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HUNT Doctor Carla Millar

This week, Jeremy Hunt announced a wholesale change in the way the NHS will approach the investigation of mistakes and preventable deaths.

The Health Secretary plans to shift to the “no blame” model adopted by the airline industry, which is intended to make it easier to learn from mistakes by encouraging pilots and other staff to report them.

Instead of trying to apportion blame and punish the guilty in the event of a preventable death, investigations will now proceed on a “no blame” basis, with obvious exemptions for gross negligence or malice.

A court order required to force the publication of something the investigators felt was best kept private. This is because, as Hunt puts it, “bad mistakes can be made by good people”.

Such practices have made air travel a lot safer – fatality figures have fallen even as many times more people than previously are flying. Indeed experts credit the shift to the no-blame investigatory culture with saving thousands of lives.

Obviously there may be difficulties translating it to suit the medical world. But combined with other measures announced yesterday – including a tightening of the law to protect whistleblowers and a new ‘honesty league table’ of how NHS Trusts approach errors – mark a decisive step in a new direction.

This should give pause to those who have allowed themselves to buy into the BMA caricature of the Health Secretary as a cold-hearted persecutor of doctors, and may be part of a deliberate effort to consolidate his relationship with the profession after a strained few months.

Had he that cast of mind, Hunt might instead have sought to use avoidable deaths as a cudgel against them, and made it easier for the victims of medical mistakes, or their families, to prosecute. There are always good headlines in that sort of justice.

That Hunt has instead decided to shield doctors from the consequences of their mistakes, in the best long-term interests of patients, demonstrates a sincere commitment to the duties of his office for which he deserves credit.

Ministers taking the lead in driving reforms at the departmental level has been the hallmark of David Cameron’s Government. Just as Michael Gove is modernising prisons and Iain Duncan Smith continues to press ahead with Universal Credit, so would this sea change in NHS attitudes to blame represent an important example of minister-led Conservative reform.

Unfortunately, Hunt is unlikely to receive the sort of direct support that other reforming ministers have enjoyed from Number Ten, in the form of set-piece speeches and the like. Downing Street thinks Health is too risky to get the Prime Minister personally involved.

But this remains an important and worthwhile cause and for that reason, as well as the power struggle with the BMA, that must stand by the Health Secretary and resist any urge to move him in the next reshuffle.

24 comments for: Hunt is right to take on the NHS’ blame culture

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