Guardian News and Media/London
Outgoing NHS boss Sir David Nicholson has combined a belated public admission of his mistakes over the Mid Staffs scandal with a warning that the service must undergo painful changes if it is to remain viable.
Nicholson, who retires at the end of March after eight years as the NHS England chief executive, said he regretted not intervening properly when concerns about Stafford hospital emerged and was wrong not to meet relatives of patients who received poor care there.
“The biggest and most obvious mistake I made (in his 36-year NHS career) was when the Healthcare Commission reported on Mid Staffordshire (Stafford) hospital (in 2009) and I went into the hospital and I didn’t seek out the patient representatives and the people who were in (local patient campaign group) Cure the NHS. I didn’t do it because I made the wrong call,” Nicholson told an audience of health professionals and policymakers at the NHS’s health and care innovation expo in Manchester.
He also admitted he was “wrong, absolutely wrong” not to meet the families, who were campaigning to expose inadequate care at the hospital, simply because he feared his visit would “turn into a media circus”.
“There are absolutely no shortcuts to understanding and talking to patients and relatives and people. That’s a mistake that I made that I bitterly, bitterly regret”, he added.
Nicholson dubbed “the man with no shame” by campaigners and tabloid newspapers for refusing to resign over the affair or apologise directly spoke with feeling and remorse, and went much further than his previous statements about his actions over the hospital, though again did not say sorry.
He also admitted doing too little about Stafford in 2005 when he was chief executive of the NHS’s West Midlands strategic health authority.
Addressing the NHS’s future sustainability in the face of rising demand for care but what are expected to be tight budgets for years to come, Nicholson called for hospital funding to be slashed and instead used to provide medical care closer to patients’ homes.
At a hospital he visited recently, he said, 28% of the patients were diabetics, many of whom could have been treated better elsewhere, except lack of money means few other facilities exist.
“We need to reduce investment in hospitals to make that happen. But we find it very difficult to live with the consequences of doing that,” he said.
He urged politicians to stop adopting short-term approaches to the NHS and be prepared to defend the greater centralisation of hospital services. Recalling the five health secretaries he has worked with, he confirmed for the first time the suspicions that Andrew Lansley, the architect of the coalition’s radical restructuring of the NHS in England, wanted him out.
