Analysis: Hospital mediocrity isn't the problem - it's the failure to address it

The NHS needs a blame-free culture, a spirit of openness and the ambition to succeed

"Trapped in mediocrity" is the striking phrase Sir Bruce Keogh uses to describe the 14 poorly performing NHS trusts.

There is no scandal here on the scale of Mid-Staffs, nothing to justify lurid headlines at the weekend of 13,000 excess deaths.

But what Sir Bruce has uncovered is sufficiently disturbing: long-standing problems at each of the trusts which were widely known throughout the NHS but to which a blind eye had been turned.

It is not mediocrity itself that is the problem - somebody has to be below average - but the failure to address it. That is the real scandal.

Culturally and institutionally, the NHS is averse to acknowledging poor performance. Hospital death rates have been circulated to all NHS trusts since the late 1980s. When I got hold of a set and published them (in The Times) in the mid-1990s, I was besieged by calls from managers asking where the figures had come from (they had never bothered to look at them) and sued by surgeons at the worst performing trusts unhappy at having their work exposed to the limelight.

Nearly 20 years on, Jeremy Hunt warned last month that surgeons who declined to publish their death rates would be named and shamed. But the Keogh review suggests much remains to be done. It found leaders of the 14 trusts were still "struggling to understand and take advantage" of the death rate and other data available.

Mr Hunt today lambasted Labour in the Commons for ignoring quality and compassion in its "target-driven" NHS, to the fury of Andy Burnham, former Labour health secretary. But as Sir Bruce rightly notes, quality of care is only an issue for patients who can access it. Until 2008 the challenge for the NHS was that thousands couldn't. "The key issue was not whether people were dying in our hospitals avoidably but that they were dying whilst waiting for treatment."

Now the waiting list problem has been largely solved, we can focus on quality. It was high death rates that identified these 14 hospitals - but these are a smoke alarm, not a diagnostic test. It is as foolish to suggest the trusts were responsible for 13,000 excess deaths as that every woman with a breast lump has cancer.

The weekend headlines served only to alarm patients, demoralise staff and turn the public against a much cherished institution, for political gain. If the NHS is to improve, it needs, as Keogh says, a blame-free culture, a spirit of openness and the ambition to succeed.

Life and Style
ebookNow available in paperback
ebooks
ebookA delicious collection of 50 meaty main courses
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Sales Executive - OTE £30,000+

    £16000 - £30000 per annum: Recruitment Genius: They are looking for individual...

    Recruitment Genius: IT Project Coordinator / Manager

    £25000 - £40000 per annum: Recruitment Genius: A Project Coordinator is requir...

    Recruitment Genius: Mortgage Advisor - OTE £95,000

    £40000 - £95000 per annum: Recruitment Genius: This is an exciting opportunity...

    Recruitment Genius: Trainee Vehicle Inspectors / Purchasers

    £20000 - £40000 per annum: Recruitment Genius: Trainee Vehicle Inspectors / Pu...

    Day In a Page

    Greece debt crisis: EU 'family' needs to forgive rather than punish an impoverished state

    EU 'family' needs to forgive rather than punish an impoverished state

    An outbreak of malaria in Greece four years ago helps us understand the crisis, says Robert Fisk
    Gaza, a year on from Operation Protective Edge: The traumatised kibbutz on Israel's front line, still recovering from last summer's war with Hamas

    Gaza, a year on from Operation Protective Edge

    The traumatised kibbutz on Israel's front line, still recovering from last summer's war with Hamas
    How to survive electrical storms: What are the chances of being hit by lightning?

    Heavy weather

    What are the chances of being hit by lightning?
    World Bodypainting Festival 2015: Bizarre and brilliant photos celebrate 'the body as art'

    World Bodypainting Festival 2015

    Bizarre and brilliant photos celebrate 'the body as art'
    alt-j: A private jet, a Mercury Prize and Latitude headliners

    Don't call us nerds

    Craig Mclean meets alt-j - the math-folk act who are flying high
    How to find gold: The Californian badlands, digging out crevasses and sifting sludge

    How to find gold

    Steve Boggan finds himself in the Californian badlands, digging out crevasses and sifting sludge
    Singing accents: From Herman's Hermits and David Bowie to Alesha Dixon

    Not born in the USA

    Lay off Alesha Dixon: songs sound better in US accents, even our national anthem
    10 best balsamic vinegars

    10 best balsamic vinegars

    Drizzle it over salad, enjoy it with ciabatta, marinate vegetables, or use it to add depth to a sauce - this versatile staple is a cook's best friend
    Wimbledon 2015: Brief glimpses of the old Venus but Williams sisters' epic wars belong to history

    Brief glimpses of the old Venus but Williams sisters' epic wars belong to history

    Serena dispatched her elder sister 6-4, 6-3 in eight minutes more than an hour
    Greece says 'No': A night of huge celebrations in Athens as voters decisively back Tsipras and his anti-austerity stance in historic referendum

    Greece referendum

    Greeks say 'No' to austerity and plunge Europe into crisis
    Ten years after the 7/7 terror attacks, is Britain an altered state?

    7/7 bombings anniversary

    Ten years after the terror attacks, is Britain an altered state?
    Beautiful evening dresses are some of the loveliest Donatella has created

    Versace haute couture review

    Beautiful evening dresses are some of the loveliest Donatella has ever created
    No hope and no jobs, so Gaza's young risk their lives, climb the fence and run for it

    No hope and no jobs in Gaza

    So the young risk their lives and run for it
    Fashion apps: Retailers roll together shopping and social networking for mobile customers

    Fashion apps

    Retailers roll together shopping and social networking for mobile customers
    The Greek referendum exposes a gaping hole at the heart of the European Union – its distinct lack of any genuine popular legitimacy

    Gaping hole at the heart of the European Union

    Treatment of Greece has shown up a lack of genuine legitimacy