{
  "id": 15122446,
  "title": "The Letby case inquiry will lead to more blame and suspicion in the NHS – and patients will be less safe | Mark McDonald",
  "url": "https://urgent.news/2026/10/17/the-letby-case-inquiry-will-lead-to-more-blame-and-suspicion-in-the",
  "topic": "health",
  "section": "Health & Medicine",
  "published": "2026-10-17T05:00:24.000Z",
  "source": {
    "name": "Guardian Health",
    "slug": "guardian-health",
    "url": "https://www.theguardian.com/commentisfree/2026/oct/17/lucy-letby-public-inquiry-nhs-patients-medics"
  },
  "original_language": "en",
  "account": "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.\n\nNeonatal 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.\n\nThe 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.\n\nMcDonald 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.",
  "summary": "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…",
  "key_points": [
    "Mark McDonald fears the Letby inquiry will increase blame and suspicion in the NHS.",
    "Neonatal units are high-pressure environments where mistakes can lead to infant deaths.",
    "No-blame culture may be replaced by surveillance society, hindering patient safety."
  ],
  "editors_take": "The upcoming inquiry risks dismantling the NHS's established no-blame culture by replacing openness with a surveillance-driven environment that discourages clinicians from working in high-pressure neonatal units.",
  "illustration": null,
  "coverage": {
    "outlets": 1,
    "also_reported_by": []
  },
  "ai_generated": true,
  "disclaimer": "Summaries, key points and the editor’s take are written by software from other outlets’ reporting and may contain errors — always check the linked original."
}