Patients going into hospital trust their lives to the doctors and nurses who treat them.

Visitors and staff also regard hospitals as places of safety. It is shocking to discover that more than 100,000 people have been injured in accidents in Scottish hospitals in the past four years.

This means an average of 64 people, most of them patients, have been hurt every day. Incidents include deaths, amputations resulting from accidents, broken limbs, electric shocks, burns and inhalation of toxic fumes and damage inflicted by violence on the wards.

It is a disturbing catalogue. Even slips, trips and falls, which cause minor injuries in healthy people, can be serious for patients who are already weakened. A secondary problem, such as a broken limb, will add complications, especially in elderly patients.

Last week Professor Paul Knight, who is the new president of the British Geriatrics Society and a consultant at Glasgow Royal Infirmary, warned that older patients in Scottish hospitals do not always receive care specifically tailored to their needs. The physical environment of hospitals must also be adapted to cope adequately with the increase in older patients, who are more frail and more likely to be confused.

Margaret Watt, chairwoman of the Scottish Patients Association, has called for new signage on wards to warn of potential dangers. This may help where there is an "accident blackspot" such as a sudden step. But with an average of three incidents every hour, something more radical would appear to be required.

Despite being protected from cuts, all NHS budgets are stretched and there are staff shortages in some areas. Additional pressure on staff inevitably means less intense supervision of individual patients. Last year the Royal College of Nursing warned that one nurse cares for about nine patients on older people's wards, a ratio that speaks for itself.

With millions of patients being treated in Scottish hospitals every year (1.2 million in Greater Glasgow and Clyde alone) plus large numbers of staff and visitors, some accidents will be inevitable. It is essential that when something goes wrong, it is followed by a risk assessment and a strategy to prevent a recurrence. With such a disturbingly high number of incidents, however, it is difficult to be confident that this is always done effectively.

In some cases accidents will result not only in the need for additional treatment and longer care but claims for compensation, which have also risen in recent years. Increased payments, in turn, deplete the budget, add to pressure on staff and reduce funding for repair and maintenance.

A potentially vital step towards halting this vicious circle is the National Confidential Alert Line for NHS employees, or whistleblowers' hotline, for staff worried about risk to patients. Significantly, it has averaged a call a day since it went live last month. Frontline staff clearly feel their concerns will not be acted on. Only a culture of accident prevention that starts from the top will make hospitals the safe places they ought to be.