Melding backs New Zealand no-fault model for NHS safety

Pamela S Melding backed New Zealand’s no-fault patient-safety model in Guardian letters published Oct. 22, citing 2005 legislation and earlier reforms as alternatives to Thirlwall recommendations for NHS neonatal units.

Evidence grade: Claim (no study cited). The letters matter because they frame neonatal safety as a policy choice between stronger surveillance and systems designed to encourage disclosure, but they do not provide comparative outcome data.

Melding, who wrote that she had worked in New Zealand as a hospital consultant, clinical director and deputy chief medical officer, argued that the country’s system changed after 1970s accident-compensation legislation removed medical-injury damages claims from public courts.

She wrote that an 1980s inquiry led to the independent Health and Disability Commissioner, where complaints about health facilities, organisations or practitioners first go for review. She also said New Zealand’s 2005 “no fault, no blame” law created a duty to report risks of harm to the public.

Mark Hanson, writing from Hertfordshire, said Lady Justice Kathryn Thirlwall’s proposals appeared to favour “surveillance, suspicion and blame,” including cameras in cots and more reporting of colleagues. “Destroy candour and you destroy one of the most powerful tools of patient safety,” he wrote.

An unnamed reader wrote that her daughter was born in March and died seven days later in a neonatal intensive care unit. She said she believed the death was preventable, but placed greater concern on what she described as the trust management’s defensive response.

Paul Whiteing, chief executive of Action Against Medical Accidents, added a different emphasis. He wrote that NHS staff need to raise concerns without fear, while patients and families must also be heard and involved in safety decisions.

The letters cannot establish whether New Zealand’s model would transfer successfully to the NHS, whether Thirlwall’s recommendations would improve or worsen safety, or how neonatal outcomes compare under different legal systems. The Guardian letters did not include an NHS response, a Thirlwall inquiry response or outcome data.

Source: letters page, The Guardian Health, Oct. 22, 2026.

Atlas360 reports health research and does not provide medical advice.