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 the New Statesman’s Politics Live conference yesterday (28 June) about the future of the NHS alongside Wes Streeting, the shadow health secretary, and Victoria Steele, the superintendent pharmacist at Lloyds Pharmacy, the former health secretary said that the health service needs to get better at “learning from its mistakes” and encourage staff to improve rather than fixate on defending their errors in legal proceedings.
Hunt described health workers as the “second victims” of medical negligence, who go into their profession with best intentions but end up afraid of being “sued, fired and struck off the register”. Many fear extensive investigation from 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 avoidable deaths. This makes it “practically impossible” to ensure mistakes don’t happen again, he said, while a “proper learning culture” and less interrogatory processes would improve outcomes.
Hunt cited maternity care as an example. A baby being born with cerebral palsy in the UK can warrant a court case that lasts years. In Japan, a “no blame” system with automatic compensation for families introduced in 2009 has significantly reduced the number of newborns with the condition, in part, it is thought, because of the reduced conflict and pressure on doctors.
Steele echoed Hunt’s point, saying that a similar issue exists for pharmacists, with investigations from the General Pharmaceutical Council, coroners’ inquests and criminal cases being “difficult” for individuals involved.
The cost of clinical negligence to the NHS (and the taxpayer) is substantial. According to the British Medical Journal the NHS paid out £2.4bn in negligence claims in 2018-2019, roughly 2 per cent of the entire budget for the NHS in England. In obstetrics specifically, the NHS pays £12.7m a week for the costs of harm.
Hunt said that there was a wider need to think retrospectively and to learn from other countries, especially when it comes to the Covid-19 pandemic. “We could have saved a lot of lives if we introduced South Korean style test and trace much earlier than we did,” he said.
He admitted that he had regrets over his time as health secretary, including not investing enough in social care, which has led to a “delayed effect” on hospitals, and not reforming GP services so that patients are able to consistently see the same doctor, which can have a positive influence on a patient’s health. He praised the previous Labour government for bringing down NHS waiting times. “I’m a big believer in health secretaries trying to learn from what their predecessors have done 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]
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