“The conspiracy of silence in health care quality”

There is a conspiracy of silence about the quality of medical care and its hazards. This can only be addressed through professional action coupled with consumer action in a genuine partnership: the hammer and the anvil, or, as the South Africans say, “one hand washes the other”. The implication of this is much more openness about results, outcomes, and failings and a willingness for professionals to be self‐critical and for the public to be forgiving.