Charles Massey, chief executive of the General Medical Council (GMC), says patient safety is falling victim to an unhealthy culture.
Harm to mothers and their babies is at risk of being normalised owing to a “toxic” culture of cover-up in the NHS, the head of the doctors’ regulator will say.
Charles Massey, chief executive of the General Medical Council (GMC), will tell delegates at a conference on Monday “something must have gone badly wrong” in workplaces when trainee doctors are fearful of speaking up.
He suggested the “tribal” nature of medicine could mean doctors and other staff are pitted against each other, which may prevent people raising their concerns or admitting when things go wrong.
In a speech seen by the PA news agency, Mr Massey will tell the Health Service Journal patient safety congress in Manchester: “That doctors are making life and death decisions in environments where they feel fearful to speak up is profoundly concerning.
“Those are the very factors that lead to cover-up over candour and obfuscation over honesty. And it is in those cultures that the greatest patient harm occurs.
“Everyone in this room will be aware of the scandals of recent years concerning maternity care. This is one of the most high-risk and high-pressure areas of medicine.
“One where the consequences of things going wrong can be especially tragic and far-reaching, affecting both a mother and her baby, not to mention their wider family.”
GMC data shows that more than one in four (27%) obstetrics and gynaecology trainees admit they have felt hesitant escalating a patient to a more senior medic – a higher proportion than in other areas of medicine.
The specialty also has above average rates of workload stress, bullying and doctors who feel unsupported by colleagues, according to GMC findings.
“These data suggest a situation where, too often, patient safety is falling victim to unhealthy culture,” Mr Massey will say.
“The unthinkable – harm to mothers and their babies – is at risk of being normalised. And toxic culture is in no small part to blame.”
Mr Massey will say that mutual respect between health professionals is crucial, despite medicine being “notoriously tribal”.
He will call on employers to recognise their role in ensuring workplaces promote a sense of belonging and inclusion among staff.
“Behind these statistics lie real people, real tragedies,” he will say.
“I have met some of them and their testimony is searing. So for them, and for all the patients we’re here to serve, we must demand better, and never accept as normal cultures which don’t have safe care at their heart.”
Health Secretary Wes Streeting has launched a national maternity investigation into what he sees as “systemic” failures in NHS care.
He has said families who have lost babies at the hands of the NHS have often been “gaslit” in their search for the truth.
According to Mr Streeting, NHS trusts across England are failing as are regulators, and there has been “too much passing the buck”.
Senior midwife Donna Ockenden is currently examining how hundreds of babies died or were injured in the care of Nottingham University Hospitals Trust, following her review into mother and baby deaths at Shrewsbury and Telford Hospital NHS Trust.
Other trusts have also been involved in maternity scandals.
The national investigation announced by Mr Streeting in June consists of two parts.
The first is investigating trusts of greatest concern at the moment, including Leeds, Gloucester, Mid and South Essex and Sussex.
The second part of the investigation will be a “system-wide” look at maternity and neonatal care, uniting lessons from past maternity inquiries to create one “clear set of actions” designed to improve national NHS care.
A National Maternity and Neonatal Taskforce, chaired by Mr Streeting, has also been set up, made up of experts and bereaved families.
The investigation is expected to conclude in December.
