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Exclusive interview: CQC chair admits mistake over release of Morecambe Bay names

The Care Quality Commission made a mistake in not initially publishing the names of those implicated in the alleged cover up over Morecambe Bay, the chair of the regulator has admitted to HSJ.

David Prior told HSJ in an exclusive interview: “We should have published and been damned.”

He said the CQC’s decision to redact the names from the independent report into the regulation of University Hospitals of Morecambe Bay Foundation Trust was based on legal advice it risked breaching the Data Protection Act, because individuals had provided information for the report with the expectation it would not be published.

Mr Prior told HSJ the CQC had received “legal letters” threatening action under the Data Protection Act after individuals named in the report were sent details of the criticisms they would face in the report ahead of its publication.

When pressed on whether this included any of the four individuals at the meeting where it is alleged a cover up was discussed, Mr Prior said there were “two I can think of.”

Mr Prior told HSJ that one of the main reasons for it deciding to publish the names, less than a day after the initial publication, was the Information Commissioner’s indication that the law should not prevent it from doing so.

Mr Prior said: “Partly because of the Information Commissioner and partly because the level of public interest was so great we felt we ought to put the names out and take the legal risk we were running under the Data Protection Act.”

Asked whether, with hindsight, he thought the CQC should have consulted the commissioner before publication, he told HSJ: “When you employ top lawyers you sort of expect it might have occurred to them to do that.

“But the answer isn’t to blame the advisers, we took the decision not to put the names in and that was a mistake. Mea Culpa, guilty as charged.”

Mr Prior denied the initial decision to exclude the names was an attempt to protect individuals – including former CQC chief executive Cynthia Bower and former deputy chief Jill Finney – who were present at the meeting where it is alleged an instruction was given to delete a critical internal report. 

“If we’d been about protecting individuals we would never have commissioned an independent report and we would never have committed to publish it. We acted out of best intentions to abide by the law and as it turned out we made the wrong call on that. We should have published and been damned.”

Since the publication of her name Ms Finney has publicly denied the allegation in the report she ordered the internal review criticising the CQC’s regulation of Morecambe Bay be deleted. Ms Bower also denied giving an instruction to delete the report and said she had “no note or recollection of such instruction being given”. Both women pointed out the report was not deleted.

The Grant Thornton report concluded that the information contained in the internal report was “sufficiently important that the deliberate failure to provide it could properly be characterised as a ‘cover-up’.”

It noted that the internal report had not been provided to the firm’s investigators at the start of their investigation in July 2012 and was not found during searches of the CQC’s “official records”. Instead they had been notified of the report’s existence by a regional member of staff who had heard of it and were provided with it by Ms Finney three months into their enquiries.

Asked whether he stood by the Grant Thornton report Mr Prior pointed out the consultancy firm is well respected and had spent more than nine months formulating its judgement.

He confirmed the CQC was in the process of instructing lawyers to establish what disciplinary action or sanctions it can impose on staff involved, including the possible “forfeiture of pensions”. Health secretary Jeremy Hunt last week indicated he supported such moves.

Mr Prior added: “We want to get definitive advice because this applies to other people in the public sector as well.”

He said the Grant Thornton’s conclusions made the case for the regulator’s new strategy, which involves a move to inspectors which are specialists in the issue being investigated. He also highlighted the complete overhaul of the executive team as evidence himself and David Behan were making progress. HSJ reported in April that the whole team had been or was being replaced.

The Grant Thornton review was prompted by concerns raised by non-executive director Kay Sheldon, and considered concerns of James Titcombe, whose son Joshua died at the trust in 2008.

Ms Sheldon’s term on the board comes to an end in November and until now has not been expected to be renewed.

However, asked whether the Grant Thornton report had made him more favourable to asking her to remain a non-executive, Mr Prior said:  “She has been absolutely vindicated and so by September I will come to a clear view on this… watch this space.”

Readers' comments (15)

  • Glad to see the NHS fair blame culture is alive and kicking. Who would want a top job in the NHS. It will not be long before the Government & media have ensured public confidence is completely lost on the NHS. But then at least the Gov will have an excuse to privatise the NHS

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  • Surprised HSJ has not reported Cynthia Bowers angry rebuttal of the charges in today's Independent - believe her or not, she makes a good point that, if fraud/wrong-doing is suspected, it would be better to call in the police than a firm of accountants.

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  • As a young NHS manager it is just getting increasingly disheartening and demoralising reading about ever more senior leaders undermining all calls for transparency and openess. Euqally depressing to hear the media revel in scandal and proclaim the negatives of a system dedicated, quite aimply, to helping people.

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  • Perhaps the wrong done to patients and their families is getting lost in the static over whether the Data Protection Act applies or not! The Information Commissioner had already said that it didn't apply and if you ask a lawyer they'll rub their hands with glee at being asked to give an opinion on whether it applies (or not).
    PS Have you noticed how we are all anonymous again?

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  • Graham Elderfield

    As so often seems to be the case these days, the culture which has prevailed in the NHS is one of fear of giving bad news, whether on targets or clinical errors, and we seem to no longer be honest with staff, patients, or the Government when it comes to addressing something that has gone wrong. Managers in the NHS have lost their moral compass and need to stand up to what they believe in, rather than fear the backlash from the top of the organisation. I am afraid the legacy of the leadership of the NHS for the past few years has been one of fear and threat.

