Today was by far one of Jeremy Hunt’s best performances on the NHS in the House of Commons.

Having been criticised recently by two former Secretaries of State for the Health, Alan Milburn and Stephen Dorrell, the room for manoeuvre was very slim.

On the issue of ‘that number’ for safe staffing, Hunt had a trick up his sleeve with apparent support for not setting levels. The concern about setting a minimum number was that this would not reflect the skill mix of nursing staff on the wards, and might unwittingly end up being a quasi-target.

Whilst the construct of economic competition and the NHS has been virtually ubiquitously conceded to be a failure, it is possible that NHS Trusts will not wish to compete ‘in a race to the bottom’ over staffing levels.

How these data will be presented in a meaningful way is anyone’s guess.

But the beauty with this approach is that it avoids Government centrally specifying indirectly the staffing budget for NHS Foundation Trusts. So, if these Trusts later go ‘bust’ due to an inability to balance the books due to a massive PFI loan, it’s not perceived as the Government’s direct fault.

If Trusts run bargain basement staffing levels, Government is not to blame.

And result! They still get their £30bn ‘efficiency savings’?

And the hardworking nurses who get made redundant, even having passed their ‘good character’ test?

Nothing to do with me, mate.

He also had some further issues ‘under control’. The review into patient complaints, co-authored by Prof Tricia Hart, had successfully concluded that the current NHS complaints system is inadequate. Something’s going to be done about it apparently.

Hunt further decided that, whilst he would impose a statutory duty of candour for organisations, he would go no further than the current position of the clinical regulators requiring candour in the professional clinical code from individuals.

Of course, the ‘acid test’ is whether any of this works in practice.

There is still a sizeable yet relatively small number of people who feel that some people in the NHS do not demonstrate any candour at all.

So why isn’t this deception fraud? Quite simply, that’s because it’s not under the Fraud Act (2006), strictly defined in law as exposing someone to a loss financially (or producing a material gain).

It may be one day that the legislature considers a statutory offence of fraudulent misrepresentations in official clinical notes.

There were some further issues.

‘Healthcare assistants’ were rebranded ‘nursing assistants’, which means that their legal regulatory requirements might one day be defined with greater clarity. Hunt argued that requiring them to have a certificate ensured a level of competence.

But have Hunt’s remarks fundamentally changed things?

Possibly yes, if NHS FT CEOs are not able to do a ‘merry go round’ of jobs even after demonstrable failure.

Will this work? Well… probably not.

Will it be a revolution of the kind to make Russell Brand envious?

Probably not, if there are still toxic parts of the NHS, Hunt’s medicine cannot reach.

If Hunt were a medic, he’d understand this in terms of drug bioavailability. But he’s not.

As an associate justice of the U.S. Supreme Court, a man called Louis Dembitz Brandeis (1856-1941) tried to reconcile the developing powers of modern government and society with the maintenance of individual liberties and opportunities for personal development.

He coined the famous phrase, “Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants; electric light the most efficient policeman.”

The Berwick Report was fundamentally about organisational learning after mistakes.

Everyone makes mistakes, and sometimes these mistakes are harmful to the team’s efforts. However, it is argued developing a strong culture of transparency and accountability can focus your teams efforts where they belong: doing brilliant work.

The alternative is a blame culture.

Perhaps for the most serious offences, ‘wilful neglect’ (which is very hard to prove, if the case law of section 44 Mental Capacity Act is anything to go by) will get people ‘out of the system’.

Today, noticeably Sir Brian Jarman was absent.

The day’s media coverage was not accompanied by a torrent of media reporting about ‘needless deaths’.

Even Sir David Nicholson in August 2013 had got fed up. He was calling for more balance in the way the media handles the NHS in an interview he gave.

“It’s either all fantastic or all terrible, when in fact both things happen simultaneously.”

“There were managers versus doctors, doctors versus nurses, surgeons versus medics…”

He had made a speech where he said:

“Over the last few months, it’s as though a wheel has been spun every so often… ‘Let’s all attack nurses’ or another week it’s ‘let’s have a go at general practitioners’.”

Nicholson had therefore progressively been highlighting the need to stop the witch hunts and take a more grown up view of the situation.

In corporate culture, the giant ENRON was brought down by off-balance-sheet transactions: transactions deliberately designed to conceal from trustees, regulators and the market the extent of the risk to which shareholders were exposed. Their lawyers and accountants connived to make the deception as lawful as they could, but it remained a concealment.

This is exactly the same problem the NHS faces.

So regulation strives to shine a light into those awkward nooks and crannies, but it is a cumbersome light source and there is a large body of professionals dedicated to dimming its flame and to diverting its glare.

Any company needs to be transparent about its corporate decisions including its business plans. It must be transparent.

That is why nobody can make out why the Government is so evasive about making private companies accountable to the same freedom of information disclosure requirements as the NHS.

This parity is clearly in the public interest, with a new liberalised market with equality of provider, when ‘commercial sensitive’ decisions can impact on patient safety.

Not my crap speak. Theirs.

On 4 March 2013, a Conservative Stephen Barclay MP used the sunlight as disinfectant allegory. Barclay opined that the Prime Minister had said that sunlight is the best disinfectant, “and that applies on our hospital wards. It is best for us to have well-informed patients and staff who are able to voice their concerns.”.

Later on 16 July 2013, another Conservative David Tredinnick MP asked, “Sadly, the problems at George Eliot hospital go back well over a decade, so these special measures will be very welcome, but is not one of my right hon. Friend’s fundamental problems dealing with a culture of secrecy, where in the past a board with a problem would talk to a strategic health authority board and nobody would know what was going on? Is not sunlight the best disinfectant?”

And not to be outdone, a third Conservative, Stephen Dorrell MP, reverted to disinfectants and transparency.

Dorrell remarked today, “Is not the central driver of my right hon. Friend’s recommendations to ensure that never again shall we have closed institutions in a closed system where that is possible, and that the key way forward is to throw sunlight into institutions that have too often been unchallenged?”

If the complaints system works, then that’s great. If NHS FTs compete to produce good levels of safe staffing, that’s great.

If NHS CEOs don’t go round the circuit with massive salaries but terrible performance, that’s great.

If you can stop people going to hospital unnecessarily, by pumping more money more effectively into the outsourced NHS, that’s great.

If some managers no longer bully, even though nobody wants to change the faulty Public Interest Disclosure Act (1998), that’s great.

If private providers decide ‘to do the right thing’ in the name and transparency, and decide not to hide behind a corporate veil of commercial sensitivity so as to publish data on staffing, that’s wonderful.

But that’s a lot of ‘if’s.

And there may not be enough sunlight to go round.