There have been two stories in the news recently. Firstly there was the Dispatches programme on Channel 4 last night called “Secrets from the Cockpit” around safety concerns being raised by Ryanair pilots. Then this morning the Telegraph lead with the headline “Patients ‘failed by toxic NHS cocktail’” where the health service Ombudsman is quoted as saying that complaints go unheard and lessons are not learnt.

The Ryanair story was sparked by the three Ryanair flights declaring fuel shortage Maydays in one night when diverted from Madrid to Valencia because of a storm. The Spanish authorities were concerned, not because Ryanair were operating illegally, but because they were operating very close to the wire on the amount of fuel they carried. If all airlines operated in this way it is conceivable that a situation would arise when an airport couldn’t cope with all the fuel shortages at once. Ryanair are already Europe’s biggest airline so this is not just a theoretical issue. The programme then drew on information from a Ryanair pilots’ survey and interviews with individual pilots about safety concerns.

In the NHS the Ombudsman is concerned that patients are now too frightened to complain for fear of receiving even worse treatment as a result. Staff were also defensive about complaints, reluctant to investigate and this creates a barrier to learning.

Both organisations have pressure on performance. Ryanair has a model of keeping costs low by operating planes with fast turnaround times and tight schedules. The NHS is under funding pressure and has faced a number of recent scandals and headlines over poor patient care. One could argue that Ryanair hasn’t had any fatal accidents yet, whilst poor care has been blamed for patient deaths in the NHS, but both organisations are facing real performance pressure.

The way organisations operate effectively is to have standard procedures and practices. These are the way things are done and should be designed with both performance and safety in mind. Those designing the operating procedure should have carefully calculated the costs and risks involved and if the organisations are resourced and staff work according to those procedures the organisation should operate within an appropriate safety envelope.

However, designers of standard operating procedure can’t think of everything and aren’t aware of developing situations on the ground. Therefore they need to be open to feedback from those directly involved, be they patients or pilots. A culture of not listening, thinking that they know everything already or simply being defensive will lead, over time, to the ossification of inappropriate operating procedures, alienation of staff who will stop reporting incidents and eventually more accidents.

So my questions for Ryanair would be: –

  1. How many pilot safety issues have been raised?
  2. How were they dealt with?
  3. How many changes in operating procedures have been made as a direct result of safety concerns?

Similarly for the NHS my questions would be: –

  1. How many patient care issues have been raised?
  2. How were they dealt with?
  3. How many changes in operating procedures have been made as a direct result of patient concerns?

What is needed is a receptive and open culture and the last thing we are trying to do is minimise the number of pilot safety issues or the number of patient care concerns raised.

Mike Bourne

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