The Lucy Letby case could dismantle the NHS

[Purpletreesinmygarden]

NHS clinical employee of 25 yrs. Watched the news last night and was horrified, but sadly not surprised, at the managers’ responses- both those at the time of the deaths and now. These people are politicians at heart; they avoid taking any responsibility And are never held to account. Career -wise they only ever move sideways or up. Clinical staff who try to call them out get screwed. The senior drs on this unit knew what was going and yet were threatened and made to apologise. If you don’t work in the NHS please don’t think this this is an isolated incident…….whilst not necessarily on this scale and with quite such tragic consequences, this behaviour is rife in every hospital. Perhaps this case will finally bring some meaningful reform.

I also think that Organisations are terrified of sacking people and being taken to tribunals. To the extent that they will turn a blind eye to almost everything.
our organisation only gets rid of civvy staff pretty much when they have absolutely no choice as the alternative would be public outrage. Ie criminal offences or large scale dishonesty. Officers are different, they sack them at the drop of a hat. Because they have no recourse to employment law.

In my team we have people that come in to do a job, then are completely useless/always "off sick" but plastered over their Instagram gadding about at gigs and the theatre/refuse to do the shift pattern that was clearly advertised when they applied on the grounds "I'm too tired to work nights". No actions are ever taken - because management are too reluctant to actually take positive actions

Very true. I was just thinking that the way that the senior management treat the health care professionals who speak up about poor practice, is exactly the same as the way that senior management (don’t) deal with the same types of concern in academy schools and private prep schools.
People who don’t work on the shop floor should not be promoted to such positions. It is always DANGEROUS.

Indeed. DH is an NHS consultant ( incidentally, has been divisional director for medicine and had his eyes 'widely' opened, not in a good way). He shares a tiny office with two other consultants and a secretary ( not a PA) with 3 others.

As I understand it several doctors blew the whistle. Qualified professionals with more than a hunch.

It appears they then acted on instructions from a Manager, as this thread attests, typically not a medically trained professional.

The Doctors them wrote an apology, on instruction to Letby.

The bit I am not clear on is that, given their status as Doctors, why they accepted this? Why didn't they escalate if they felt the matter hadn't been addressed? Why didn't they persist in going higher through the procedure, even to the Police?

@Vitriolinsanity Perhaps they were not 100% sure and they had dozens of other patients competing for their time. When those doubts became suspicions Thinking time was in short supply.

I was just reading in the guardian about this, but essentially they did eventually go to the police once they realised they had run out of road trying to get hospital management to investigate.

But I imagine this is what the investigation will really dig into.

There was a baby decapitation case at an NHS hospital in Dundee Scotland a few years ago.

https://www.thecourier.co.uk/fp/news/dundee/665013/ninewells-expert-guilty-of-medical-misconduct-over-baby-decapitation/

2018

OP, your points are well made, and I'm sure most doctors would agree with you. If this case speeds up the process of dismantling the NHS in it's current form, that would at least be a positive outcome. It is well known that the NHS needs proper accountability and an end to the culture of everything being someone else's fault, huge wastage of resources, excessive sick leave and spurious "bullying" complaints when anyone tries to do something productive.

Correct. In a major, high profile hospital near me, to my knowledge none of the consultants had an office and had to share secretarial support.
But if they could have PAs, those people would be highly qualified professionals who would deserve a decent salary. It's not just a case of "clinicians good, everyone else bad". Some non-clinical roles are essential, but there are probably too many inessential ones, and no accountability.

I have had a lot of treatment in a private hospital and it has been excellent. The NHS spends too much time on politics, trans, diversity etc instead of addressing 7 million people needing treatment.

I know many companies are inefficient, the are not killing people

Yes, and it was absolutely horrific and a similar story.

The big difference though, is in the UK, the doctors told the mum what happened, and the baby's head was sewn back on, not as a cover up, but so she could hold him. In the US case, the mum was not told, the doctors arranged the baby to cover it up (by using a blanket and propping the babys head up).

