Michael White: Reaction to response is cause for dismay

The Francis investigations into the crisis at Stafford Hospital should have lost their power to shock by now.

So I was startled to find myself being dismayed by some of the points made by MPs after Jeremy Hunt announced the government’s response to the Commons the other day. Can perfunctory inquests on NHS deaths still be held 13 years after Harold Shipman’s mayhem? Apparently yes.

• More on the government’s response to the Francis report

“Cruelty became the norm in our NHS,” the health secretary said at one point, referring to Robert Francis’ observation that dreadful things had become “normal” in that troubled local regime. A tabloid headline in the making there. But that’s not to say that other hospitals (indeed some parts of Stafford, too, so they tell me) don’t give “wonderful and compassionate” care, as Frank Dobson was first to point out.

‘Can perfunctory inquests on NHS deaths still be held 13 years after Harold Shipman’s mayhem? Apparently yes’

Mr Hunt agreed. Indeed he was extravagant in his praise of the NHS − it is ”a moral being or it is nothing”, rooted in “a noble ideal” and ”the most loved British institution, and rightly so”. Steady on, Jeremy, or you will sound like an acute case of producer capture after barely a year at the helm.

Singled out

Singled out for special praise “as one of the best hospitals in the country” was Salford Royal, whose local MP, ex-minister Hazel Blears, has been a champion of its “triangle of care” for dementia sufferers. Actual versus planned staffing levels on individual wards are posted daily on the hospital’s website, another local Labour MP, Worsley’s Barbara Keeley, pointed out.

“We have based our recommendation today precisely on what Royal Salford does,” replied Mr Hunt, though not so precisely as to seek more than monthly updates at first. But it is all good stuff even if (as HSJ has pointed out) much of the new openness doctrine predates Francis. Making it happen is the challenge (yet again). But the trauma of Francis may be enabling what Stephen Dorrell called “the sunlight” into closed institutions which had been “doing the system’s business,” not the patient’s.

Faced with an admission by Tory MP Rehman Chishti that Medway Maritime had the seventh worst mortality rate in 2005-6 and is now in “special measures” (note the jargon borrowed from education), Hunt confirmed it is linked for reform to admired Frimley Park, handily off the M3 at Camberley and the secretary of state’s own local hospital. Its CEO, Andrew Morris, was a finalist at last week’s HSJ Awards. Troubled George Elliott in Nuneaton (another of those middling sized, isolated NHS communities?) is linked with Birmingham’s University Hospitals, also praised by Hunt (and HSJ).

New style

As so often when things are really serious, the Commons mood was sombre and less partisan. Labour’s Andy Burnham, quite despondent in his demeanour, allowed his successor to suggest − twice and without challenge − that, by accident or design, Labour ministers had “put pressure on regulators” to tone down bad news and sent similar signals into the wider NHS. A damning charge if they can make it stick.

Apart from squabbles about nurse staffing levels data (both sides cans be right) and the need to replace career-fear-complicity-in-cruelty with candour about errors (even reporting “near misses” airline-style, which has raised air safety) there was much focus on the need to upgrade the status of lowly healthcare assistants, “nursing assistants” as they will become after high-powered columnist Camilla Cavendish’s report.

I like her story about the “stop the line” procedure borrowed from Toyota by Hinchingbrooke Hospital so that a missing swab doesn’t end up sewn into a patient’s abdomen and end in costly litigation.

Michael White writes about politics for The Guardian