Friday 22 March 2019
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Lessons for social care

John Burton, Head of The Association of Care Managers, writes:

The Mid Staffs NHS Trust Public Enquiry has lessons for social care. Day after day the enquiry hears from those whose lives have been devastated by the failure of care and those who worked in the hospital and, in their different ways, attempted to protest against the vicious, callous management regime.

We learn that consultants, trying to maintain standards on their wards, were not even aware that there was a regulator for the hospital. We hear how they were terrified of the Chief Executive who was systematically cutting staffing, causing needless deaths and terrible suffering, in order that the finances of the hospital would qualify it for Trust status.

We learn that the whistleblowing policy included clauses that effectively warned staff not to blow the whistle, and how repeated complaints, warnings, and alerts of dangerous practice were simply not responded to. There was a culture of fear and bullying: “speak up at your peril”.

We hear senior consultants saying how they had been suspended as troublemakers and that the whole of the NHS was run by “diktat”, and that they were totally overloaded by new policies that had nothing to do with patient care and were described as “downright dangerous”.

And over and over again we hear how professionals (nurses, doctors and consultants) were ignored and intimidated.

Clearly, there were many people who were too frightened to speak up, but what about those whose job it was - and those organisations whose job it was - to oversee and regulate this deadly calamity? Those managers, outsiders, and committees who did receive complaints and those who did know that something was very seriously wrong with this hospital?

The parallels with social care are striking. Well, they would be because we have the same problems of the domination of outside organisations, their overloading proliferation of policy and their insatiable demand for irrelevant paperwork. In social care we have the same problems of finance and understaffing, of bullying and managing by diktat, and of the devaluing of the professional care manager.

We must ask ourselves why the NHS and Social Care could ever have got into this mess? And why didn’t more people stand up together and protect the service against the menace of ignorant, rampant bureaucrats on absurdly inflated salaries?

Speaking of whom, the enquiry will soon be hearing from the former Chief Executive of the West Midlands Strategic Health Authority (SHA) who is now the Chief Executive of the Care Quality Commission. CQC now regulates Mid Staffordshire NHS Trust as it regulates (but rarely inspects) care homes. Do we think that this person is in the right job? Perhaps we’ll hear why she thought that Stafford General Hospital was well managed when she was in charge of the SHA; so well managed that she was thought suitable to run the new Care Quality Commission.

John Burton, Head of The Association of Care Managers.