Francis report criticised over bid to 'legislate for culture change'

Legislation proposed in the Francis report to create a 'duty of candour' for all medical practitioners will not inspire the cultural change the NHS requires, medico-legal experts have warned.

Dr Stephanie Bown: legislation wrong path to culture change
Dr Stephanie Bown: legislation wrong path to culture change

Dr Stephanie Bown, director of policy and communications at the Medical Protection Society (MPS), said that making it a criminal offence for doctors not to speak up about concerns will not bring the culture change that the Mid Staffordshire public inquiry report calls for.

‘We are trying to create a change in behaviour,’ she said. ‘You can’t do that through legislation.

‘Weak organisations and people will do the minimum necessary as if you just comply with this it will be a tick-box approach, and that defeats the purpose of a culture change - doing it because it is the right thing to do. They will do it because they feel that somebody is watching them.’

One of the 290 recommendations in the Francis report, which the government is due to respond to next month, states that ‘a statutory obligation should be imposed to observe a duty of candour: on healthcare providers who believe or suspect that treatment or care provided to a patient has caused death or serious injury to a patient to inform that patient or other duly authorised person as soon as is practicable of that fact and thereafter to provide such information and explanation as the patient reasonably may expect’.

Mr Francis also called for it to be a criminal offence for ‘any registered medical practitioner’ to knowingly obstruct another in the performance of the above duties and recommended that ‘non-compliance with the statutory duty should entitle the patient to a remedy’.

Dr Bown said that GPs will feel this is another burden which they may not feel wholly equipped to deliver.

The report said that local GPs only expressed ‘substantive concern’ about the quality of care at the trust after they were ‘specifically asked’. But it said that ‘no individual or organisation could be singled out for criticism in this as ‘they were not explicitly required to act in this way, and unfortunately it did not occur to any of them to suggest it'.

It said there was a combination of factors which produced the vacuum in which the running of the trust was allowed to deteriorate.

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