A public inquiry began yesterday into failings at an NHS hospital criticised for routinely neglecting patients and providing appalling standards of care.The inquiry, announced by Health Secretary Andrew Lansley in June, aims to build on the work of an earlier independent investigation into the care provided by Mid Staffordshire NHS Foundation Trust between 2005 and 2009.

The latest inquiry, being held at the offices of Stafford Borough Council, began with an opening statement by its chairman, Robert Francis QC.

Mr Francis, who begins hearing expert evidence next week, also chaired the previous independent inquiry into failings at Stafford Hospital.

That inquiry, which published its findings last February, identified systemic failings at the hospital, where managers were preoccupied with cost cutting and labour Government targets.

Launched after a Healthcare Commission report published last year, the previous inquiry revealed a catalogue of failings at the trust, which also runs Cannock Chase Hospital.

Appalling standards put patients at risk and between 400 and 1,200 more people died than would have been expected in a three-year period from 2005 to 2008.

The previous Labour government rejected calls for a full public inquiry into events at the hospital, instead ordering the independent inquiry.

Mr Lansley said in June that the new inquiry would be held in public in order to combat ”a culture of secrecy” and restore public confidence.

When he announced the latest inquiry, Mr Lansley told Parliament: ”We know only too well what happened at Mid Staffordshire, in all its harrowing detail, and the failings of the trust itself.

”But, we are still little closer to understanding how it was allowed to happen by the wider system.

”When this inquiry has completed its work and I return to this House to present its report, I am confident that we will, for the first time in this tragic saga, be able to discuss conclusions, rather than questions.”

In a statement issued last month, Mr Francis said he was committed to carrying out an independent, evidence-based and transparent process, to identify the broader lessons to be drawn for the wider health system.

Mr Francis said: ”I believe this is an important opportunity to contribute to the improvement of standards in the NHS and the protection of the public, building on the lessons from Mid Staffordshire.

”My aim is that, through an open, candid and reflective consideration of the events at Mid Staffordshire, the inquiry will be able to make recommendations which will assist to shape the regulatory, supervisory and commissioning structures of the NHS of the future.”

From: http://www.telegraph.co.uk/Mid-Staffordshire-hospitals-inquiry-to-hear-of-failings-at-Trust

A senior judge has delivered a stinging rebuke to the Department of Health over its treatment of a former head of an NHS trust that experienced the worst superbug outbreak in memory.
Lord Justice Sedley gave his ruling as the Court of Appeal awarded more than £190,000 in damages to Rose Gibb, former chief executive of the Maidstone and Tunbridge Wells NHS Trust in Kent, where outbreaks of clostridium difficile from 2004 to 2006 infected more than 1,100 patients and led directly to 90 deaths.

Ms Gibb went to court after the Department of Health withheld a six-figure severance payment she had agreed in return for her resignation days before a report into the outbreak was published by the Healthcare Commission.

The judge said the trust had offered to compensate Ms Gibb, who was paid £150,000 a year, so it could “sacrifice on the altar of public relations a senior official who had done nothing wrong”. Its decision was one that “the Department [of Health] does not appear to have cavilled at,” he added.

But when the department later disallowed most of the payment, worth £250,000, it triggered the court action by Ms Gibb.

Lord Sedley said: “The effect of unwarranted departmental interference has been to trap the trust between a rock and a hard place and to expose it, in its attempt to escape, to heavy legal costs.” He added: “It seems that the making of a public sacrifice to deflect press and public obloquy, which is what happened to the appellant, remains an accepted expedient of public administration.”

The Healthcare Commission inquiry into the outbreak, published in October 2007, was highly critical of the trust’s leadership but pinned much of the blame on the Trust’s board – all of whom resigned following its publication.

The Commission’s report said the trust should review its leadership and the trust ordered its legal advisers to report on allegations against Ms Gibb. But no adverse findings were discovered and a decision was made not to remove her by the trust’s Remuneration Committee.

That decision was reversed at a meeting of the committee in September 2007, when it was decided to pay off Ms Gibb before publication of the Healthcare Commission report in October. It was agreed that she would receive £75,000 in lieu of notice and £175,000 compensation.

