The truth is that the process takes time, and there are still examples of where candour is lacking. Allegations have recently surfaced in the press, the substance of which makes it appear that that reporting has not happened. There is much work to do, but the signal has gone out loud and clear that if people are open, transparent and honest from the start when something goes wrong, that should not be punished but should be recognised as a way of improving how we look after
patients, in the same way as profound changes in the airline industry have made our aeroplanes much safer. We need that change in the NHS.
We also now recognise that however important ministerial objectives and national targets may be, NHS organisations should never prioritise them at the expense of dignity and respect for patients. We now know that the best way to deal with poor care is for people to speak out about it, whether they are a health care assistant, doctor, nurse or even Secretary of State, and that that should never be confused with “running down the NHS”. We also know that failing to speak out about poor care, or to support those who do, is a betrayal not just of patients but of the kindness and humanity of more than 1 million dedicated NHS staff, thousands of whom pledged themselves to compassionate care just two days ago on NHS change day.
What has happened in the past year? Robert Francis asked why the system effectively failed to detect or deal with the problems at Mid Staffs for a shocking total of four years. We have re-established the CQC as a rigorous and independent inspectorate, with three powerful new chief inspectors appointed to speak truth to power. The Keogh review inspected 14 hospitals last summer, and the new chief inspector of hospitals, Professor Sir Mike Richards, has already completed inspections of a further 18 trusts, with 19 more inspections taking place now. As a direct result, 14 trusts are now in special measures—a record in NHS history—and, thankfully, long-standing problems are finally being tackled.
On staffing, the inquiry found
“an unacceptable delay in addressing the issue of shortage of skilled nursing staff.”
The latest figures show that not only are there 3,500 more nurses on our hospital wards since the Francis report, in just a year, but we now have more nurses, midwives and health visitors in the NHS than ever in its history. From this summer, all hospitals will publish their staffing levels monthly, on a ward by ward basis, so that shortfalls are speedily identified.
Robert Francis identified a closed, defensive and secretive culture at Mid Staffs. In response, we have ended gagging clauses and we are making it a criminal offence for trusts to publish or provide specified information that is false or misleading. We are also placing a statutory duty of candour on organisations so that they are required to be honest with patients about poor care, and professional regulators are consulting on a new professional duty of candour that provides protection for staff against being struck off if they are open about the problems they see. I believe that will create one of the most transparent and open health care systems in the world.