Was Rodney Ledward a statistical outlier?

Editor—Looking at statistics will not add anything if managers are aware of problems that place patients at risk but fail to act, as happened in the Ledward case.¹,² Jean Ritchie QC chaired the inquiry into Rodney Ledward and found that as early as 1986, 10 years before his suspension, senior management was aware of Ledward's “high complication rate and his cavalier manner.”³ She also identified that “a culture of not telling tales was a big part of the problem.” What is better, telling tales or managers turning a blind eye to safety issues?

Whistleblowing is nowadays encouraged in the NHS, and there is an expectation of “a climate of openness and dialogue in the NHS, which encourages all staff to feel able to raise concerns about healthcare matters in a reasonable and responsible way without fear of victimisation.” That quote comes from Andrew Foster, director of human resources for the NHS, in a letter dated 25 July 2003 that accompanied a policy pack produced in partnership with Public Concern at Work about whistleblowing.⁴ The pack was circulated to all chief executives in NHS trusts, primary care trusts, and strategic and special health authorities.

From that date, no organisation had any excuse not to protect a whistleblower or to take notice of concerns raised in a reasonable and responsible manner. A chief executive is responsible for avoiding clinical governance failures and ensuring that there is no breach of statutory duty in relation to section 18 of the Health Act 1999.

A whistleblowing policy that is properly and effectively implemented should make redundant any need to trawl statistics to find those doctors who need help or need to be removed to protect the public.