NHS should have single regulator, Sir Ian Kennedy tells Mid Staffs inquiry

At the end of his evidence to the Mid Staffordshire Foundation Trust public inquiry yesterday, Sir Ian was asked if he still believed there was  a case for merging quality and economic regulators, as set out in his report on the 1998 inquiry into children’s heart surgery at the Bristol Royal Infirmary.

He said: “I still hold to the view that the more people you have in this field, the more you’ll have territorial disputes and the more stuff will fall through the cracks… I think it needs to be an entity, one body, that may have arms, may have different sub-entities… they find out what is common and do it collectively. They find out what is unique and do that separately.”

In his evidence to the inquiry, Sir Ian presented an email from former Monitor executive chairman Bill Moyes sent in March 2008 which he claimed showed Monitor was pressing for the investigation into the trust to be “curtailed”.

In the email, Mr Moyes asks if the HCC could carry out a “quick preliminary investigation” to establish if there was a “prima facie case” for a fuller investigation, citing the amount of resources it would need.

Sir Ian told the inquiry his reading of the email was Mr Moyes was questioning the HCC’s view that there was a need for an investigation which he said was “inappropriate”.

Asked why the finished report into the investigation had not been published until almost a year later in March 2009, when a draft had been ready in December 2008, Sir Ian said he was unable to help.

He defended his decision to remove figures from the final report suggesting there had been between 400 and 1,200 excess deaths at the hospital, insisting that although he supported the methodology behind the statistics he was “categorically” not put under any political political pressure.

He said he had taken the decision as the notion of excess deaths was “difficult for non-statisticians to grasp” and “became cruel to relatives, carers, parents” who wanted to know if their relative was among the number. Removing the figures would also avoid getting dragged down into a debate about data, he had felt.

He said: “I wanted to make sure that we didn’t get into that discussion [about the validity of the statistics], but rather say that the care being delivered had been appalling… that patients and their carers and relatives had been ill-served and something had to be done.”