Patient campaign group Cure The NHS founder, Julie Bailey (centre), is surrounded by family members of patients as she delivers a statement to the press following the Mid Staffordshire NHS Foundation Trust Public Inquiry at the Queen Elizabeth II Conference Centre in London yesterday.
Guardian News and Media/London
The prime minister has formally apologised for the care scandal at the Mid Staffordshire NHS hospital trust and announced immediate moves to improve patient care, increase accountability of hospitals and tackle a culture of “complacency” in the NHS.
Among the fast-tracked reforms were proposals that hospital boards could be suspended for ongoing serious care failures; an element of performance-related pay for nurses would be introduced; a new chief inspector of hospitals modelled on the Ofsted inspection agency for schools; and an inquiry into hospitals with the highest mortality rates nationwide.
David Cameron made the statement in the House of Commons after Robert Francis QC published his report into the institutional and structural failings in the NHS that allowed a catalogue of horrific incidents to occur from 2005-09, despite complaints from patients, families and staff members.
Cameron opened his statement by insisting he had a “deep affection” for the NHS and that most staff did a good job most of the time. “It’s a fantastic institution, a great organisation I always want to think the best of it,” he said.
Listing a series of findings about failures - ranging from the board of the hospital trust through layers of bureaucracy to regulators and the department of health, including doctors who “kept their heads down” and the Royal College of Nursing, which Francis said was “ineffective” as a professional body and a trade union - Cameron said the report identified three “fundamental problems” with the culture of the NHS.
They were: a focus on finance and figures rather than patient care; a view that patient care was “always someone else’s problem”; and a tendency towards “defensiveness and complacency”.
“All too often there’s a culture of only examining the positives, rather than any critical analysis,” said the prime minister.
“Managers were suppressing inconvenient facts in favour of looking for comfort in positive information What this inquiry tells us was that there was a manifest failure to act on the data available to the hospital and more widely.”
Cameron commended the previous government for apologising for the scandal when it was exposed, but said the latest report revealed that blame went far further than staff and managers at the hospital.
“I’d like to go further and apologise to the families of all those who have suffered for the way that the system allowed this abuse to go unchecked and unchallenged for so long,” he added. “On behalf of our government and indeed our country, I’m truly sorry.”
The government would consider all the report’s 290 recommendations, and make a further statement in March, said Cameron.
However, he also announced immediate moves to tackle underlying problems. Among those were proposals that hospital boards in future could be suspended for serious and ongoing care failures, not just for financial failure.
The government has already extended the list of “zero harm” issues it wants to see eliminated totally from the NHS, including bed sores, which for too long had been seen as an “occupational hazard”.
In future, nurses would be hired for compassion and not just academic qualifications, and pay rises would be linked to quality of care not just the length of time served, said the prime minister.
Other recommendations for immediate action included a review of the Nursing and Midwifery Council and the General Medical Council for doctors, with possible changes to their structures; the possible transfer of powers to launch criminal prosecutions for care scandals from the Health and Safety Executive to the Care Quality Council; and a new inspection regime, which would focus more closely on how clean, safe and caring hospitals were.
Cameron’s focus on quality of care, and his conciliatory tone towards the Labour administration of the time, will be seen as part of Health Secretary Jeremy Hunt’s strategy to shift the debate on the NHS from last year’s inflammatory reform of the health system structure, to less divisive issues such as care standards.
In a notably consensual exchange, the Labour leader Ed Miliband also praised the vast majority of NHS staff, who he said “share our horror” at the “appalling betrayal” of events at Stafford hospital.