Trust v accountability in healthcare

The essays in this book were written in the aftermath of the Bristol paediatric cardiac surgery debacle, the Alder Hay scandal (over the use of dead children’s organs) and the Shipman murders. In the foreword, Rabbi Julia Newburger, Chief Executive of the King’s Fund in London, explains that, despite this context, the overall message goes far beyond calling for more accountability measures for healthcare.

Other contributors reinforce her challenge. They are calling for a cultural change — one of leadership within medicine and within management. This leadership needs to take up where government leadership finds it increasingly hard to deliver.

The 15 contributors include journalists, psychologists, sociologists and ministers of religion, as well as clinicians. The difference between accountability (witness the plethora of “quality committees” mushrooming in our hospitals) and trust is the underlying theme. We are warned that increasing focus on system audit may not bolster the public’s confidence. It is the insistence on professional integrity and the restoration of earned trust that will promote cultural change and bring back confidence in the healthcare system.

I highly recommend this book to all clinician and management leaders. It is a powerful, challenging and exciting collection of essays by a variety of individuals, all of whom are deeply concerned by the present breakdown of trust in our healthcare system.

Kerry J GoulstonChair NSW Greater Metropolitan Transition Taskforce North Ryde, NSW