Nicholson faces down critics
pharmafile | March 5, 2013 | News story | Medical Communications, Sales and Marketing | Mid Staffs, NHS, Nicholson
Sir David Nicholson, chief executive of the NHS, has been involved in testy exchanges with MPs at the House of Commons Health Select Committee this morning.
The hearing is on the Mid Staffordshire NHS Foundation Trust Public Inquiry, otherwise known as the Francis Report, which detailed failings leading to the deaths of as many as 1,200 patients between 2005 and 2008 due to poor care.
Sir David was in charge of the West Midlands Strategic Health Authority, with overall responsibility for overseeing Mid Staffs hospitals, for some of that time and has been under pressure to resign.
In the hearing he denied that he had accountability for the deaths through substandard care because his remit had been to create one SHA from three existing ones and merge 70 Primary Care Trusts into ‘about 40’.
He was also responsible for ensuring that all these organisations delivered the ‘must be dones’ such as reducing hospital-acquired infections.
“I accept that was a narrow definition of accountability,” Sir David admitted. “That was a failing [of the system].”
As well as his personal responsibility, questioning from MPs covered whistleblowing, complaints, patient care and mortality rates.
At the start of her questions, committee member Valerie Vaz MP said: “Please don’t feel that this is a trial” and went on to ask whether he had heard any ‘rumblings’ of problems at Mid Staffs Hospital itself when he was at West Midlands.
Sir David said that he had not, adding: “As shocking as it is, that is the truth.” He also said that it was ‘not true’ to say that no-one had been held to account for the deaths, citing the departure of senior executives.
He also believed that the NHS “was neither equipped not capable of monitoring those organisations at that time.”
“The leadership of the NHS had lost focus on what was important,” he added.
Although Sir David gave a confident performance, he seemed occasionally irritated, denying Vaz’s assertion that he was “a process man, a procedure man”.
He was also testy as he was required to answer numerous questions from Vaz on exactly which hospitals he had visited and who he spoke to.
At one point Sir David said: “To help you with all of this, I spent 11 hours being cross-examined by a QC in public and there are 500 pages of transcripts.”
He remains under pressure: 20 MPs have signed Conservative MP Charlotte Leslie’s Commons early day motion calling for him to ‘face appropriate consequences’ for the Mid Staffs scandal.
As well as bankbenchers and the media piling on pressure, around 4,800 people have also signed an e-petition on the DirectGov website calling for Sir David to go.
However, former health minister Lord Darzi insists he should stay in post, writing in The Times: “In the journey towards high-quality care David Nicholson has led the way.”
Getting rid of him would be “a distortion of the past and an unnecessary risk to the future”. And despite the political pressure, prime minister David Cameron has backed Sir David, saying it would be wrong to find ‘scapegoats’ for Mid Staffs.
Shadow health secretary Andy Burnham also believes he should stay.
Sir David is head of the new NHS Commissioning Board, which is about to become the NHS’s lead body. Facing down calls for his head, he told the Committee that he would lead the organisation through the restructuring put in place by the Health and Social Care Act 2012.
“I will take responsibility for leading the NHS through these enormous changes,” he said. “I am absolutely determined to do that.”
Robert Francis QC made 290 recommendations to bring about a ‘fundamental culture change’ in the NHS after finding patients at Stafford Hospital were subjected to ‘appalling and unnecessary suffering’ there.
NHS leaders have acknowledged a need to repair public confidence on a ‘sad and shameful day’.
The Department of Health is to make a detailed response to Francis this month, although permanent secretary Una O’Brien apologised ‘wholeheartedly’ in February for its part in the failings at Mid Staffs.
Half a dozen more hospitals in England are also being investigated.
Adam Hill
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