But the trust rescinded the agreement after being ordered by the director-general of NHS Finance, Performance and Operations to withhold the £175,000 compensation payment, which has since increased to £190,000 with interest.

The Court of Appeal yesterday ordered the trust to pay Ms Gibb the full amount of the compensation plus the costs of the court hearings.

Lord Sedley concluded: “Perhaps those responsible will now reflect that, since such blame as the report allocated was subsequently accepted by the trust’s board – all of whom resigned following publication of the report – there had been no good reason to dismiss the CEO; and that all this money, both compensation and costs, could have been spent on improving hygiene and patient care in the trust’s hospitals.”

Patients and relatives affected by the superbug reacted angrily. Former Bucks Fizz singer Cheryl Baker, whose mother-in-law Doreen Ford died at Maidstone Hospital in 2008 aged 77 after contracting clostridium difficile, called on Ms Gibb to give the money to the families whose loved ones died.

From: http://www.independent.co.uk/payout-for-hospital-chief-after-90-superbug-deaths

There will be a full public inquiry into the scandal hit Stafford Hospital in Mid Staffordshire NHS Trust, the government has announced.The Tories had promised the probe in opposition after reviews had criticised “appalling” standards which were said to have caused needless deaths.

Campaigners consistently said it was the only way to uncover the failings, but previous labour ministers had resisted.

As they emerged into the rain from the House of Commons to pose for photographers, Stafford Hospital campaigners hugged each other and laughed. “It’s the first time we’ve smiled since this whole thing began,” Julie Bailey told me. She’s the woman who founded Cure the NHS after her mother died at the hospital having experienced what Julie says was eight weeks of dreadful care.

The group has been pressing for a Public Inquiry since the Healthcare Commission first uncovered the extent of the problems at Stafford Hospital last year. They argued that anything less wouldn’t have the powers to answer all their questions. Julie Bailey looked tearful as I asked her about her mother’s experience.

“I’ve done this for her,” she said. “She’d have done all this and more if she’d had the chance.” She believes the public inquiry will mean people who’ve been able to duck questions until now will be forced to account for themselves. “It’s not about revenge,” she said, “it’s about accountability and openness. Tomorrow we’ve got to start a new beginning for the NHS because we don’t need any more unnecessary deaths.”

The problems at Stafford – run by the Mid Staffordshire NHS Trust – were laid bare by the NHS regulator in March 2009.

The Healthcare Commission reported there had been at least 400 more deaths than expected between 2005 and 2008.

It cited a catalogue of poor standards, including cases where receptionists had been used to assess emergency patients.

But this was just one of a long-line of reviews.

These included an independent inquiry launched by the government. It was held in private and reported in February, saying the trust had become driven by targets and cost-cutting.

Campaigners believe the failings of Stafford go much further than one badly-run trust however. The trust had been climbing the NHS ratings ladder during the period in question and was even given elite foundation trust status.

So earlier this year the Labour government set up a further inquiry looking at the role of the wider regulatory agencies, but this was not enough for campaigners.

They demanded a more wide-ranging probe which had tougher powers. A public inquiry is held in open and is able to compel witnesses attend hearings and cross examine them.

Mr Lansley said: “We know only too well what happened at Mid-Staffordshire, in all its harrowing detail, and the failings of the trust itself.  “But we are still little closer to understanding how it was allowed to happen by the wider system.  The families of those patients who suffered so dreadfully deserve to know. And so too does every NHS patient in this country.

“This was a failure of the trust first and foremost, but it was also a national failure of the regulatory and supervisory system who should have secured the quality and safety of patient care.”

The inquiry will be chaired by Robert Francis QC who had led the government inquiry and was asked to do the same for the follow up one.

Mr Lansley said he did not want Mr Francis to go over the ground already covered, but focus instead on how the culture in the NHS allowed this to happen.

The final report is expected in March 2011.

The health secretary also said he wanted to strengthen the ability of staff to whistleblow.

He said he would be issuing guidance to trusts on their procedures as well as looking to introduce a contractual right for staff to raise concerns that are in the public interest.

