Dirty tricks against independent candidate reported to police

VANDALISM OR AN ATTACK ON DEMOCRACY?

road photo's 067The grubby face of politics emerged today as Jan Hansen, the Lincolnshire Independent candidate for Martin Hill’s patch of Folkingham Rural, made a formal complaint to the police about vandalism to his election signs.  Signs like the one adjacent.

On Sunday night a sign, in Threekingham, disappeared.  Just one of those things you may think. It was quickly replaced by Mr Hansen.

road photo's 071

road photo's 077road photo's 075Mindless vandalism perhaps? Mr Hansen runs the chocolate shop in Folkingham.  A dissatisfied customer ?

But the next night three of the signs, including a replacement sign in Threekingham, were promptly vandalised as you can see from the photographs.  The request to ‘please vote’ remained intact but Mr Hansen’s name was surgically removed.

These signs were some 4 miles apart so there must have been some considerable effort made.

It is difficult to conclude other than this is an affront to democracy, carried out as a result of some, to be charitable, misguided loyalty to one of the other candidates.

I know Martin Hill the conservative candidate and the current leader of Lincolnshire County Council.  He will have been mortified by this; I am sure the other candidates (Mr Morgan for Labour and Mr Withnall for the LibDems) will share that view.

They would all agree that this intolerance and suppression of information about other candidates has no place in our elections.  This is not trivial.  Will it be bully boys trying to intimidate candidates to prevent them standing next time?  Lets hope the police find whoever did it; if their motive was to prevent a free and fair election they should be treated harshly by the courts.

Meanwhile I assume that all the candidates will roundly condemn these acts and will endorse that part of the sign remaining PLEASE VOTE.

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Does size matter?

Sorry about the heading but this subject ‘does matter’ and needed a bit of spicing up! It is about whether small rural hospitals are fairly funded and the implication on the quality of care and even death rates.

We need to start with some very dull but important documents the government published recently produced by a working party.  The documents are called ‘Payments by Results and the Market Forces Factor’.  You can just see them flying off the bookshelves and being downloaded to Kindles, left, right and centre.

Important documents because they could have an impact on the safety or quality of your care.  And they are deeply flawed.

Why?  Because by implication these documents say, to use a private sector analogy, a small rural corner shop should charge less than Tesco’s.  I kid you not.  And if the small rural hospital is paid less, it has less income to spend on staff.  Recent reports suggest that there may be links between higher death rates in hospitals and low staffing levels.

In this market-driven NHS, bequeathed to us by both major political parties, you cannot let the market decide how much each hospital can charge for its services.  Heavens no.  This is done by this national working party with the assistance of academics.

They have come up with a ‘Market Forces Factor’ (MFF) .  The higher the factor the more you can charge for each operation or procedure. Simple.

There are 245 Trusts in England.  In the league table of MFF’s where do you think we are?

241 of the 245 Trusts are allowed to charge more than Lincolnshire’s own hospitals.  You should feel for Cornwall and Devon as their 4 Trusts get treated even worse than us.  But look at the following:

  • Peterborough, Stamford and Northampton get 4.6% more
  • Cambridgeshire gets 6.2% more
  • Hinchingbrooke, which in effect has gone bankrupt, gets 6.5% more

Don’t even mention some of those around London, where it is 25% plus more.

But what’s a few percentage points worth you might think?  Using the above surrounding areas as comparators, for ULHT it could be, say, an extra £20m pa or more for exactly the same workload.  That a lot of extra nurses, a lot of extra care and  attention you are NOT getting if you are in one of our hospitals.  No wonder the CQC has been so critical of staffing levels at hospitals, such as Boston Pilgrim; one of 17 hospitals highlighted in reports earlier this year as having dangerously low staffing levels.

Look at the chart below.  It shows how much more hospitals can charge per procedure than the lowest charging hospital, poor old Cornwall.  ULHT are to the extreme right, one of the lowest charging Trusts in the country; others can charge almost 30% more.

pbr mff

So how do we get to this bizarre situation?

