Worshipping the NHS costs lives

This toxic institution, believed to be the envy of the world, has been poisoned by individuals' self-promotion at the expense of the sick

Share

Imagine if an airline crashed 10 planes each year, killing 3,000 passengers in avoidable accidents; after its most disturbing disaster, wiping out 1,200 people, the two managers responsible were promoted to the firm's top jobs – one as chief executive, the other in charge of safety. Then it was discovered that the company silenced whistleblowers while covering-up serious failings that led to fatalities.

It is fair to assume there would be an immense public outcry. The airline would be grounded, the managers deservedly hounded into prison. Politicians would demand the overhaul of an industry plainly suffering profound structural flaws.

Yet this is precisely the scenario in our hallowed National Health Service, while Britons cling to a nostalgic notion that this creaking, outdated institution is the envy of the world. Perhaps, as scandal after scandal washes over the service, our nation can finally grow up and see that such myopic worship helped foster a culture of complacency kills patients.

Young and old alike are dying needlessly – eight a day, in what Jeremy Hunt, the Secretary of State for Health, rightly calls a silent scandal. The latest shocking revelation is that the official health watchdog suppressed the truth about baby deaths at a Cumbria hospital. Before, it was a report into hundreds of mainly old people dying in hideous circumstances in the bloodstained wards of two mid-Staffordshire hospitals. Regularly, there are stories of disabled people dying of discrimination; Mencap has logged more than 100 in six years.

It is beyond belief that the managers who oversaw the sordid events in mid-Staffs were rewarded with the top NHS jobs; I warned of its folly two years ago. Sir David Nicholson was the bungling local bureaucrat who failed to stop the deaths as he focused on cost-cutting and mergers – yet the entire NHS was placed in his hands. His successor was Cynthia Bower, who said the situation "wasn't on my radar" and blithely told an inquiry: "Mistakes are made, people do die unnecessarily." She was put at the helm of the body protecting patients.

The Labour Party should hang its collective head in shame at this grotesque betrayal of Aneurin Bevan's legacy. As it pumped money into the pockets of producers and delivered platitudes about patient care, ministers allowed layers of managers under this duo to calcify the system and unleash cover-ups, fear and bullying of staff. They gave GPs huge pay rises while ruining out-of-hours care, introduced a target culture that distorted clinical priorities and prevented a public inquiry into events at mid-Staffordshire.

The biggest mistake was Gordon Brown's creation of the Care Quality Commission (CQC) by merging three disparate regulators to cut costs. Obsessed with bureaucracy, this inept behemoth scaled back its core duty of monitoring hospitals and care homes; the number of inspections of adult social care institutions fell by two-thirds. A senior official admitted it took "a groundswell of opinion" to persuade them "our best evidence comes from stepping over the threshold at locations and speaking to service users and staff".

The Health Secretary has thought about killing this bloated watchdog that never barks, but concluded the last thing the NHS needed was more upheaval. That is understandable, given the experiences of his predecessor. But I fear it may turn out to be wrong, since the body remains overloaded, with 30,261 very different organisations at 49,528 locations under its guard – although at least the new boss admits it is not fit for purpose.

Mr Hunt deserves credit for trying to create a body aggressively on the side of patients while seeking severe consequences for anyone suppressing evidence of wrongdoing. Yet already the new CQC chief executive is tarnished by poor handling of the latest cover-up, and hospitals are earmarking money to "facilitate" visits by inspectors. And yes, Mike Farrar, the senior manager accused of failing the Cumbrian families has landed another top NHS post.

So how do we restore honesty and transparency to a health service that seems to rely on the tenacity of bereaved families and brave whistleblowers to expose deadly flaws? There will, of course, always be mistakes. The key is to empower staff to feel confident to challenge them, while remoulding services around the needs of patients with reforms such as personal budgets for long-term and complex conditions.

I saw some clues at Hinchingbrooke, the first NHS hospital run by a private provider, which cut costs while improving services by reducing the number of managers and restoring responsibility to clinical staff. It also imported a famous quality-control system from Toyota that encourages workers to stop production if they see a fault. Two weeks after its introduction, theatre nurses halted a senior consultant during an operation after they suspected a swab was missing; it was found in the patient's body.

