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NHS watchdog in 'cover-up' claim over Morecambe Bay deaths

The NHS watchdog is once again under the spotlight after allegations were made in an independent report that its former bosses covered up a failure to investigate a hospital where mothers and babies died through neglect.

The Care Quality Commission (CQC) is facing accusations that it deliberately suppressed an internal review that highlighted weaknesses in its inspections of University Hospitals of Morecambe Bay Trust.

A report, published today but leaked earlier to the Daily Telegraph and the BBC, found that the health watchdog’s managers were so concerned about how damning the review would be that they ordered it should never be made public and that it should be destroyed.

The report, by management consultants Grant Thornton, was ordered by David Behan, who became chief executive of the CQC last summer.

It suggests that senior managers at the CQC were more concerned about protecting the organisation’s reputation than about patient care when they ordered the review to be suppressed.

Concerns about the maternity unit at Furness General Hospital in Cumbria came to light in 2008, but the CQC gave the Morecambe Bay trust the all-clear in 2010.

But when a review into maternity care was ordered the following year it was so damning it was suppressed. The report reveals how a CQC official was ordered last year to destroy the review.

In accounts of discussions between senior managers about what to do with the findings, one senior manager said: “Are you kidding me? This can never be in a public domain nor subject to FOI [Freedom of information request]. Read my lips.”

An official who carried out the review was asked to delete it and write a different review without criticism of the CQC.

The report said he felt he was “being put in a very difficult position” and was asked to do something that was “clearly wrong”.

The report says the man “said that he felt very uncomfortable about the apparent weight that was being given in the meeting to the potential media impact and reputation damage his report findings might cause CQC. His view was that the focus instead should have been on patient safety and the protection of service users”.

University Hospitals of Morecambe Bay Trust was warned in 2011 that it would be closed down without major changes.

On Tuesday night a spokesman for the CQC said the organisation’s culture was changing, saying: “We let people down, and we apologise for that.

“This report reveals just how poor the CQC oversight of University Hospitals Morecambe Bay was in 2010.

“This is not the way things should have happened. It is not the way things will happen in the future. We will use the report to inform the changes we are making to improve the way we work and the way we are run.

“There is no evidence of a systematic cover-up or of any collusion between CQC and the Public Health Service Ombudsman, but the example of how an internal report was dealt with is evidence of a failure of leadership within CQC and a dysfunctional relationship between the executive and the board.

“There is evidence of a defensive, reactive and insular culture that resulted in behaviour that should never have happened.”

CQC’s chair David Prior said: “CQC’s chief executive, David Behan, was absolutely right to commission an independent report into CQC’s handling of the registration and subsequent monitoring of UHMB - and absolutely right to publish it in full.

“The publication draws a line in the sand for us. What happened in the past was wholly unacceptable. The report confirms our view that at a senior level the organisation was dysfunctional. The board and the senior executive team have been radically changed.”

Tim Farron, MP for South Lakes, was so concerned about the allegations in the report that he has asked the Speaker of the House of Commons for an urgent question to be tabled.

Mr Farron said: “These allegations are shocking and if true highlight massive failures in the system that is supposed to keep patients safe.

“I am asking for the secretary of state to come to House of Commons and account for what happened, tell us who is responsible and what he is going to do to hold them to account.

“I have tried to support the families affected by this tragedy for years, but this report shows that collusion could have happened at the highest level - heads must roll for this.”

A spokesperson for the NHS Confederation said the report by Grant Thornton was “another key sign” of the problems associated with the previous NHS inspection regime. It is not acceptable that the CQC, which should have been the body that acted on behalf of the public, failed in its duties.

“The report indicates why we  welcome the policy proposals issued by the secretary of state to create a new clearer role of chief inspector of hospitals, a legal duty of candour for the NHS and the imminent work by the CQC to improve their inspection regime.

“We fully welcome and support the Government’s commitment to an independent inquiry into the failings of the maternity services at University Hospitals Morecambe Bay NHS Trust and the wider lessons that should be drawn from the trust’s problems.”

Discussion

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Readers' comments (11)

  • tinkerbell

    thank God for a few good honest wo/men who uncover these cover ups.

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  • I echo Tink's post, amazing that such a maverick attitude can exist in these organisations at such a high level.

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  • tinkerbell

    Cynthia Bower, bless her, 1.3 million pension. CQC say they couldn't have spoken up because they would have been sued.

    There were people in the CQC who knew about the report but they left, they've all left now.

    Rotten to the core.

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  • tinkerbell

    I am in total agreement with this poster on another site.


    "Does the CQC need a radical overhaul? Does that need to be seen through? Yes,"

    Should those responsible for "covering-up" the failings of the CQC to investigate the deaths of patients including babies be named, shamed and prosecuted? YES.

    Should the "whistleblower" (Kay Sheldon) who raised concerns but was (yet again) ignored by the management of the CQC be rewarded for exposing the "cover-up" be rewarded for her courage? YES

    Should an organisation deemed by its own new boss to be "not fit for purpose" be scrapped immediately in the interests of patient safety? YES

    Should there be urgent legislation passed to bring criminal prosecutions against any individual, or organisation which ignores or covers-up poor-care or mistreatment of patients in the NHS or any other public (or private?) service? YES

    It's time for the "totally dysfunctional" CQC management team to be held accountable for their shocking and immoral criminal behaviour!

