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The Letby case inquiry will lead to more blame and suspicion in the NHS – and patients will be less safe | Mark McDonald

I fear for what comes next because medics must be able to ask questions, raise concerns and admit mistakes. A defensive staff is dangerous for everyone Mark McDonald is a barrister representing Lucy Letby I have been Lucy Letby’s barrister for the past two years. I have spent thousands of hours going through the evidence, speaking to experts and examining what happened to the babies who died or…

The Letby case inquiry will lead to more blame and suspicion in the NHS – and patients will be less safe | Mark McDonald

Mark McDonald, Lucy Letby's barrister, expresses concerns over the upcoming inquiry into her case, fearing it may lead to more blame and suspicion in the NHS, ultimately compromising patient safety. McDonald has spent years researching the case, examining evidence and consulting with 30 experts, all of whom believe Letby is innocent.

He argues that the convictions represent a major miscarriage of justice in British legal history, as the police, NHS, criminal justice system, and numerous experts were involved in the miscarriage.

Neonatal units, where Letby worked, are described as challenging environments where doctors and nurses make critical decisions under immense pressure and with limited information. Mistakes can result in the death of these tiny, critically ill babies, which is an uncomfortable truth that must be acknowledged when discussing neonatal safety.

McDonald worries that the inquiry may foster a culture where clinicians become too cautious to work in such environments, fearing that their actions will be scrutinized and potentially result in criminal investigations.

The NHS has long aimed to develop a "learning" or "no-blame" culture, emphasizing the importance of openness, trust, and learning from mistakes rather than assigning blame. However, the Thirlwall inquiry's emphasis on monitoring and surveillance, coupled with its recommendation to move away from the no-blame culture, could create a "surveillance society" within the NHS, where clinicians fear that every adverse outcome may lead to scrutiny and blame.

McDonald argues that patient safety hinges on trust, openness, and learning from mistakes, not a culture of suspicion. He criticizes successive governments for not learning from previous inquiries in neonatal and maternity care, which identified issues with leadership, communication, teamwork, and listening. McDonald contends that the government must protect both patients and the workforce, as they are inseparable.

He calls for trade unions to defend both patients and their members, ensuring that healthcare professionals are not unfairly judged based on hindsight and that adverse clinical outcomes are not mistaken for criminal conduct.

Written by urgent.news from Guardian Health's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.

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