Guest Editorial > “Willful Blindness” by Margaret Heffernan



“Willful Blindness” by Margaret Heffernan | Roger Steer

Roger Steer reviews a new paperback that may have more impact than the Francis Report

“Willful Blindness” by Margaret Heffernan


“Willful Blindness” by Margaret Heffernan: Simon and Schuster 2011. RRP £7.99 (paperback)


This month two events coincided: the publications of the Francis Report on Mid Staffs and the paperback edition of “Wilful Blindness” by Margaret Heffernan. My contention is that in the long run the latter event may turn out to be the more significant for the NHS.


While Francis rightly castigates and recommends a ‘back to basics’ and a new seriousness of approach, his tone has all the hallmarks of a headmaster admonishing naughty sixth formers. In the fullness of time it is likely the normal service of “wilful blindness” will be restored.


Margaret Heffernan goes deeper and explains why this may be so and offers help on how it may be prevented.


First, “wilful blindness” is explained as a legal doctrine whereby “knowledge can be inferred if the defendant deliberately blinded themselves to the existence of a fact”. It has been used to prosecute in the Enron affair, and it casts an explanatory shadow over events in the Catholic Church, Nazi Germany, B.P., BBC (over Jimmy Saville), News Corporation and within our armed forces; and into our most intimate relationships.

For those that doubt perception problems, despite the clichés of the elephant in the room and the example of the ostriches’ head in the sand, looking at is recommended.


The book provides a unifying theme that encompasses related concepts of groupthink, wishful thinking, corruption, compliant submissive behaviour, ahistoricism (bias for the present), fear, exhaustion, conformity, bystander behaviour, courage, deference, complexity, division of labour and inability to pick up signals. It draws on psychology, history, organisational and management theory, and economics; and draws parallels in various fields: business, religious orders and cults, the military, the public services and banking. It lists heroes and villains, whistle-blowers and predictors of the past and future. Best of all are the vivid anecdotes. My favourites are Sir George Tyron who had unusual (and tragic) ways of inducing critical thinking in the navy; the cults predicting the end of the world and their ability to rationalise going on; and more poignantly, the German lady writing to complain about her view of the killings in the concentration camps and asking that it could at least be done out of view because of the distress it caused.


The medical world receives plenty of coverage and the author zeroes in very quickly to the heart of the NHS problem. Needless to say it doesn’t seem to be what Francis identifies or seeks to correct. He probably thinks it wasn’t in his brief – hence his insistence it is for the NHS now to heal itself.


My recommendation is therefore to read this book before you read the Francis report and then come to your own conclusions. For my part I intend to review the Francis report with a sharper eye.


Roger Steer