Leading Article: Deadly trust in Beverly Allitt

THE CRIMES perpetrated by Beverly Allitt are unique in their seriousness. But the circumstances that allowed her to plot and kill for 58 days on a children's ward are commonplace. It is just fortunate that there are not more Beverly Allitts. For the National Health Service, like many caring institutions, has a natural trust in professional staff. Abuse seems inconceivable, and even obvious danger signs may pass unrecognised.

Take, for example, the bogus general practitioner jailed last year. His prescriptions included shampoo to be taken internally and creosote for a tooth complaint. Yet he had practised unchecked for 30 years. Another bogus hospital doctor was exposed only after a patient died. He had not been discovered earlier, despite wandering the hospital in a green operating theatre uniform. The hospital had no operating theatre.

Thoughts that such abuses are a product only of highly sophisticated planning, rather than failure in the system, were dispelled by a government-commissioned study published last week. It found that NHS hospitals were a criminal's paradise, offering easy pickings for thieves and open house to thugs. Official reports have also highlighted the abuse of mental patients in top-security special hospitals and scandals in homes for the mentally handicapped.

The central issue raised by the Beverly Allitt case is the quality of NHS management. Managers are too often unaware of what is happening on the wards. If senior staff do not monitor a hospital properly, or fail to keep managers

informed, similar tragedies will occur.

Other caring institutions have taken years to come to terms with their vulnerability to criminals and the insane. Frank Beck, like Allitt a qualified professional, sexually abused children in four local authority homes for 13 years. Complaints to police and social services officials were considered unbelievable and went unheeded. In recent years there have been nine inquiries into conduct in children's homes, but changes relating to inspection, training and recruitment have been adopted only in the past year.

The internal inquiry into the Allitt case features worrying parallels to the situation finally acknowledged in these homes. The inquiry has found that Ward 4 at Grantham and Kesteven hospital was poorly staffed, suffered from low morale and was inadequately supervised. This provided fertile ground for Beverly Allitt. Yet the treatment of Graham Pink, the NHS whistle-blower, shows why staff may be reluctant to expose poor conditions. He was sacked.

Sir Cecil Clothier has promised a speedy investigation into the Grantham killings. But his remit is inadequate: his inquiry will take place in private and cannot subpoena witnesses. It is unlikely to look at the broader problems endemic in the NHS. Virginia Bottomley, Secretary of State for Health, must learn the lessons of failed initiatives on children's homes and convene a public inquiry. This is the minimum she can offer to angry, grieving parents. Anything less will fail to reassure the public and deter would-be criminals.