Letby and managerial regulation—a warning for NHS culture

The heartache caused by Lucy Letby is beyond imagination.1 Patient safety seems to have been trumped by reputational concerns and a desire not to upset Letby’s feelings.I find the official NHS response misleading, however.There are already good whistleblowing policies in place, but there is an unequal fight between these and the daily pressure to deliver and do what is needed to deliver. The government, NHS England, NHS chief executives, and trust boards don’t always want to hear the truth.The government’s main concern is re-election and the avoidance of reputational damage. This culture has cascaded down through the system. If a chief executive is deemed responsible for reputational damage and the ensuing political fallout, then their job is on the line. With the average length of tenure only three years for an NHS chief executive, this is a well grounded fear.There is often no honest conversation. Indeed, this is discouraged (despite…
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