There comes a point when the question is no longer whether mistakes were made, but whether anyone in authority will ever be held accountable for them.
The breast cancer scandal at County Durham and Darlington NHS Foundation Trust is one of the gravest failures in the history of our region's health service.
At the centre of this appalling chapter was the trust's leadership. Sue Jacques was the chief executive. The ultimate responsibility for the organisation rested with her.
Read more: Calls to strip County Durham NHS boss at helm during breast surgery scandal of OBE
No chief executive can be expected to know every detail of every clinical decision. But they are responsible for the culture they create, the systems they oversee and what happens when red flags are raised. Review after review has painted a picture of warnings ignored, concerns missed and opportunities to intervene squandered. The question is not whether one individual caused these failings. It is whether the person charged with preventing them should still be celebrated for services to patients.
The answer is no.
A joint criminal investigation remains ongoing and it would be wrong to prejudge its conclusions.
An OBE is among the highest honours this country can bestow.
It is intended to recognise exceptional service. When hundreds of patients have been harmed and public confidence shattered, that honour becomes impossible to defend.
The women at the heart of this scandal cannot simply walk away from the trauma inflicted upon them. Neither should the person who led the organisation responsible walk quietly into retirement with an OBE intact. Accountability matters. The integrity of the honours system demands it.
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