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End marketisation of NHS — Gledhill

15 February 2013


THE report on "the worst crisis any district general hospital in the NHS can ever have known" is evidence that "the marketisation of the health service has gone too far," the Bishop of Lichfield, the Rt Revd Jonathan Gledhill, said on Tuesday.

Published on Wednesday of last week, the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry covers "serious failings" at the Trust between January 2005 and March 2009.

In a letter to the Health Secretary, the inquiry chairman, Robert Francis QC, said that the report told the story of the "appalling suffering of many patients". This was "primarily caused by a serious failure on the part of a provider Trust Board" that "failed to tackle an insidious negative culture involving a tolerance of poor standards and a disengagement from managerial and leadership responsibilities".

The report also highlights a "completely inadequate standard of nursing". It suggests that there may be a "concerning potential for conflict between the Royal College of Nursing's professional role of promoting high-quality standards in nursing, and its union role of negotiating terms and conditions and defending members' material and other narrow interests."

The first inquiry report on the Trust, published in 2010, included stories of patients left in soiled bed-clothes for lengthy periods, patients not assisted with eating, water left out of reach, patients treated with "what appeared to be callous indifference", and privacy and dignity denied "even in death".

The Francis report expresses a "very grave concern" that the regulatory system of the NHS "failed in its primary duty to protect patients and maintain confidence in the health-care system". It was the "persistent complaints made by a very determined group of patients and those close to them" that had brought the situation to light.

Mr Francis, who has made 290 recommendations, called for a "fundamental culture change" to create an NHS in which patients were put first. This would be achieved by "engagement of every single person serving patients in contributing to a safer, committed and compassionate and caring service".

He warned that Stafford "was not an event of such rarity or improbability that it would be safe to assume that it . . . will not be repeated."

Bishop Gledhill, in whose diocese the Trust sits, said on Tuesday: "Our first obligation is to make sure that the chief recommendations of the Francis report are carried out so that people will not be afraid to go to their local hospital." He argued, however, that hospital staff had been "trying to make improvements for several years"; they had "often been the ones who have borne the weight of the cuts and reductions. We have now seen what many of us suspected - that the marketisation of the health service has gone too far . . . covering the bottom line has become all-important."

Although Mr Francis concluded that the Trust had "prioritised its finances and its Foundation Trust application over its quality of care", he also referred to a management that had "no culture of listening to patients". On Wednesday, the Prime Minister emphasised that "Francis does not blame any specific policy," and announced responses, including the creation of a Chief Inspector of Hospitals, and an immediate investigation into the care standards of hospitals with the highest mortality rates.

Angela Tilby

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