Monday, January 07, 2013

Mid-Staffs scandal linked directly to NHS market

In the run-up to the publication of the inquiry into health care tragedies at mid-Staffordshire, the ConDems and the right-wing media are leading the charge against the trust in particular and NHS bureaucracy in general.

But what is not emphasised, naturally, is that the imposition of markets and competition in the NHS, combined with the spiralling costs of the wretched “public finance initiative” and spending cuts, is likely to result in many more catastrophes for patients.

Mid-Staffs happened under New Labour’s watch, with the desperate drive for foundation status leading to management putting health care second. The Tories have deepened the role of the market in other ways and are enforcing £20 billion of “efficiency savings”.

None of this should blind anyone to the fact that this could be, as campaigner Julie Bailey has said,  “the worst scandal in NHS history”. She set up Cure the NHS after her mother died at North Staffs hospital, along with hundreds of other patients in a catalogue of poor and often distressing forms of treatment.

It is not the first time that the hospital trust has hit the news. The inquiry which is being led by Robert Francis QC, follows a two-volume 800-page February 2010 report to parliament. Some 290 witnesses have so far given evidence and more than a million pages were considered by Francis and his team.

There were many whistleblowers, from nurses up to specialist registrars, but their concerns were ignored by those higher up in the bureaucratic chain. Relatives   desperately tried to provide for their loved ones many of whom were being denied medication, food and drink in dirty conditions.

The inquiry revealed that, in 2005, the hospital’s executive board was far more concerned with its cost-cutting plans to achieve foundation trust status – then New Labour’s flagship policy.

As Laura Donnelly writes: “The NHS trust was desperately short-staffed with 100 vacancies for nurses alone, but from 2005 onwards it embarked on widespread job cuts. Between 2006 and 2008, 160 nurses left the trust either through retirement or redundancy.....The board’s obsession with the project [for foundation trust status] left executives blind to the impact cuts would have on patients.”

A review for the hospital watchdog Monitor last month concluded that the Mid Staffordshire NHS Trust was not “clinically or financially viable” in its present form. Other trusts in similar positions like the South London Healthcare Trust are set to be broken up.

The irony was that regulator Monitor was the very body that authorised Foundation Trust status back in 2007.  Meanwhile, another regulator, the Healthcare Commission (later re-named the Care Quality Commission) announced that the trust was to be investigated! Both chief executive and chair resigned before the scandal was exposed in 2009.

ConDem’s health secretary Jeremy Hunt has tried to distance the government from New Labour’s “culture of targets and performance management”. Of course, the political class pretends there is no connection between the enormous cuts imposed under both Labour and the ConDems, and the callous – even life-threatening - attitudes by some staff in the NHS.

But those working in the very heart of the health service, such as Barts and London hospital orthopaedic surgeon David Goodier, have made things crystal clear. In an email sent to his trust, Goodier said it was a combination of poor management and government cuts that have led to patient needs being ignored.

The crisis is not only in Staffordshire. It exists in the National Health Service as a whole. Untangling the welter of bureaucracies, the watch-dogs that didn’t bark or were ignored and working for the real needs of patients is the challenge of the day.

That means abolishing the role of the market in the NHS, stripping away the power of the pharmaceuticals to milk healthcare dry, ending PFI contracts that resemble pay-day loans at public expense and putting the service at all levels under the direct control of staff, patients and local communities in place of overpaid bureaucrats.

Corinna Lotz
A World to Win secretary

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