When the working party decides how much individual hospital trusts can charge they take into account:

  • land values.  It is of course well known that the value of land has a direct correlation with the cost of your hip replacement!  Land values in Lincolnshire are amongst the lowest in the country.
  • local wage levels.  Wage levels in Lincolnshire are amongst the lowest in the country.  They simply ignore that staff are on national terms and conditions, using some pretty flawed research to justify their stance; one interpretation of which is that they wish to discourage hospitals from using national pay scales for non medical staff.
  • London medical staff costs.  They adjust for this but ignore that, for example, rural hospitals have difficulty retaining staff and also tend to have high costs due to the use of expensive locums.

And importantly they do not look at the size and geographic location of hospitals and whether you can get economies of scale.  This works against all of the hospitals in Lincolnshire and particularly Boston Pilgrim and Grantham Hospital where it is obvious that, due to the small size of the hospitals, unit costs will be higher. This is not taken into account and the Hospitals are not allowed to charge for it, potentially driving down staffing levels with worrying implications.  Size does matter and it works against small rural hospitals.

Perhaps the working party and their academics should come to our hospitals?  Or perhaps they do not want to.

Perhaps, rather than fund our hospitals properly, they want this flawed market to make our hospitals fail, to have the excuse to close what they may regard as small inconvenient little places or hand them over to the private sector.

If they agreed that our hospitals should be paid more, as the cake is fixed, others will need to get paid less.  They wouldn’t want to upset the powerful teaching hospitals and London, would they?

I suggest you write your local MP drawing his attention to this blog.  Ask him to do something about it.  You might also write to our local authority health scrutiny committee.

I fear however that all they will get back from London is technical gobbledygook, divorced from reality and the real market.  In the real market the little corner shop charges more. Size does matter and driving down what relatively small rural hospitals get paid can lead to lower staffing levels and risks to patients – you and me.

But this been going on for years, nobody’s done anything about it before, so why should they now? After all it’s only Lincolnshire.

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Your £21m has been unavoidably delayed……..

If you travel by rail and the train is delayed you can get compensation, depending upon the length of the delay.  And so we should.

But what if other things are delayed?

What is generally not known is that our Council tax bills meet very little of the cost of our local services.  The majority of the cost is actually met by grants from central government. The government have to decide how to allocate these grants to different parts of the country to reflect their need and be fair.

The government agreed, in 2012, that the system for allocating these grants was flawed and that many local government services in rural areas were underfunded relative to other parts of the country.  It was agreed to move money from the over funded areas (often affluent councils in the SE) to rural areas like Lincolnshire.  Good news you might think.

This long overdue change should have brought £16 million into the county but because of ‘damping’ to prevent large changes in grants from one year to another, this money never arrived, and the way things are going will not arrive any time soon. A bit like the wrong sort of leaves on the line or the wrong sort of snow……(or more to the point the wrong type of politicians….)

Worse still, other changes which would have brought in another circa £5m have also been ‘unavoidably  delayed’ making a total of £21m.  Perhaps the overhead cables are down as well?

The effect is that we have to make bigger cuts to protect those over funded, and often more affluent, areas from making cuts to transfer the money to us.

Money we should have had in the first place!

Bizarre.  Many of those affluent areas protected by this so called ‘damping’ are conservative, but they obviously have Councillors and MP’s with more clout…….

They do not go out of their way to tell you the sums involved.  They would rather that you did not know how much ‘damping’ is costing you and your council.

The losses by Council are shown below:

Authority

Amount of Formula Funding for 2013/14 (£m)

Damping Amount Applied for 2013/14 (£m)

Percentage Damping Applied for 2013/14

County Council

178.608

17.246

9.7%

Boston

5.211

0.843

16.2%

East Lindsey

12.108

1.087

9.0%

City of Lincoln

6.941

0.209

3.0%

North Kesteven

5.880

0.175

3.0%

South Holland

6.460

0.850

13.2%

South Kesteven

7.004

0.103

1.5%

West Lindsey

5.513

0.764

13.9%

TOTAL

227.725

21.277

9.3%

The total effect of this on you depends where you live, the size of your house etc but for some of us the combined effect on our county and our district council tax bills it could be about £100 per household.

Even worse the impact is either our council tax levels are higher or our cuts are deeper than they should otherwise be – whilst others, who it is now acknowledged had been over-funded for years, keep their (or should I say our) money.

