CQC storm: ‘Bullying culture’ may mean care scandals go undetected

A former inspector of the Care Quality Commission has described how criticism was quashed and ‘good people’ were forced to shut up or quit

Many more hospital scandals may have gone unreported under the leadership of two ex-managers named in connection with cover-up allegations at the NHS watchdog, a top former inspector warned today.

Cynthia Bower and Jill Finney presided over a “closed, bullying culture” at the Care Quality Commission, in which “criticism was not tolerated” and the concerns of staff were ignored, Dr Heather Wood told The Independent.

“Staff had no confidence in the leadership – no faith that if they raised concerns they would be listened to,” said Dr Wood. “When serious issues were raised the default setting was: ‘We have been reassured by what the Trust and Strategic Health Authority has told us.’ I would say there are questions over any assurances we’ve had,” she added.

Dr Wood, who exposed catastrophic failings at Staffordshire Hospital, lifting the lid on the biggest NHS scandal in years, left the CQC in August 2010 and was gagged from criticising the regulator.

She has spoken out in the wake of claims that Ms Bower and Ms Finney were involved in an attempt to cover up the CQC’s failure to raise the alarm at Furness General Hospital in Barrow, where as many as 16 babies may have died because of substandard care.

“Criticism was not tolerated,” Dr Wood said of the CQC under Ms Bower’s leadership. “It was a culture in which anyone who tried to question or challenge, no matter how constructively, was slapped down and warned by their manager that they weren’t being ‘corporate’.

“People either gave up, shut up, or put their heads down because there were mortgages to pay,” she said. “A lot of good people left, some forced, others because they couldn’t cope with the culture. It was a very unhealthy, closed, bullying culture.”

She said replacing specialist inspection teams with “highly bureaucratic” inspectors with no clinical expertise had led to “lightweight assessments” of hospitals.

Yesterday Jeremy Hunt, the Health Secretary, pledged that it had been a “huge mistake” when the CQC was formed in 2009 to rely on a “generalist system of inspectors with light-touch training”.

He said the recently appointed chief inspector of hospitals, Professor Sir Mike Richards, would preside over a new system of “really thorough, deep-dive inspections”, clinically led by experts with experience in hospitals. The CQC will also receive £40m extra funding to improve its inspections regime, Mr Hunt said.

Ms Bower left the CQC last September with a £1.35m pension pot, but Mr Hunt said yesterday that former executives responsible for the alleged cover-up could be stripped of their pensions,

Pressure is increasing on Ms Bower’s successor, David Behan, and the CQC’s chairman, David Prior, to explain their initial decision not to name CQC employees referred to in an independent report which made allegations of a cover-up.

The pair have been summoned to appear before the Commons Health Select Committee. Charlotte Leslie, a Conservative member of the committee, said that they had made “a massive error of judgement” by initially keeping the names secret. Officials connected to cover-up allegations – including Ms Bower and Ms Leslie – were eventually named in a letter to the Secretary of State on Thursday.

“I think we need a very full inquiry into the network of relationships between senior Department of Health officials, ministers and managers because it all looks far too cosy and I am worried that we are going to see a series of these horror stories emerge and are not going to get to the bottom of the issue,” Ms Leslie told BBC Radio 4’s The World at One.

Professor John Ashton, joint director of public health for Cumbria, said the problems at CQC reflected a wider malaise within the health service. “The leadership of these organisations is pre-occupied with the reputation of the organisation and isn’t focused on public good and public benefit,” he told The Independent.

Ms Bower said on Thursday: “As chief executive of the CQC the buck stops with me so I deeply regret any failings in the regulation of University Hospitals Morecambe Bay during my time in charge.” However, she denied being part of a cover-up, insisting she “gave no instruction” to delete the damning internal report. Ms Finney has also said allegations that she “instructed the deletion of the internal review” are “untrue”.