Nhs

As the Mid-Staffs tragedy unfurls, it becomes more and more apparent that contrary to the insistence of former Labour Ministers and Prime Ministers, this was not an isolated case, but an appalling example of problems evident throughout the NHS. Indeed, back in 2008, the then Labour Government received reports from respected international health consultants warning of a culture of fear and compliance within the NHS; a place where the emphasis was on 'hitting the targets, but missing the point' and patient safety came second to presenting a set of statistics suitable for dispatch-box delivery.

I knew that British doctors are well-paid but unti I saw, via Kevin Drum, this chart I had no idea they were so much better-paid than most of their peers in the western world.  This is culled from a 2004 OECD report (Pdf) and all figures are in PPP-adjusted dollars. Of course, doctors received significant pay increases during the Blair years. Specialists were not treated as kindly as (well-trained) GPs but even their wages increased by more than 30% in real terms. Which is fine. The constituency demanding pay cuts for doctors is very small. Nevertheless, these charts (which are not, I think, outdated in any significant sense) are worth recalling next time doctors try suggesting they are hard done by.

Health tourism is raised every now again by politicians, but never has it been raised so forcefully by such a senior doctor. In this week's Spectator, Professor J.Meirion Thomas, a consultant surgeon with the NHS and one of Britain's leading cancer experts, speaks out about health tourism. He writes: I am frustrated at seeing the NHS targeted by patients who are ineligible for free care, but who usually get through the net. Specialist units may be especially vulnerable. Reluctantly, I have decided to share my concerns. The final trigger to write this article was a potentially ineligible patient who accused me of unethical behaviour because I would not promote his application with my Trust for immediate and free NHS care.

Can anyone think of a bigger scandal in any British public service than that revealed at Stafford Hospital? It is worse than Aberfan, or Bloody Sunday, or the King’s Cross fire, or Jimmy Savile, or even the abolition of grammar schools. Up to 1,200 people died unnecessarily, not because of one error, or a particular set of errors, but because of the way an entire hospital was run for several years. There is plenty of evidence now emerging that comparable disasters have taken place at other hospitals, for similar reasons. Yet I searched last Saturday’s Guardian in vain for a single mention. Politicians are desperately closing the subject down. They have persuaded themselves that everyone loves the NHS, especially its nurses.

There’s normally no shortage of outrage in our politics. In Britain today, we specialise in working ourselves into a bate. This is what makes the lack of outrage at what happened at Mid Staffs all the more peculiar. If the government had received a report detailing such appalling behaviour in any institution other than an NHS hospital and responded so meekly, there would have been a series of angry front pages denouncing Whitehall complacency. The government is considering changing the law of the land because of what happened at the care home Winterbourne View, which was appalling but nowhere near as serious as what happened at Mid Staffs. But when it comes to the NHS, we all suspend our critical faculties.

Is it time we faced up to the fact that the NHS itself is the reason for the continuous stream of scandals? It’s not just the Mid Staffs Foundation Trust, or the ‘Nicholson Challenge’ or ‘the reforms’, or ‘the culture’. The NHS suffers from systemic faults. Above all, the regular flow of defects and failures is what you would expect from a command-and-control regime that has a monopoly. It’s not as though making this claim is new. The last Labour Government recognized the structural flaws in the NHS nearly a decade ago.

Should heads roll over the Mid Staffordshire Hospitals Trust scandal? I ask only because as I listened to Mark Carney giving evidence to the Treasury Select Committee for several hours this morning, I found myself browsing through a number of articles on this site and others about the Libor scandal. Back in those heady days of George Osborne accusing Ed Balls of having questions to answer, and Bob Diamond resigning from Barclays ahead of his appearance before the same select committee, people were very keen for heads to roll, and not just those sitting on bankers' necks. They were also keen that those who performed badly when questioned about their suspicions of Libor fixing didn't rise to higher positions, with Paul Tucker watching his own shot at the job Carney has now won slipping away.