Jeremy Hunt: Addressing the silent scandal of our NHS
Jeremy Hunt MP is Secretary of State for Health. Follow Jeremy on Twitter.
The shocking failures at Mid-Staffs and Morecambe Bay hospitals show the terrible consequences of lax safety and a culture of secrecy - two linked and mutually reinforcing problems. In a speech today at University College London Hospital, I am setting out how we break the cycle. Those of us who passionately believe in the values of the NHS and the skill of its staff are often best-placed to speak up where we know it can do better for its vulnerable patients.
The first duty of every hospital should be to do the sick no harm. The NHS’ record on patient safety is strong by international comparison but is it as good as it should be? Julie Bailey, James Titcombe and other brave campaigners who have lost their loved ones know the answer to that question is unequivocally "No."
In too many corners of our NHS, we have become so numbed to the inevitability of patient harm that we accept the unacceptable. Labour’s obsession with top-down targets and process requirements fostered a culture which too often neglected the individual and concealed failure. Only by ensuring that every person is treated as though they were our own family member will be realise the ambition of zero harm. And only by shining a light on poor performance will we confront negligence and neglect.
Over time, grim fatalism about statistics has blunted the anger we should feel about every single person we let down. Figures show 0.4% of people treated suffered unnecessary harm and 0.003% ended with a person’s death. This is a tiny proportion, but still amounts to nearly half a million people harmed unnecessarily every year, 3000 of whom lost their lives. That’s more than eight patients dying needlessly every single day - deaths occurring not despite our best efforts, but as a direct result of our failures.
In all there were 326 so-called ‘never events’ reported in 2011/12. These are incidents of such shocking negligence that they should never happen. And yet on this data, every other day we leave a foreign object inside a patient, every week we operate on the wrong part of someone’s body, and every fortnight we insert the wrong implant.
This is the silent scandal of our NHS. As James Titcombe, who lost his 9 day old son Joshua at Furness General Hospital, said this week: "We need it to change. We need that culture to change. Patient safety should be the number one priority." World-renowned health safety expert, Professor Don Berwick, will be reporting to government soon on how to drive cultural change across the system. He understands, as I do, what it means for everyone from chair to cleaner to be focused on where improvements can be made.
The overwhelming majority of medical staff already shares this belief. Exceptional leaders within our NHS are tackling the problem head on, driving a culture of openness and honesty that experts know to be vital. But a number of current initiatives will drive this into every corner of the system.
Our new Duty of Candour will make it a criminal offense to provide false data. Publishing performance data will also have a huge impact and I welcome the support of the Royal College of Surgeons on the publication of surgical outcomes data, following the dramatic improvements resulting from publishing overall success rates in heart surgery.
Also critical is strengthening the doctor/patient relationship. We should return to having the name of the responsible consultant and responsible nurse written above every patient’s bed. We will be working with the professions, regulators and employers to see how this can be taken forward across the NHS.
Finally, we need to ensure a system of oversight that gives proper weight to patient safety issues. That Morecambe Bay was registered ‘without conditions’ in April 2010 is a disgrace. Our new Chief Inspector of Hospitals, Professor Sir Mike Richards, will deliver deep dive inspections providing expert peer-review insight on every hospital, with patient safety being one of the five key aspects he will consider.
Furthermore, I have asked Sir Mike to publish a six- monthly statement on the state of patient safety in the NHS. As a culture of transparency takes hold, the reported number of safety breaches is likely to increase rather than decrease. Sir Mike's report will give us a vital independent perspective as to whether the actual likelihood of a harm-free experience is increasing or declining.
These changes will be underpinned by technological transformation to deliver a paperless NHS by 2018. This transparency revolution will provide electronic medical records, shared in an instant between GPs, hospitals and departments.
The challenges are huge and the system is rising to them. On broadly the same budget, we are doing 400,000 more operations than at the time of the last election. But we were also elected to make the NHS safer and more compassionate. That’s what we promised in 2010. That’s what we’re delivering.