Too much blame is being placed on trust boards for patient safety incidents, due to the erosion of parliamentary accountability, according to the shadow health secretary.

Speaking at a Conservative party conference fringe event in Manchester last week, Andrew Lansley called parliamentary accountability in relation to the NHS a "fallacy", caused by rising numbers of foundation trusts and ministers refusing to accept responsibility for major failings.

Mr Lansley said cases such as the Clostridium difficile outbreak at Maidstone and Tunbridge Wells trust between April 2004 and September 2006, in which at least 90 patients died, revealed that too much blame was being placed on top managers.

He said: "No minister admitted any responsibility. It was all the chief executive's and trust's fault. I don't think it quite works like that.

"There were systematic failings like the target approach and the lack of support from the strategic health authority."

Powers of scrutiny

He said MPs' powers of scrutiny were also weakened by ministers not being answerable for foundation trusts, which are accountable to Monitor. Employers, parliament and health professionals all had a part to play in patient safety, he said. Doctors and nurses needed to refuse to violate codes of conduct set out by their professional regulators.

Mr Lansley was responding to claims by Medical Protection Society director of policy and communications Stephanie Bowen that ultimate responsibility for safety lies with government. Ms Bowen said: "We must have a culture of openness.

"The government has the power to change the culture and set the standards that employers are expected to apply."

See NHS infection control: a clean bill of health