Should “safe space” material be kept confidential?

Airline pilot Martin Bromiley began a campaign to create the Health Service Safety Investigations Branch 17 years ago, just a few weeks after his wife died when routine surgery for chronic sinusitis went catastrophically wrong.

“If anything, I felt comradeship with the operating team,” he tells The BMJ. “I felt that they had done what they believed was right but things just didn’t work out. Yet I could see that the doctors were on their own.”

“When things turned to disaster they had little if any support from the hospital and crucially there was no plan to investigate and make sure lessons were learnt. I felt that had to change,” he recalls.

What was needed, he argued, was a replica of the Air Accident Investigation Branch (AAIB), which Bromiley, as a pilot, knew was crucial to safe aviation. “The AAIB and its international equivalents have been responsible for the extremely high levels of safety seen today in aviation,” he told The BMJ. “The rule was simple: that in almost every case errors are systemic and failures that are there will be multiple and minor.”

“The only serious offence for an aviation crew is failing to speak up when they see or are involved in an aviation error,” he says.