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Threat of court for bad NHS managers

HEALTH managers could be taken to court if they fail to provide adequate care for patients, the Government announced yesterday.

The move, outlined by Alan Milburn, the Health Minister, will be the first time that a legal duty of quality has been imposed on every hospital in England since the birth of the National Health Service in 1948. Every hospital will have to appoint someone to take charge of quality issues, either a doctor, a nurse or a clinical professional, who will have to submit regular reports to trust boards.

There will also be a new framework to ensure that standards are continuously monitored and improved.

Mr Milburn said: "What counts for patients is the quality of service. Until now the principal legal duties of NHS trusts have been financial.

"Balancing the book remains important, but quality of care to patients should be the first priority."

Last year the health secretary, Frank Dobson, announced a nationwide review of breast cancer screening arrangements and promised that there would be sweeping reforms to both breast and cervical cancer screening.

The review followed a series of cancer screening cases which fell below acceptable standards in Kent, Devon and north Staffordshire.

Last November, cervical smear tests on almost 18,000 women had to be re-checked after an investigation found that 16 who had been given the all-clear should have been recalled for further examination.

The decision, by Warwickshire Health Authority, was the latest in a series of blunders in which cervical and breast cancer tests cleared women who were later found to have early signs of cancer.

All the women were examined at the pathology laboratory at the Hospital of St Cross, Rugby, and doubts about the accuracy with which the smear tests were read arose after it was noticed that fewer abnormalities were being detected than would have been expected from national levels.

A few weeks earlier, it emerged that 12 women who had been given the all-clear following breast screening at Royal Devon and Exeter Hospital were found to have cancer.

Shortly before that there was an independent investigation into cervical screening at Kent and Canterbury Hospital, where five women died and more than 330 required urgent investigation after high numbers of wrongly read samples came to light in 1995.

Mr Dobson said the reforms of breast and cervical cancer screening would strengthen quality assurance, eliminate weaknesses in the organisation of screening and restore the public confidence.

The full plans, which are to be outlined later this spring, and will come into force next year, will set explicit standards and also make it easier for "whistleblowers" to complain about the poor work of colleagues.

A spokesman for the Department of Health said: "Although the machinery is still there, there is still the suspicion of a strong temptation not to rat on a mate, though what the mate is doing may be injurious to patients."