Please God that health care does not get worse than it was in Mid Staffordshire NHS Trust. The Secretary of State has accepted the damning findings and recommendations of the independent report but still refuses to hold a full public enquiry. What is he scared off? A brief study of the bloated soviet-style bureaucracy that controls the NHS may provide an answer. In the NHS, there are dozens of interlinking commissariats which report to and on each other and they are run by an even larger number of commissars. The commissars all have portentous and similar sounding titles and move frequently between the various commissariats. Trying to ascertain who is responsible for what is challenging and often, just when you think you are there, the commissariats will be renamed and some poorly performing commissars, who should be sent off to the Gulag, are promoted out of harm’s way.
You may not have heard of the Care Quality Commission. It is an amalgamated quangopoly, which started work on All Fools’ Day 2009. It ate up the Health Care Commission, the Commission for Social Care Inspection and the Mental Health Act Commission. You should have heard of the Health Care Commission. They are the ones who published the initial report on Stafford. The public did not and still does not understand how so many unexpected deaths went unnoticed and unreported for so long. To improve our understanding, we need still more information about commissariat structure.
Stafford hospital was under the governance of the West Midlands Strategic Health Authority until February 2008. The West Midlands Strategic Health Authority (SHA) had all the mortality data for West Stafford at the same time as the Healthcare Commission but, unlike the Healthcare Commission, West Midlands SHA did not understand the significance of the data. They thought the unexpectedly high death rate was merely a statistical aberration caused by faulty computer coding. So they ignored it. As was said in the House of Commons, the SHA “had the wool pulled over its eyes.”
The Care Quality Commission (CGC) is charged with monitoring and maintaining standards of care in the NHS. Commissar Cynthia Bower was the first Chief Executive at £200,000 a year. But just a minute. Previously, she was the Chief Executive of West Midlands Strategic Health Authority and so must surely take some responsibility for the Mid Staffordshire debacle. Or is that unfair? Perhaps one should not hold Cynthia Bower responsible. It takes several years for hospital services to become as bad as they were in Staffordshire. Cynthia Bower only took over that position in 2005. Some of the blame must surely fall on her predecessor, who was Comrade David Nicholson. He has moved on from West Midlands Strategic Health Authority too. He is now Sir David Nicholson, and is Chief Executive of the National Health Service.
Onwards and upwards, comrades.