Former health secretary Andy Burnham has defended his decision to back Mid Staffordshire Foundation Trust’s Monitor application, blaming the system for failing to pick up problems at the trust sooner. 

In his evidence to the public inquiry Mr Burnham, who signed off the bid when a junior minister under Alan Johnson in June 2007, admitted he had seen just four lines of civil service advice on the trust but said he had expected Monitor to verify the quality of services at the trust.

However, earlier in the hearing Mr Burnham had admitted that the Healthcare Commission’s annual health check, which determined whether a trust could apply to Monitor, provided a limited picture of services at the trust.

Inquiry counsel Tom Kark QC yesterday presented evidence from four witnesses stating the regulator had not carried out independent assessments of quality as part of its authorisation process but relied on the HCC’s assessment.

Pushed to defend his decision, Mr Burnham said he was following department advice, that the bid had already won approval from the primary care trust and the strategic health authority, and been through a period of public consultation where no one, including local GPs, had raised concerns.

“If all of this hasn’t flagged up any issues on what basis am I coming in to overturn the advice of civil servants,” he said.

Asked what he thought the weaknesses of the foundation trust policy were, Mr Burnham pointed to the “failure of hospitals to grasp the local accountability side of the FT model” and the failure of the Government to give “adequate thought to what happens when things go wrong”.

He said the foundation trust policy had been an attempt to introduce more localism into the NHS and move away from a top down, target driven culture.

Asked why, in light of that, he had intervened with Monitor’s performance management of Mid Staffs when he returned to the DH as health secretary in June 2009, three months after the HCC’s report into the trust was published,  Mr Burnham told the inquiry the regulator had been “overwhelmed” by the situation and was not acting quickly enough to appoint full time management.

As health secretary Mr Burnham ordered an independent inquiry into failings at the trust but faced criticism from local campaigners for not ordering a public inquiry.

Defending his decision Mr Burnham said he had not wanted to distract the trust from it priority of improving services.

He said he had “resisted” the advice of civil servants in the DH, including NHS deputy chief executive David Flory, who were against holding any kind of inquiry.

However, he said the problems at the trust were “ultimately a local failing by the trust, its board, its senior management”.