Health Minister Reacts to Francis Report

dan_poulter17:05 Wednesday 6th February 2013
Drive BBC Radio Cambridgeshire

[C]HRIS MANN: A public inquiry into “appalling failings” within the Mid-Staffordshire NHS Trust, believed to have contributed to the deaths of at least 400 patients, has called for a zero tolerance approach to poor standards of NHS care in England. In his second highly critical report, Robert Francis describes a failure of NHS systems at every level. (TAPE)
ROBERT FRANCIS QC: This is a story of appalling and unnecessary suffering of hundreds of people. They were failed by a system which ignored the warning signs, and put corporate self interest and cost control ahead of patients and their safety. I have today made 290 recommendations, designed to change this culture, and make sure that patients come first. (LIVE)
CHRIS MANN: And later in the Commons David Cameron offered an apology. (TAPE)
DAVID CAMERON: This public inquiry not only repeats earlier findings but it also shows these wider systemic failures. So I’d like to go further as Prime Minister, and apologise to the families of all those who suffered, for the way that the system allowed this horrific abuse to go unchecked and unchallenged for so long. On behalf of the Government and indeed our country, I’m truly sorry. (LIVE)
CHRIS MANN: But all this comes too late for Christine Dalziel. Her 64 year old husband George died at the hospital after surgery for bowel cancer. She says he was so scared of the nurse, he didn’t ask for help. (TAPE)
CHRISTINE DALZIEL: He was frightened to drink. He was frightened that he would actually mess the bed again, because she was so nasty with him, and he had to call her. They were just completely left on their own all the time. And if they rang the bell, it was very rare the nurses or anybody came to see them. (LIVE)
CHRIS MANN: Well earlier I got reaction to the report from the Health Minister Dr Dan Poulter, who’s also the MP for Central Suffolk and North Ipswich. (TAPE)
DAN POULTER: Well today’s a very humbling day for anybody who, like me, I’m a doctor, who works in or who cares about our NHS. It’s a humbling day for frontline staff, and for everybody. And how we got to the position where a hospital could potentially through bad care led to the death of up to a thousand people, and not provided basic human dignity in care, is something that I think all of us will find incredibly distressing and completely unacceptable. And what we now need to do is look at the many recommendations that have been made out of the Francis Report, to make sure the best we can that this never happens again in the future.
CHRIS MANN: Dr Poulter, you worked in the NHS. How do you imagine that there have been so many failures, as he puts it, at every level?
DAN POULTER: Well today there was the Report. It was very clearly acknowledged that there were systemic failures at Mid-Staffordshire. There were failures in professionalism from doctors and nurses. But more importantly and more crucially, there was a failure, a cultural failure at the Hospital, that the focus was not on patients sometimes, it was on ticking boxes, targets and bureaucratic processes. And nothing is ever more important in a hospital than looking after patients. And what came out of the exchanges in the House of Commons and came out of the Report was very clearly we need to deal with the fact that that culture is very often set by senior managers, by the Board of Trust. And we have to be able to hold those people to account for the culture they set in hospitals.
CHRIS MANN: Well the Prime Minister’s led the way in saying sorry for the scandal today. But for those families of the victims, they say that’s not enough. They want to hear about resignations, about sackings. When is that news going to come?
DAN POULTER: Well I think the Prime Minister was right to make the point, to put upon record an apology from the Government, although it happened when the Prime Minister was .. the current government was still in opposition. He’s nevertheless right. The Government acknowledges and does apologise and puts on the record an apology for what’s happened. And it was the Prime Minister who actually instigated this inquiry. And it’s important I think and certainly my own experience as a doctor is that it’s very rarely one individual who is responsible when things go very very badly wrong. And it’s often many people, and it was that systemic failure at the hospital level, failure of frontline professionalism, through to the management culture that was there that was largely to blame. And it’s about trying to draw general lessons, and to make sure we take things forward in a way that stops this from happening again.
CHRIS MANN: You’ve already made that point. I’ve asked you when are there going to be resignations? When are there going to be sackings? That’s what the victims’ families are calling for.