The OP and some others here are arguing that them be more transparency with private healthcare. The reality seems to be the opposite often.

I'm listening to your points, but I'm still struggling. If I were a doctor and I thought babies were dying in enough similar circumstances to arouse my professionally qualified concerns, would I accept the actions of a, stress not a doctor, butManager.

Perhaps I didn't phone the police because I didn't have a PA/dedicated Secretary. Apologies for being flip.

I'm watching the footage. I'm trying to understand, but these qualified professionals were in the room.

Maybe an NHS employee can say what happens if a Whistleblower doesn't think their concerns have been handled appropriately.

In education it goes all the way to the DfE.

But , for Gods sake, why not talk to the police?

It's very difficult to whistleblow in the public sector. The biggest risk to self is losing your job.
I don't expect the HCPs actually thought LL was murdering the babies but that she was incompetent. If they thought murder they would have called the police in regardless of procedure I'm sure

Because they could be hung out to dry, deregistered, months years of interrogation ,police interviews - for the powers that be to decide you are the problem, life ruined.

i f there's no cctv of ll committing the crimes, if other colleagues are backing her - if managers want it kept quiet…..

Also the media and public demand someone is to blame and must be destroyed for want of a better word- eg baby P or any other awful child death (other than the actual culprits).

@Vitriolinsanity there were two investigation before police involved by medics I believe or at least by royal college of peadatrican?

"efficiency and accountability is (as a general rule) 1000x better in the private sector"
Like water companies for instance? Nothing that is an effective monopoly, is providing a universal service or where the state would step it to underwrite it, should be private. What is needed, as others have said is accountability and transparency. Why is that chief exec doing interim jobs still? Although I think he recently stepped down from one. I can't believe that Drs don't have the first and last say on patient safety issues in hospitals.

How quick the vultures are to start circling. Every hint that they may be in with a chance to manipulate and fool people to make money for themselves.

Public debt, private profit. That’s all every nationalisation has ever brought. We have a vast increase in the number of billionaires and the rest of us are grossly impoverished.

I used to be on a hospital board and with the group of hospitals represented every single unexpected death was looked at in great detail. It just could not have happened in my country. The British system needs to stop this awful hierarchy stuff and listen to staff. It is not the first time this sort of thing has happened there. What about Shipman ?

I doubt it will change anything, otherwise changes would have been made following Beverly Allitt and Harold Shipman.
They will pay lip service and nothing more.

And give managers and board members/shareholders a financial incentive to cover shit up as well? Oh, please, scuttle back.

I hope it is the end tbh… I have had such bad care throughout my life especially maternity. During labour I almost died because the doctor made a mistake, the midwife lied in my notes, and the NHS closed ranks to prevent any accountability. Same with my friend’s mum she was killed by a nurse who didn’t know what she was doing, no accountability & no changes. Lucy Letby couldn’t have gotten away with it for so long in a half decent hospital.

I worked in the NHS decades ago.

It’s been a sacred cow for too long. It’s underfunding, politics and some of the actual staff and not just the managers. Plus the actual structure, the waste is appalling. I lasted six years. I had nightmares I would have to go back to nursing for a few years after. I’m glad it exists but needs dismantling and rebuilding. It’s an undertaking so vast and unwieldy I don’t think it will ever happen.

Been clinical, a clinical manager and senior manager - all the NHS is about these days is ass- covering!! Also those managers who are rubbish and hop and sidestep from job to job, they get the jobs them as they are the ones with the brass neck to apply and cronyism assists them in their path! Those with real skills who are more self aware of their own abilities and limitations are as rare as hens teeth!

There is a blame pushing culture which I have witnessed, it's ruthless!! There is a lot of colluding. Something goes wrong and it's survival of the fittest (or loudest and most senior) , exactly like Adam Kayes book, 'This is going to hurt) it's rarely the consultants fault! Usually gets pushed down the food chain.

The entire culture is rotten and antiquated, it's got very low objectivity too. There are usually multiple contradictory "agendas" to most decisions or actions.

I know I am cynical, but with good reason