Viewpoint: Individual failing hospitals do not mean the NHS is failing

The NHS is in the line of fire as never before, writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: 'The problem with the NHS is politicians who skew its priorities for their own purpose and add no value to anything.'
Dr Chand: 'The problem with the NHS is politicians who skew its priorities for their own purpose and add no value to anything.'

NHS England medical director Professor Sir Bruce Keogh's report to be released today is expected to describe poor care, medical errors and management blunders at 14 trusts investigated over high death rates - including Tameside where I have worked for last 30 years.

Tameside Hospital has been in the spotlight almost on a recurrent basis for the last 14 years or so. Fears have been raised about its patient safety record and the quality of service periodically over the years. The issues have been complicated by reports of poor training of junior doctors in some departments, a recruitment problem and a crisis in staff morale. 

Little acknowledgement of the problems

Health bodies, the public and politicians have all stated their concerns to the SHA and CQC, but until the Keogh report on 14 failing foundation trusts (FTs) was released there was little or no acknowledgement of the problems or solutions that were needed to improve the care and image of the hospital.

Tameside Hospital is the most important provider of secondary care for the population of Tameside and Glossop in Greater Manchester. Yet there have been unedifying reports of patients being left in hospital corridors because the A&E was full, patients being treated in the car park, individual horror stories by carers and relatives, and Monitor being highly critical of financial inefficiency of the FT.

However, the recent criticism of the hospital in the glare of the media has eventually resulted in the resignation of Christine Green, the CEO of Tameside FT. She had defiantly remained in post despite years of criticism over the higher than average death rates. It was evident to many that her failings had multiplied over the years and therefore the trust board and the CCG had no faith that she would return the hospital to the status it deserved.

Tameside FT faces multiple challenges

The new CEO and MD will have a job on their hands. The hospital faces multiple challenges - it has to restore the public’s trust, the CCG has to have faith in the services it commissions and staff’s flagging morale needs to be built up. The serious recruitment problems have to be addressed as an urgency, on the back drop of more austerity and a PFI which hangs as a noose around the neck of the hospital. More immediately, the threat of yet more adverse publicity by the Keogh review is likely to put off the top-end managers who can turn the hospital around.

Many such hospitals have been failing for years. One reason is the FTs operate as quasi independent hospitals so the public CCGs/PCTs/DH had little influence on them. Most FTs have been busy chasing targets and financial efficiency not duty of care. The underlying principle of FTs needs changing. Transparency and accountability could be made better and there must be a greater emphasis on duty of care. Francis’s recommendations needs implementing, particularly on staff levels, for example doctors, nurses and diagnostics.

The problem with the NHS is politicians who skew its priorities for their own purpose and add no value to anything. And to all those who put it down and claim others have it better.  You just don't appreciate what you have and by the sound of it won't do until one day it’s not there.

Individual failing hospitals do not mean NHS is failing. Despite all the allegations of mismanagement, incompetence and cover-up, people still have an enormous affection for the NHS . The NHS is still trusted by the public but good stories don't make headlines. 

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