David Cameron appears to back Sir David Nicholson in PMQs, exclusive interview with Dame Fiona Caldicott and the rest of the today’s news
5.36pm: Some tweets on Sir Ian Carruthers’ speech at the Local Government Association meeting this afternoon (see 12.45pm) from @kayewiggins:
“Sir Ian says says councils will need to provide better evidence in future if they oppose local NHS shake-ups…
“Some #localgov scrutiny is good at providing evidence on impact of NHS shake-ups but need to accept this isn’t always the case, Sir Ian says…
“Sir Ian nervous about presence of journo (me) at LGA mtg. Cllr tells him NHS needs to get used to #localgov culture of being open to public.”
5.03pm: Conservative MP Chris Skidmore, a member of the Commons health committee, has written a blog for The Spectator in a same vein to Jeremy Hunt’s earlier today (see 4.23pm). Mr Skidmore says: “The blame must be turned squarely on Labour health ministers who have been allowed to slip through the net.”
4.39pm: Labour health spokesperson Lord Hunt has tweeted: “Just got report of Lords Scrutiny Committee on Sec. 75 NHS privatisation regs. Devastating critique of original regs. No wonder pulled…
“Lords Scrutiny Committee on original Sec. 75 NHS privatisation regs says that they may imperfectly achieve their policy objective…
“Lords Scrutiny Comm. on original Sec. 75 NHS regs points to huge no. of representations received about breaking of Ministerial commitments.”
The secretary of state says: “Labour now has a choice. It can sit back, relieved that David Nicholson is taking the pressure for ministerial decisions they made which had disastrous consequences. Or it can take the harder course of action and accept that a lack of interest in patients by ministers had appalling consequences and that they are willing to learn the necessary lessons.”
The NHS chief executive has been named in an application sent to Camberwell Green magistrates’ court yesterday by a member of the public.
Retired investment banker Alan Edwards has applied to the court to seek permission to bring a prosecution against Sir David on four counts: corporate manslaughter, misconduct in public office, perverting the course of justice and conspiracy to pervert the course of justice.
3.19pm: Telegraph deputy political editor James Kirkup contemplates that David Cameron’s support for Sir David Nicholson might be wavering following prime minister’s questions this afternoon (see 12.33pm).
He says: “Perhaps Mr Cameron is coming to agree with his colleagues who now believe that the best possible outcome here is for Sir David to fall his own sword and depart in a vaguely dignified way.”
3.13pm: Following the NHS Change Day discussions on Twitter, Paul Corrigan looks at how innovation can be spread in the NHS.
He writes: “In other industries the main way innovation is spread is the pull of innovation into every corner of the industry. The main mechanisms for pulling the spread of innovation are staff and customers.”
2.52pm: HSJ readers continue to react to Sir David Nicholson at the health committee, with a debate underneath yesterday’s article. Here’s what some readers have said:
- “I’m impressed by the chief executive’s robust defence. I don’t believe he should resign because of Staffordshire. My concern is whether he is the person who will change his own behaviour to lead the cultural change that the NHS requires.”
- “Leadership requires followers and if 90% don’t believe the leader is credible, they won’t follow.”
- “Each and every day patients continue to be treated across the wider NHS despite the system. If he walked away today we would still continue to treat patients because that’s what we do and what keeps us going while we wade our way through the mess that is the reforms.”
- “Many of the people who know him are supporting him, I’m sure he is a very good colleague and friend, but elsewhere in the NHS his credibility is greatly reduced.”
2.29pm: Ministers have been challenged to make urgent changes to the Nursing and Midwifery Council’s powers in order to improve public protection − as it emerged just 13 nurses are currently facing sanctions in relation to the high profile care failings at Mid Staffordshire Foundation Trust.
The regulator currently has no powers to review decisions by its panels to close cases when they decide there is no case to answer − even where fresh evidence comes to light.
2.11pm: The Department for Work and Pensions has said will give staff on sick leave more support to get back into work through new “fit note” guidance.
The guidance advises doctors on how they can give the most useful advice about what patients can do at work and how they can return to the workplace as soon as possible. The guidance is based on research and feedback from patients, GPs and employers.
1.03pm: In his leader, HSJ editor Alastair McLellan writes about “the new power of mortality ratios”, how they can be useful and the dangers of giving too much prominence to any one indicator to assess a hospital’s performance.
12.53pm: HSJ’s Twitter chat on how to make positive change happen faster in the NHS starts at 1pm, as part of the debate on NHS Change Day. Follow the discussion using the hash tags #hsjchat and #nhschangeday.
12.45pm: At the Local Government Association community wellbeing board meeting Sir Ian Carruthers outlining possible changes to the system for NHS reconfigurations. Kaye Wiggins from HSJ sister title Local Government Chronicle is covering the the event live, follow her at @kayewiggins.
12.38pm: Also at PMQs, David Cameron was asked by Labour MP Debbie Abrahams about the decision to amend Health Act regulations on competition. The prime minister said the regulations are being clarified and the government should not be afraid of allowing private companies to provide services. He pointed out that Labour proposed this in the party’s 2010 manifesto.
12.33pm: At prime minister’s questions David Cameron has expressed his support for Sir David Nicholson again.
Labour MP Graham Stringer said Mr Cameron should “sack” Sir David “immediately” over the high death rates at Mid Staffordshire.
In his answer, Mr Cameron said Sir David has “made his apology and wants to get on with his job” and “other people should be considering their position too”.
