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Government has let a culture of poor health care flourish Government has let a culture of poor health care flourish
(3 months later)
Accusations of poor and dangerous care, cover-ups and scandal – this has been a week in which the NHS has again been buffeted. Awful at any time but when the NHS has just undergone arguably the biggest reorganisation in its history, and is increasingly being asked to do more for less, this provokes real questions for the future of healthcare.Accusations of poor and dangerous care, cover-ups and scandal – this has been a week in which the NHS has again been buffeted. Awful at any time but when the NHS has just undergone arguably the biggest reorganisation in its history, and is increasingly being asked to do more for less, this provokes real questions for the future of healthcare.
There is good news. The overwhelming majority of care in our hospitals is outstanding. The NHS may appear to be in crisis, but it is most certainly not in peril. The bad news is that if action is not taken soon, then it may be too late. Everybody knows what the problems are: there are pockets within which a culture of poor care is allowed to flourish; a system of regulation proved unfit for purpose; and a complaints procedure that all too often views the complaint as a problem to manage, rather than an opportunity from which to learn.There is good news. The overwhelming majority of care in our hospitals is outstanding. The NHS may appear to be in crisis, but it is most certainly not in peril. The bad news is that if action is not taken soon, then it may be too late. Everybody knows what the problems are: there are pockets within which a culture of poor care is allowed to flourish; a system of regulation proved unfit for purpose; and a complaints procedure that all too often views the complaint as a problem to manage, rather than an opportunity from which to learn.
That was the most disappointing thing about health secretary Jeremy Hunt's speech on patient safety on Friday. The measures he set out are worthy ones, but they aren't the huge changes that are so desperately needed. The blueprint for true change was set out by Robert Francis's report .That was the most disappointing thing about health secretary Jeremy Hunt's speech on patient safety on Friday. The measures he set out are worthy ones, but they aren't the huge changes that are so desperately needed. The blueprint for true change was set out by Robert Francis's report .
Put the patient first every time. Reform the ineffectual complaints procedure. Ensure sound overall leadership. Enforce a duty of candour. Regulate healthcare assistants. That's what the secretary of state and his department, should be committed to; that's what the speech should have announced.Put the patient first every time. Reform the ineffectual complaints procedure. Ensure sound overall leadership. Enforce a duty of candour. Regulate healthcare assistants. That's what the secretary of state and his department, should be committed to; that's what the speech should have announced.
For far too long, successive governments have been all too aware of the problems But they have chosen to hide behind the shield of short-term measures and empty "tough" rhetoric.For far too long, successive governments have been all too aware of the problems But they have chosen to hide behind the shield of short-term measures and empty "tough" rhetoric.
Take just one example – the Care Quality Commission. It has been clear to anyone who has read a CQC inspection report that the process has been far from robust. It is clearly not the case that an accurate picture of the standard of care in a hospital can be gleaned from looking at one ward, for a limited period of time and from talking to a handful of patients..Take just one example – the Care Quality Commission. It has been clear to anyone who has read a CQC inspection report that the process has been far from robust. It is clearly not the case that an accurate picture of the standard of care in a hospital can be gleaned from looking at one ward, for a limited period of time and from talking to a handful of patients..
But why didn't the Department of Health take action? We have some sympathy for the CQC, which, ever since its creation, has been asked to do too much. To ask one organisation to regulate social care, primary care, dentistry and hospitals is ridiculous and dangerous. Everyone knew it, everyone said it, yet governments did nothing.But why didn't the Department of Health take action? We have some sympathy for the CQC, which, ever since its creation, has been asked to do too much. To ask one organisation to regulate social care, primary care, dentistry and hospitals is ridiculous and dangerous. Everyone knew it, everyone said it, yet governments did nothing.
When you listen to thousands of complaints, as the Patients' Association does every year, you can track the pattern of behaviour that shows the system is not designed in the interest of the patient.When you listen to thousands of complaints, as the Patients' Association does every year, you can track the pattern of behaviour that shows the system is not designed in the interest of the patient.
No individual should have to fight for information about safety in their NHS. We pay more and more for a system that we are assured is the envy of the world. If the individual complaints process failed them, until last week, they at least had the belief that the quality monitoring organisations would do the right thing and protect them against dangerous care and practice. Now that, too, is shown to be questionable. The impression given is that there is a greater wish to keep the lid on problems rather than solving them.No individual should have to fight for information about safety in their NHS. We pay more and more for a system that we are assured is the envy of the world. If the individual complaints process failed them, until last week, they at least had the belief that the quality monitoring organisations would do the right thing and protect them against dangerous care and practice. Now that, too, is shown to be questionable. The impression given is that there is a greater wish to keep the lid on problems rather than solving them.
The Holy Grail is an NHS that is transparent, accountable and, most importantly of all, safe. But this just isn't the case for far too many patients.The Holy Grail is an NHS that is transparent, accountable and, most importantly of all, safe. But this just isn't the case for far too many patients.
The individuals involved in the CQC, NHS managers and, of course, those who deliver the poor care should shoulder the blame. But it is those with ultimate responsibility for setting the direction and culture of the NHS – the politicians – who are truly at fault.The individuals involved in the CQC, NHS managers and, of course, those who deliver the poor care should shoulder the blame. But it is those with ultimate responsibility for setting the direction and culture of the NHS – the politicians – who are truly at fault.
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