There is not a squeak of any measure to prevent the bullying that was so prevalent at Mid Staffordshire, says Roger Kline
“We must ensure,” said health secretary Jeremy Hunt in January, “that the compassion that led nurses and healthcare assistants into the profession does not get ground out of them.”
Four weeks later, the report on the Mid Staffordshire inquiry by Robert Francis QC showed what happens when excessive workloads, diluted skill mix, bullying and the sacrifice of patient care for financial targets grind compassion away.
Four weeks after that, the 2012 NHS staff survey showed that one in four NHS staff were bullied at work last year and even more fear the consequences of raising concerns. It’s no wonder that the number of reported incidents fell by 100,000 last year just as the NHS was facing the perfect storm of rising demand and funding cuts.
Another four weeks later, the health secretary published the government’s response to the Francis report and then, on April Fool’s Day, ushered in the chaos of the Health and Social Care Act. The one piece of good news was the new duty of candour, which should help ensure trusts are more honest with patients and staff.
“Almost no one emerged well from Mid Staffs other than the courageous patients’ and relatives’ group led by Cure the NHS founder Julie Bailey”
Yet almost none of the key causes of the Mid Staffordshire scandal identified by Mr Francis have been tackled. There is no regulation of healthcare assistants, even though most trust chief executives support this; it beggars belief that the person treating your cat is better regulated than the person caring for your mum or dad. There is not a squeak of any measure to prevent the bullying so prevalent at Mid Staffordshire and elsewhere. There will be no effective regulation of poor general managers. Nurse managers and medical leaders who behave badly may have their careers terminated but poor leaders who are not clinicians remain virtually unregulated.
To rub salt into the wound, nurses are singled out as so lacking in compassion they must spend a year as healthcare assistants (unregulated) to learn compassion.
After the Bristol Royal Infirmary baby deaths inquiry a decade ago, we were told such a scandal must never happen again. It did, in Mid Staffordshire. I recommend you read the summary recommendations of the 2001 Bristol inquiry; they are shorter but otherwise remarkably similar to those of Mr Francis 12 years later.
What is worse is that, thanks to Professor Brian Jarman, the trust and region were warned something appeared to be seriously wrong, but they ignored the warnings. NHS chief executive Sir David Nicholson, who recently announced he will retire in March 2014, once led the regional NHS and admits he “failed to make the care and safety of patients [his] first concern”. Between Mr Hunt’s disastrous upheaval in NHS structures and the impact of Sir David’s funding cuts, we have a certain recipe for future scandals.
Almost no one emerged well from Mid Staffs other than the courageous patients’ and relatives’ group led by Cure the NHS founder Julie Bailey.
The Nursing Times Speak Out Safely campaign encourages staff to raise the alarm and seeks to protect them when they do so. It is a scandal that many staff still rightly fear the consequences of whistleblowing. Every week, along with colleagues in Patients First, I hear examples of NHS staff from all walks of life who have raised concerns and then paid a heavy price. If Mr Hunt is serious about stopping compassion being “ground out” of NHS staff, then protecting those who blow the whistle before it happens should be a top priority.
● Sign the Speak Out Safely petition at tinyurl.com/NTSOS-petition
Roger Kline is a director of Patients First, a visiting research fellow at Middlesex University, and the author of The Duty of Care, a free download from www.publicworld.org/projects/duty