Ed Miliband failed to acknowledge problems in the Welsh healthcare system in front of the local party faithful, so what does this tell us about Labour’s stomach for tackling the tough issues?
After walking up eight floors in hospital to visit a friend one night this week, I was struck by the orderly, caring decency of the night shift staff.
But in a week of headlines about whistleblowing, from Sir Robert Francis’s review to HSBC, this thought competed with a less welcome one: what if Labour’s cultural affinities with NHS workers are similar to those that allow senior Tories to tolerate aggressive tax avoidance among the wealthy?
‘I was disappointed Ed Miliband did not urge NHS Wales to do better by its customers’
What if such ties draw Labour back from sufficiently rigorous criticism of the service’s shortcomings? Or lead them to recoil from the individualism of “awkward squad” whistleblowers, who eschew team solidarity in the interests of patients?
It’s too sweeping a generalisation, of course, though I was disappointed that Ed Miliband - who is well ahead on NHS issues, the new HSJ/FTI poll confirms - did not use Saturday’s speech to the Welsh Labour conference to urge NHS Wales to do better by its customers.
Keogh for Wales
Just because the Tories are playing political rugby with it, it doesn’t mean some indicators aren’t poor. Jeremy Hunt wants a Welsh Keogh review of high mortality rates in hospitals. Fair point.
But since I recently complained here about the NHS being a cheap election target, I should say right away that when MPs debated the Francis review, the tone was far more constructive on both sides, as Mr Hunt remarked several times.
‘News leaked that election conscious ministers are sitting on Lord Rose’s critical report on NHS management’
Andy Burnham even acknowledged the health secretary’s sincerity in wanting to tackle the culture of “fear, bullying, ostracisation (is that a real word?) and marginalisation” that persists.
It didn’t stop him protesting that Mr Hunt is still allowing ward bullying to increase (The Guardian’s Polly Toynbee calls mild mannered Hunt the “NHS bully in chief” for berating failing trust executives down the phone), and hasn’t included social care in the new regime.
Let alone reformed post-Shipman death certification (“it’s complicated,” he was told) or published the risk register (cheeky, as a minister, Burnham didn’t either).
Remember, we’ve beefed up the inspection regime and broadened it to include GP and social care, Hunt reminded him.
Climate of fear
Inspection has become a Toynbee versus Tories battleground too.
MPs had some cruel stories about NHS whistleblowers whose careers have been derailed, in contrast to bullying chief executives who go on to other high paid jobs. All this came before news leaked that election conscious ministers are sitting on former Marks & Spencer boss Lord Rose’s critical report on NHS management.
‘Strikingly absent was any challenge to Francis’s decision not to propose criminal sanctions’
Echoing last month’s report on complaints procedures from the Commons health select committee, Mr Hunt made a useful point about the need to disentangle employment law issues that whistleblowing might trigger - such as wrongful dismissal - from issues of professional behaviour.
Less usefully, he partly blamed the “climate of fear” on Labour’s “top-down targets” culture.
But strikingly absent from the exchanges was any challenge to Francis’s decision not to propose the kind of criminal sanctions that Hunt seems happy to impose on, for example, wilful neglect.
Why? Because he wants to “create a supportive culture through which people listen and learn” - not buck passing, he says.
A “transparent, no blame learning culture” does exist in the best hospitals, as it does in the nuclear, oil and airline industries, ministers insist. Not sure how true that is, are you? BP? Sellafield? Those missing Malaysian black boxes, anyone?
Outside critics say the new whistleblower’s “guardian” should not be a trust employee and the new national officer should be free of the regulator. But MPs seemed willing to give it another try. Just like those banks, eh?
Michael White writes about politics for The Guardian