EDITOR—The multiplicity of recommendations of the non-medical report into the performance failures of the heart surgeons at Bristol Royal Infirmary1 prompts Coulter to repeat the slogan “put patients at the centre.”2 The primary issue—that of poor clinical practice going unchecked—has again been obfuscated. The failure of clinical self regulation caused the serial disasters at Bristol; smothering this uncomfortable truth risks its remedy.

Coulter says that openness and empathy should be shown to patients after …