Edicts from Whitehall are not enough

The report highlights shocking failures in patient care at Stafford Hospital. The central question now is whether Robert Francis’s diagnosis of the causes of these failures and his recommendations will prevent anything like this happening again.

The Francis report is the latest in a long line of reports into NHS organisations in which patients died unnecessarily or were seriously harmed. These reports date back to the inquiry into Ely Hospital, Cardiff, published in 1969, which found evidence of people with learning disabilities being treated cruelly and inhumanely. The Secretary of State at the time, Richard Crossman, responded by establishing the Hospital Advisory Service to inspect hospitals for people with learning disabilities and mental health problems.

Now David Cameron has announced that a Chief Inspector for Hospitals is to be appointed. The problem is that serious failures in patient care have continued despite the work of the Hospital Advisory Service and other regulators, such as the Care Quality Commission. Clearly inspection and regulation on their own are unlikely to provide the safeguards needed.

What’s needed is a change in culture in the NHS to ensure that everyone is treated with dignity and respect. This cannot be achieved by political fiat. Every hospital must create a climate in which staff are encouraged to treat patients as well as they can.

Robert Francis has recognised this in his report and the task now is to implement his recommendations to ensure that another inquiry like this will not be needed again. The priority must be to shift from a culture in which the behaviour of staff is driven by compliance with targets to one in which there is a real commitment to patient-centred care in every hospital and surgery.

Professor Chris Ham is chief executive of The King’s Fund