The Prime Minister David Cameron and Health Secretary Jeremy Hunt
(London Times p.8, March 7) blame Labour's targets and its "flawed
star-rating system for hospitals" for contributing to the Mid Staffs
scandal which has dominated UK newspapers for weeks now.
It was not necessarily targets per se which contributed, but the
obsession with finding candidates for Foundation Trust status. The Mid
Staffs star ratings in last four years of star-ratings were
respectively 2,3, 0 and 1 ie all over the place, and poor at the time
that the then- CEO of the region overseeing Mid Staffs, David
Nicholson (now NHS CEO for all England) chaired a diagnostic meeting
to explore Foundation status in December 2005.
What is more, Foundation Trust status was a further development of
the Conservative policy of 'self-governing Trusts' from the 1990s, and
is of course a central plank of the present government's extension of
the NHS 'market.'
Neither should Labour get off the hook. For the more fragile Trusts
(like Mid Staffs) to get Foundation status, job cuts were de rigeur -
usually large-scale nursing cuts. Labour's former Health Secretary
Alan Milburn created the flawed regime of Foundation status, and his
successors (John Reid, Pat Hewitt, Alan Johnson and Andy Burnham) all
oversaw it.
It could be argued that Mid Staffs' clinical and financial status made
it unsustainable as a Foundation Trust ie it could only handle the job
cuts by affecting safety. So what was the NHS management regime
thinking of........'obeying orders' from semi-detached Ministers? From
2005, David Nicholson, was the man who governed with blunderbuss
rather than rapier in pursuit of financial balance, creating the
backdrop of huge pressure on Mid Staffs. He was not asleep at the
wheel but driving in the wrong direction.
For him to stay despite all his craven quasi-apologies is like saying
that the post of NHS CEO is a remedial training position for
slow-learners in leadership. He blames the system. But good leaders
speak truth to power and resign on principle if they are ignored.
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