The NHS needs major reform to tackle the ‘terrible blame culture’ that exists when doctors, nurses and other key workers make mistakes, Jeremy Hunt has said.
On a panel at New Statesmen Politics Live conference yesterday (June 28) on the future of the NHS alongside Wes Streeting, the shadow health secretary, and Victoria Steele, the superintendent pharmacist of Lloyds Pharmacy, the former health secretary has said the health service needed to get better at “learning from their mistakes” and encouraged staff to improve rather than focus on defending their mistakes in legal proceedings.
Hunt described health workers as the “second victims” of medical negligence, who enter their profession with the best of intentions but end up fearful of being “sued, fired and struck off the register”. Many fear a full investigation by their NHS trust, the Care Quality Commission (CQC) or NHS England.
“The result is that they end up being forced to be very defensive,” said Hunt, who has written a book, Zero, calling for reforms to NHS culture to eliminate preventable deaths. This makes it “virtually impossible” to ensure that mistakes don’t reoccur, he said, while an “appropriate learning culture” and less questioning processes would improve results.
Hunt cited maternity care as an example. A baby born with cerebral palsy in the UK can warrant a lawsuit that lasts for years. In Japan, a “no blame” system with automatic compensation for families introduced in 2009 has dramatically reduced the number of newborns with the disease, in part, it is believed, due to reduced conflict and pressure on doctors.
Steele echoed Hunt’s point, saying a similar problem exists for pharmacists, with General Pharmaceutical Council investigations, coroners’ inquests and criminal cases being “difficult” for those involved.
The cost of clinical neglect to the NHS (and the taxpayer) is substantial. According to British medical journal the NHS paid out £2.4billion in negligence claims in 2018-19, around 2% of England’s total NHS budget. In obstetrics specifically, the NHS is paying £12.7million a week for injury costs.
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Hunt said there was a broader need to think retrospectively and learn from other countries, particularly in relation to the Covid-19 pandemic. “We could have saved a lot of lives if we had introduced South Korean-style testing and tracing much earlier than we did,” he said.
He admitted he had regrets about his time as health secretary, including not investing enough in social care, which had a ‘delayed effect’ on hospitals, and not reforming the general practitioner services so that patients can always see the same doctor, which can have a positive influence on a patient’s health. He praised the previous Labor government for cutting NHS waiting times. “I’m a big fan of health secretaries trying to learn from what their predecessors did well rather than rushing in and dismantling it,” he said.
[See also: Jeremy Hunt interview: He “wouldn’t rule out” running for the top job again]