Stafford Hospital- the scandal that shames the NHS PT2
For those whose relatives were deprived of care and even food and drink at the Stafford Hospital it was difficult to understand why there were so few nurses to tend to patients.They could little imagine that in August 2005 in the hospital trust’s executive offices, a board led by Martin Yeates had decided to embark on cost-cutting plans as it attempted to secure “foundation trust” status.
Foundation hospitals were a flagship policy for Labour, supposedly the best in the country, and given many freedoms from Whitehall, including over executive pay, and holding board meetings in secret.
The trust needed to convince Monitor, the regulators, that it could meet key targets, particularly the four hour wait, on a lower budget.
The NHS trust was desperately short staffed, with 100 vacancies for nurses alone, but from 2005 onwards it embarked on widespread job cuts. Between 2006 and 2008 160 nurses left the trust either through retirement or redundancy; £1.3 million was spent on redundancy payments.
The board’s obsession about the project left executives blind to the impact cuts would have on patients.
Wards became more reliant on unqualified and untrained healthcare assistants, employed at much lower cost than nurses. On one floor of the hospital, the staff shortages became so extreme that two nurses were left to care for 40 patients.
West Midlands strategic health authority, which had responsibility for supervising the hospital, commissioned which took more than a year to decide – wrongly – that the flaws lay with the data not the care being given by the hospital trust.
As a result no action was taken to examine the actual quality of care at the hospital. In July 2008, a month after the report on the figures was produced, the authority’s chief executive, Cynthia Bower, was promoted to run the Care Quality Commission (CQC), which would be given oversight of all health and social care in England and Wales.
By now, the trust’s bid for foundation trust status had been approved in June 2007 by Andy Burnham, then a junior health minister.
The authorisation was made by one regulator – Monitor, which is responsible for foundation trusts – without being told that another regulator, the Healthcare Commission, later replaced by the CQC, was poised to announce a full scale investigation of the trust, because of its concerns.
It was another year, before, in March 2009, the scandal was finally exposed. By now, Mr Yeates, the chief executive of the trust, and Toni Brisby, its chairman, had already quietly stepped down.
The investigation into Stafford found that failings were such that between 2005 and 2008, there were between 400 and 1,200 “excess deaths” – in other words, up to 1,200 more people died than would have been expected at a hospital with a similar catchment area.
In the regulator’s last act, Sir Ian Kennedy, the chairman of the Healthcare Commission, described the findings as “appalling” – the worst that the regulator had ever uncovered.
Gordon Brown, then prime minister, said that what went on was “inexcusable” and a plethora of reviews and inquiries were announced – but crucially, not a public inquiry to establish how the systems supposed to supervise hospitals – the health authorities, and a labyrinthine regulatory system – failed so catastrophically.
In opposition, the Conservatives called for such an inquiry, which was also demanded by patients’ group Cure the NHS and by a campaign led by this newspaper.
On 9 June 2010, just a month after the Coalition was formed, Andrew Lansley, then health secretary, announced that a public inquiry would go ahead, and now its findings are about to be sent to Jeremy Hunt, his successor.
Tags: Health Direct, Health Professionals, Labour shambles, National Health Service, NHS, nhs cash shortages, NHS Deaths, NHS targets, Nurses