Why patient safety demands a Hillsborough Law with a legal duty of candour for all health and care professionals

Summary

More than three decades after the preventable death of 10-year-old Robbie Powell, the UK still does not have a legal mechanism to hold individual clinicians accountable for dishonesty.

This evidence-based opinion piece from Steve Turner argues that an ethical code of conduct is not sufficient to ensure accountability and that an individual legal duty of candour is essential for patient safety. It makes the link between Hillsborough Law and Robbie's Law.

Content

No legal duty to tell the truth

More than three decades after the preventable death of 10-year-old Robbie Powell and the subsequent cover-up by medical professionals, the UK still does not have a legal mechanism to hold individual clinicians accountable for dishonesty. The proposed Hillsborough Law[1]—which seeks to establish an individual legal duty of candour on public officials—must include all health and care professionals: managers, leaders and frontline clinicians alike. Anything less would be an affront to patient safety and public trust.

The heart breaking story of Robbie Powell, who died in 1990 due to multiple clinical failings has long been a call to action for legal reform.[2] His case, meticulously documented and campaigned for by his family, exposed how doctors could mislead families and official inquiries without legal consequence.[3] The European Court of Human Rights ruling on Robbie’s case made it chillingly clear: there is no individual legal duty of candour on doctors.[4] The media aptly dubbed it “a doctor’s right to lie".[5] This remains true today.

A conspiracy of silence?

The Robbie Powell case predates Hillsborough. It is the landmark case on duty of candour and yet it receives little attention in the press and media. It was referred to by Sir Robert Francis in the report on the failings at Mid Staffordshire,[6] and the significance of the Robbie Powell case was a factor in the collapse of the 2021 trials of former police officers and a solicitor involved in the Hillsborough disaster.[7]

After Hillsborough, the Robbie Powell case, through its influence on the concept of 'duty of candour', played a role in the broader discussions around transparency and accountability in public life. Because there was (and still is) no individual statutory duty of candour on police officers or public officials, the legal framework makes it easier to defend against allegations of dishonesty or misconduct, even when unethical behaviour was clear.

That such a crucial legal precedent draws so little public attention is telling. It highlights how deeply entrenched the culture of denial and protection is, not only in policing but across public institutions—including the NHS and the whole of health and social care.

The argument against legally enforced accountability

Some clinicians argue that a statutory duty is unnecessary. In fact, in 1998 a BMA spokesperson publicly defended this view, claiming that "the ethics of this are rather more important than the law" and a strict legal framework would be "unhelpful".[8] Sadly, history proves otherwise.

In a parallel situation on public accountability, the Post Office scandal,[9], where countless subpostmasters were failed by Post Office leaders and managers who stayed silent, showed the cost of misplaced institutional loyalty. Healthcare has its own shameful examples, including the Infected Blood Scandal[10], the widespread mistreatment of people with autism and learning disabilities, and shocking failures highlighted in multiple reports and other systemic scandals examined in the Thirwall[11] and Lampard[12] inquiries. Again and again, professionals have failed to speak out—and when they do, they are often ignored and even blacklisted.[13]

This is not a question of bad apples; it is a systemic failure of accountability. Without a legal duty of candour that applies to individuals, there is no deterrent to dishonesty and no justice for those harmed by it. Regulatory bodies have repeatedly proven they are not enough.

Time to act: Hillsborough Law incorporating Robbie’s Law now

A Hillsborough Law that excludes clinicians from individual accountability would betray the very purpose of the legislation. It would ignore the hard lessons from decades of cover-ups, including the tireless efforts of Robbie Powell’s family to expose the truth. We cannot afford to continue a system where telling the truth is optional, and silence carries no consequence.

Patient safety depends on truthfulness. And truthfulness must be enforceable—not merely expected.

References

1. UK Parliament. Public Authority (Accountability) Bill ‘Hillsborough Law’, 2017 (accessed 28.07.2025).
2. Robbie's Law – Telling the truth in healthcare. The campaign for an individual legal duty of candour, 2025 (accessed 28.07.2025).
3. Hartles S. ‘Robbie Powell: Time for Truth, Justice and Accountability’. The Open University, Harm & Evidence research collaborative., 2025 (accessed 28.07.2025).
4. European Court of Human Rights (45305/99) (4th May 2000) – (Third Section) – Decision – POWELL v. THE UNITED KINGDOM (accessed 28.07.2025).
5. Hammond P. Robbie’s Law – Telling the truth about medical harm. Private Eye: Medicine Balls 1332, 2013. (accessed 28.07.2025).
6. UK Government. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationary Office, 2013 (accessed 28.07.2025).
7. Conn D. Hillsborough families attack ‘ludicrous’ acquittals of police. The Guardian, 26 May 2021 (accessed 28.07.2025).
8. Powell W. Duty of Candour [Robbie's Law]. Relevant section at 9.09. Channel 4 News, 24th April 1998  (accessed 28.07.2025).
9. Post Office Horizon IT Inquiry, 2025 (accessed 28.07.2025).
10. Infected Blood Inquiry, 2025 (accessed 28.07.2025).
11. Thirwall Inquiry (accessed 28.07.2025).
12. The Lampard Inquiry is an independent statutory inquiry investigating the deaths of mental health inpatients in Essex between 2000 and 2023 (accessed 28.07.2025).
13. Turner S. The systemic silent killer – ending the stigma around whistleblowing in healthcare. 2023 (accessed 28.07.2025).

This article was first posted on LinkedIn and has been edited for the hub: https://www.linkedin.com/pulse/why-patient-safety-demands-hillsborough-law-legal-duty-steve-turner-0jgue/?trackingId=cK7GxZXtgvMnt%2FcnwYYCyw%3D%3D