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Dr Phillip Lee MP: My views on NHS accountability and public transparency
By Dr Phillip Lee MPMarch 13, 2013
It has been a month since the final report on the failures of Mid Staffordshire NHS Trust was published and in the light of the evidence given by Sir David Nicholson last week, I want to outline my views on NHS accountability and public transparency.
There is something fundamentally wrong when the man who oversaw some of the worst neglect ever recorded in the NHS is allowed to effectively say ‘sorry’ for the actions not taken in Mid Staffordshire and retain his current position as NHS chief executive.
While other senior figures may have gone, as long as Nicholson remains, the public will have no trust in the system in its present form.
The report stated there was failure at every level that led to the needless deaths of thousands of patients. This was caused by a failure of management, a failure of regulation and overall a huge failure of care and trust.
The negligence that led to these deaths needs to be regulated and immediate reforms need to be made to the attitude of NHS management.
Sir David Nicholson, current NHS chief executive and former head of West Midlands Strategic Health Authority in 2005, appeared before the Health Select Committee and gave evidence about his role in the trust. Nicholson stated he was ‘absolutely’ part of the culture which led to failures in Mid Staffordshire so how can he hold his hand up and say he was involved yet not be truly held accountable for the failures by resigning from his post?
As the head of West Midlands Strategic Health Authority, he oversaw the whole Mid Staff NHS Trust so he clearly had a responsibility for when things went wrong.
The main problem that has been highlighted in this case is the target culture within NHS management.
They focused on hitting financial targets and perverse political pledges instead of improving the quality of care.
To quote Nicholson from the committee hearing, ‘...patients were not the centre of the way the system operated’. This shocks me and as a GP I understand the importance of patient care, so purely seeking to hit and beat targets is wrong.
The surprising point is that Nicholson said that he was not made aware of key mortality data which displays a fundamental failing on his part since hospitals are judged on these important figures.
More importantly, there have been suggestions the trust skewed figures by reclassifying deaths as palliative care, essentially masking the provision of poor care.
The original report suggested, quite rightly, that to cause death or harm to a patient by non-compliance should be a criminal offence.
Neglect is unacceptable and this is true for both doctors and nurses treating patients and the hospital management since they have essentially neglected the hospital they run.
It is necessary for the public to have access to the truth about our hospitals.
I have supported calls from colleagues in Parliament to make hospital data available to the public so they can make their own judgements. Restoring public confidence is imperative.
I will be speaking in a backbench business debate on this subject tomorrow and I hope many of you will be able to tune in on BBC Parliament to listen to this important debate.
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Most recent user comments 4 of 4
14/03/2013 at 06:43 Offensive or Inappropriate?
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They got stroppy until it was proven I actually had a rare and chronic underlying condition which if left undiagnosed would have resulted in death.
I'm fortunate that I'm prepared to speak up and be a proactive patient - many aren't as confident.
13/03/2013 at 18:28 Offensive or Inappropriate?
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It seems to me that if any targets should receive financial renumeration it should be diagnosing cancers early enough to save the NHS and Social Services money in palliative care services.
I would also like to see better criteria for diagnosing underactive Thyroid which is actually the root of a lot of obesity. Many people fall into the bracket where if they were tested in the States, would be classified as needing treatment.
It is also not good enough that people should consult their GP with the same problem over a number of visits only to be treated as neurotic when they believe further investigation is needed. The cost of these visits and prescriptions for medication that doesn't cure the condition mostly outweights the cost of further tests after a few visits.
I am afraid to see my GP because I am made to feel that I am wasting thier time, when actually the opposite is true. Any working person who takes time off work to wait an hour is very likely to really need to see a GP. Why else would we risk our work attendance record to sit arround in a waiting room only to be rushed by a GP who is running late.
13/03/2013 at 17:19 Offensive or Inappropriate?
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The honourable member for Bisham has a point, I find it gratifying that he tackles an issue that can affect any of us at any time. Having been the unfortunate recipient of potential fatal 'care' at an allegedly top hospital (resulting in a personal apology from the Chief Exec.), I can attest to the fear that sub-standard care by health professionals can instill. When such neglect becomes routine and involving the elderly and frail it is a matter of disgrace. Quite how Nicholson thought he could defend his position is frankly a sad indictment of the corporate culture that exists in almost every sphere of public life.
And at least Dr Lee has the benefit of airing an opinion based on experience and first hand knowledge.
Which makes a change.
13/03/2013 at 16:00 Offensive or Inappropriate?
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