The must-read stories and debate in health policy and leadership.

No blame, just answers

If there is one person who knows what makes a good – or bad – public inquiry it is former Department of Health permanent secretary Dame Una O’Brien.

Between 1998 and 2001, she was secretary to the Bristol/Kennedy Inquiry, which was then the largest public inquiry into the NHS.

Ms O’Brien (as she was then) took up the top job at the Department of Health in 2010 and, therefore, oversaw the setting up of both Mid Staffs/Francis inquires – as well as dealing with their recommendations. Since leaving the civil service she has served on the public inquiry investigating the causes of a public sector spending scandal that led to the collapse of Northern Ireland’s power-sharing executive.

Dame Una calls for an inquiry into the government’s response to the coronavirus crisis, “with powers to compel production of documents; take evidence on oath and require statements from witnesses”. She adds that “the public need to be confident that all relevant documents, minutes, emails, texts and even Zoom records are handed over to the inquiry in a timely way”.

However, the inquiry cannot be a “prosecution” or “a blame game.”

The former Department of Health chief says a chair must be appointed as soon as possible, so they can influence the terms of reference. Public hearings could start “later this or early next year”.

She concludes: “No previous inquiry can guide us here; for the covid-19 public inquiry, as with so many other aspects of life the virus has affected, we will need innovation on a previously unimaginable scale. It will certainly be a public inquiry like no other.”

Where surgery has its work cut out

Junior doctors are often the backbone of service delivery in any trust, so HSJ’s story about the problems of trainees at the Brighton and Sussex University Hospitals Trust must make grim reading for those working there.

The future of general surgery foundation trainees is in doubt, after the General Medical Council said they should be taken away unless there is significant improvement in their education and training.

The covid-19 crisis has given the trust a reprieve, as the GMC is not going to take any action during this time. But that is only temporary and it appears there is much to improve, not just with this group of trainees but also more senior surgical ones and those in obstetrics and gynaecology. When things get back to normal, the trust may have its work cut out.

Auction site’s portal is a lottery

The vast majority of GPs and community providers are still waiting on an online PPE portal from the Department of Health and Social Care and tech giant eBay. When it’s rolled out, the website should give organisations better access to central stocks of protective kit and other covid-19 related products.

But so far, the portal is available to just 2 per cent of the country’s 58,000 primary care, social care and other community organisations.

In the meantime, GPs and community providers continue to make do with often expensive and restricted stocks from existing suppliers, drops from local resilience forums and emergency packages from a national hotline. Experiences of PPE provision in the community vary widely, and it’s hoped the new portal will help improve distribution. But it could be some time before most smaller providers see any benefits.

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