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A crisis of trust?

UK Hospital Ward
By Joseph Stephens
22 August 2023
Public Affairs

Yesterday, Manchester Crown Court concluded what is believed to be the longest murder trial in UK history. Lasting over 10 months, the trial of Lucy Letby found the nurse guilty of the murder of seven babies at the Countess of Chester Hospital over a six-year period. Letby’s crimes, alongside details of poor governance and unaccountability at Chester Hospital have sparked shock and anger among the public and raised questions about public trust in the NHS.  

The anger resulting from this case is such that many, including Labour Leader Sir Keir Starmer, are calling for new legislation to force criminals to face their victims during sentencing proceedings. Now the trial is concluded, attention has turned to the failings of the hospital to protect the most vulnerable. Claims that hospital bosses protected and enabled Letby emerged during the trial. By shutting down investigations into her conduct and dismissing doctors’ concerns, senior staff are accused of putting the hospital’s reputation ahead of their duties of safeguarding and candour.  

A non-statutory inquiry announced by the government on Friday 18 August will aim to effectively address these accusations. The political reaction meanwhile has been uniform; disdain at Letby’s refusal to appear before the parents of her victims, and that an NHS hospital could allow a murderer to operate under their protection for so long. Many have called for a more powerful statutory inquiry to allow for greater investigatory powers.  Representing some of the victims’ families, lawyers from Slater and Gordon stated that “an inquiry needs to have a statutory basis to have real teeth.” 

Issues of trust are not uncommon in the NHS. During covid, distrust in the health service stemming from poor personal experiences was identified as a fundamental reason for low vaccine uptake in underserved communities. It is easy to break down trust in institutions but exceptionally difficult to build it up again. There is still much to learn about how these crimes were allowed to happen, but the defensiveness of hospital staff and the “Kafkaesque nightmare” described by doctors trying to report their concerns about Letby, have already done great damage. The story from beginning to end wounds one of Britain’s most respected public institutions. Despite not being linked to Sunak’s pledge to improve NHS waiting times, this puts further political pressure on the issue of the NHS as a whole.