Who’s to blame for the NHS’s blame culture? | Letters

Dr David Zigmond, Dr Richard Sloan, Dr Eric Watts and Dr Ian Freeman respond to an article by the former health secretary Jeremy Hunt

Jeremy Hunt’s article (Here’s the direct effect of our NHS blame culture: babies die. Tragedy after tragedy, it can’t go on, 9 October) will be welcome to many, especially those healthcare professionals who have had to endure the intimidating mistrust and adversarial working culture he describes.

What is missing from his account is the seminal role of government’s NHS reforms in creating these problems. In particular, the creation, then proliferation, of commercialised and competing autarkic NHS trusts and outside providers over many years. This has generated a growing culture of corporate defensiveness and reputation anxiety. Within such conditions, practitioners then adapt to behave much like employees in large commercial organisations – they must show compliance, “loyalty”, conformity and seamless performance, albeit speciously.