The recent case of a doctor being struck off after being convicted of manslaughter by gross negligence has been the subject of much interest from Twitter lawyers and medics. I offered my own view at the time that in order to retain public confidence the conviction and subsequent decision to remove her registration was correct. Now she has been granted an appeal against the ruling by the General Medical Council. It seems much substance will be made of the institutional failings within the NHS which contributed to a great extent in her failure to perform her duties adequately and led to the tragic death of a child in her care. It appears to be another case to be excused by an ism. It began when Stephen Lawrence, a black British man from Plumstead south east London was murdered in a racially motivated attack while waiting for a bus in Well Hall Eltham on the evening of 22 April 1993. The subsequent report, The Macpherson Report published on 24 February 1999, found that the police investigation into Stephen's murder was “marred by a combination of professional incompetence, institutional racism and a failure of leadership by senior officers. Since then the problems within an organisation have often proved to be an alibi for personal incompetence. Social services departments` failures have been used to some extent as excuses for those working within them in cases of grooming of girls by mainly Pakistani men. Comment on the news earlier this week that Alison Saunders Director of Public Prosecutions aka chief of the CPS has focused on the failures of the institution rather than the serial incompetence and rotten decision making of the lady herself. This derogation of responsibility is a further sign of the moral authority we vest in senior public servants and politicians being diminished. What begins at the top as sure as night follows day percolates through society like a hot knife through butter so that individual responsibility becomes a rare commodity and those abusing it are all the more likely to evade their just deserts. This is what we are becoming; a country in decline where nobody is blamed for the problems and institutions continue to fail.