NHS rewards bosses after 1,200 ‘excess’ deaths at scandal-hit hospitals

Published in The Mail on Sunday (May 1st, 2011)

Julie Bailey is still haunted by the death of her mother, who entered hospital a sprightly 86-year-old but was dropped by a nurse and never recovered. She sat by the bedside for six long weeks, holding the hand of her panic-stricken parent as her life ebbed away.

She was horrified by the gruesome scenes around her in a hospital that viewed itself as a national trailblazer: patients screaming in pain, but ignored by those meant to care for them; confused old people falling out of bed and left in soiled bedding; patients left hungry and thirsty.

‘Things were so bad I started feeding, watering and taking all the other patients to the lavatory,’ said Ms Bailey, a cafe owner.

‘It felt like it wasn’t just my mum I watched dying, but all the others as well.’

Her mother was among hundreds of victims of Britain’s worst health scandal this century, caused by a litany of failings and an obsession with targets at Mid Staffordshire NHS Trust.

It stands as a shameful symbol of an NHS tied up in red tape and focused on management reorganisation losing touch with those entrusted into its care. It is also the most egregious example of how in the public sector you are not sacked for failure – but promoted to bigger and better things.

Unbelievably, two of those who oversaw the tragedy are now among the most senior National Health Service managers.

One is Sir David Nicholson, the NHS chief executive who is overseeing the health reforms planned by the Government. The other is Cynthia Bower, who succeeded him as chief executive of the strategic health authority (SHA) overseeing the two hospitals at the centre of the scandal, Stafford and Cannock Chase.

She is now the £200,000-a-year head of the Care Quality Commission (CQC), the super-watchdog formed two years ago to safeguard standards in health and social care in England. SHAs manage local services on behalf of the Government.

Yet despite her role to ensure highquality care, Ms Bower has admitted the situation at Stafford ‘wasn’t on my radar’. Last week, she was called to testify to the public inquiry into this awful chapter. Over two days, in a masterclass of buck-passing and obfuscation, she refused to accept any significant responsibility.

Pressed to admit that the SHA had failed in its duty to protect patients, she was unrepentant. To the amazement of observers, she said: ‘I don’t accept there was a serious failure.

‘I completely accept there was a serious failure in care and I accept there were signs we should have picked up, but I don’t accept there was a serious failure by the SHA, no.’

She has said the SHA responded to evidence of high death rates by commissioning a study from Birmingham University. As a result of this, the SHA concluded, wrongly, that Stafford’s problems were due to poor information systems, not poor medical care. She pointed out that an administrative merger had contributed to the failure. The man in charge of the merger? Sir David Nicholson.

Ms Bower expressed ‘deep sorrow’, admitting patients were ‘let down’, but said it was inevitable some died without good cause in hospitals.

‘Mistakes are made, people do die unnecessarily, however uncomfortable a truth that is’ – this from someone paid a small fortune to decide if thousands of hospitals, GPs and dentists are fit to practice.

Her stance shocked the victims’ families. Among them was Julie Bailey, who attended all 75 days of the inquiry. After her mother’s death in 2007, she joined other relatives to launch a pressure group called Cure The NHS to ensure other patients do not suffer in the same way.

At Stafford the alarm bells had included a critical report into clinical governance, damning patient surveys, warnings on staff shortages and a zero-star rating given by the CQC’s predecessor. It took a private research group to persuade the authorities to act.

One official estimate suggested between 400 and 1,200 ‘excess’ deaths between 2005 and 2008 alone. Wards were filthy and blood-splattered; heart monitors were switched off because nurses did not know how to use them; receptionists were left to determine needs of those arriving at A&E. Some patients were left screaming in agony, others grew so thirsty they drank water from vases.

Much of the blame must lie with those on the front line. But staff who spoke out were ignored, while doctors were preoccupied with waiting lists. Meanwhile, the management focused on financial targets and winning foundation hospital status.

Under Sir David the SHA was accused of concentrating on administrative merger and cost cutting.

The catastrophic failings reveal something rotten in the NHS. Some action has been taken, including the encouragement of whistleblowing and abolition of some targets.

But a series of reports has raised continuing issues of neglect, all too often involving the elderly and disabled. It seems strange that a pair of bureaucrats who failed to prevent hundreds dying in obscene conditions should end up in two of the top positions in the NHS.

Their promotion smacks of contempt for patients.

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