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True candour

BMJ 2019; 367 doi: (Published 03 December 2019) Cite this as: BMJ 2019;367:l6754

Rapid Response:

Re: True candour

Dear Editor

I read the article “The route to true candor” by Giles Maskell: BMJ 2019;367:16754, with renewed interest. I agree with volunteering all information to persons who may have been harmed by provision of services and being honest and frank. Why should we stop at the doctors being honest about mishaps during patients care? Why should we not make the public aware of the shortages nearly all hospitals face throughout the country and staff being put under stress and the unrealistic demands made on them.

I suggest the hospitals should put a board outside the entrance, like that at the entrance of car parks, stating the number of staff shortages, vacant beds and the number awaiting on trolleys in A & E. The scanners which are not working, the delay in discharge due to the shortage of care in the community and nursing home beds. And also the number of staff who are absent due to work stress related illness or involved in appraisals and revalidation.

Then, some may decide that their visit to hospital could wait another day or may even decide to have the investigation done elsewhere and others may even decide to take their loved ones home and bridge the gap before the care starts. This will make the public more appreciative of the care provided by the very hard working staff under difficult conditions in a constantly over stretched system. They will also be more understanding when unintentional errors are made. Less demanding. Maybe more volunteer to feed their elderly in the ward.

I am in total agreement with the basic principles of the duty of candor. We need to be open and honest not only with the mistakes made but also with the contributory factors, the unreasonable demands imposed due to shortage of resources.

Above all the hard working, dedicated staff should feel supported and the sacrifice made be appreciated. The public also should realize as Pierce Morgan said on ITV, “we have an NHS which is the envy of the world but it is giving way at its seams”. If we don’t support the NHS staff, the greatest assert, we are in danger of losing our national treasure.


R Jeyarajah
Consultant Physician
St Helier Hospital

Competing interests: No competing interests

12 December 2019
Rajaratnam Jeyarajah
Consultant Physician
St Helier Hospital