This site is intended for health professionals only

Why do we keep playing with fire?

The terrible fire at Grenfell Tower in west London offers a telling metaphor for a wider malaise.

A loss of life – predicted and preventable. A media furore. Promises of a review by ministers to ensure it never happens again. But the Grenfell tragedy follows a fatal blaze four years ago at another tower block in Camberwell, south London, which had itself been preceded by a similar fire.

Although each event prompts government promises that change will occur, the relevant fire prevention rules have not even been reviewed. While we don’t know if that could have prevented this tragedy, it’s clear that enforcement of the existing regulations has been undermined by massive cuts to local authority budgets.

Postmortems are conducted, everyone nods gravely – and nothing changes.

And this theme continues. A decade ago, as a new reporter for Pulse, I covered the ‘Baby P’ scandal. You may recall the media frenzy at the time, with doctors, social workers, lawyers and police all castigated for failing to protect a 17-month-old boy called Peter from horrifying abuse at home that led to his death.

Dr Jerome Ikwueke, Peter’s GP, was particularly singled out for not raising concerns when he found bruises on Peter’s head and chest after the boy had apparently fallen down the stairs. This had personal consequences for the GP – he was suspended for 12 months by the GMC, although was later reinstated – but also for his profession.

A whole army of acronyms – GMC, CQC, RCGP, NICE – all piled in to tell GPs in no uncertain terms that they had to take specialist training, report any concerns and work closely with other agencies to prevent abuse or neglect.

And GPs have done so. Our story today reveals an increase in safeguarding referrals for both adults and children. Has it made a difference? It is hard to say, but it has occurred as social services’ funding is slashed, and many GPs feel their concerns are not being acted upon quickly enough.

Some 60% of GPs report an inadequate response from social services and 42% have experienced ‘unacceptable delays’. GPs told us they are concerned that there are not enough social workers to follow up quickly and that frequent changes of staff undermine safety. I know I am not alone in being horrified that the welfare of many vulnerable people is being put at risk in this way. 

But it fits with an established pattern. Conflagration, reaction, promises of change and then very little delivered. And I could give other examples: children’s mental health services, asthma mortality rates and perhaps even the GP Forward View.

All follow a similar pattern, where important issues are dealt with on a 24-hour news cycle rather than as something that deeply affects people’s lives. Ministers get distracted by squabbling over Brexit or snap elections and then are reshuffled to another department, leaving the most vulnerable to suffer most.

I would not be surprised if there is another Grenfell, Baby P or Victoria Climbié waiting to happen. GPs are held to account for their mistakes, but those in charge of our institutions repeatedly seem to get away with what should amount to criminal negligence.

Nigel Praities is editor of Pulse