Letby's actions themselves are horrendous, but tge cover up by the hospital and refusal to act on the concerns of the consultants is an extra level of betrayal.
I do think it comes down to the culture of the hospital though, not just the NHS as a whole. I'm a HCP, not a nurse, and I work in rehab, not acute. A few years back in my old job, there was a complaint made about me and a colleague- it was completely groundless, there was plenty of evidence to show we hadn't done what had been alleged (and it turned out there were reasons the complaint had been made) but that isn't the issue, what has stayed with me is the attitude of my old head of department. She wasn't a nice person, multiple complaints of bullying had been made against her, and she was responsible for dealing with the complaint which really worried me. However, she behaved nothing like I had expected, she was really supportive, completely on our side, and at the time I was so relieved. It wasn't until later that I realised her attitude wasn't personal, ie 'Bloatstoat and X would never do such a thing, I know them and trust them' or relying on evidence, ie 'I've looked at the records and spoken to everyone else who was there and I know this didn't happen'. She just completely closed ranks and refused to acknowledge the possibility it could have happened, totally 'no therapist in my department would ever do this' and was incredibly angry the complaint had been made.
In that case, she was right, it didn't happen. But she was right for the wrong reasons. I pride myself on being good and professional at my job, but I could have made a mistake, no one is perfect. I could have been the sort of person who did do something unspeakable deliberately. She did an investigation of sorts, but there is a difference between really investigating the facts, and going in with the attitude that you know what must have happened and are looking to back that up. In that sort of culture if it extends to management I can see how even a group of consultants aren't listened to, because people are so caught up in the myth of their perfect department or hospital they refuse to acknowledge anything that contradicts this.
I work somewhere else now. It feels very different. I would like to think no one would allow any patient to be hurt in any way, but after this who can be sure of that.