No man is an island

any man’s death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee.

I thought long and hard about whether to start this piece of writing, on this topic and in this way. First off, I want to stress that this is in no way an attempt to use someone else’s tragedy to make my own political point, or show off my grasp of the written word.

No-one who has ever loved and lost, whether that be a parent, a child, a sibling, a pet, a dear friend, a childhood acquaintance, should be able to read anything about the Lucy Letby case and not feel a surge of sympathy, and anger, even if many of us, thankfully, can’t even begin to understand the pain the parents of those poor babies have suffered.

As the parent of premature twins, one of whom spent a week in neo-natal intensive care, I know that you place your trust in the doctors and nurses there. You put your most precious possession into their hands, at a time when you are at your most vulnerable. I can’t even begin to articulate my horror at what happened. There’s anger at Letby, yes. So, so much anger, but also anger at those in the establishment around her who did nothing. Not even when the evidence from senior paediatricians was presented to them that something was very, very wrong about the number of babies in the neo-natal units who were dying and almost dying. They claimed there was insufficient evidence, yet, when presented with it, the police took just 10 minutes to decide there was something to be seriously investigated.

I keep asking myself what on earth were those senior managers and executives thinking? Did they just not want to deal with the extra paperwork? Were they more concerned with the Trust’s reputation – and by implication their own – in an NHS where there had already been serious investigations into maternity care at other Trusts? Could they just not conceive of a woman, a young, attractive, sociable woman killing children? Did they assume it was just a bunch of senior – male – consultants throwing their weight around, and that it was just a doctors v nurses power-tussle? Did they belittle the concerns of bereaved and frantic parents, as being driven by heartache and grief? Or were they so proud of their feminist credentials that they automatically jumped onto the side of a poor bullied nurse,  being victimised by the nasty men in senior positions? Which is in itself, a pretty sexist stance to take, if you ask me.

We appear to have an epidemic of people in this country who are promoted beyond their capability, not just to do the jobs they are paid significantly to do, but their capability to care about how well they do it.

There is a management culture of backside-covering, of reputation managing, of getting out while you can, and leaving the flack for someone else to pick up. Of assuming that system and process is always right, even when instinct and experience is saying something different. Why else would Paula Vennels, head of the Post Office at a time when the worst miscarriages of justice this country has ever seen were being perpetrated upon sub postmasters, have been conspicuous by her absence in the Post Office Horizon Enquiry? Why else would CEOs of privatised water companies have been able to swan around on massive salaries and bonus schemes the rest of us can only dream of, whilst overseeing the systematic destruction of our waterways? While their shareholders trouser huge dividends, even as our rivers die before our very eyes.

Hopefully, the current outrage won’t abate, and those whose inactions allowed a psychopath to continue a killing spree amongst the most vulnerable citizens, those that she was supposed to protect, will have to answer for their decisions. Letby has been found guilty of  seven murders, but others are also culpable. Although if the Post Office is anything to go by, I’m not hopeful they will all be found so.

I need to bring the mood up, mine as much as my readers’. So, luckily, we have lots of people who do care about doing their jobs to the best of their ability. I’m thinking of course, of a particular set of humans this week. A group of women who have spent the last few years trying their very best to live up to the expectations we have of them. Yes, they fell short at the final hurdle, beaten by a team that simply played better than they did. That hurt will run deep, but they can be very, very proud of how far they have come, what they have achieved, and what that will mean for the future of women in top-class sport.

When people annoy me in future, I may be all icy calm on the outside (although, possibly not), but rest assured, inside I plan to be 100% Mary Earps. We are Lionesses. Hear us ROAR

About Fiona Russell-Horne

Group Managing Editor across the BMJ portfolio.

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