Were suspicions about Lucy Letby ignored to prevent ‘reputational damage’ to the NHS?

Editorial: The protection of patients should never be sacrificed to protect the image of a hospital. The NHS is a service, not a business

Lucy Letby continued to harm babies after concerns were raised about her (PA)

Lucy Letby murdered five babies between June and October 2015. At that point, the lead consultant on the Countess of Chester Hospital neonatal unit, Dr Stephen Brearey, raised concerns about her.

Her final two victims – and this does not include the further six counts of attempted murder of which she has been convicted – she murdered in June 2016. It was 2017 before anybody had contacted the police.

It is impossible to imagine the pain and suffering of these babies’ parents. It might be possible, however, to think that the parents of her final two victims will spend the rest of their lives suffering even more than the rest. They will know that what happened to their babies could have – and should have – been prevented. That suspicions had already been raised – and had lingered for almost a full year.

Dr Brearey’s comments on what occurred are utterly damning. He has pointed out that within the NHS, doctors and nurses are approved and overseen by regulatory bodies, but that there is no such regulation for NHS managers, an ever more powerful class of NHS staff.

He told the BBC that his public comments on failures with regard to Letby has prompted clinical staff all over the country to contact him and tell him of examples where, in his own words, “clinicians raised concerns with senior members of the hospital and their lives were made very difficult by doing that”.

The NHS needs managers. It is an enormous organisation. It is one of the most tedious comments periodically made by politicians that you can improve the NHS by getting rid of its managers and appointing more doctors and nurses, as if the experience of patients will somehow be improved if doctors and nurses are answering phones and booking appointments and upgrading IT systems.

But it is clear, at least from Dr Brearey’s comments, that the current system isn’t working. Dr Brearey has said that when he raised concerns, senior management were concerned about potential reputational damage to the organisation. The damage that was done, in the end, are among the most stomach-turning crimes in UK legal history.

Whether Letby’s treatment, which was to drag her accusers through grievance and disciplinary procedures, was done with half an eye on limiting reputational damage, will be a matter for a future inquiry.

But the conclusions any inquiry may reach are, as far as Dr Brearey is concerned, available now. That the NHS should be run as a service, not as a business. That the idea of “reputational damage” is something that should trouble a boardroom – not a hospital ward.

That is not to say that the reputations of hospitals and NHS trusts don’t matter. They certainly do. Patients must feel confident in the quality of the services they use, given they are regularly a matter of life and death.

But the closing of ranks, the careful managing of potentially damaging allegations, is itself damaging to patients. When Dame Cressida Dick was forced to step down as commissioner of the Metropolitan Police, it was said that her downfall came about because she prioritised loyalty to her officers over loyalty to the people she was meant to protect.

It is precisely this mistake that the NHS must not make – and it appears to be failing. Its overarching priority should not be its reputation, but its patients.