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Charlotte Leslie MP: We need a judge-led inquiry into the NHS - one which goes right to the top

Charlotte Leslie is the Member of Parliament for Bristol North West. Follow Charlotte on Twitter.

Screen shot 2013-06-24 at 10.58.42One of the most devastating things about the Morecambe Bay Scandal - the revelation that the Care Quality Commission (CQC) apparently buried a report raising alarms about the Furness General Hospital Maternity Unit - is that, for anyone who has spent a lot of time looking into how the top echelons of how the NHS elite work, it is diabolically shocking, but not nearly as surprising as it should be.

Indeed, one of my fears is that because the Morecambe Bay revelation is so sickening, so horrific, all focus will be attracted to investigations into just one hospital. It is imperative there is a police investigation into what went on at Morecambe, but mounting evidence also shows that Morecambe Bay and Mid Staffs are likely to be just symptoms of a worrying network of cover-up at the heart of the NHS.

Right from the very beginning of the Mid Staffs scandal, New Labour were at contorted pains to stress that this was a ‘one-off’; not representative of the health service and its target-culture reforms at all. That is why it is so important to squash what was going on at Morecambe – and, I suspect we will find, at other hospitals as well.

In March 2010, Professor Brian Jarman, who collects and analyses mortality data, wrote to the then Secretary of State, Andy Burnham, warning him that 25 Hospital Trusts had alarmingly high mortality rates. This was just before a general election. Burnham quickly passed to buck to, yes, the CQC, and conveniently, (and unsurprisingly, given what we now know) no more was said about it.  In 2008, Labour Ministers and the Department of Health determinedly buried three reports they had commissioned from independent international experts which were highly damning of the NHS ‘culture of fear’. (One of these was by Don Berwick, who is now being hailed as the man to sort out our NHS.) They were only revealed after a Freedom of Information Request in 2010, after a tip-off from a concerned medic.

We should not forget in all this that the scandal of Morecambe Bay was only revealed because a dedicated group of parents such as James Titcombe, who lost loved ones at the hospital, persisted against all the odds in mining out the buried truth. At no point in this shameful saga in the NHS has it been an official body which has revealed the terrible truth – it has always been passionate members of the public, or brave NHS Employees with principles and backbone, many of whom have lost their jobs - or, like Julie Bailey who revealed the Mid Staffs scandal, have suffered persecution for revealing the truth.

And doing the maths, calculating the number of other individuals with terrible stories to tell, it is highly likely that in the coming months other scandals will emerge – not as isolated incidents, or unrelated ‘one-offs’, but as symptoms of a system that promotes managerial failure, and operates a cosy network of unaccountable, highly paid individuals watching each others’ backs.

The same old names keep emerging. At the heart of it is David Nicholson, now promoted from overseeing Mid Staff’s darkest days to Chief Executive of NHS England, who has been splitting his time between London and Birmingham.

Around him there is an oddly Birmingham-centric group. His wife is Chief Executive of Birmingham Children’s Hospital Trust, and has enjoyed a cataclysmic rise thought the NHS Managerial ranks.

Dierdre Kelly, on the CQC Board at the time of the Morecambe Bay cover-up is Professor of Paediactric Hepatology at this same hospital. (It was Birmingham University that commissioned a report to discredit mortality data on Mid Staffs that Harvard University said it would have been ‘irresponsible’ not to aggressively act upon.)

Cynthia Bower, the Chief Executive of the CQC at the time had been promoted to that position from being David Nicholson’s successor as Chief Executive of the Strategic Health Authority overseeing Mid Staffs.

Then there’s Sir Hugh Taylor. He is Chief Executive of the Guys and St. Thomas’ Trust, where Guys children’s cardiac unit is listed as having mortality data on a par with Leeds, higher than Leicester or Brompton which were ear-marked for closure - but was mysteriously not identified as having any difficulties and not identified for closure.

Sir Hugh worked closely with Sir David as Permanent Secretary in the Department of Health, just as Sir David had come from his post at Mid Staffs, via NHS London, to be Chief Executive of the NHS.

There is also Barbara Hakin – who faces possible investigation for stifling the whistleblower Gary Walker in North Lincolnshire Trust. David Nicholson recently appointed her as his deputy in NHS England, without letting Jeremy Hunt know.

Such a stream of coincidences does all seem a bit odd.  What is almost as odd is the incredible amnesia that overcomes many of these individuals whenever an important question is asked. No one can ‘recall’ anything.  No one can ‘recall’ smothering the Morecambe Bay report – but someone must have done, since it never came out.  We also now know that the normal routes of investigation, like FOI, are limited. If the piece of information is uncomfortable, it now seems likely that someone will say ‘read my lips’ and suppress its release.

That is why three things need to happen if we really want to change this. Firstly, David Nicholson, the man at the centre of the web, who was in the position of authority when this culture grew up, should be sacked.

Second, a major inquiry, led by a judge, should be held into what has happened; it should reveal the relationships and interrelationships between NHS managers, Department of Health Officials, Secretaries of State and Ministers at the time. It should look at how appointments were made, and where interests of individuals lay, who know what and when (for example, why did Andy Burnham ignore 81 requests to look into Mid Staffs? How could it have been possible for David Nicholson not to know about mortality data when he was in charge of Mid Staffs, as he claims? Who instigated the Birmingham University Report to squash the data when they did find out about it?). This is the only way to get to the bottom of this almost mafia-like web of self-interest.

Finally, the root cause of the rot should be tackled. It was Labour who decided to take over the inspection of hospitals and pull it ‘in-house’ into Government where it could be controlled better, and bad news eliminated from the shiny new Labour icon of the NHS. By ultimately having control over inspections and bad news stories, it made it possible to construct the religion of the NHS, and label anyone making a constructive criticism or revealing bad practice a heretic.  The result has been that behind this gleaming facade of good PR, our beloved NHS has been allowed to rot from the inside, and patients have needlessly died.

Jeremy Hunt is rightly determined to restore transparency, accountability and high quality to the NHS. If he can devise a system which makes the inspection regime genuinely independent of government, and driven by the best of professional knowledge, expertise and commitment to patient care, we might stand a chance of reversing a truly diabolical decade in the history of the NHS. 


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