We need to move beyond sterile debates over the sanctity of the NHS and perils of privatisation to address fundamental questions of how to evolve a 21st-century health service at a time of austerity. The NHS was designed for a post-war world that no longer exists and fails too many patients most in need of care. Costs are outpacing budgets and, as society ages and medicine advances, these pressures will only grow more intense. The alternative, with sickening inevitability, is more shameful scandals, more shocking cover-ups and more senseless deaths.

twitter.com/@ianbirrell

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Guru Careers: Software Developer / C# Developer

£40-50K: Guru Careers: We are seeking an experienced Software / C# Developer w...

Guru Careers: Software Developer

£35 - 40k + Benefits: Guru Careers: We are seeking a Software Developer (JavaS...

SThree: Trainee Recruitment Consultant / Resourcer

£18000 - £23000 per annum + Commission: SThree: As a Trainee Recruitment Consu...

Ashdown Group: UI Developer - (UI, HTML, CSS, JavaScript, AngularJS)

£25000 - £40000 per annum: Ashdown Group: UI Developer - (UI, JavaScript, HTML...

Day In a Page

Read Next
The PM proposed 'commonsense restrictions' on migrant benefits  

So who, really, is David Cameron, our re-elected ‘one nation’ Prime Minister?

Andrew Grice
Time travel: Thomas Cook has been trading since 1841  

A horror show from Thomas Cook that tells you all you need to know about ethical consumerism

Janet Street-Porter
Sun, sex and an anthropological study: One British academic's summer of hell in Magaluf

Sun, sex and an anthropological study

One academic’s summer of hell in Magaluf
From Shakespeare to Rising Damp... to Vicious

Frances de la Tour's 50-year triumph

'Rising Damp' brought De la Tour such recognition that she could be forgiven if she'd never been able to move on. But at 70, she continues to flourish - and to beguile
'That Whitsun, I was late getting away...'

Ian McMillan on the Whitsun Weddings

This weekend is Whitsun, and while the festival may no longer resonate, Larkin's best-loved poem, lives on - along with the train journey at the heart of it
Kathryn Williams explores the works and influences of Sylvia Plath in a new light

Songs from the bell jar

Kathryn Williams explores the works and influences of Sylvia Plath
How one man's day in high heels showed him that Cannes must change its 'no flats' policy

One man's day in high heels

...showed him that Cannes must change its 'flats' policy
Is a quiet crusade to reform executive pay bearing fruit?

Is a quiet crusade to reform executive pay bearing fruit?

Dominic Rossi of Fidelity says his pressure on business to control rewards is working. But why aren’t other fund managers helping?
The King David Hotel gives precious work to Palestinians - unless peace talks are on

King David Hotel: Palestinians not included

The King David is special to Jerusalem. Nick Kochan checked in and discovered it has some special arrangements, too
More people moving from Australia to New Zealand than in the other direction for first time in 24 years

End of the Aussie brain drain

More people moving from Australia to New Zealand than in the other direction for first time in 24 years
Meditation is touted as a cure for mental instability but can it actually be bad for you?

Can meditation be bad for you?

Researching a mass murder, Dr Miguel Farias discovered that, far from bringing inner peace, meditation can leave devotees in pieces
Eurovision 2015: Australians will be cheering on their first-ever entrant this Saturday

Australia's first-ever Eurovision entrant

Australia, a nation of kitsch-worshippers, has always loved the Eurovision Song Contest. Maggie Alderson says it'll fit in fine
Letterman's final Late Show: Laughter, but no tears, as David takes his bow after 33 years

Laughter, but no tears, as Letterman takes his bow after 33 years

Veteran talkshow host steps down to plaudits from four presidents
Ivor Novello Awards 2015: Hozier wins with anti-Catholic song 'Take Me To Church' as John Whittingdale leads praise for Black Sabbath

Hozier's 'blasphemous' song takes Novello award

Singer joins Ed Sheeran and Clean Bandit in celebration of the best in British and Irish music
Tequila gold rush: The spirit has gone from a cheap shot to a multi-billion pound product

Join the tequila gold rush

The spirit has gone from a cheap shot to a multi-billion pound product
12 best statement wallpapers

12 best statement wallpapers

Make an impact and transform a room with a conversation-starting pattern
Paul Scholes column: Does David De Gea really want to leave Manchester United to fight it out for the No 1 spot at Real Madrid?

Paul Scholes column

Does David De Gea really want to leave Manchester United to fight it out for the No 1 spot at Real Madrid?