Government urged to drop barring scheme

In his report into failings at Mid Staffordshire Foundation Trust, Robert Francis QC recommended a system in which executives and non-executives faced disqualification from holding similar positions in future in cases of incompetence or serious misconduct.

Health secretary Jeremy Hunt proposed the introduction of a scheme similar to that used for teachers in the government’s initial response to the Francis report in March.

However, the leadership standards task and finish group, set up by the Department of Health to review the proposals, reported it was “not fully convinced” a barring scheme was a proportionate solution to the problem.

The group’s final report, seen by HSJ, stated: “Managing the tension between ensuring fairness for individuals and ensuring a proportionate, cost-effective approach for the system and the taxpayer is likely to be of particular difficulty.”

It recommended the government should “proceed carefully” with any barring scheme and should “seriously consider if the alternatives set out in this report are likely to be just as effective”.

For example the group said much better use could be made of existing disciplinary processes.

It also proposed a “certificate of good standing” which individuals could show to potential employers as a formal record that they were a fit and proper person. The certificate would include disciplinary findings, relevant criminal convictions and whether an individual had been dismissed or resigned while a disciplinary or other investigation was taking place.

The group, which was chaired by Professional Standards Authority chief executive Harry Cayton, said this would help to counter a “lack of trust in references”.

The group backed the fit and proper persons test proposed by Mr Francis and being developed by the Care Quality Commission and Monitor. However, it said it should apply only to board level appointments and must apply to commissioners as well as providers and social care bodies.

Under the government’s current plans the test will apply only to organisations regulated by the CQC.

The group also recommended the test and any barring mechanism should only be applied on the “basis of culpable behaviour causing harm not personal or technical competence”. “Neither the ‘fit and proper persons’ test nor the barring mechanism should be applied to the detriment of individuals in cases of simple failure. In any walk of life people will fail from time to time,” it said.

Details of the government’s next steps in relation to ensuring management accountability are expected in the response to the Francis report next week.