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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