12.02pm: Michael White has made some interesting observations from Sir David Nicholson’s appearance at the health committee yesterday in his HSJ column, including a comparison between Sir David and Paul Dacre − editor of the Daily Mail.
He also writes of Sir David’s performance: “It was touch and go once or twice as the red warning light on that choleric face started to indicate overheating. But my feeling was it was good enough to keep HIM at the helm of HMS NHS. ‘Hitting the target and missing the point’, emerged as a favourite soundbite − and a good one.”
11.33am: Hospital spending on private finance schemes is increasing at an alarming rate, a report by the Nuffield Trust has said.
Repayments on private finance initiatives has increased by almost £200m in two years. In 2009-10 NHS trusts in England spent £459m repaying PFI debts but by 2011-12 the figure was £628.7m as more schemes were completed.
Andy McKeon, a Nuffield Trust trustee, has written a piece analysing the report on hsj.co.uk. He says: “Making savings without improving productivity is a very hard road to go down, with diminishing returns as non-pay costs are increasingly squeezed. It certainly isn’t a sustainable long-term strategy.”
11.26am: Sue Day’s opinion article on the benefits of taking the NHS brand overseas has been prompting some interesting areas of discussion:
- “Profit, when it is the NHS making it, is seemingly OK. The slightest mention of profit, when it is the independent sector or entrepreneurs making it in the UK by supplying the NHS, results in vitriolic comments.”
- “If there is one lesson from Francis then it would be to keep out own house in order before we go global.”
- “I am currently working on the planning of a women and children’s Hospital just outside Shanghai.The country’s health care system is so very different and incomparable with the UK. The culture shock of the lack of health and safety and clinical practices can be immobilising to British health staff.”
11.19am: The Department of Health has released guidance for unsecured creditors on their rights under special administration for NHS trusts and foundation trusts in England.
The guidance includes an overview of the special administration process and information on how the liabilities of trusts and FTs will be treated if these organisations are put into special administration.
10.57am: Venture capital investment firm Albion Ventures has sold Nelson House, a mental health rehabilitation hospital, to a joint venture formed by Care UK and Sussex Partnership Foundation Trust for £8m.
The transaction is the first to involve a joint venture between the NHS and a private healthcare provider to acquire a hospital. The sale follows Care UK’s aquisition of Specialist Hospitals last month.
10.52am: A report to Monitor from consultants Ernst and Young has recommended cutting expenditure on Mid Staffordshire Foundation Trust by half, as services are moved to other trusts.
All the options presented to the regulator envisage cutting the trust’s income from £100m to between £48m and £52m.
10.49am: Sarah Wollaston, a Conservative member of the Commons health committee, has told HSJ that Sir David Nicholson should oversee the end of the NHS reorganisation, and then resign as NHS Commissioning Board chief executive.
She said: “He might have the confidence of the NHS Commissioning Board − the wider issue is whether he has the confidence of the patients and wider NHS staff.”
10.40am HSJ exclusive: In an interview with HSJ, Dame Fiona Caldicott has said her review into information governance in health and social care is likely to recommend a new duty to share information between agencies where it is in a patient’s best interests.
In 1997 Dame Fiona carried out her first inquiry on the subject, which led to the six principles of information governance and the introduction of “Caldicott guardians” in public bodies, responsible for the oversight of sensitive personal data.
Dame Fiona said: “We’ve suggested a new principle which is about the duty to share information in the interests of the patients’ and clients’ care.”
10.19am:The Spectator’s conclusion on Sir David’s health select committee appearance is he “didn’t deliver the most confident performance… but he didn’t leave the session looking fatally wounded”.
10.16am: The Guardian has devoted an editorial to Sir David Nicholson this morning. But, unlike The Times, the Telegraph and the Mail, the paper does not call for him to resign or be sacked. In doing so it opens a clear left/right Fleet Street divide on the issue.
Referring to Sir David’s Communist past, The Guardian styles him “a tankie under fire”. “The many flaws of Mr Nicholson should not obscure the reality that in the end it is ministers who must carry the can − and for good reason,” the piece argues.
The other NHS story in the paper is on health minister Norman Lamb’s announcement that the government will amend its controversial competition regulations in secondary legislation under the Health Act, covered by HSJ yesterday. The story is also the subject of Steve Bell’s cartoon.
10.07am: The Daily Telegraph also has Sir David at the health committe on page one, including a Matt cartoon, but inside it is running an interview with former United Lincolnshire Hospitals Trust chief executive Gary Walker.
Mr Walker said he can “provide evidence” that his £500,000 compromise agreement was sanctioned by the Department of Health.
9.58am: Sir David Nicholson is on the front page of the Daily Mail today for the seventh time in a month. “The man with no shame” has been branded “the man with no answers” in what the article describes as an evasive performance by the NHS chief executive.
HSJ’s graphic shows the rest of Sir David’s front page appearances.
9.50am: Sir David Nicholson’s appearance at the Commons health committee yesterday makes many of the newspapers this morning.
Sir David’s questioning was also the lead story on the BBC evening news bulletins (as covered on HSJ Live yesterday), ITV News’ evening programmes and Newsnight, as well as making the front page of the London Evening Standard.
7.56am The NHS has a poor reputation for adopting and disseminating novel ways to deliver care. Yet, as the HSJ Awards demonstrate each year, many in the NHS do manage to introduce and sustain a variety of healthcare service innovations.
Researchers from Brunel University interviewed NHS employees who won HSJ Awards from 2007 to 2009 to understand the secrets of their success for successfully implementing service innovations across 15 primary and secondary NHS organisations.