The situation can be starkly demonstrated in that if Lincolnshire received the same level of grant per head of population as many parts of the south east then, rather than sending out council tax bills, Councils would probably be sending out refunds!

There has been little in the way of effective lobbying about this by  Conservative Councillors or MP’s.  When they complained they got a few crumbs off the top table – about a million.  They did not protest too much, make a big issue of it, threaten to resign or anything like that – of course not perhaps because they did not want to upset their party bosses in London. 

So our money remains ‘unavoidably delayed’; are we, like the railways, to get compensation – I think not.

Just remember when you vote in the May County Council elections, vote for those who will put Lincolnshire first rather than those who just say it.

We may not be able to do much about the wrong type of leaves or the wrong sort of snow.  We can do something about the wrong type of politician in power……..so vote in a new breed, those who are independently minded and who just might put Lincolnshire above national party interests.

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The missing £100m and the problems in our hospitals – the sign of things to come?

A particular beef of mine is the grossly unfair underfunding of Lincolnshire public services, assessed at an eye watering £100m pa – or around £500 per household.  As the austerity programme bites it will affect vital services in every part of the country, but if you are already underfunded……..the impact will be even more severe. I blame our failed local political leaders for this.  Read on.

Our local hospitals have again gone on alert telling Lincolnshire residents not to go to A&E unless it is absolutely essential, as the hospitals are overfull – again.  This follows earlier alerts last month as well as reports over the past 24 months or so of continuing problems, such as long waiting times.

Hospitals are at the end of a complex chain of services involving social care, nursing homes, community care and GP’s; some of the failures of Lincolnshire’s health economy can be tracked back to a failure of leadership within the NHS, especially by the former East Midlands Strategic Health Authority and our own PCT who had the statutory duty to co-ordinate this myriad of services and prevent people going to hospital where that was not necessary.  Around 17% of those in hospital are admitted because these other, often community based, services either do not exist or are in adequate.

But the that is not the only problem. In 2009 based on the government’s own calculations of need, Lincolnshire’s NHS was underfunded by £70 million in comparison with other parts of the country, many of which, especially in the south east, were over-funded.  Money was supposed to have been moved from them to us but – you’ve got it – it was not.  It was left in the ‘too difficult to do box’ so those in the leafy suburbs of London and their big teaching hospitals continue to be ‘over-funded’.

But it is not just the NHS.

It is also local government.  The government agreed in 2012 that many local government services in rural areas were relatively underfunded and other parts of the country were over-funded.  They said money should be moved from those more affluent areas via a series of changes to the grant distribution formula.  Do you think we got it?  Answers on a post card.

If you need a clue the answer is 2 letters and starts with an N.

If the money had been moved it should have brought £16 million into the county but because of ‘damping’ to prevent losses in grants for those affluent areas this money too never arrived.  In fact it is worse as the total ‘damping’, taking into account sums from earlier years, is £21m pa – or getting on for £100 per household.

But is it is not just the NHS and local government.

It is also the police.  A tidy £7m short with yes you’ve got it the south east and urban areas, often with lower crime rates than us, having bigger grants.  I have commented upon this in the past – read about it here and here.

So that’s where the £100m comes from.  The equivalent of circa 2,500 jobs which could either be created or protected.  Quite an economic boost and it should have been a big buffer against the cuts and could well have prevented the problems ULHT currently have; if it has affected health when will it start to affect other services?  Is this just a sign of things to come?

So what do they decide down in London? Lets leave the affluent south east over-funded. You can almost hear them saying ‘Don’t bother to move the money because Lincolnshire’s not like Guildford or Tunbridge Wells with lots of important people to upset and their politicians won’t make much of a fuss either.’

Now that’s the real problem.  This has been known about for years and what have our local political leaders done?  What has our conservative led County Council done?  What have our conservative MP’s done (or the former Labour MP for Lincoln for that matter) and what did our conservative led police authority do?  Not a lot.  To add insult to injury the conservatives are standing in the county council elections under a banner of ‘STANDING UP FOR LINCOLNSHIRE’.

Wonder if we can report them to trading standards?

