NHS Suffers Biggest Embarrassment in its History

Yesterday was indeed a tough day for the NHS. In fact, David Cameron felt so bad about the results of a damning report set to expose an awful problem in his nation’s National Health Service (NHS) that he felt obliged to start his press conference with the statement, “I love our NHS.” The problem is, it was discovered over a series of investigations and reports spanning more than 5 years that an estimated 400 and 1,200 patients died needlessly at Stafford Hospital (part of the NHS) between January 2005 and March 2009. Yes, this is the worse scandal to hit the NHS since it was founded in 1948.

“There were patients so desperate for water that they were drinking from dirty flower vases,” Prime Minister David Cameron told parliament in a statement on the report. Describing events at Stafford Hospital as “a despicable catalog of clinical and managerial failures,” Cameron apologized to all the families affected on behalf of the government and the country. The author of the 3,000-page report, lawyer Robert Francis, said: “This is a story of appalling and unnecessary suffering of hundreds of people.” “They were failed by a system which ignored the warning signs and put corporate self-interest and cost control ahead of patients and their safety,” Francis said in a televised statement as his report was published.

Francis described a sclerotic bureaucracy mired in “a culture of secrecy and defensiveness” in which whistleblowers were silenced and angry family members who complained were ignored. Remarkably, the report also cited the existence of contractual gagging clauses –instituted for the sole purpose of silencing those who would otherwise cry foul.

On balance, however, it was probably not as bad as it might have been for Mr. Cameron. He didn’t shy away from making the critical point: He said the report’s findings of systemic failure meant that “we can’t say with confidence that the failings of care are limited to one hospital.” He followed up by saying that would create a new post of chief inspector of hospitals and enforce a new regime of hospital inspections by November (2013).

Here’s an edited version of the timeline that was published in the Daily Mail:

  • November 2007 –Julie Bailey’s mother dies needlessly at Stafford Hospital. So devastated is she that she creates the “Cure the NHS” campaign group.
  • May 2008 –The Healthcare Commission (an independent watchdog group) launches an investigation into the unreasonably high death rates at that facility.
  • March 2009 –Trust CEO Martin Yeates and its Chairman Toni Brisby resign prior to the release of the Healthcare Commission report –a report that would reveal that between 400 and 1,200 more people died (“400 to 1,200 more than would expected”) while under the care of this trust (between 2005 and 2008).
  • July 2009 –The government finally gets involved. Health Secretary Andy Burnham announces a second independent inquiry, chaired by Robert Francis QC.
  • November 2009 –The inquiry formally opens, but the hearings are held in private. In its opening statement, trust officials apologize for the ‘harm and distress’ caused to patients and their families.
  • February 2010 –The government report is published. It concludes that patients were ‘routinely neglected’ at the trust. Among other conclusions, the report suggests that the trust was likely preoccupied with cost cutting and other financial targets, and lost sight of its patient responsibilities.
  • June 2010 –David Cameron announces yet another public inquiry will be held that will investigate the failings at the trust, with Robert Francis as the Chairman. Over the next several months, each new report reflects additional and ongoing shortcomings  –the snowball effect.
  • December 2012 –It is revealed that the trust has paid out more than £1m in settlements to patients for “inhumane and degrading” treatment.
  • January 2013 –The latest independent investigation concludes the trust is “clinically and financially unsustainable.” And for good measure, police are forced to launch a criminal investigation after a four-month-old baby boy was discovered with a dummy taped to his face –at the same trust.
  • February 2013 –NHS chief executive Mike Farrar says the release of the report (yesterday) will be “one of the darkest days” in NHS history. Yet despite the cry of an outraged public that would like to see him hung from the yardarm, he refuses to resign.

I have to admit that the mention of “too much emphasis on cost cutting” caught my attention. Surely, at some point soon here in the US, a plaintiff lawyer is going to cite “aggressive cost cutting” as a contributing factor to his client’s claim against a hospital.

No doubt that government officials in the UK will also take a closer look at “foundation trust status,” the related pressures it creates for hospital managers and/or how appropriate its incentives are in a care delivery context.

Source: Reuters, Daily Mail

—Tom Finn

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