Intended for healthcare professionals


Head of Healthcare Commission excised figures on excess deaths from Mid Staffordshire report

BMJ 2011; 342 doi: (Published 06 May 2011) Cite this as: BMJ 2011;342:d2900
  1. Clare Dyer
  1. 1BMJ

The last chairman of the Healthcare Commission removed figures showing that Stafford Hospital had between 400 and 1200 excess deaths between 2005 and 2008 from the commission’s final report into the hospital’s “appalling” standards of care, against the wishes of its author.

Ian Kennedy, who chaired the commission from its beginning until it was abolished in 2009, told the public inquiry into failings at Mid Staffordshire NHS Foundation Trust that he decided to excise the figures because people did not understand the statistical concept of “excess deaths.”

He said he took the action because of his experience a decade ago chairing the inquiry into children’s heart surgery at Bristol Royal Infirmary and denied that he had come under pressure from the Department of Health for England or anyone else. Shortly after the damning report was published, in March 2009 (BMJ 2009;338:b1141, doi:10.1136/bmj.b1141), the figures were leaked.

Sir Ian told the inquiry, chaired by Robert Francis QC: “Mention of excess deaths was difficult for anyone but statisticians to grasp. In Bristol it became cruel to parents, relatives, and carers because they were keen to know whether it was their child who had been one of the 31 [excess deaths]. “We could only say we didn’t know.”

He also said he wanted to prevent arguments over statistics in the Stafford case. “I wanted to make sure we didn’t get into that discussion but rightly say the care was appalling,” he told the inquiry.

But he said that the NHS had become too politicised and that when scandals arose the Department of Health seemed more concerned about how to “handle” the story than to make changes.

“My experience of the Department of Health is they have a tendency to shoot the messenger rather than embrace changes that need to be made. Their first priority is to ‘handle’ the situation rather than consider and implement change. Those were the realities we had to work with,” he said.

Sir Ian revealed that the health department had asked him, just before the 2005 election, to delay until after the election an announcement that Northwick Park Hospital would be put into special measures after nine women in two years died in childbirth. “I said, ‘[You could do that] if you’re prepared to handle Jeremy Paxman [the presenter of the BBC’s Newsnight television programme] tomorrow when someone dies,’ Sir Ian recalled. “And there was a sharp intake of breath, and then we got on doing what was in the interests of the hundred or so women who were expecting to deliver their babies every week in Northwick Park.”

He called for one overarching regulator, which could have subentities, to regulate the healthcare system as a whole in England. “You want a way of tracking what happens between the community, the GP, the hospital, and all the way around that system.” The more regulators there were, he said, “the more you’ll have territorial disputes and the more stuff will fall through the cracks.”


Cite this as: BMJ 2011;342:d2900