising safety alarms – has also called for a law to be created making it a criminal offence to cause detriment to people who have made protected disclosures.
Last week the government announced an independent inquiry into how the neonatal nurse was able to murder seven babies and attempt to kill six others. Pressure has been mounting from bereaved families and experts calling to strengthen the investigation to a statutory inquiry where witnesses would be compelled to give evidence.
On Tuesday, a senior cabinet minister conceded a statutory inquiry was “on the table”. “I was speaking to the prime minister yesterday and he made it really clear that what we need to do is make sure the families get answers, we learn the lessons as well, and it is a very transparent process that everyone can get behind,” Gillian Keegan, the education secretary, told Times Radio.
“What will happen next is there will be a chair appointed, the chair will work with the families to look at the terms of reference, discuss the pros and cons of different types of inquiry, and then they will come to a conclusion.”
Following the unexplained deaths of seven babies in 2015, Brearey and other senior doctors asked an independent expert to carry out a review. The report was shared with the medical director of Countess of Chester hospital in 2016.
The concerns were responded to in 2016 – by which time Letby had murdered five babies – by a hospital manager who said there was “no evidence” against the nurse “other than a coincidence”.
Brearey said concerns raised by clinicians were “turned on the head”. An experience, he said, that was not uncommon in the NHS. “You go to senior colleagues with a problem and you come away confused and anxious because that problem is being turned in a way in which you start to realise they’re seeing you as a problem rather than the concern that you have,” he said.
Following Letby’s conviction, detectives have started contacting more families believed to be harmed by the nurse, including examining the records of more than 4,000 babies born at the Countess of Chester hospital and Liverpool Women’s hospital.
• In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or by emailing jo@samaritans.org or jo@samaritans.ie. In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counsellor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org
