Sir, –As your editorial ("The failings in our medical negligence regime persist", September 17th) indicates, there is clearly a need for healthcare professionals and organisations to communicate more effectively with the public about medical errors. However, tensions surrounding professional accountability (as opposed to institutional accountability) and the "no blame" culture within the health service prevent healthcare professionals communicating clearly with the public.
Most errors are committed by competent, hardworking healthcare professionals trying to do the right thing. Therefore the traditional focus of identifying who is at fault is a distraction. It is far more productive to identify error-prone situations and settings and to implement systems that prevent healthcare professionals committing errors. This shift in the safety agenda from an individual focus to a system focus has been at the detriment of professional accountability. Under-developed systems of professional accountability, inadequate support from professional bodies for professional regulation, inadequate understanding of regulation and inadequate rules for reporting serious misconduct have let this happen.
To regain public trust in our health system requires finding the right balance between a “no blame” culture and one with a strong professional ethic and accompanying robust accountability system. – Yours, etc,
Dr PETER LONERGAN,
Dublin 8.