I was interested to read Paul Sankey on proposals to introduce a duty of candour as part of the health reforms.

There is nothing new in this, as those familiar with the inquiry into the management of care of children receiving complex heart surgery at Bristol Royal Infirmary will recall.

Recommendations from Bristol included the adoption of an NHS-wide culture of safety and openness firmly centred around a duty of candour when a mistake was made, even when that mistake might bring legal liability. The report was widely disseminated and much discussed but, as it reaches its 10th anniversary this year, it looks increasingly clear that anything but an enforceable statutory duty of candour looks doomed to failure.

It is therefore dispiriting to read about the latest toothless attempt to bring about the culture of safety and openness that was a key recommendation of the Bristol inquiry. The argument then (and it remains just as potent today) was that the more that is known and understood about adverse events generally, the more it would be possible to address their causes and prevent them in future.

Emma Wray, solicitor (clinical negligence), Sway, Hampshire