There seems to be no let-up in the stream of NHS trusts hauled before the Chief Inspector of Hospitals to be condemned like heretics before the Inquisition. The latest to be recommended for 'special measures' was East Sussex Healthcare NHS Trust.
The verdict follows a woeful series of similar stories. In September the national press latched onto a similar fate befalling the Cambridge University Hospitals Trust, administrator of the internationally-lauded Addenbrooke's Hospital.
What is particularly saddening about these stories is that nobody in their right mind thinks NHS staff set about wanting to be 'Inadequate', or turn up at work thinking they will do anything other than their level best to provide the best care for their patients. There is often what the Care Quality Commission describes as a 'disconnect' between staff and management, with management seeming to have little idea of what actually providing that care involves.
• One of the areas where there is the prospect of negligence cases being brought is that of lower-limb amputation due to inadequate treatment of vascular breakdown. It is an area fraught with uncertainty - when is the amputation a failure of treatment and when is it a necessary intrusion to save life?
The sad story of a pensioner with mental health difficulties whose refusal to accept an amputation was upheld by a judge, despite it being deemed necessary to save his life, brings the dilemma into a sad focus.
• No-one can have escaped the fact that the end of September marked the return to British soil of the Rugby World Cup. Rugby is a game in which the prospect of being concussed is finally being recognised as a serious risk. The same is true of all contact sports. There is at last a recognition that allowing a player to continue following a head injury without being treated is a serious dereliction by authorities.
A little-known accompaniment to concussion are symptoms following the injury, known as post-concussion syndrome. The occurrence of the condition, which has a series of physical and psychological symptoms which may be lifelong, is unconnected to the seriousness of the original injury. It is a lottery - not aided for the sufferer by the fact that in some cases the fact of their suffering is denied by defendants.
• Which brings us back to clinical negligence cases. The Association of Personal Injury Lawyers (APIL) is still finding itself having to go into battle to persuade the powers-that-be that clinical negligence victims should be compensated and not demonised.
The exchange followed the publication of the Annual Report of the NHS Litigation Authority, which included an attack on fees and a commitment to drive down costs. At the same time the government announced a move to cap costs in negligence cases.
As APIL points out, if there was less negligence when treating patients, there would be no need for negligence cases. Simples!