Writing in the latest edition of The Lancet, one of the world’s most respected medical journals, its editor Richard Horton says,

If GOSH’s [Great Ormond Street Hospital’s] management team had been in Wigan they would almost certainly have departed by now. Perhaps GOSH is just too important to be seen to fail. Even when a child dies. (The Lancet – free registration required)

The reason for his comment that had it been another hospital, the management team would have been sacked or resigned by now is the criticisms levelled at the hospital not only for its role in the death of Baby Peter but also its subsequent failure to hand over key evidence of its mistakes to one inquiry and the claim that it provided evidence to a second inquiry – only for that inquiry’s chair to flatly contradict Great Ormond Street’s claim.

Moreover, its Chief Executive Jane Collins avoided a General Medical Council investigation into her behaviour only by virtue of coming off the medical register and the hospital has finally after three years apologised for its treatment of a whistleblower in the Baby P case. Last year around half its top medical staff signed a letter of no confidence in its senior management.

The Lancet‘s editor says:

There are unanswered questions. Have the events that led to the death of Peter Connelly been fully and transparently investigated? Have the right lessons been learned? And have those who managed (and continue to manage) children’s services at GOSH and its associated facilities been held properly responsible for the quality of care they delivered? The answers to these three questions are the same—we don’t know. These uncertainties now rest with the Secretary of State for Health to resolve as a matter of urgency.

He also speculates that the reason for Great Ormond Street seeking to avoid criticism and failing to be open about events is that it is nearing its long-term quest for foundation hospital status – meaning that criticism of its leadership is the last thing the hospital wants at this moment. However, Andrew Lansley has the power to insist these questions and failings are fully investigated – if he chooses to.

UPDATE: Richard Morris has more on the story here.