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When is an independent an independent……

I saw an interesting piece on the new Boston Eye blog questioning when an independent candidate is a genuine independent and whether a ‘party’ or group of ‘independents’ means that in fact they are not at all independent, with their own hierarchy, power structures etc. and all the characteristics of the national political parties which many of us have grown to detest.

Over my many years in local government I have worked with politicians of all major political parties.  I have been both a returning officer and a candidate – I actually stood for the police commissioner elections.  In that election I had to form my own party (of 3 people) as if I did not as a candidate I would have had two real and very serious disadvantages:

  • I would not have been entitled to copies of the electoral register until late in the electoral process – registered parties have easy access to the register.  It makes it more difficult to target your campaign or even to make sure that your nomination paper are correct.
  • I would not have been able to put any description on the ballot paper, unlike registered political parties who can use a variety of descriptions and a logo on their ballot form.

So as you can see it is a real ‘no brainer’ to form such a party; it is a necessity to level the playing field in a electoral process which favours established political parties.  It is difficult enough to fight an election as an independent, but a lack of access to the register and no description on the ballot form would have made the uphill struggle nigh-on impossible.

It is for these reasons and for the organisational benefits of shared learning, networking and economies of scale that the Lincolnshire Independents were formed.  And they do not behave or act like a political party.  For example to quote (highlighting mine):

Mission

- We represent YOU and NOT a political party
– We vote in the interests of YOUR village/town and NOT how some political party tells us to vote
– We join together as a network of Independents who then work together both locally and nationally

Description

Lincolnshire Independents encourage individuals to widen their interest, participation and election to all levels of government not aligned to mainstream parties and politics – their commitment being to the interests and well-being of the communities where they live and work and wish to represent as well as the wider interests and well being of Lincolnshire.

Lincolnshire Independents are the coming together of independents united under the Lincolnshire Flag to work and support each other to further and promote the interests of the diverse communities they represent and Lincolnshire as a County.

Lincolnshire Independent members in the final instance are able to make decisions and vote in the interests of the communities they represent rather than take a party instruction. There is no party whipping system, which, is the mainstream party practice. Lincolnshire Independents are able to work with and support any group, organisation or individual, regardless of their political leanings, if it benefits, or enables a positive outcome.

Lincolnshire Independents are a registered political party in order to comply with Political Parties Elections and Referendums Act 2000 and Political Parties and Elections Act 2009 amongst other Acts. This regulates finances and transparency relating to donations, loans and accounting.

Lincolnshire Independents being a registered political party requires formal membership subscription which does not permit membership of the mainstream parties and avoids the accusation of “ so and so party member in disguise as an independent”.

Activities

Providing an Independent voice in local government

I am not a member but I have worked with them and attended some of their meetings.  The Lincolnshire Independents are not like a party at all, they have no whip, they do not ‘parachute’ candidates into wards or divisions and above all they are free to vote how they like on behalf of their constituents.

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The £50 election bribe – with your own money?

All of us should by now have received our council tax bills and no doubt many of us will be pleased that the County Council has effectively frozen its charge.  Good news, as none of us like to pay more than we need.

For some time now central government has been ‘bribing’ or should we say ‘incentivising’ councils to freeze their tax bills by giving them a special grant.  In 2012/3 the county council used a whopping £13m of such grants to keep the council tax down.  The ‘incentive’ for this year, 2013/14 was a miserly £2m so a £11m hole emerged and it had to be plugged.

How to plug the gap I hear you ask?  Well in times of austerity and taking a lead from their political masters in London there would be only one way our conservative controlled Council would do it – more cuts.  As the Chancellor keeps telling us we would lose all credibility if we did not get out spending down and quickly. There is no plan B.

And of course if they did not plug the gap by cuts it would mean putting up the Council Tax by around 5% or £50 per household.

But no.  Our ever inventive Conservative controlled Council pulled a rabbit out of the hat and came up with a wheeze called the ‘financial stability’ reserve or perhaps more appropriately ‘lets con the people and get re-elected’ reserve.  They used the reserve to plug the £11m hole and hey presto no extra cuts, no 5% increase in Council tax and,  just what the (spin) doctor ordered, a Council tax freeze. To add insult to injury, the £11m they are giving us back, to freeze the council tax, was raised from us in the first place.  It equates to around £50 off the average band D council tax bill.

