Charlotte Leslie is the Member of Parliament for Bristol North West. Follow Charlotte on Twitter.
One of the most devastating things about the Morecambe Bay
Scandal – the revelation that the Care Quality Commission (CQC) apparently buried a report raising alarms
about the Furness General Hospital Maternity Unit – is that, for anyone who has
spent a lot of time looking into how the top echelons of how the NHS elite
work, it is diabolically shocking, but not nearly as surprising as it should
Indeed, one of my fears is that because the Morecambe Bay
revelation is so sickening, so horrific, all focus will be attracted to
investigations into just one hospital. It is imperative there is a police
investigation into what went on at Morecambe, but mounting evidence also shows
that Morecambe Bay and Mid Staffs are likely to be just symptoms of a worrying
network of cover-up at the heart of the NHS.
Right from the very beginning of the Mid Staffs scandal, New
Labour were at contorted pains to stress that this was a ‘one-off’; not
representative of the health service and its target-culture reforms at all.
That is why it is so important to squash what was going on at Morecambe – and,
I suspect we will find, at other hospitals as well.
In March 2010, Professor Brian Jarman, who
collects and analyses mortality data, wrote to the then Secretary of State,
Andy Burnham, warning him that 25 Hospital Trusts had alarmingly high mortality
rates. This was just before a general election. Burnham quickly passed to buck to, yes, the CQC, and
conveniently, (and unsurprisingly, given what we now know) no more was said
about it. In 2008, Labour Ministers and
the Department of Health determinedly buried three reports they had
commissioned from independent international experts which were highly damning
of the NHS ‘culture of fear’. (One of these was by Don Berwick, who is now
being hailed as the man to sort out our NHS.) They were only revealed after a
Freedom of Information Request in 2010, after a tip-off from a concerned medic.
We should not forget in all this that the scandal of
Morecambe Bay was only revealed because a dedicated group of parents such as James
Titcombe, who lost loved ones at the hospital, persisted against all the odds
in mining out the buried truth. At no point in this shameful saga in the NHS
has it been an official body which has revealed the terrible truth – it has
always been passionate members of the public, or brave NHS Employees with
principles and backbone, many of whom have lost their jobs – or, like Julie
Bailey who revealed the Mid Staffs scandal, have suffered persecution for revealing
And doing the maths,
calculating the number of other individuals with terrible stories to tell, it
is highly likely that in the coming months other scandals will emerge – not as
isolated incidents, or unrelated ‘one-offs’, but as symptoms of a system that
promotes managerial failure, and operates a cosy network of unaccountable,
highly paid individuals watching each others’ backs.
The same old names keep emerging. At the heart of it is David
Nicholson, now promoted from overseeing Mid Staff’s darkest days to Chief
Executive of NHS England, who has been splitting his time between London and
Around him there is an oddly
Birmingham-centric group. His wife is Chief Executive of Birmingham Children’s
Hospital Trust, and has enjoyed a cataclysmic rise thought the NHS Managerial
Dierdre Kelly, on the CQC Board
at the time of the Morecambe Bay cover-up is Professor of Paediactric
Hepatology at this same hospital. (It was Birmingham University that commissioned
a report to discredit mortality data on Mid Staffs that Harvard University said
it would have been ‘irresponsible’ not to aggressively act upon.)
Cynthia Bower, the Chief Executive of the CQC
at the time had been promoted to that position from being David Nicholson’s
successor as Chief Executive of the Strategic Health Authority overseeing Mid
Then there’s Sir Hugh Taylor. He is Chief Executive of the Guys and St.
Thomas’ Trust, where Guys children’s cardiac unit is listed as having mortality
data on a par with Leeds, higher than Leicester or Brompton which were
ear-marked for closure – but was mysteriously not identified as having any
difficulties and not identified for closure.
Sir Hugh worked closely
with Sir David as Permanent Secretary in the Department of Health, just as Sir
David had come from his post at Mid Staffs, via NHS London, to be Chief
Executive of the NHS.
There is also Barbara Hakin – who faces possible
investigation for stifling the whistleblower Gary Walker in North Lincolnshire
Trust. David Nicholson recently appointed her as his deputy in NHS England,
without letting Jeremy Hunt know.
Such a stream of
coincidences does all seem a bit odd. What is almost as odd is the incredible
amnesia that overcomes many of these individuals whenever an important question
is asked. No one can ‘recall’ anything. No one can ‘recall’ smothering the Morecambe
Bay report – but someone must have done, since it never came out. We also now know that the normal routes of
investigation, like FOI, are limited. If the piece of information is
uncomfortable, it now seems likely that someone will say ‘read my lips’ and
suppress its release.
That is why three things need to happen if we really want to
change this. Firstly, David Nicholson, the man at the centre of the web, who
was in the position of authority when this culture grew up, should be
Second, a major inquiry, led by
a judge, should be held into what has happened; it should reveal
the relationships and interrelationships between NHS managers, Department of
Health Officials, Secretaries of State and Ministers at the time. It should
look at how appointments were made, and where interests of individuals lay, who
know what and when (for example, why did Andy Burnham ignore 81 requests to
look into Mid Staffs? How could it have been possible for David Nicholson not
to know about mortality data when he was in charge of Mid Staffs, as he claims?
Who instigated the Birmingham University Report to squash the data when they
did find out about it?). This is the only way to get to the bottom of this
almost mafia-like web of self-interest.
Finally, the root cause of the rot should be tackled. It was
Labour who decided to take over the inspection of hospitals and pull it
‘in-house’ into Government where it could be controlled better, and bad news
eliminated from the shiny new Labour icon of the NHS. By ultimately having
control over inspections and bad news stories, it made it possible to construct
the religion of the NHS, and label anyone making a constructive criticism or
revealing bad practice a heretic. The
result has been that behind this gleaming facade of good PR, our beloved NHS
has been allowed to rot from the inside, and patients have needlessly died.
Hunt is rightly determined to restore transparency, accountability and high
quality to the NHS. If he can devise a system which makes the inspection regime
genuinely independent of government, and driven by the best of professional
knowledge, expertise and commitment to patient care, we might stand a chance of
reversing a truly diabolical decade in the history of the NHS.