» Fears and smears – wilful inattention from healthcare journalists?

In an article today in the Independent, subtitled “Fears and smears”, Ed Miliband MP writes:

“They want to distract attention from the issues that matter. With the support of a determined section of the press, they have decided that mudslinging matters more than the futures of millions of families across this country.”

Discussion of the NHS is an incredibly sensitive area and yet it has been done incredibly badly by many journalists and politicians.

Mid Staffs was an unacceptable disaster. It was THE low point in the NHS.

Relatives of loved ones have shown incredible bravery and resilience in the face of an unbelievably tragic intolerable event.

For many, the issues in Mid Staffs appeared to be simply brushed under the carpet for political purposes, and real patients and relatives suffered.

The claim over professional codes and a duty of candour

On Thursday, Jeremy Hunt gave an answer on Mid Staffs on the BBC programme ‘Question Time‘. Regarding making it easier for people to speak out, “people are going to be given protection in their professional codes which have happened before.”

Mr Hunt is therefore speaking as if this has sprung up from nowhere.

Not true, even from the briefest scan of ‘Five Minute Digest – Duty of Candour’ in ‘Pulse Today‘:

The claim that Burnham opposed an inquiry

There are two inquiries – when you read the rest of this article, be mindful that

November 2009 – Robert Francis QC begins hearing evidence in private as part of his independent inquiry
February 2010 – Robert Francis QC publishes his independent inquiry report into the poor care at Mid Staffordshire Foundation Trust
May 2010 – Change of government and Health Secretary
November 2010 – The public inquiry begins to hear evidence
December 2011 – The public inquiry finishes hearing evidence after more than 12 months

In Question Time last week, regarding Mid Staffs, Mr Hunt explained, “Your party opposed a public inquiry. Andy Burnham decided to oppose a public inquiry.”

The Executive Summary of the Report of the public inquiry, published in 2013, is here.

The way the original private inquiry was set up by Andy Burnham MP, the then Secretary of State for Health, is described in the 2013 Francis report as follows.

A new Government was elected in the UK in May 2010. The way in which Andrew Lansley MP, the then Secretary of State for Health, set up a public inquiry is provided in the 2013 Francis report as follows.

This actually came as no surprise, as Andy Burnham MP had already stated that the second Inquiry would be held in public, as cited here.

Francis himself did not want the first inquiry to sit in public for the first time, and is even reported as being satisfied with the arrangements, as cited here.

The problem here is in the media at large the genuine message that Burnham set up the first inquiry in 2009 ‘to give patients a voice’ has been swamped by the toxic meme from some, and they know who they are, that ‘Burnham blocked an inquiry’.

The claim that Burnham never apologised

Another blatant classic lie is that Burnham has never ‘apologised for Mid Staffs’.

This is addressed too, as cited here.

The claim that Burnham resisted an inquiry under the Inquiries Act

Burnham obviously did not have any powers as Secretary of State for Health after the General Election of May 2010. The decision for the second public inquiry comes after that date.

It has been claimed furthermore that Andy Burnham MP resisted his inquiry to take place under the auspices of the Inquiries Act, but Burnham did actually leave it all times to be directed by Francis, the Chair of the Inquiry.

This legally is a somewhat obtuse claim, as it was a Labour government which enacted the Inquiries Act in 2005 in the first place.

In Appendix 1 of the bundle of documents entitled “Independent Inquiry into care provided by Mid Staffordshire NHS Foundation Trust January 2005-March 2009 Volume 1″ Appendix 2, Andy Burnham MP as the then Secretary of State for Health in his Written Ministerial statement (21 July 2009) first cites his perceived need to set up an inquiry “swift so as not to unduly distract the new management and staff at the hospital from improving services for today”, but that he has the power to convert the Inquiry to one under the Inquiries Act should the Chair of the Inquiry (Robert Francis QC) should demand it.

This exact text of the statement is indeed evidenced in Hansard, for 21 July 2009 Column WS188 as per here.

In Appendix 2 of the bundle of documents entitled “Independent Inquiry into care provided by Mid Staffordshire NHS Foundation Trust January 2005-March 2009 Volume 1″ Appendix 2, Andy Burnham MP as the then Secretary of State for Health repeats (10 September 2009) his willingness for his inquiry to be set up under the Inquiries Act not the NHS Act.

This is the evidence that Burnham gave to Francis 2 on 6 Sep 2011, page 178:

Indeed, parsimoniously, the option of ‘converting another form of inquiry’ into an Inquiry as under the Inquiries Act at any time is clearly good application of the law, under section 15 Inquiries Act (2005).

The claim that ‘wilful neglect’ legislation is a fundamental new shift in the law

The Berwick Report itself was all about constructive organisational learning, and only introducing a statutory crime of ‘wilful neglect’ for the most extreme cases.

Some vocal campaigners in Mid Staffs clearly desire targeted retributive justice, but the media thus far have refused to cover why the law of ‘wilful neglect’ in the form of section 44 Mental Capacity Act (2005) has failed to see a flurry of successful criminal prosecutions in Mid Staffs. We have instead discusssed it here. ‘Wilful neglect’ is NOT a fundamental new shift in the law, unless it can now be applied to adults with full capacity.

