Why can’t NHS managers spot a serial killer?

No one who has paid any attention to NHS scandals over the past few decades should be at all surprised by the way in which managers at Lucy Letby’s hospital repeatedly dismissed concerns about her. When worried consultants produced considerable evidence to show that the nurse was present at every single event where a baby had dramatically collapsed or suddenly died, they ended up being the ones in the firing line. Management even forced them to apologise to Letby personally at an HR meeting, to which, bizarrely, the nurse brought along her parents.

Doctors are suspicious of the calibre of those managing them, and the managers are often on the defensive

Yet in the NHS, monumental managerial failures are not unusual, they’re typical. In the independent inquiries into all NHS disasters of recent years, such as Mid Staffordshire, Morecambe Bay and Shrewsbury and Telford, there is one common theme: the managers got in the way of those trying to get to the truth. From scandal to scandal, nothing seems to change.

NHS managers are often the bogeymen in healthcare. Clinicians love to denigrate their clipboard-clutching overlords. The only time I’ve ever heard someone booed at a church service was when I was in a congregation that was stuffed to the rafters with doctors from the local NHS hospital and a young woman stood up to say she was an NHS management trainee. And if you want to get a few cheap cheers as a politician, you can call for the managers to be abolished – as Liz Truss did when she was campaigning for the Tory leadership last year. In fact, it was Truss’s heroine, Margaret Thatcher, who brought in general management to the NHS after discovering that no one was effectively in charge of hospitals.