DAN POULTER: A lot of the people who were at Mid-Staffordshire at the time have now left the Trust, and have already moved on. And I know that’s not necessarily .. you know, there’ll be disappointment from some of the relatives and families about that. But the bigger question there is how do we stop bad managers from being recycled elsewhere.
CHRIS MANN: We’ll come to that in a moment, but what about those that are still there? Will they be forced to resign? Will people at the top in the NHS, who should have been keeping an eye on this, will they be forced to resign too? And will others face prosecution?
DAN POULTER: Well the Prime Minister made it clear that .. you know, being very non-political about it, that even though the Shadow Secretary of State Andy Burnham was I think involved as Secretary of State around the time of the scandals, it’s not about blaming one individual. It was a systemic failure. And a lot of the individuals at a local level have now moved on. And, you know, I think it’s important ..
CHRIS MANN: So let’s get this right. Are you saying there’s going to be no resignations. that no-one’s going to be fired, that no-one’s going to be prosecuted?
DAN POULTER: Well I mean the person that you might think is most responsible which is the Chief Executive of the Trust. They’re now gone. They’ve moved on. So there’s nobody to fire in that respect.
CHRIS MANN: But Robert Francis QC describes a failure of NHS systems at every level. Surely someone has to take the blame for that? It can’t just be one person. He said it’s at every level.
DAN POULTER: Well the main focus of his report was particularly on the failings within the management and the Board of the local Trust. Almost, I think as far as I’m aware, everybody has now moved on, or is no longer working in the Health Service in many cases or is no longer involved. And that, you know I know that’s not going to necessarily be exactly the answer that some of the relatives will want, but the longer term issue there is how do we deal with failing management longer term. We can’t allow bad managers ever to be recycled elsewhere in the system. Robert Francis made the point very clearly that this is a systemic failure across the processes and across the way that things were run in the NHS that allowed, for example, … we have very obvious feedback from the Trust, from staff. Frontline staff they’re saying that the frontline staff, only a quarter of them would heve recommended Mid-Staffs the place they’d want their own relatives to be treated.
CHRIS MANN: One final question. Could it happen today? Could it be happening today?
DAN POULTER: Well we certainly hope not. But what we have to make sure is that whilst the majority of the NHS provides high quality care on a day to day basis, and all of the people .. most of the people who work for the NHS are driven by the very best motives, that there may well be isolated pockets of bad care.
CHRIS MANN: So that’s a yes is it? It could be happening today
DAN POULTER: What we have to do is take this report, look at its recommendations, and come forward with robust proposals to make sure this doesn’t happen again.
CHRIS MANN: Is that a yes or a no to the question, could it be happening today?
DAN POULTER: Well what the Prime Minister said today ..
CHRIS MANN: No I’m asking you Dr Poulter as the Health Minister. Could it be happening today.
DAN POULTER: I’m fairly .. I’m fairly .. I’m fairly .. I’m pretty confident that in the majority of the NHS we’ve now improved the inspection regimes, the Care Quality Commission, to make sure it doesn’t happen. Every day, in every hospital, no matter how well that hospital looks after patients in generality, one patient could always be not treated as well as we’d like. The point is, and I know that as a doctor, I know that there are colleagues of mine who are fantastic doctors occasionally get it wrong. So we know that that’s not really a very sensible question to ask me.
CHRIS MANN: Dr Poulter, we have to leave it there.
DAN POULTER: The point is how we learn from this.
CHRIS MANN: I’ll leave the audience to judge for themselves whether it was a sensible question or not to answer.
DAN POULTER: The point is how we learn from mistakes from individual doctors and frontline staff.
CHRIS MANN: Simple question. Could it be happening to us now on this level.
DAN POULTER: Any doctors now .. today, or any nurse, could make a mistake. And we all know that.
CHRIS MANN: We’re not talking about an individual mistake. We’re talking about what you described as a systemic failure. Dr Poulter ..
DAN POULTER: I don’t think there’s another Mid-Staffs actually in the system at the moment.
CHRIS MANN: Ok. That’s the answer to the question I was looking for. Thank you very much.

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