Julie Bailey, founder of Cure the NHS, the campaign group set up by the families of victims, said: “A year ago David Cameron promised a public inquiry and he’s kept that promise.  The terms of reference and scope are just what we wanted.”

“Former health ministers, Department of Health executives in Whitehall and in Stafordshire will now have to exlain why they did not stop this disaster.”

From: http://news.bbc.co.uk/1/hi/health/10274537.stm

NHS bosses are earning annual bonuses of tens of thousands of pounds on top of their six figure salaries as Anna Walker, chief executive of the Healthcare Commission, got £68,000 in bonuses.

Hundreds of chief executives, departmental directors and board members of hospitals and other NHS organisations have received extra payments of as much as £32,000 – the largest single year’s bonus unearthed by freedom of information requests submitted by the Liberal Democrats.

The £32,000 bonus went in 2008-09 to Beccy Fenton, deputy chief executive of the Heart of England hospital trust, who already earns £170,000 a year. She received it after generating almost £1m of consultancy work for her employers, including private sector contracts. The trust stressed last night that the £32,000 was a one-off sum for consultancy work.

Anna Walker, who was chief executive of the Healthcare Commission until it was disbanded last year, earned the largest combined amount in the past three years – £68,150 on top of her six-figure salary. She received £22,375 in 2006-07, £23,000 in 2007-08 and £22,775 in 2008-09 for running the then NHS watchdog in England.

Norman Lamb, the Lib Dems’ health spokesman, condemned the payments as shocking. “These bonuses are utterly scandalous. People will be disgusted by the extent to which fat cats in the public sector have been enriched at a time when the NHS has denied people drugs that they need and access to treatments such as in mental health,” he said. “We thought it was just in banking, but the unacceptable bonus culture appears to be alive and kicking in the upper echelons of the NHS.”

This is the first time both the number of bonuses and their size has been disclosed. The Lib Dems sought information from every hospital trust, primary care trust (PCT), mental health trust and ambulance service in England, as well as other NHS bodies such as strategic health authorities.

While some pay no bonuses, many do. However, the figures do not reveal the full picture because some refused to disclose theirs and a few simply gave their chief executive’s salary band.

The £32,000 one-off bonus and the £68,150 over three years are large but not atypical.

Laura Roberts, chief executive of the Manchester PCT, received £25,732 extra in 2008-09, while Dr Patrick Geoghegan, her counterpart at South Essex Partnership mental health trust – who earns £170,000-180,000 – received £20,573 in the same year for helping it do well against NHS targets.

South Essex trust spokeswoman Maxine Forrest, said: “In 2008-09, to recognise the trust’s exceptional performance in national ratings, a one-off bonus was paid. Dr Patrick Geoghegan is chief executive of one of the most successful and highest-performing NHS organisations in the country.”

Paul O’Connor, a former chief executive of Birmingham Children’s Hospital, received a one-off £15,000 bonus in 2007 for helping it to achieve semi-independent foundation trust status within the NHS. He resigned late in 2008 after the Observer revealed doctors’ concerns that some care was sub-standard.

The chief executive of the Royal Berkshire hospital trust received £54,611 in bonuses over three years in 2007-09, while the chief executive of the Human Tissue Authority was given £37,895 in 2006-09.

Many chairmen, divisional directors and both executive and non-executive directors of NHS bodies also receive bonuses. The Royal Berkshire hospital trust spent £240,728 on bonuses in 2007-09, more than any other NHS body that provided figures. Eight executive directors shared another £186,117, as well as the £54,611 payment to the chief executive.

Large payments to senior figures in those three years were also made by the Healthcare Commission (£215,550), the London Ambulance Service (£130,646), the Hertfordshire Partnership mental health trust (£122,465) and Portsmouth Hospitals (£105,000).

All three main parties have pledged to slash NHS management and bureaucracy. “This is the first real analysis of the bonus culture at the top of the NHS, and it’s shocking,” said Lamb. “Bonuses of £20,000 or more are more than many NHS staff receive as their full year’s salary.”

From: http://www.guardian.co.uk/society/2010/apr/25/nhs-bonus-liberal-democrats