We ask the UK government to introduce legislation requiring enforceable measures for the NHS, police and CPS where serious failings or neglibence are identified. This should include a statutory duty for organisations and individuals to act transparently and honestly during investigations
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Senior leaders within the NHS, Police & CPS must be held responsibile when failures of duty happen.
Following serious incidents in our country that lead to Inquiries, lessons are not learnt, mistakes are not acknowledged and so trust in public services erodes.
Lessons from Inquiries that are expensive to hold, in the first place, must be embedded by law. An example is the Clunis Inquiry where lessons were not learnt or unlearnt because they was no statutory power to embed them in systems.