The successful prosecution of Newham Healthcare trust offers little cause for celebration (see news, page 4). The£16,500 it will now have to pay, on top of its own legal costs, could and should have been used to fund services for its patients. Instead the money will disappear back into the government's coffers.

But the case serves as an important reminder to any trust tempted to skimp on health and safety of the real perils that await them - not so much the fine and costs order themselves, for in the context of a£4m operating deficit they are tiny, but the tragic and needless death of an elderly woman in the trust's care.

Though the trust had clearly taken steps before the event to introduce a risk assessment process, the absence of controls noted by the Health and Safety Executive's inspectors reveals that attempts to rectify a decade- long failure to comply with national guidelines came too late and achieved too little.

Newham was not the first and will not be the last trust to face the courts. But the steps it has taken since the case was brought - and the high profile given to health and safety by Grampian University Hospitals trust, which narrowly escaped prosecution - show it can be done when the incentive is there.