David Zigmond: Can we reduce childhood sepsis by more vigilant management? I doubt it

david_zigmond2Recently the health secretary, Jeremy Hunt, said “I am determined we blaze a trail across the world in developing a truly safe healthcare system with airline levels of safety.” (Economist Radio, 28/1/16)

He was commenting on the death of a child from sepsis: a condition often of shocking inexorability. His muscular soundbite was bound to be popular—who would disagree with such an aim? But how realistic is it?

Human lives and illnesses have a nature and complexity far beyond aeroplanes and airports. The latter can only offer a very partial model for the former.

However wise, competent, or conscientious medical practitioners are, certain conditions will continue to outflank us. Even if we put every mildly feverish child into an ICU, there would still be the very rare—but always tragic—death.

We must always aspire to zero failure, while recognising that this is an imperfectible project. When we fail we must always look again.

There are some problems that no kind of law, cleverness, or threat can obviate. Recognising this constitutes wisdom in all our relationships, both private and public. The health secretary, too, needs this discrimination.

Would more chivvied reform or management now help us with this conundrum? I doubt it. It is far more likely to merely add to our profession’s exhausted and anxious fatigue.

David Zigmond is a GP in London.

Competing interests: I declare that I have read and understood BMJ policy on declaration of interests and I have no relevant interests to declare.