Letters: The Lucy Letby killings shouldn’t mean we lose trust in all NHS managers

Murder mystery

Sir: I once made a diagnosis of a very rare condition too late to cure the patient. She was nevertheless grateful and thanked me, though my conceit evaporated when she asked: ‘What took you so long?’

I suspect the managers at the Countess of Chester Hospital must feel as I did (‘Hospital pass’, 26 August). Murder was not on the top of their differential diagnoses. Many senior clinicians who have had leadership roles in NHS hospitals bear the scars of conflicts with management, though perhaps not as deep as those of the Chester paediatricians. 

We would nevertheless acknowledge that most managers are dedicated, conscientious professionals committed to the success of their hospitals. They do not get the recognition and adulation received by the clinical staff. They have an unenviable job reconciling the demands of senior executives with pressure from the clinicians whom they manage. The executives are no less uncomfortable as they live with a succession of often mutually exclusive priorities from government, Royal Colleges, trades unions and universities. If all managers are to be tarred with the Chester brush, we will struggle to recruit high-calibre people to repair and reform an NHS which they did not break. The inquiry will probably find individual failures but it should look at the root causes which are in the system.

C.G. Winearls, FRCP 

Consultant nephrologist 1988-2019; Clinical director Oxford Kidney Unit 1995-2009; Oxford University Hospitals NHS Foundation Trust

Bring back matron

Sir: Isabel Hardman rightly concludes that: ‘If previous inquiries are anything to go by, nothing will really be done – and we will have to wait for the next scandal.’

Sadly no form of inquiry into the events leading up to Lucy Letby’s serial murder conviction is likely to restore trust in the management of NHS neonatal units.