The claim that ‘there was a culture of cruelty in the NHS and no-one noticed”

Staff in various NHS Trusts have voiced loudly their resentment as being targeted in some sort of ‘hate campaign’.

Jeremy Hunt last week specifically referred to how a culture of cruelty ‘became normal in our NHS’, not in any particular Trust.

as cited in Hansard 19 November 2013.

Summary

The problem in this imbalance of irresponsible reporting is that it creates a culture of fear in NHS nurses, even in those ‘who have nothing to hide’. It is not a mature discussion of the technical problems in the law. It is instead ‘red meat’, ‘dog whistle’ politics of the worst kind, of a particular political inclination. As a result of memes about the Inquiry, candour and putting clinical staff in the clink, an irresponsible media has diverted attention from important issues.

By allowing copious air time for lies, the important discussion of why A&E is experiencing difficulties, a lack of a stated minimum level of safe staffing, why social care cuts have been so dangerous, or why NHS 111 has failed so dramatically, have not been explored in any level of acceptable detail.

Sadiq Khan MP tried valiantly to bring up how staffing levels had been so low, and ‘without the doctors and nurses, it’s all talk and no action.” But the stench of the narrative above diverted him from discussing the critical issues as much as he would have liked, although he did get in an official statistic about a cut in nursing numbers.

Real staff are none-the-wiser. Patient campaigners are led down the river without a paddle. Voters are completely bamboozled.

This is an unholy disgusting mess from those responsible. Call it wilful inattention.

Thanks to the public tweets of @gabrielscally for many of the extracts cited in the article.

http://twitter.com/mjh0421 Mervyn Hyde (@mjh0421)

I would like to be the first to defend Labour and there is little doubt that the media is universally attacking them, but even when being attacked by their enemies they still continue to propagate the same messages that their enemies espouse.

The truth surrounding Mid Staffs has been spelled out by an ordinary member of the party rather than the party itself. Steve Walker has exposed the deceit of the Tories relating to the so called deaths at Mid Staffs but not a word from the party.

I have to ask why that is if they still believe in the NHS here.

It was also Steve Walker that that proved that Ian Duncan Smith was lying about the statistics used against the unemployed and benefit claimants.

We are now in the last 18 months of this government and have yet to hear what Labour really stand for, which by now, they should be leading the agenda not the Tories.

Smears and bribery are the Tories stock in trade, the way to beat that is spell out what people like Steve walker have been forced to do on their own.
Pat Brennan

I agree that the time is ripe for the Opposition to set out its stall for the Election in 2015, and to take the moral ‘high ground’. Labour need not fear the ‘truth’ about its years in Office, when much good was done but is mostly forgotten now. We, the electors, need to know what Labour when elected will do to make life better now (and in future) for the many not the few.
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https://www.facebook.com/barry.davies.921 Barry Davies

It Doesn’t help when the all three parties repeat the same lies about Stafford hospital, the intent to privatise the NHS seems to be palpable with all three big parties. It is time that when the Prime minister repeats the proven fabrication that people drank from dirty flower vases, at his parties conference he can be held accountable for his lie, and publicly apologise, however it seems that the people wanting a duty of candour don’t think it should apply to them. Journalists have also continually referred to the amount of preventable deaths incorrectly, Francis said maybe one preventable death and yet it has been described as hundreds, with figures nothing to do with Stafford presented as real, and despite hundreds of complaints the political Party, and media apparatchiks try to say that these are true facts because they have been printed in papers and repeated on the news ad nauseum. If Labour genuinely wants to retain the NHS it needs to put forewords a better way of running it than the current industrial process methodology, people are not commodities to be processed in a set time limit, and the underfunding and waste of that money in bean counting jobs. However it seems that it is more likely that MP’s with their fingers in the pies of private companies will get their way and make more money for those companies costing more for a worse service.
Anonymous for obvious reasons

Invoking the public interest disclosure mechanisms is bound to involve a lot of preliminary thought. Is it an important matter? Am I worrying about nothing? What should I do about it? Should I go public?

Some of these questions might be thought through, through discussions on social media – without necessarily revealing any allegations.

I’d be interested to know, however, how many trusts have policies that state “it is inappropriate [for employees] to discuss [trust] policy on twitter/social media”.

When I raised a question recently about whether there was en evidence base for a policy recently – without stating who I work for – I was threatened with disciplinary action. Just for asking if there was an evidence base, and saying this was important because the policy might well be driven by politics rather than evidence.

The response to this very mild questioning was bullying and threats, followed by pompous self-justification.

It seems that any question about the evidence base is assumed to be an implicit statement that there is no evidence base for the policy; and that this is an implicit statement that the organisation is behaving improperly in implementing it. (Each step, of course, is logically fallacious).

If a simple question about the evidence base for an employer’s policy is going to be framed as “criticism”, and employees bullied and threatened for asking simple, genuine and legitimate questions, what chance is there that Hunts claims about “…making it easier for people to speak out, “people are going to be given protection in their professional codes which have happened before.”” will ever carry over into practice?