Anybody would think that a County Council election was in the offing.

These reserves will run out sooner or later and the council tax will have to be increased sooner or later and more cuts implemented sooner or later.  This appears to be a crude manipulation of the budget to fit in with an election cycle with the intention of improving the Conservatives chances of being re-elected; it is exactly the sort of thing that brings party politics and their politicians into disrepute.  It kicks into the long grass, at least until after the elections, the need to be honest with the public about where the cuts will be coming from.

So when you go out to vote just remember they have tried to ‘bribe’ you by giving you £50 of your own money back to make themselves look good in the run up to an election.  Don’t ya just love ‘em?

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Underfunded, overstretched hospitals. But who gives a damn? Part 2

A while ago I published a blog with the title ‘Underfunded overstretched hospitals.  But who gives a damn? It was followed by an even more stark blog ‘The £0.5m 677 death cover up’. Enough to rattle a few important people you would have thought.

In my experience the overwhelming majority of NHS front line staff want to provide fast access to safe care in clean hospitals; from time to time they have been let down by a few of their front line colleagues.  The governments actions, post Mid Staffs, have homed in on holding front line staff to account but have not tackled that equally worrying aspect of the NHS; a management culture of spin and cover up and a culture more concerned with targets than with safety.  The cover up culture so ably demonstrated by our own ULHT when it lied to its own staff.  This is so deeply ingrained that to change this management culture and make sure we have a safe NHS you have to change the people.  There is evidence that this culture has contributed to avoidable harm to patients.

So I ask again who gives a damn about all this?

Lincolnshire Independents, who will be fielding around 40 candidates in the May County Council elections, have taken an interest and made it clear that they give a damn.  They want proper funding of Lincolnshire’s NHS and the Chair of ULHT held to account for his use of £0.5m of our money, intended for patient care, being spent on gagging people.

So what have our Conservative MP’s done????

Well all credit to Karl McCartney.  He has made it clear that he thinks that Nicholson the CEx of NHS should go.  He has signed the early day motion condemning Nicholson. Stephen Phillips has, behind the scenes, been trying to get ministers to understand the seriousness of Gary Walker’s allegations.  The others………..  if they have been very active, it is not apparent, well to me anyway.  Remember this is about the safety of your or your families care.

Mark Simmonds, MP for Boston, used to be critical of Labour’s funding of Lincolnshire’s NHS.  Whilst Boston Pilgrim Hospital has been on the receiving end of damaging reports from the CQC about care at that hospital, it is not clear that Mr Simmonds has done much more that write the odd letter.  In fairness he has been busy dealing with health issues,  but just not in our county; allegedly he has been paid at a rate of £3000 per day to help Circle Health as a private provider take over Hinchingbrooke Hospital.

Nick Boles, the infamous MP for Grantham even refused to meet me when I wanted to talk to him about a number of matters including the safety of our local NHS……But then reading the Grantham Journal he does not seem that interested in what his constituents think.

Edward Leigh, former Chairman of the Public Accounts Committee, Sir Peter Tapsell father of the house, John Hayes, now in No10,  three senior members of the Conservative Party who could make a difference to the NHS……. seem not to have been that interested – well not in public at least. Conservative Councillors who lead the local Health Scrutiny Committee seem to have been asleep …….

Perhaps they all have private health insurance and we are not all in it together.

Labour have been silent (but of course they had 10 years to sort out the funding of Lincolnshire’s NHS and failed).

I am sure that all of these MP’s and Councillors are concerned about the quality of of care provided by our NHS and its funding.  If that is the case it would inspire more public in them if that was more apparent. Some visible leadership would not go amiss.

So when you vote in the County Council elections in May, just remember who is clearly standing up for Lincolnshire and who it would seem is not.  By and large with a few notable exceptions it does not appear to be the Conservatives.  Lincolnshire Independents who can and do speak out, without having to look over their shoulder for fear of upsetting party bosses in London, are prepared to put Lincolnshire first.  About time somebody did.

