Feature Mid Staffs Inquiry

Did the government ignore criticisms of the NHSin the run up to the Mid Staffs scandal?

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f652 (Published 05 February 2013) Cite this as: BMJ 2013;346:f652
  1. Nigel Hawkes, freelance journalist
  1. 1 London, UK
  1. nigel.hawkes1{at}btinternet.com

What was it about three reports into NHS care quality that led the government to shelve them quietly, only for them to resurface at the Mid Staffs public inquiry? And was the depiction of a shame and blame culture pervading the NHS a caricature? Nigel Hawkes reports

When Lord Darzi was parachuted into the government in 2007 and asked to set the NHS on a new course towards greater quality of care, three outside bodies from the US were contracted to provide advice. But top managers did not like what they had to say.

There were claims that the NHS was characterised by a pervasive culture of fear, that “shame and blame” was embedded in the system, stifling innovation, and that patients were the last thing anybody ever took into account. But these were “a caricature,” declared Hugh Taylor, permanent secretary of the Department of Health, when forced to respond to the claims during the public inquiry into Mid Staffordshire NHS Foundation Trust in September 2011. Counsel for the department, Gerard Clarke, said that these were “broad and sweeping allegations about a supposed general culture” that the evidence the department itself had gathered did not justify.

Taylor’s dismissal of the findings as “overstated” and “pretty poorly evidenced” may not have been the best of judgments. While the reports were being commissioned in late 2007, the then health secretary denied the chief executive of Maidstone and Tonbridge NHS Trust, who had resigned after failings at her trust, an agreed pay-off in order to make an example of her.1 She later won a court battle to restore the payment, one of the Appeal Court judges remarking that the Department of Health had been willing to see her sacrificed “on the altar of public relations.”2

For David Nicholson, chief executive of …

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