We’re in danger of ignoring the lessons from the Lucy Letby case

Editorial: The Independent has revealed that the principal regulatory body for nursing, the NMC, showed a disturbing and unforgivable failure to act when allegations of serious unprofessional (and even criminal) behaviour came to its attention. Patients have the right to be treated with respect – and have a right to dignity

Former nurse Lucy Letby was found guilty last month of murdering seven babies (Chester Standard/SWNS)

Something has plainly gone very badly wrong with the principal regulatory body for nursing, the Nursing and Midwifery Council (NMC). Though less well known than the equivalent body for doctors, the General Medical Council, it performs a similar role in setting an ethical framework, enforcing professional standards and, above all, ensuring patient safety. Or rather, it would seem, that is the role that it has been failing to perform satisfactorily.

As The Independent reports, the NMC has shown a disturbing, indeed unforgivable, failure to act when allegations of serious unprofessional (and even criminal) behaviour have come to its attention. A whistleblower has provided evidence detailing incidents for which there can be no justification. They include the case of a male nurse in Coventry who admitted sharing indecent images of children, but was only struck off three years after the complaint was first raised. Another was a male nurse in Kent who groped a patient, yet was permitted to practice with no restrictions for eight months after their case was reported. Then there is the female nurse who was convicted of racially abusing members of the public but faced no initial sanctions – albeit the conviction was later overturned.

Isolated incidents? They are not, of course, the norm on the wards and in the clinics of the nation. We know that our caring professions are just that – compassionate and caring. They could not function if they were otherwise. But, as previous stories uncovered by The Independent about inadequate care and subsequent scandals and cover-ups in maternity units and mental health facilities suggest, workplace cultures can deteriorate and vigilance is relaxed. The Lucy Letby case is another extreme example. The result is neglect, disdain and secrecy, as well as clinical harm. Some of that may be inevitable, given the size of the NHS and the habitual institutional instinct – throughout society – to self-preservation. But it cannot be excused.

Yet the frequency and nature of the cases of professional misconduct ignored or tolerated by the NMC is surprising. The NMC apparently has a backlog of 5,339 conduct cases. Too little is being done. Too often, staff accused of gravely concerning actions are allowed to carry on because the police investigation is incomplete. That seems unduly cautious, given the life-and-death environment in which these professionals work. Some NMC inquiries are allowed to meander on for years. This is absurd and unacceptable.

As our whistleblower explains: “I, and other colleagues, have repeatedly escalated our concerns internally, but the NMC has failed to demonstrate the reflection and insight it expects of the nurses, midwives and nursing associates on our register.”

The NMC hasn’t sought to challenge the evidence put to it by The Independent. Indeed, further to its credit, the chief executive and registrar of the council concede that “it’s essential we have a culture at the NMC where people feel able to speak up. I’m grateful that these concerns have been raised with us and I take them extremely seriously”.

With such manifest and admitted failings by the professional watchdog, a key question now arises: “Quis custodiet ipsos custodes?” (“Who will guard the guards themselves?”).

Fortunately, there is an answer to that. The NMC is itself regulated by the Charity Commission and the Professional Standards Authority, and the PSA is taking steps to ensure the NMC is returned to health.

From the accounts heard by The Independent, it seems there is a “culture of fear” within the NMC in which staff are scared “of making mistakes” and afraid to be honest when errors are made. Staff are also under pressure over the “huge” backlogs of investigations and given “unachievable” targets.

Obviously, these and other problems need to be fixed as soon as possible – and with whatever it takes. Patients have the right to be treated with respect and have a right to dignity. That, after all, costs nothing – and is no additional burden, even in our cash-strapped NHS.