Tuesday, March 05, 2013

Nicholson should not resign, he should be put on trial

If a private company were responsible for the deaths of up to 1,200 people there would be a national outcry and demands to jail those responsible.

Yet, after no fewer than five investigations into what happened at Stafford Hospital, no individual has received so much as a slapped wrist.

How can this be?

The police have begun an investigation into what must be the biggest scandal in the history of the NHS.

Years after the event, they have finally stirred themselves.

Matthew Ellis, the police and crime commissioner for Staffordshire, claims they have “information not in the public domain”.

How they came by it should itself be the subject of a public inquiry.

Why do the police have information which has not been declared even to tribunals set up by the Government?

The latest inquiry by Robert Francis QC uncovered years of abuse and neglect at the hospital leading to the unnecessary deaths of between 400 and 1,200 people.

These aren’t statistics, they’re individuals who placed their trust in a system which ended up killing them – horrific for the victims and their loved ones.

This isn’t a case of an individual nurse or doctor. Mr Francis concludes the failings go right to the top of the health service.

The police investigation is no doubt being staged mainly for political reasons.

Everyone from David Cameron down believes scapegoats must be found, heads must roll and someone should pay.

He says: “One of the important points about the Mid-Staffordshire inquiry is to make sure, when a failure like this takes place, there is proper accountability.

"In the report, you can see exactly what happened to the people who were involved. Some of them were allowed to retire, some were allowed to move within the health service. There wasn't proper accountability, there wasn't proper consequences and that is not acceptable."

Actually Dave, some of them didn’t move or retire, they were promoted, given more money, more power and more responsibility.

And it is not too late to insist on “proper accountability and proper consequences”.

It’s highly likely the police will content themselves with digging out a few especially shocking cases of neglect involving a heartless nurse or two.

But let’s hope they are mounting a major prosecution of people at the very top of the NHS on a charge of corporate manslaughter.

The health service as a whole is guilty of causing unnecessary deaths as a result of several layers of mismanagement, indifference and neglect.

The doctors and consultants must take much of the blame. They saw what was going on but “kept their heads down”, according to Mr Francis.

But the real defendants should be among the £200,000-a-year bureaucrats in whom we mistakenly place our trust.

Chief among these is Sir David Nicholson.

In 2003 he was Chief Executive of Birmingham and The Black Country Strategic Health Authority. In 2005 he took on Shropshire and Staffordshire as well, at about the time people started needlessly dying at Stafford Hospital.

He did so well in the West Midlands he became chief executive of the entire NHS in England in 2006.

He is paid over £200,000 a year, claims £50,000 a year in expenses and enjoys benefits-in-kind worth £37,600.

There haven’t been any successful corporate manslaughter prosecutions against individuals.

But the charge was introduced after a series of disasters including the 1987 “Herald of Free Enterprise” tragedy when 193 passengers and crew died and the 1999 Ladbroke Grove rail crash which killed 31 people.

Corporate manslaughter cases usually end up in large fines for the businesses involved.

There’s absolutely no point in similar penalties for the NHS because the whole case would involve the re-cycling of our money.

But where does the buck stop in a scandal like Stafford Hospital? Surely it must stop somewhere.

Or is the health service such a rambling and unwieldy organisation that officially nobody can be held to account for anything? Is the NHS so big it is always someone else’s fault?

That cannot be acceptable.

We rightly condemn top bankers for bringing the nation to the brink of bankruptcy and some of them, like Sir Fred Goodwin of RBS, even had to quit (albeit with hefty pay-offs).

That was only money. When it comes to lives, it seems no individual is to blame – just a “culture”.

The Francis report says: “The negative aspects of culture in the system were identified as including: lack of openness to criticism; lack of consideration for patients; defensiveness; looking inwards not outwards; secrecy; misplaced assumptions about the judgements and actions of others; acceptance of poor standards; a failure to put the patient first in everything that is done.”

And it’s clear the culture is dictated from the top – Sir David’s department “has not always put patients first”.

So where does the buck stop? Who sets the tone for an organisation? Who is responsible for its corporate culture?

It’s time Sir David was made to face up to his personal responsibility for this national tragedy. But he’s probably so lost in NHS bureaucracy he thinks culture is something they grow in a test tube.

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