Hyponatraemia cases show how a cover-up greatly worsens a wrong

But only yesterday did a report formally conclude that medical professionals covered up treatment failures.

Mr Justice O’Hara ruled that in many cases the truth had to be “dragged out” of the experts.

The judge is proposing “a statutory duty of candour” to be introduced in which there is a duty to tell patients and the families about major failures in care.

It is fair to note that hospitals and the health profession have improved greatly in some spheres of interaction with patients, such as informing people that a loved one has died, something that was once done by people who had no training.

It is not hard to see how experts would be loathe to have to advise a relative that their child’s death was in part caused by negligence. But while such reluctance is more than understandable, it can never be acceptable.

Marie Ferguson, whose daughter Raychel died yesterday, said a mistake was forgivable but an orchestrated cover-up was not. One of the children, Adam Strain, four, died in 1995, yet it was known almost immediately he died from hyponatraemia.

Negligence and wrongdoing happens in every conceivable walk of life, from medicine to law to finance to sport to journalism to teaching to churches and more. Yet in the Watergate scandal in Washington in the 1970s, and countless times in public life before that and countless times since, cover-ups have greatly compounded the original wrong. Police lies over the Hillsborough stadium disaster were a stark example.

This important inquiry had helped to achieve changes before it even reported: the department of health said that the findings acknowledge the steps it has already taken. The health trusts are “urgently reviewing the recommendations”.

It is to be hoped the families can now find closure and that such an appalling episode is most unlikely to happen again.