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Nicholson’s leadership of the NHS – the man with no memory

The failure of the NHS to use mortality data effectively is worrying to put it mildly and it seems clear from comments from other, such as Sir Brian Jarman, that Nicholson must take some responsibility for that.  Nicholson may argue that he did not know, cannot remember, did not see the emails etc and play the role to quote from the Daily Mail of the ‘man with no answers’.  Perhaps in the wake of his climbdown to the Public Accounts Committee and his eventual admission that Gary Walker did blow the whistle to him he should now be called the ‘man with no memory’.

Well here is another one where he cannot say he was not told.  It is an extract from my evidence to the Health Select Committee dealing with a report Nicholson personally commissioned into allegations of bullying:

‘a)   The report when it was released was shocking.  At paragraph 15 it stated ‘we frequently encountered differing accounts of the nature [of meetings and telephone conversations]’ in the face of conflicting evidence about what happened in meetings and in phone calls they decided to ‘principally use extracts from relevant correspondence and reports as a more reliable account of the tone and style of communications and therefore relationships…’. 

b)   I considered this an absolutely extraordinary approach when dealing with allegations about bullying and amounted to suggesting that bullying must be in writing either for it to count or for it to be investigated.  It is extraordinary to suggest that correspondence and reports would be a ‘more reliable’ account of relationships. If, as a former Chief Executive of a local authority employing 20,000 staff, I had allowed such a criteria to be used in such an investigation I would expect to be strongly ridiculed.  If I had been David Nicholson I would have binned the report as soon as I got to that paragraph.

c)    Last year I was asked to conduct a review of the culture of NHS Lothian, one of the largest health organisations in the UK, after the manipulation of waiting lists.  I was commissioned to submit a confidential report to Nicola Sturgeon, Deputy First Minister and to produce a public report.  We conducted around 60 one to one confidential interviews and were informed of numerous incidents where staff were either told or witnessed others being told that they would ‘get their P45’ or be ‘parted from their livelihood’ if they did not meet targets. These threats were never in writing.  If my review of NHS Lothian had been based on the Goodwin criteria as set out in paragraph 15, its conclusions would have been very different and completely inaccurate.

d)   I remain appalled at the quality of the report and it is difficult to conclude other than the results were a foregone conclusion and just part of the culture of cover up evident elsewhere in other parts of the NHS. I referred to it as whitewash.

e)   However the position is even worse than that in that David Nicholson ignored limitations of paragraph 15 and added further whitewash.  In spite of the report making it clear that there were conflicting accounts of meetings and phone conversations, David Nicholson issued a statement saying that there was no bullying ‘whatsoever’.  The word whatsoever does not appear in the report.’

 Now the Mid Staffs report refers to bullying and makes it clear that it exists in other parts of the NHS.  In this brave new post Mid Staffs world we need leaders who will challenge such conduct and make it clear that it is unacceptable and inconsistent with safe care.  In this case you may well conclude that Nicholson was party to the use of whitewash as alleged above  or he genuinely believes that correspondence and reports can be more reliable in the assessment of bullying.  Either way……..

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Would you want to be a ‘frequent flyer’ of the NHS with Nicholson in charge?

Just when you thought it couldn’t get any worse, Prof Sir Brian Jarman criticised the NHS for failing to use mortality data to improve safety in our hospitals.  There is media speculation that the failure to use this information could have led to 20,000 preventable deaths over the past 10 years.

Shocking.

But then we recall David Nicholson’s comments at the Mid-Staffordshire Inquiry don’t we?  The comments were ‘Quality was not an organising principle of the NHS’.  Staggering comment from somebody running an organisation that we place our trust in for our, and our families, life saving care.

On these number round 200 patients per month die needlessly, about as many passenger as you get on the average flight.  If a major airline decided that quality was not an ‘organising principle’ of its services and had the equivalent of one plane crash per month you wouldn’t fly them would you?  You would definitely not want to be a frequent flyer. If you were the regulator you would ground them, wouldn’t you? If you were a shareholder of the company you wouldn’t accept that the person who was running the company could remain in post,  would you?

It is truly shocking that after the Mid-Staffordshire report and these revelations that Sir David Nicholson remains in post.

