Last month the Healthcare Commission revealed that between 400 and 1,200 excess deaths occurred when hospital managers, desperate to save £10 million, concentrated on targets rather than on looking after patients, staff tuition or infection control.
The politicians immediately distanced themselves from the situation and announced two inquiries: but government ministers are also part of the problem, because it was they and the DoH who set the financial and access targets in the first place.
Four hundred deaths - that's nearly twice Shipman's toll. Yet Mid Staffordshire hospitals have faded from the news, while the government is falling over itself to introduce draconian legislation to avoid a repeat of Shipman. Does the establishment get on its high horse over the misdeeds of individual practitioners while minimising systemic failures? It would appear so.
What are the lessons from Mid Staffordshire? As we all know, simplistic financial and waiting time targets aren't adequate ways to measure the quality of clinical care and should be abandoned.
More importantly, the NHS desperately needs a disciplinary body, analogous to the GMC, to control its managers: let's call it the NHS Managerial Council (NHMC). All NHS managers should possess a licence to manage which could be revoked if their behaviour has led to sub-standard care.
NHS managers should know that every decision they make might be scrutinised by the NHMC - just like doctors and nurses. It is an affront to hard-working, high-quality clinicians that we can be bossed around by incompetent or self-interested managers who fear no such retribution themselves.
Without an NHMC the NHS will continue to kill and injure patients, as did Mid Staffordshire NHS Foundation Trust and by implication, its overseeing SHA.
I don't like to say 'I told you so', but I have repeatedly drawn attention to the necessity of a formal regulatory body for NHS managers. Will the DoH and the politicians listen now, four hundred deaths later?
- Dr Lancelot is a GP from Lancashire. Email him at GPcolumnists@haymarket.com