NHS: Cure it, don’t kill it!

by Daphne Liddle

THE INQUIRY into the shocking scandal at the Mid Staffs general hospital, headed by Sir Robert Francis QC, was delivered on Wednesday morning.

The awful stories of around 400 unnecessary deaths and countless miserable experiences suffered by patients at the hospital have already been well documented — thanks to their families and NHS campaigners.

The Francis inquiry was supposed to look into the failings of the NHS management self-monitoring systems that failed to spot the abysmal level of care being experienced by staff at Mid Staffs Hospital.

The inquiry produced a number of recommendations, including making it a criminal offence to cause harm to a patient and giving boards more powers to suspend or prosecute individuals.

It also proposed intruding a “duty of candour” to be imposed on all NHS staff, making them liable to prosecution if they do not report the failings of those around them.

And it proposed a single regulator for financial and care quality for the whole NHS.

The inquiry found that the failings of Mid-Staffs arose in great part from a management culture that was more concerned in meeting targets — financial targets and targets for numbers of patients treated successfully — which ignored patient wellbeing.

This was a recipe for disaster for geriatric patients. The geriatric ward at Mid- Staffs — as in many other NHS hospitals is the Cinderella ward because these patients are never going to walk out restored to full fitness and health. They are never going to count towards success rate targets but they are going to take a lot of staff and money to look after properly.

Staffing on these wards is all too often reduced to the lowest level and the best staff in the world cannot deliver the care needed by these people if there are not enough of them — or if they are untrained ward assistants or auxiliary nurses.

Nursing unions have welcomed the Francis report inquiry recommendation that auxiliary nursing staff and ward assistants should be registered and get proper training.

The managers themselves are in an impossible position, trying to meet budget cuts while continually “increasing production” — treating more patients with fewer staff and resources.

They have been set up by past governments, both Tory and New Labour, to be the scapegoats for the failings of a great health service that the ruling class is trying to destroy.

A single person to monitor all the NHS services in England would be totally inadequate.

Scandals like Mid-Staffs will make people afraid to go into hospital — and though Mid Staffs is an extreme case there are many other NHS hospitals with similar problems.

The recommendations of the Francis inquiry will not solve the fundamental problems. Criminalising workers for failing to achieve the impossible, or for failing to act as narks against their colleagues, will only make the situation more desperate and drive people away from working for the NHS. It will end up employing only those people who cannot get work anywhere else.

The one thing Francis failed to recommend that would probably have prevented the scandal at Mid- Staffs was the reinstatement of Community Health Councils.

These bodies, abolished by the Blair government in 2003, included elected representatives of local councils, government appointees and members of the public.

They were truly independent and had statutory powers to inspect hospitals, clinics, dentists and so on and to take up complaints from patients or their friends or relatives. If they found something wrong they had the power to order changes.

A CHC would have been able to respond to the complaints of patients’ relatives in Mid-Staffs years before the scandal finally broke out — and saved many lives.

CHCs still exist in Wales.

Carol Lamyman-Davies, director of the Community Health Councils (CHCs) in Wales, said: “When in hospital, patients are often at their most vulnerable and sometimes, frail state. Each person must be treated with dignity and compassion and not as a number.

“Never complacent about the standards of nursing care provided to patients, CHCs play a significant role in monitoring, physically, the state of our NHS services in Wales. It was a dark day for the NHS in England back in 2003 when CHCs were abolished.”

If we want to prevents disasters like Mid Staffs and defend the NHS from those who want to discredit it to destroy it we should start to campaign for the reinstatement of CHS.