The publication of Ann Clywd MP’s report on how the NHS handles complaints is an important moment. While for many years health policy has been about structure, treating the body of the NHS, this is the first real step to heal the soul of the health service.
The Clywd Report has unearthed horrifying witness evidence, from the nurse who refused to help a vomiting patient, telling the family that “I’m a graduate, I don’t do sick”, to the relative who was made to wait until an eBay auction finished before they could get assistance.
It is clear that not only is a new system for whistleblowing and complaints needed, but that the internal culture of much of the NHS requires a great deal of attention. It is an outrage that anyone even needs to suggest that care and compassion ought to be mainstays of the health service.
Aside from Ann Clywd’s recommendations, there are a number of lessons here:
1) The political culture around the NHS must change
Almost as shocking as the poor care suffered in the Stafford scandal is the treatment dished out to those who blew the whistle on it. Julie Bailey has been driven from her home town after a number of attacks against her, including the desecration of her mother’s grave. It’s time we acknowledged that such attitudes are fuelled by political rhetoric in which anyone who questions the NHS in any way is demonised as hating the idea of free healthcare or wanting to destroy the service outright. That isn’t acceptable, it leads to incidents like the attacks on Julie Bailey, and it prevents anyone have a serious, productive discussion about how the NHS could be improved.
2) Facing up to these problems requires bravery and personal experience
Ann Clywd MP has done a fantastic job of her report on NHS complaints. It must have taken a great deal of bravery not only to revisit the devastating experience of her husband’s death, but also to campaign for what is right on a topic where many of her colleagues either prefer to look the other way or suspect any discussion of NHS failings to be a Tory plot. Until we have a more reasoned political culture around health policy, with less vitriol and more open-mindedness, people like her are going to remain essential to addressing these problems.
3) Without transparency, things go wrong
This has been demonstrated time and again, but still large public bodies fail to learn the lesson. According to the Clywd Report, many complaints submitted to NHS organisations simply bounce off the surface – they are met coldly, minimised and eventually lead to no changes or improvements. Forcing NHS managers to publish and then defend rates not only of complaints but also of complaint resolution would be a good start to changing things.
4) “The NHS” is now two political issues
It’s been true for many years that the NHS is high up the electorate’s list of priorities. Traditionally, this is interpreted as popular concern for its future, opposition to cuts in services and suspicion of Conservative intentions towards it. That defensive concern remains widespread. But now there is a second reason why many people hold the NHS as a priority – they are horrified at what went on at Stafford and elsewhere, and they want to see such failings stamped out. It is no longer so simple as saying that an electorate which cares about the NHS wants no change; many are willing to vote for the right sort of improvements.
5) We need new ways to make the NHS accountable
Ultimately, this story is about a failure of accountability. In some hospitals, people suffered and died unnecessarily, but it took years to expose it and start to set it right. 3000 people a week complain about NHS care, but all too often they are not listened to. In any quango – and the NHS is a series of quangos, delivering one service in different ways across the country – there is a lot of lip-service given to forums, stakeholders, consultations and so on. But the evidence of failures suggests that system is not good enough. We ought to ask whether there are ways for the NHS’ patients and funders, the electorate, to have more oversight and more say in how their local services are run.