Jeremy Laurance: Transparency alone will not prevent deaths

The NHS is going through a torrid time. The death of baby Ebony Rose McCall-Comley means more bad headlines, only days after the shocking report on conditions at Basildon and Thurrock NHS Trust, the sacking of the chairman of Colchester NHS Trust and the sudden resignation of Baroness Young, chair of the NHS regulator, the Care Quality Commission.

After a decade of record investment and improving services, it looks as if we are back to the bad old days of failing hospitals, neglected patients and lives at risk. Public confidence in the NHS is seeping away. What has gone wrong?

First, maternity services are under heavy pressure. Despite the increase in NHS funding, the birth rate in some parts, such as Milton Keynes, is rising so rapidly it is outpacing the ability of the NHS to keep pace. A national inquiry into England's maternity services involving all 150 maternity units last July uncovered widespread problems including a shortage of midwives, obstetricians and beds. Without sufficient staff, continuity of care is shattered, increasing risks and decreasing the quality of care. That is disturbing enough.

Worse, despite the array of performance measures the NHS now has to give early warning of things going wrong, the problems at Milton Keynes maternity unit were revealed only after remarks by the coroner in the Romy Feast case triggered an inspection by the CQC. Without the intervention of the coroner, Thomas Osbourne, the problems might have gone unnoticed. Now, if Terry McCall's allegations about the care of his granddaughter, Ebony, are confirmed, they appear to have recurred.

There is much wrong with the NHS performance measures, shown by the example of Basildon, rated "Good" in October and slated for killing hundreds of patients in November. They are too bureaucratic and not up to date. We must refine them.

But even an accurate and sensitive measure of performance is valuable only if the problems revealed are acted on. The increase in transparency in the NHS in the past decade is a significant advance. But it will be worthless unless the NHS learns from its failures.

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