Sitting leaders ask you to stand up for safety

Here is an excellent letter in the British Medical Journal (18 July 2009; 339:124).



The same letter in text format (minus references) is below:

Sitting leaders ask you to stand up for safety

If junior doctors follow the recommendation of medical leaders and stand up for the safety of patients will they receive support from those leaders? (1)

“Staff concerns about safety at Mid Staffordshire trust were ‘lost in a black hole.’” (2) The evidence suggests that whistleblowers who report concerns are treated no better in the NHS now than at the time of the scandal at Bristol Royal Infirmary. (3) Medical leaders are responsible for the culture of silence. To become a medical leader one needs to compromise principles for expediency to meet the demands of politicians (in an organisation or government) with the power to advance or destroy a career. Medical leaders lack moral authority because few of them have taken the risk of speaking out on their way to the top. They are too often complicit in concealment of problems to protect their organisations or political masters.(4)

Fiona Godlee spoke at the conference and represented the BMJ.(1) The BMJ has removed from its website articles that have appeared in the paper journal purely to avoid the risk of the journal being sued for libel. The articles have not been retracted because there are no grounds for retraction of truthful reports. Does the BMJ want junior doctors to take the risk of losing their careers by speaking out when it is afraid of the financial cost of speaking?

Liam Donaldson also spoke at the conference.(1) I have had correspondence and meetings with the chief medical officer to discuss misconduct by doctors, but I am left with the impression that he is unwilling or unable to act when the allegations involve senior medical leaders. Yet Sir Liam wants junior doctors to be brave enough to speak about problems.

The motivational speeches of medical leaders to junior doctors seem to be like the pep talks of generals to soldiers at the Somme before the troops went over the top and the leaders returned to their chateau for lunch. Medical leaders must now lead from the front and share the risks.

Peter T Wilmshurst
Consultant cardiologist
Royal Shrewsbury Hospital
Shrewsbury SY3 8XQ

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