The Francis Report is a savage indictment of the cuts necessary to achieve privatisation

By Rachel Maskell

The Francis Report into the tsunami of failings at Mid Staffordshire NHS Foundation Trust is a savage indictment of the cuts necessary to achieve privatisation which is accelerating across the NHS.

The findings of Robert Francis QC are a stern wake-up call for politicians of all parties that the glossy prospectus of private healthcare companies taking over the NHS for the alleged benefit of patients is a chimera – and will lead to disaster and further fragmentation. It is clear that patient care and private profit, like oil and water, don’t mix. How much more evidence is required.

A complete overhaul of dysfunctional management in the NHS needs to happen as a matter of urgency and the first person out the door should be Sir David Nicolson, chief executive of the new NHS Commissioning Board – perhaps, the most powerful person in the coalition’s new NHS. In 2005, he was the regional NHS official who had the oversight of Mid-Staffs when the clinical failures were taking place. Later, as a NHS chief executive, he had accountability as to how the NHS responded as the scandal unfolded. The words ‘buck’, ‘stopping’ and ‘here’ have a certain resonance.

Once the anger has subsided, how best to proceed to guarantee that Mid Staffs is never repeated?

Unite, the UK’s largest union, is promoting the idea a network of ‘patient safety officers’ that should be established across the NHS to banish the culture of fear highlighted by the Francis Report. Patients, families and staff, wary of raising concerns about patient care through conventional channels, should be able to go in confidence to an independent ‘patient safety officer’ in place throughout all the provider and commissioning NHS organisations with powers to investigate and then order change. Unite is also calling for the creation of a National Intelligence Unit (NIU) – with a dedicated hotline for whistleblowers – to co-ordinate information about trusts that are causing concern.

These two recommendations are in a five-point response to the Francis Report that the union, which has 100,000 members in the health service, launched today. Unite said that it consistently raised concerns when the abuse was occurring and this was borne out by the witness statement that Unite regional officer, Mark Young gave to the inquiry. We believe that Mid Staffs is not unique and that the culture of bullying exists across the NHS – and poor morale leads to poor productivity.

The advent of NHS privatisation and the additional proposal that staff are subject to performance related pay, will further reinforce the culture of silence which will mitigate against concerns being raised. Ministers will use Mid Staffs as an excuse to allow the Health and Social Care Act to act as an express gateway for private companies to take-over large swathes of the NHS. The fact Mid Staffordshire was desperately seeking foundation trust status – the half way house to privatisation – when hundreds of people died unnecessarily proves the point that privatisation does not bode well for patient care.

It is not a coincidence that as Mid Staffs was spiralling into the abyss there were 150 nursing vacancies.

The key here is poor ‘watch your back’ management. Excellent clinicians are doing their best for patients against a background of £20bn so-called efficiency savings and they deserve a system in which they can raise professional concerns without fear of reprisal.

Health secretary Jeremy Hunt said that he wants patients treated as human beings, and not as numbers – now he has the opportunity to make this aspiration a reality.

Rachel Maskell is Head of Health at Unite