Across the pond in the United Kingdom, court proceedings are providing a sharp spotlight on the harms associated with government-run health care. While the immediate trial involves a single nurse, in a larger sense, the entire system of socialized medicine stands in the dock.
Lucy Letby, who worked for Britain’s National Health Service (NHS) in a neonatal intensive care unit, is being retried for the attempted murder of one of her patients. Last year, a jury convicted Letby of murdering seven babies and attempting to murder six others, while acquitting her of two murders and deadlocking on the murder of four babies.
We may never know the specific circumstances behind each of the tragic deaths Letby is associated with. But regardless of whether she was to blame for some, or none, of the children who passed, it’s very clear what is to blame for all of them: Britain’s National Health Service.
Scenario 1: Bureaucracy Enabled a Murderer
Statements made before the most recent trial reveal an NHS culture seemingly more focused on protecting its reputation than ensuring that patients were protected from a potential criminal on their staff.
For instance, when hospital staff raised concerns about the nurse being at the center of several patient deaths, “Letby responded by filing a bullying complaint against the doctors in late 2016. The hospital apologized to her and pressured two doctors to write an apology to Letby in early 2017.”
One of the doctors forced to apologize to Letby testified at the recent trial that, when he tried to raise concerns, “we were explicitly told at that stage it was the wrong thing to contact the police because it would be bad for the reputation of the trust and there would be blue and white tape everywhere.”
This doctor, who tried but failed to raise the alarm, said that “it’s a matter of infinite regret I didn’t handle it differently” and that the deaths of the children are “going to be in my nightmares forever.” But the real fault lies among the higher-ups who were more worried about “the reputation of the trust” than the possibility that one of their own staff was deliberately murdering patients.
In February 2016, Britain’s Care Quality Commission audited the hospital and said the pediatric wing needed safety improvements. But the commission told The Wall Street Journal “that the agency hadn’t been made aware of the increase in newborn baby deaths at the time of its review.”
Then as a result of publicity surrounding the Letby case, a group representing NHS whistleblowers has claimed that “a culture detrimental to patient safety” pervades the entire service.
Scenario 2: Nurse as the Scapegoat for a Flawed System
On the other hand, a lengthy feature article published in The New Yorker in May took a contrarian view: that Letby has become a scapegoat by being at the center of a series of awful coincidences. The story hypothesizes that statements Letby made that the public viewed as an admission of crimes were instead the byproducts of a nurse wracked by guilt that she couldn’t care for her patients properly. In so doing, The New Yorker provides numerous examples of poor and under-resourced care provided by the NHS hospital in question.
For instance, one of the nurses on Letby’s unit admitted that “we had massive staffing issues,” with people being asked to take extra shifts — the same conclusion reached by a team from the Royal College of Paediatrics and Child Health. Then there’s this:
An inquest for a newborn who died in 2014, a year before the deaths for which Letby was charged, found that doctors had inserted a breathing tube into the baby’s esophagus rather than his trachea, ignoring several indications that the tube was misplaced. “I find it surprising these signs were not realised,” the coroner said, according to the Daily Express. The boy’s mother told the paper that “staff shortages meant blood tests and X-rays were not assessed for seven hours and there was one doctor on duty who was splitting his time between the neonatal ward and the children’s ward.”
A baby delivered via C-section, “a girl who was dusky and limp when she was born, should have been treated with antibiotics immediately, doctors later acknowledged, but nearly four hours passed before she was given the medication. … The baby continued to deteriorate throughout the [next] night and could not be revived.”
Given these instances of substandard care, several of which have nothing to do with her, one law professor told The New Yorker that Letby had been turned into a “fall girl” for the NHS’s broader failings:
Looking for a responsible human — this is what the police are good at. What is not in the police’s remit is finding a systemic problem in an organization like the National Health Service, after decades of underfunding, where you have overworked people cutting little corners with very vulnerable babies who are already in a risk category. It is much more satisfying to say there was a bad person, there was a criminal, than to deal with the outcome of government policy.
The fact remains, however, that government policy lies at the heart of the Lucy Letby case.
Problem of Government Control
Whether Letby committed the crimes as alleged matters a great deal to the families of the deceased children, who have searched in vain for nearly a decade for answers and explanations regarding their children’s deaths. But when it comes to larger questions about Britain’s NHS, the question of whether Letby actually murdered her patients seems somewhat beside the point. As James Freeman of The Wall Street Journal recently observed, “[E]ither the government bureaucracy enabled the killer or the government bureaucracy is the killer” (emphasis original).
Therein lies the problem with government-run health care, where politics takes precedence over patients. The Lucy Letby case shows an NHS focused more on saving face than saving patients — the result of politicians trying to control the purse strings and a bureaucratic culture with little accountability.
So the next time Sen. Bernie Sanders, I-Vt., or any of his colleagues claim that socialized medicine benefits patients, remind them about Lucy Letby and the children who died in her care.
