Views & Reviews Personal View

Francis inquiry has let the government off the hook

BMJ 2013; 346 doi: (Published 16 April 2013) Cite this as: BMJ 2013;346:f2320
  1. David Hands, visiting professor in health policy and management, University of Glamorgan; former chief executive of North Wales Health Authority; researcher; and international consultant
  1. davidmhands{at}

The inadequate inquiry into what happened at Mid Staffs has allowed the UK government to blame frontline clinicians rather than those in charge, claims the former chief executive of North Wales Health Authority David Hands

As a former NHS chief executive, I share the shame of Mid Staffordshire Foundation Trust, but Robert Francis’s second report and the government’s response to it leave me disturbed.1 It is impossible not to agree with Francis’s diagnoses of inappropriate culture and system failure; however, it is astonishing that he focuses blame on the local trust and professional behaviour.

Francis observes that Mid Staffs is probably not unique but, after three years and £13m, provides little more than embellishment of the facts established in his first report.2 This myopia has enabled politicians to indulge in characteristic evasion.3

Francis interpreted his brief narrowly and admits that his recommendations were influenced by those he criticised. It is a pity, in the interest of the candour that he urges on the NHS, that this correspondence has not been published.

The “culture of fear” that Francis identified is most apparent in the many harrowing stories of whistleblowers.4 5 6 Gagging clauses are …

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