Who should resign this week? The blame game continues with more Mid Staffs finger pointing. As newspapers identify further unpleasant aspects of the wider tragedy, there is a risk that we stop reading about it and just move on to the next news story. Sad, isn’t it, that the main messages from one of the low points in the history of the NHS could be lost in the fall out.

Who cares about patients? Recently, I hosted a round table discussion on compassion. (The podcast is up on bmj.com) and I was struck by a comment by Jocelyn Cornwell, “there is a sort of fantasy, which is (that) everybody in the health service cares.” Something I never questioned. I always assumed that the basic principle underpinning health was caring for others. My horror at what happened in Mid Staffs, and other recent stories about health and social care, stems from the huge contrast between what happened to patients (i.e. you and me) and my assumption that people in hospital would actually care for us. Isn’t that what patients expect—to be looked after?

And, if you were unhappy about some aspects of the health service, would you now feel able speak up? Never mind the recent outlawing of gagging clauses, it seems the whistleblower always suffers. If you dare, you need to be a very strong character, determined and resilient. Imagine how difficult it must be as a young nurse or junior doctor to question a situation or challenge superiors. Even senior staff put their careers at risk. When I asked if there was now a culture where doctors and nurses could stand up and be counted? Sadly, Peter Carter, Chief Executive of the RCN said: “…. we’re certainly not there now.” And, I agree.

Domhnall MacAuley is primary care editor, BMJ.