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‘Blame culture must change to learning culture’ to prevent repeat of Gosport scandal

Health and social care secretary Jeremy Hunt says it is too hard for staff to raise concerns

The NHS blame culture must change if the health service is to prevent scandals like the one at Gosport War Memorial Hospital, say health leaders and ministers.


Health and social care secretary Jeremy Hunt: ‘We make it too hard for doctors and nurses.’
Picture: PA

A healthcare safety expert warned that staff face being ‘fired, gagged and blacklisted’ for raising concerns, while the health and social care secretary admitted the current system made it too difficult for nurses and doctors to come forward.

Change to a learning culture

They spoke following the publication this week of the Gosport Independent Panel (GIP) report, which said the lives of 456 patients at Gosport War Memorial Hospital in Hampshire were cut short by the overuse of diamorphine and syringe drivers between 1989 and 2000.

After the report’s release, health and social care secretary Jeremy Hunt said the blame culture in the NHS has to change to a learning one to encourage staff to raise concerns.

‘We make it much too hard for doctors and nurses to do that. They are worried there will be litigation, they will go up in front of the GMC or NMC, the reputation of their unit – in some places they are worried they might get fired, so we do have to tackle that blame culture and turn that into a learning culture,’ he said.

‘A desire not to know’

Professor Sir Brian Jarman, head of Imperial College London’s Dr Foster Unit, which specialises in health safety data, said he would be ‘unsurprised’ if incidents like the Gosport scandal were still occurring in other hospitals.

‘There really is a desire not to know,’ he said. ‘Whistleblowers are still fired, gagged and blacklisted.’

National Guardian for the NHS Henrietta Hughes said without a work environment that supported freedom to speak up, staff were ‘enslaved in a culture of fear’.

Dr Hughes heads the National Guardians Office, which supports 500 Freedom to Speak Up Guardians at trusts in England to give staff an avenue to raise concerns about patient care and other issues.

‘Lack of decisive action by leaders’

Defending staff at the trust who did not raise the alarm, she said: ‘It is an insult to everyone that spoke up about the issues at Gosport War Memorial Hospital to say that staff should have raised concerns.

‘It is clear the reason why dangerous practice persisted was the lack of decisive action by leaders.

‘Leaders in all parts of the health system need to take heed of this report, to be aware that individuals in their organisations know of issues about which they do not feel safe to speak up.’

The Nursing and Midwifery Council has not ruled out taking action against nurses employed at the hospital during the period in which the deaths occurred.


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