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  • Currently watching Paxman taking Behan apart on Newsnight. Terrible that it takes a news programme to challenge these incompetents. Transparency, my *rse!

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  • tinkerbell

    Jeremy Paxman asking the burning question 'was there corruption between the CQC and DH?'

    Heather Wood healthcare commission investigator says 'not surprised there's been a cover up'. Go girl.

    Are the names going to be published in this alleged cover up? Go Jeremy!

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  • If the CQC falsify their findings or cover them up then what is the point of them? What is the point of having any regulatory body who is incapable of regulating.
    Why can't CEOs, Directors of Medicine and Directors of Nursing go round their hospitals, see what is going on, speak to their staff and regulate themselves?

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  • If a nurse or doctor was found guilty of covering up anything that affected patient care they would be out on their earole.
    Why are we protecting these so called 'regulators', do any of them actually do anything.

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  • michael stone

    Today's Times, page 7, in a 2-page spread about the CQC/Morecombe Bay, has got a 'Q&A' section.

    Question 1 is:

    'Who regulates the NHS?'

    The answer it gives:

    'Regulation of the health service is a shambles. There is no shortage of regulatory bodies and more are being created. Their responsibilities often overlap and they usually work without reference to each other. Raising a complaint against a doctor or a hospital can take years'

    It moves on to:

    What do they all do?

    Why has this been allowed to happen?

    Who is in charge of regulation?

    Is the CQC's fear of breaching data protection laws justified?

    Anonymous | 20-Jun-2013 1:46 pm

    That might be true, but as the Times helpfully points out in one of the answers:

    'Staff are rewarded for getting on with their job without fuss, which discourages challenging the way things are done.'

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  • michael stone

    tinkerbell | 19-Jun-2013 10:51 pm

    'Are the names going to be published in this alleged cover up?'

    They might have been by now - I've not checked. But when I left home at about 1-30, I think Radio 4 was telling me that two goverment ministers had said 'I expect the names to be published later today' and 'the names could be published within an hour' - but the CQC was still 'looking into the legal aspects'. The chap who regulates data protection, seemed to have said (this morning) he saw no reason why the names could not be published in this type of situation.

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  • michael stone

    Amid the ongoing personal tragedies of Morecombe Bay, and the ‘call for blood’, there is something else here which will probably be almost ignored: yet this is fundamental, in terms of ongoing institutional behaviour.

    The basic position (as claimed by CQC leaders) of the CQC on Wednesday, was (my words) “ We were faced with either not publishing the report at all, or publishing it without the names: we can’t publish the names, because of data protection issues, and we have taken expert legal advice about this”.

    After the furore, by Thursday mid-afternoon, “ The CQC has sought further legal advice, and we have now decided to publish the names”.

    THE LAW DID NOT CHANGE BETWEEN WEDNESDAY AND THURSDAY – and ‘expert legal advice’ HAD BEEN QUOTED for the ‘we can’t publish the names, because of the law’ original decision.

    Trusts, etc, often use ‘we have got expert legal advice on this’: beyond being ‘a defence mechanism to cover us if we get it wrong’, this ‘expert legal advice’ is merely an opinion – IT CANNOT BE CLAIMED TO BE ‘RIGHT’. Lots of complex legal questions, are sent to panels of judges for rulings – sometimes 5 judges will rule 3-2 about something, and that isn’t very persuasive about ‘laws being well-understood’, is it ?

    The CQC is now ‘consulting more expert lawyers’, this time about ‘can we bring some sort of ‘action under employment law’ against various people’ – see above, all the CQC will get is an expert opinion.

    Theresa May, invariably says ‘Our lawyers are confident we should win this case’ (my phrase) and even so, the courts often rule ‘against her’.

    The Director of Public Prosecutions has issued some guidance, which means that relatives are in practice no longer prosecuted for assisting a suicide if their motivation appears to be ‘compassion’: yet legally, it is far from clear that ‘acting out of compassion’ is a defence (and for professionals, assisting a suicide out of compassion, has been explicitly stated as not being a defence). Why has the DPP issued that guidance ? Might it be that there is a concern that the public (juries) are out-of-step with the law, and that a prosecution might fall if the jury considered ‘assistance out of compassion’ should not be an offence, even if told by a judge that it was (those old enough, might recall the Clive Ponting case {I think his first name was Clive – not certain}).

    Why does this matter ? Because firstly, ‘expert legal opinion’ isn’t like expert scientific opinion: ask a chemist ‘What would happen, if I poured fuming nitric acid into a beaker full of ethanol ?’ and ‘Nothing good if you are doing the pouring and standing next to the beaker’ is a pretty reliable answer, whereas many answers from legal experts, are far less certain.

    Secondly, lawyers ‘take sides’ – they represent their own clients. And, they will, I suspect, come up with arguments to support the position of their client. Throw in ‘and are often very defensive’ and ‘expert legal advice’ is often a major impediment to ‘getting sensible things done, and sensible improvements made’.

    Even more fundamentally, when things like Morecombe Bay or this non-published report happen, everyone ‘on the outside’ sees very clearly ‘that in common sense and moral terms, this is absurd and unacceptable’ but the people on the inside will tell you ‘our hands are tied for legal reasons’. I’m listening at the moment to Hunt on Radio 4, and you can be certain that his ‘desire for openness and transparency’ re the CQC, will be much ‘more nuanced’ if the issue is something the DH isn’t revealing, or the Cabinet wants to withhold, that other people want to see. Etc.

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