24 Jan 2013

Mid-Staffordshire scandal: day of reckoning beckons

So the day of reckoning is nearly upon us. The Francis inquiry report into the scandal at Mid-Staffordshire Foundation Trust will be handed to the health secretary on 5 February and published the following day.

It has certainly been a long time coming. It was finished in 2010 and was meant to be published in October but was further delayed after Robert Francis decided there was a need to give those criticised in the report a right of reply.

In the meantime, the Department of Health has begun pre-empting the report. Sir David Nicholson, the NHS commissioning board chief executive – otherwise known as the most powerful man in the health service – has let it be known that he hopes to survive the report.

Sir David, of course, was chief executive of Shropshire and Staffordshire strategic health authority between 2005 and 2006. (For those coming new to the subject, the inquiry looked at the appalling lack of care at the trust between 2005 and 2009.)

Jeremy Hunt has himself given a number of interviews where he has also called for total openness and transparency when things go wrong and he has said that NHS managers cannot expect to keep their jobs if they preside over failings in care.

Bosses held to account?

So does that mean come publication day that one of the many people in charge at the time will finally be held to account? Because so far nobody has and, indeed, several have gone on to greater things in the NHS. Even the chief executive of the trust, Martin Yeates, left with a pay off and took over as chief executive of a drugs and alcohol charity. He only suddenly stood down a couple of weeks ago when the Mid-Staffs pressure began to grow.

Then there is the question over just how transparent and accountable the system will become? There is a great deal of pressure from organisations like AvMA, the medical negligence charity, for duty of candour to be made a legal requirement. That is, if someone sees something appalling happening at a hospital they would be law, have to say something.

That is being hugely resisted by the government. Last December they announced that it will be a standard clause in NHS contracts, a move AvMA chief executive Peter Walsh described at the time as an “apparently cynical attempt to sidestep overwhelming support for a statutory duty and to pre-empt the public inquiry report”.

So what will they do if the Francis inquiry report also says (and many believe this will happen) that it should be a legal requirement? Will the government do a U-turn? Or will they ignore that bit of what is likely to be a very long read?

And will the complaints system itself be improved? Because it needs to be. I have spoken to so many patients around England who have made perfectly valid complaints and have been fobbed off with obfuscating responses that all seem terribly formulaic.

And this always means that the complaint goes further because the bereaved and aggrieved do not feel they are being dealt with properly and with decency.

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5 reader comments

  1. Philip Edwards says:


    I am willing to bet the root cause of this will be the staffing of NHS Trusts with apparatchiks willing only to toe the tory/New Labour privatisation line.

    The result is an interest for the bottom line of profit and surplus, and necessary attendance to related statistics, not patient care. Of course it flies directly in the face of the National Health Service Charter.

    Decency is well down the list of requirements. The main privatisation task at present is to salami slice off services to private agencies or to appeal to individual greed (see the GP scam). All defects are then blamed on the principle of public ownership of health services.

    Hovering in the wings are the “healthcare companies,” itchy hands just dying to gouge billions at the expense of social care and decency.

    As Nye Bevan said at the founding of the NHS – the principle of social ownership of healthcare will last as long as people are willing to fight for it.

    Make no mistake, it remains a tory wet dream to hand over the NHS to their public school chums to trouser profits. THEY WILL NEVER CHANGE.

  2. Albert West says:

    I am in total agreement with your views on the Stafford enquiry report. And I would also like to share my concerns regarding the new Healthwatch body that takes over from the current ‘Local Involvement Networks’ (LINKs) in April. The very same LINK members will have a seat on the Clinical Commissioning Groups, and it is through their voice that the door to widespread privatisation of NHS and social care services will be allowed to procceed … unchecked.
    Albert West
    Houghton Regis. Ex Milton Keynes PPI member

  3. Daphne Havercroft says:

    Nothing will change until doctors and managers are held accountable for health scandals – and punished.

    The NHS paid lip service to the lessons of the Kennedy Inquiry into the Bristol Royal Infirmary Scandal. Culture, behaviour and attitudes have not changed. Whistleblowers are still persecuted and ignored by national regulators.

    In Bristol, where we might hope that lessons would be learned after Kennedy, local NHS organisations have adopted the defend and deny approach to try to brush off a histopathology scandal, a paediatric pathology scandal and another scandal at the Bristol Children’s Hospital – this time lack of adequate post operative cardiac nursing care.

    As for MPs, if enough members of the public marched into their surgeries and demanded a legal duty of candour and accountability following the Francis Report, they would soon wake up.

    Is the British public better at whinging about problems than taking action to deal with them? We’ll find out post Francis, won’t we?

  4. Rudi says:

    I work in the NHS and I’m on the front line as a ward clerk and the ward on a whole is a good ward, but some of the senior nursing staff are lazy and we keep losing the good junior nursing staff. Our matron who abuses her position where she takes a nurse off the ward to do her work so the ward becomes short staffed. Watching today about north staffs I can understand how these problems happens. The RCN don’t help the nurses and sitting watching the RCN talking on the news about diploma nursing is wrong when I started in the NHS nurses was taught on the ward not in a classroom, then came project 2000 nursing and now diploma nurses has destroyed the quality of care. When I started we had one matron who run the hospital with an iron rod and the care was first class, now we have between 10 to 12 matrons dictating what the senior managers want. The amount of bullying that goes on and the staff are afraid to whistle blow. Senior managers dictate and the front line staff have their hands tied due to the increase of paperwork so nurses have to spend more time doing the paperwork instead of nursing care. Caring nurses who finished their 12 hour shifts stay on the ward to complete the paperwork so that their patients care does not suffer. Nurses have the highest level of sickness in in the country due to the hours they work and the stress levels they have to work under. After their 4 days week of 12 hours shifts, one week and 3 day 12hours shifts they spend their first day off sleeping all day. These are the true face of the NHS. Not what the powers of be want us the tax payer to believe. If you want the true story of the NHS you need to talk to the front line staff.

    1. Sila Tarina says:

      In response to last comment. I do agree with Julia Bailey the campaigner who finally helped uncover the Mid Staffs scandal after 10 years – of nurses covering up the “needlless deaths” of patients – that’s why they have lost their jobs in Stafford. Julia Bailey has always said that these problems occurred largely because nursing levels are dangerously low. Yet nurses continue to defend the NHS cuts – have never spoken out as far as I know to support patients – WHY IS THAT???

      Maybe as I fear they are too worried about losing what jobs they have. Well that is pointless as their jobs are probably going anyway. At one time the public had great sympathy with nurses over their pay but they have lost that support because they do not seem to care much any more about their patients. Patients seem to have become the problem for nurses under pressure, not the dreadful insane cuts to the NHS. All measures leading to a creeping privatisation and “all hours” contracts for nurses who will probably lose their pensions as well.

      The perception is that nurses and doctors are not really doing very much to help patients keep the NHS intact, or, speaking out about the problems that cuts in spending are causing them. Front line staff just do not say anything and now the patients and public see them as part of a failing NHS. They are no longer “angels” and the NHS is nio longer the jewel in the crown of the UK. It is falling to pieces and no-one including nurses and doctors do anything to support campaigners. If they want to keep working in the NHS front line staff really need to support the public campaigns instead of keeping quiet in fear – perpetuating the terrible climate of fear and cover-up that seems to be the norm in our dying health service. In fact doctors are more more supportive of these campaigns eg GPs – whats going on???

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