How long to put care and candour at the heart of the NHS?

A betrayal of the worst kind – that is how the health secretary today described events at Mid Staffordshire Trust.

Announcing a range of measures in response to the Francis inquiry, Jeremy Hunt said everything must be done to give patients the high-quality compassionate care they deserve. But has the government gone far enough?

Aspiring nurses will first have to work as healthcare assistants or support workers to “give the public confidence” that they will receive compassionate care.

In the government’s response to a report into serious failings at the Mid-Staffordshire NHS Foundation, where as many as 1,200 patients may have died needlessly due to “routine neglect”, Mr Hunt announced the changes to the way nurses are recruited.

Subject to pilot schemes, students seeking NHS funding for nursing degrees will become healthcare assistants or support workers for a year, either as part of their degree or as a prerequisite for receiving funding.

‘Radical overhaul’

Mr Hunt said a “radical overhaul” was needed, with a new chief inspector of hospitals who is able to name and shame, a statutory duty on the NHS to be candid when mistakes are made, and a revamped ratings system for hospitals.

Failing NHS bosses will be put on a blacklist to ensure they can no longer work in the health service and hospitals could be put into administration if they fail to deliver adequate care

But the health secretary rejected a recommendation from the Francis inquiry into Mid-Staffs that healtlhcare assistants should be regulated, and he said he was still considering a proposal that NHS staff who harm or kill staff should be individually liable for their actions.

Mr Hunt said he wanted a culture of “zero harm and compassionate care” in the NHS, with a “statutory duty of candour” so patients are fully informed if something goes wrong.

‘Under-staffed, over-stretched’

Shadow health secretary Andy Burnham said Labour broadly accepted the government’s response, but he questioned how the culture of the NHS could change if wards were “under-staffed and over-stretched”.

He said the Care Quality Commission had reported that one in 10 hospitals in England had inadequate staffing, a situation that was worsening because of government spending cuts.

Mr Burnham added: “Doesn’t this sound the clearest of alarm bells that some parts of the NHS are already in danger of forgetting the lessons of its recent past by cutting the frontline too far?”

The report into Mid-Staffs, by Robert Fransis QC, made 290 recommendations. Mr Francis concluded there was a “completely inadequate standard of nursing” offered on some wards at Stafford Hospital.

His report said: “The complaints heard at both the first inquiry and this one testified not only to inadequate staffing levels, but poor leadership, recruitment and training.

“This led in turn to a declining professionalism and a tolerance of poor standards.”