Health minister Lord Howe has said he is “nervous” about the proposal by Robert Francis QC for individual healthcare staff to be liable for criminal sanctions.

Mr Francis’ public inquiry report proposed legal sanctions at an individual level for staff who break basic standards, and those who withhold information about safety and quality errors from their organisation.

Lord Howe, speaking at the National Institute of Health and Care Excellence annual conference on Tuesday, said: “We are trying to button down at the moment where the criminal offense should fall, whether it should fall on the organisation level or onto an individual level.

“I think I am nervous about it falling on an individual level, if I am being candid, because it might produce the opposite result of what we want which is maximum openness and candour.”

He added he was concerned a climate of “fear and blame” could be an unintended consequence of such moves. the introducing criminal sanctions for individuals.

The Department of Health has not said it will implement Mr Francis’ recommendations for individual criminal sanctions, but has said it will take a decision later in the year, following the review of NHS patient safety led by Don Berwick.

Mr Francis told HSJ this week the lack of such santions would cause “public confidence” in the service to “evaporate”.

Meanwhile, Mr Francis, speaking at the NICE conference yesterday, said NHS managers often ignored whistleblowers because they were “difficult people with ulterior motives”.

Mr Francis said: “The first thing to know about whistleblowers, in some circumstances, is almost invariably, they are very difficult people.

“They are not going to come forward and put their head above the parapet unless they are difficult.

“Sometimes they have ulterior motives for what they are saying.

“The danger is because they are difficult people, and because what they are saying is difficult, what they are saying is just rejected.

What is absolutely important is whoever [is making the complaint], the organisation must be held to account and [the complaint must be] investigated and dealt with.”

The barrister also called for foundation trust senior leaders to act more autonomously.

He said: “The whole point of a FT is meant to be that they are autonomous from them upstairs and yet I still sense that the chief executives of many of these organisations are still waiting to be told what to do by somebody else.”