Feature Profile

All change on the road to better health care

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a2779 (Published 08 December 2008) Cite this as: BMJ 2008;337:a2779
  1. Nigel Hawkes, freelance journalist
  1. 1London
  1. nigel.hawkes1{at}btinternet.com

    The Healthcare Commission disappears next year, after only four years. Nigel Hawkes talks to its chairman, Ian Kennedy, about what it has achieved

    In Nikolai Gogol’s comedy The Government Inspector, the Lord Provost of a small town in the Russian backwoods conjures up a brilliant scene. “The first place any inspector worth his salt will want to have a gander at is the charity wing of the cottage hospital at the foot of the road yonder,” he tells the manager.

    “It’s a disgrace! Filthy hammocks hung from the rafters with even filthier patients hanging out of them roaring drunk, regaling all and sundry with bawdy songs from the trenches, may be your idea of a hygienic and recuperative environment, but it certainly isn’t mine, Sir!”

    The dread of dirt and squalor in public wards survives, even if the inspection methods have changed. The biggest splash made by the Healthcare Commission in its four year life was a damning report on Tonbridge and Maidstone NHS Trust, estimating that 90 patients had died in two outbreaks of Clostridium difficile infection. Among much that the commission has achieved, this single case with its graphic descriptions of unsatisfactory care will for most people be its lasting epitaph.

    For Ian Kennedy, who stands down as chairman when the commission is subsumed into the Care Quality Commission next April, that would be a pity. He never saw himself as a heavy handed enforcer and rejects what he calls the old fashioned view …

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