HARM to mothers and their babies is at risk of being normalised owing to a “toxic” culture of cover-up in the NHS, the head of the doctors’ regulator will warn today.

General Medical Council (GMC) chief executive Charles Massey will tell delegates at the Health Service Journal patient safety congress in Manchester that “something must have gone badly wrong” in workplaces when trainee doctors feel fearful of speaking up.

He will suggest the “tribal” nature of medicine can pit doctors and staff against each other, discouraging them from raising concerns or admitting mistakes.

“That doctors are making life and death decisions in environments where they feel fearful to speak up is profoundly concerning,” Mr Massey will say. 

“Those are the very factors that lead to cover-up over candour and obfuscation over honesty. And it is in those cultures that the greatest patient harm occurs.”

He will highlight maternity care as one of the most high-risk areas of medicine, where failures can be “especially tragic and far-reaching.”

GMC data shows that more than one in four obstetrics and gynaecology trainees admit they have hesitated before escalating a case to a senior medic — higher than in other specialities. 

The field also has above-average rates of stress, bullying and doctors feeling unsupported.

“These data suggest a situation where, too often, patient safety is falling victim to unhealthy culture,” Mr Massey will add.

“The unthinkable — harm to mothers and their babies — is at risk of being normalised. 

“And toxic culture is in no small part to blame.”

The warning comes as Health Secretary Wes Streeting launches a national maternity investigation into “systemic” failures, saying bereaved families have often been “gaslit” in their search for answers.

Led by senior midwife Donna Ockenden, the inquiry will examine problem trusts and take a “system-wide” look at services.

Royal College of Midwives chief executive Gill Walton said: “When this investigation was first announced, it was described as a ‘rapid review’ that would report by December. 

“It is vital this work gets underway quickly so that the families who have suffered unimaginable harm get the answers they need and hard-pressed maternity staff get the support and investment they’ve been calling for.”

The investigation is due to conclude in December.