How is it that we need a public inquiry to remind us that patients come first – and that the organised working class in the NHS left it to relatives and carers to force one?
Within hours of publication of the Francis report which described the “disaster” at Mid-Staffordshire Hospitals as the worst scandal in the history of the NHS, the Department of Health released figures from 5 other hospitals indicating that standards of care may be being compromised.
As Workers went to press the concerns about mother and baby deaths at Furness hospital were being reiterated. Now Professor Brian Jarman, former president of the British Medical Association, is working on a government review of 14 hospitals where mortality rates have been persistently higher than the national average.
Francis catalogued failure that would have resulted in criminal prosecution had it been discovered in a prison or a police station. Yet despite evidence of between 400 and 1,200 needless deaths, five investigations and a public inquiry costing £13 million, not a single person has been disciplined, sacked or struck off.
How is it that we need a public inquiry to remind us that patients come first – and that the organised working class in the NHS left it to relatives and carers to force one? Are NHS staff to abrogate responsibility for patients as well as pay and pensions? Is this where failure to take responsibility can lead to? If NHS staff do not resolve to put this right, personally and collectively, they lose public trust. And they open the service to its political enemies.
Custodians of quality
Changing the situation starts with the right mind-set. We are the custodians of quality. Not Monitor, the Care Quality Commission, NHS Litigation Authority or the National Commissioning Board in all its iterations. They have failed patients, their carers and their loved ones.
Next honest acknowledgement – this extract from the Francis Report should be compulsory reading – with compulsory discussion, too.
“There was a lack of care, compassion, humanity and leadership. The most basic standards weren’t observed, and fundamental rights to dignity were not respected. Elderly and vulnerable patients were left unwashed, unfed and without fluids. They were deprived of dignity and respect. Some patients had to relieve themselves in their beds when they were offered no help to get to the bathroom. Some were left in excrement stained sheets and beds.
“They had to endure filthy conditions in their wards. There were incidents of callous treatment by ward staff. Patients who could not eat or drink without help did not receive it. Medicines were prescribed but not given. The accident and emergency department as well as some wards had insufficient staff to deliver safe and effective care. Patients were discharged without proper regard for their welfare.
“At every level there was a failure to communicate known concerns adequately to others, and to take sufficient action to protect patients’ safety and wellbeing from the risks arising from those concerns. In short the trust that the public should be able to place in the NHS was betrayed.”
This extract could be read in team meetings or in union meetings. The discussion question would be: could it happen here? And if the answer is “Yes”, the next question would be “what are we going to do about it?”
Professional bodies and the Royal Colleges have an absolute obligation to take action against the people registered with them that on a daily basis decline to uphold accepted professional standards. There is a personal as well as collective responsibility to root out poor practice wherever it manifests itself. A professional code of conduct is integral to being a professional, not an optional add-on.
The Chief Executive of the NHS cannot remain in his post just as Fred Goodwin could never have been left in charge of RBS. And the position of the General Secretary at the Royal College of Nursing is untenable if the allegation is substantiated that he advised a “whistle-blower” to keep her head down, rather than fight for change in an environment where ward staff were showing a callous and persistent indifference to the suffering of patients.
There is no external solution to the problems in the NHS. It can only come from those working in the service. ■