All that is protecting the management team running Great Ormond Street Hospital from the sack over their role in the Baby Peter abuse case scandal is the international reputation of the institution, according to a leading medical journal
The hospital, the UK's premier children's medical institution, has been embroiled in allegations of a cover-up over a report it commissioned into the children's clinic it ran in Haringey, north London, where a locum doctor missed a chance to save Peter Connelly two days before he died. Lynne Featherstone, a junior Home Office minister, accused the hospital of withholding vital information and called on its chief executive, Jane Collins to resign. She has written to Andrew Lansley, the Health Secretary, demanding a government inquiry.
Now Richard Horton, writing in the latest issue of The Lancet, which he has edited for a decade, describes the episode as a "scandal" and suggests that one reason for the alleged cover-up is that the hospital is seeking foundation trust status, which it hopes to win in the autumn.
He says the trust may have feared releasing the full details of the report because it could have triggered a debate about the quality of its leadership, jeopardising its application.
Were Great Ormond Street an ordinary district hospital in a small town, rather than an internationally renowned centre for child health with a foundation trust application pending, heads would have rolled, he said.
"If Great Ormond Street's management had been in Wigan they would almost certainly have departed by now," he said. "Perhaps Great Ormond Street is just too important to be seen to fail. Even when a child dies."
The attack will increase pressure on the trust, which has been subject to a barrage of criticism over its handling of the independent report, commissioned from Professor Jonathan Sibert and Dr Deborah Hodes.
The report said the locum doctor, Sabah al-Zayyat, who was the last to see Peter Connelly, was inexperienced and should never have been hired, the Haringey clinic was short of staff and the whole child protection system was under strain.
It included a judgement by the head of the clinic, Dr Sukanta Bannerjee, that it was a "clinically risky situation".
But about half the report was cut before it was submitted to the official serious case review inquiry into Baby Peter's death.
Great Ormond Street said the cuts were necessary for legal reasons and to protect the rights of its employees.
The author of the serious case review, Edi Carmi, said much of the material edited out of the report concerned issues fundamental to the inquiry. She claimed she was not given a full picture of the problems at the clinic.
"I've never been aware of any agency withholding this sort of information from a serious case review. I find it unbelievable this level of information was not provided," she said.
Peter Connelly, who was on Haringey council's child protection register, died violently at the hands of his mother, Tracey Connelly, her lover Steven Barker, and Barker's brother Jason Owen in August 2007. Following the conviction of his killers a year later, the focus of the blame for his death fell on Sharon Shoesmith, Haringey's former director of children's services, who said that social workers had been unfairly singled out.
A spokesperson for Great Ormond Street said: "The trust has always accepted its failings in the care of Peter Connelly and said that it didn't get everything right. All members of the trust's board have personally reviewed the documentary evidence. Our conclusions are that the allegations regarding the trust's failure to share information are incorrect and unsubstantiated by the evidence."