Regulating and legislating safety: the case for candour

The Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, chaired by Robert Francis QC, contained an eye catching 290 recommendations. However, the main themes running through the report can be summarised as those of accountability, openness, patient centredness and culture. Arguably, one of the most important recommendations cutting across all of these themes is the creation of a statutory duty of candour in healthcare. This editorial suggests that a legal duty to be honest with victims of medical harm is not only ethically the right thing to do, but might (if implemented correctly) have the potential for contributing to culture change. Given that existing ethical ideals and regulatory interventions have failed to make much of an impact on open disclosure, it is legitimate to place some faith on a legal obligation to ensure that openness is taken more seriously. Putting patients first must surely include a legal duty to be honest with them.