NHS reforms could make hospitals safer and more open, MPs hear

BMJ 2011; 342 doi: (Published 04 February 2011) Cite this as: BMJ 2011;342:d787
  1. Clare Dyer
  1. 1BMJ

The shake up of the NHS in England provides a “golden opportunity” to force hospital trusts to be more transparent and give patients the information they need to make a choice about their treatment, the founder of the campaign group Cure the NHS has told MPs.

Julie Bailey was giving opening evidence to the House of Commons Health Committee, which has launched an inquiry into NHS patients’ complaints and litigation.

She set up the group after her mother was admitted to Stafford Hospital in 2007 for a routine hernia operation, had a fall on the ward, and never recovered. Pressure from the group led to a series of inquiries into what investigators found were “appalling” standards of care at the hospital.

A Healthcare Commission report in 2009 found that from 2005 to 2008 between 400 and 1200 more patients than would have been expected died at Stafford Hospital and that complaints from patients and their relatives had not been listened to (BMJ 2009;338:b1141, doi:10.1136/bmj.b1141).

Ms Bailey told the committee, “We’ve got an ideal opportunity with foundation trusts to force them to publish all of their data. Now is the time.

“Couldn’t we force them to have all of their evidence in public—to issue all of their complaints, their infection rates, and staffing levels? If all of that information was in the public arena, people would know that they have a choice, they’ll know if a hospital is safe.”

Ms Bailey said that when patients’ relatives complained, staff members would try to turn their complaint into a “concern” instead. “Nobody learns from the concern, because it’s not logged as a complaint,” she said.

The select committee is also looking at the effectiveness of the new two stage complaints system introduced in April 2009, in which complaints are resolved by local resolution and, if that fails, are referred to the health service ombudsman. Kieran Mullan of the Patients Association told the MPs that his organisation’s biggest concern was the very small number of complainants whose cases were taken on by the ombudsman, only 3%.

Catherine Hopkins, legal director of the patients’ charity Action against Medical Accidents (AvMA), suggested that there was scope for looking at alternative ways of settling lower value clinical negligence claims, apart from suing in the courts. One issue that the health select committee is considering is the possible benefits of a statutory right to compensation for “treatment injury” from an independent fund, without the need to prove negligence.

Ms Hopkins said that AvMA saw instances where people who were not represented by a lawyer were offered “derisory” settlements by the NHS Litigation Authority. AvMA advised them to consult a solicitor, and “often we find their claim is worth considerably more and it can be to a power of 10 or 100 even, believe it or not.”

Government plans to withdraw legal aid for clinical negligence claims and to change the rules for “no win, no fee” deals, so that winners can no longer claim their lawyers’ success fees or insurance premiums from the losers (BMJ 2010;341:c6567, doi:10.1136/bmj.c6567), will be the “worst of both worlds” for claimants, she said. The combination would be “a serious impediment to access to justice for some of the most vulnerable people in the country.”


Cite this as: BMJ 2011;342:d787