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Feature Mid Staffs Scandal

Francis interview: what doctors must learn from my report

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f878 (Published 08 February 2013) Cite this as: BMJ 2013;346:f878

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Re: Francis interview: what doctors must learn from my report

It is blindingly clear that there was much that went wrong at Mid-Staffs, where it is estimated that 400 to 1200 patients might have lost their lives needlessly. It would be hard to attribute this appalling lack of care and negligence to any one person, just as it is ridiculous that any nurse or doctor sets out to do wilful harm to patients. Nevertheless, it is clear that the early warning signs were systematically ignored or explained away as irregularities or misinterpretation of data and errors of coding.

As a jobbing clinician I am as aware, as many are in the NHS, that there are varying degrees of clinical engagement within Trusts. I am of the era when Griffiths took roots in the NHS and management became consolidated to drive targets and financial efficiency, with the inherent risks that there has been a complete change in the culture of the NHS. Cost cutting has become a euphemism for cost improvement and clip boards have taken the place of care plans. In the drive to achieve Foundation Trust status it seems clear that Mid Staffs ticked the box, but missed the point. What is worrying is that this flagship Trust of the Labour era might not have been on its own, and this causes the public and patients intense anxiety.

The time has then come to re-evaluate how hospitals function, and to ensure that doctors and nurses are right at the heart of decision-making. This change of culture can only be built on better education and training, instilling professional pride, establishing a code of conduct for senior managers that should enshrine the Declaration of Geneva that states "The health of my patient will be my first consideration”, and ensuring there is complete transparency in our hospital and community statistics. The NHS may not be a bottomless pit, but we cannot let financial cuts dictate the level of care that we give hospitalised patients, many of whom are so sick that they are entirely dependent on the staff for simple, basic needs. Unless we re-establish the foundations of care and compassion as guiding principles the public will never regain its faith in the NHS.

Competing interests: The views expressed are my own and not of any external organisation I work with.

12 February 2013
JS Bamrah
Consultant Psychiatrist
NHS Consultant
North Manchester General Hospital, Delaunays Road, Manchester M8 5RB