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  • Let's look on the bright side.

    Is this a rethink about the ridiculous sacking of Kay Sheldon?

    If so, why not re-run the Board appointments altogether and put James Titcombe and Julie Bailey on too instead of some of the "usual suspects" who were appointed. Might do wonders for credibility!

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  • Roy Lilley

    The Chairman's claim that they sent 'details of the criticisms they would face in the report ahead of its publication' are utterly refuted here.

    Is this another of his mistakes?

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  • Derek Mowbray

    So, what's the strategy guys? It's been long established that the overall NHS culture reflects government supported organisations, and takes its messages from politicians, their ideologies and behaviours. The ideology of command and control has always been inappropriate in such a professionally based organisation...sadly professionalism has been substituted by mediocrity and erosion of professional general standards in favour of politically inspired 'targets'. ' The powers that be only care when their systems and approaches break down. Everything else up to that point serves a political purpose. when that purpose is exposed as being flawed, all the horrors are then exposed. So, what's the strategy now?

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  • Strategy for NHS is simple

    1. Hopefully one who replaces David Nicholson will be a honest and sincere leader who will promote 'Fair and Open' Culture, Supportive and learning culture and culture of accountability for the Board.
    2. This culture will perpetuate throughout the NHS everywhere.
    3. Zero tolerance for bullying culture
    4. Excellent patient and public representation in every NHS organisation
    5. Strong medical and nursing leadership. Good doctors and nurses to take on leadership roles along with local GPs but they must be performance managed
    6. Good governance and quality assurance systems not based on political correctness but honest information and targets which mean something to our patients
    7. Regulation which measure organisational culture, leadership, staff and patient involvement and engagement.
    8. Excellent IT system
    9. Streamlined management system across primary, secondary, community and social care
    10. Good and supportive professional regulation locally and regulators to take only rare and difficult cases. Encourage staff to raise concerns and support them and leadership which deals with them

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  • Too much attention is being given to the allegation that Ms Bowers and Ms Finney ordered the report to be deleted.

    Grant Thornton may have got that wrong or may at least find it difficult to substantiate. The fact remains that the report was not published. Why?

    Because, according to Ms Finney, it was not sufficiently critical of CQC.

    "It was quite clear on reading the report that the activity was not satisfactory and CQC should have done more, so at that meeting we agreed that the report required much further work."

    Are we really expected to believe that the CQC senior team was holding out for a more damning version of the report?

    Where is the evidence that further work was commissioned and when was the beefed up report going to appear?

    If Ms Bowers and Ms Finney were not given the opportunity to respond before publication then their charge about lack of a "fair process" may have substance. But now that the "media feeding frenzy" is abating, why not take the opportunity to set the record straight and put their side of the story?

    The endless recycling of a few stale claims and counterclaims will lead cynics to conclude that the affronted actors in this drama prefer to concentrate on the weak specifics of the Grant Thornton report. Fair enough, but how about a robust rebuttal of the central allegation that the report was suppressed.

    Instead of melodramatic whining about being "hung out to dry", why don't Ms Bowers and co take Grant Thornton and Louise Dineley to the cleaners for defamation of character?

    Finally, read this passage of the Channel 4 coverage:

    Ms Finney suggested that a lack of sufficient resources meant it was "always going to be a very, very tall order" for the CQC to do its job effectively.

    "The fact that the regulatory activity in Morecambe Bay could have been better was undoubtedly a feature of the very, very sizeable agenda CQC had to lead."

    Lack of resources, sizeable agenda, nothing is our fault.

    As usual, the real scandal is lost in the nit-picking detail.

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  • I agree with Graham Elderfields points.

    Look at Spire Hospitals web-site - each hospital openly reports on key clinical standards such as infections. Perhaps privatisation would be the route to transparency and openness

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  • As a former CEO watching events from overseas it breaks my heart to see these sordid scandals undermining what is still, overall, one of the best health systems in the world. The great progress made in the past 20 years, reflected in improved mortality, improved access and record satisfaction levels is becoming invisible as a small number of lurid failures act like the scent of blood to circling sharks.

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  • So did the CQC Chair and Chief Executive ensure that the named individuals saw the report in advance and had an opportunity for a factual accuracy check and challenge or not?

    I'd like to see that question answered on oath at the Health Select Committee. We've heard conflicting reports and can't be sure who to believe.

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  • Here's a novel idea - lets re-focus the NHS on treating sick people -put matrons (or anyone one that cares about patient outcome) back in charge and tell the politicians to back off!!!!!!!!!
    Where did all these egotistic despotic "leaders" come from - Atttacted by the hugh salaries we started paying managment in the 90's I guess!!

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  • @ Anon 10:23
    The reason that Grant Thornton are not likely to face any sort of action for defamation is that you need to be an oligarch or an 'A' lister celebrity to be able to afford to take out a defamation action against anybody. It is one of the least accessible and affordable parts of the legal system in this country

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