One figure standing out in the row over the needless deaths at Mid Stafford Hospital is Julie Bailey, whose mother was among the victims. She has faced abuse and threats for highlighting the case and bravely facing the media to call for tougher measures than the Francis Report into the scandal proposes. She wants a full police inquiry and the sacking of David Nicholson, the current head of the NHS.
It is indeed astonishing that none of the management overseeing Mid Stafford has yet been held accountable. And if specific allegations are brought forward of willful neglect on the ward floor, especially any amounting to manslaughter, there should absolutely be a police inquiry. Anything less would let down the victims and I salute the Telegraph’s campaign to bring their families justice.
What we need now, in fact, is to tear down the entire edifice of power in the NHS establishment. Its old-boys’ network of trade unions, Royal Colleges and top civil servants all share blame for the culture of secrecy, gagging and hidden performance.
The Francis Report even described a situation where the unions helped to oversee nursing standards at Mid Stafford while at the same time “defending members’ material and other narrow interests.” This is madness. The reason for overseeing standards must be to protect the public – and if that means against abuse from staff, then it can’t be done by staff unions.
Ministers must come down on all this like a ton of bricks. But like Julie Bailey, I think the proposals being considered from the Francis Report fall short of what is really required. There are welcome policies, like tougher inspection and more transparency, but the changes amount to a list of administrative fixes rather than a total shift of power.
The evidence is that ordinary people want much more openness, choice and control in the NHS. They want an end to the state’s virtual monopoly and a free choice of different providers. They want information about the care hospitals and GPs deliver for patients taken out of bureaucratic obscurity and presented for all to see.
Giving people what they want in this way would transform NHS care. The abuse at Mid Stafford simply wouldn’t survive in a more open, choice-led NHS. If patients were empowered with simple information, like league tables of hospitals, and they had complete freedom to choose any provider they wished, the resulting competition would be a much more powerful catalyst for improvement than anything Francis proposes.
There needs to be more freedom at the front line too. We should end the system of national pay bargaining, along with the tendency for unconditional pay progression based on time served. Hospitals should be free to pay good nurses more for providing high standards of compassionate care. The new government scheme to collect online feedback about hospitals from patients could even be used to help recognise and reward nurses who do a great job.
All this, however, would be hugely controversial to the Old Guard who run the NHS. The unions would threaten to strike, the Royal Colleges would start a negative campaign and the bureaucrats would do their utmost to obstruct the plans.
Real change will only happen when politicians stop shying from reform for fear of upsetting elites in the NHS establishment and instead take a stand for the choice ordinary people demand. After the horror of Mid Stafford, the time for this revolution is surely now.