What is even more shocking is our politicians and Sir Bob Kerslake, the head of the civil service, leave him there.

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Grieving relatives slam Cameron

Cure the NHS, the organisation representing  grieving relatives in Mid Staffordshire and Patients First have sent a scathing letter to our beloved leader and Prime Minister, David Cameron.  It berates him for protecting NHS boss David Nicholson in the wake of the scandals besetting the NHS.  It essentially accuse Cameron of having one rule for ordinary NHS staff (and bankers for that matter) and another for Nicholson…. Of having double standards no less.

The letter is an extraordinary indictment of the Government and its willingness to embrace the changes called for in the Francis Report.  The first chance it get to change the culture by changing the head of the NHS it ducks based on what appear to be wholly improper grounds.  Shocking.

 

Full text below:

23rd February 2013

Dear Prime Minister

Formal complaint against Sir David Nicholson

We refer to our letter of 14 February 2013 calling upon you to intervene and encourage David Nicholson to do the decent thing and resign as head of the NHS, in the wake of the Mid Staffordshire scandal.

To date we have not received a reply to our letter or even an acknowledgement. Media comments and articles lead us to believe that you continue to back and support Sir David.  We are surprised at your reported comments commending Sir David for ‘the grip and grasp’ he has over the NHS and his ‘knowledge and understanding’ on the one hand and then not accepting that he either did or should have known about the problems the NHS faced in Mid Staffordshire and elsewhere and take personal responsibility.  This with respect is contradictory and illogical.

Ministers seem to be encouraging regulatory authorities, and indeed the police to pursue individual members of staff in Mid-Staffs who have failed to fulfil their duties properly and effectively which is a proper course of action.  We do not wish to condone any of those who failed but we do note that first Mid-Staffordshire report said that staff pursued targets at the expense of patient safety as they were in fear of losing their jobs.  We note that the more recent report was critical of the ‘system. In some cases these two factors may have been a significant cause of an individual’s failure of judgement or conduct.  We note and contrast the ministerial encouragement to pursue those individuals, who relented to this ‘system’ and ‘climate of fear’ and failed their duties, and the government’s refusal to pursue those who either created or failed to change that system or climate of fear.  We find such double standards by the government totally indefensible and a travesty to the memory of patients who have unnecessarily died as a result.  This is a deeply shameful and unjustifiable position for any government to adopt.  It is even more shameful when it is suggested that the pursuit of Sir David would be scapegoating whilst the pursuit of other individuals is not.

Furthermore we contrast this astonish stance with the government’s frequent statements about the banking system, that staff must not be rewarding for failure, and its determination to hold the senior managers of banks accountable and take responsibility for the activities of all of their staff.  We note, as the public will note, the inconsistency of the government that the same apparently does not apply to the NHS.

Furthermore we are extremely disturbed at media reports of your and Stephen Dorrell’s comments which amount to the protection of Sir David Nicholson because he has faithfully implemented government policies particularly at a time when the currently reform programme was extremely politically difficulty.  We find it a shocking indictment of your government and public conduct and public behaviour for ministers to shield senior civil servants from true accountability because they have been politically loyal.  It is even more shocking that occurs with a callous disregard for the views of grieving relatives.

Your refusal to intervene and the failure of moral leadership from the government together with Sir David’s unwillingness to resign, and take responsibility, leaves us with no alternative other than to submit a formal complaint to the Head of the Civil Service about Sir David and demand that it be thoroughly investigated.

You will be aware that complaints were first made in July 2012 and have not been investigated, through political interference or otherwise.  We would ask for your assurance that there will be no political interference in this broader and more extensive complaint, which goes well beyond the confines of Mid Staffordshire, and that you will support our call for a full and thorough investigation to be carried out by an individual unconnected with government or the civil service.  We would remind you of the Ministerial Code of Conduct.  We will, when we submit the detailed allegations to the Head of the Civil Service, ask for similar assurances.

If any frontline professional neglected their duty with regard to raising concerns and listening to concerns this would be investigated and, should that investigation identify that there is a case to answer, would immediately face disciplinary proceedings. Often the member of staff would face a “non-detrimental” suspension. We ask that Sir David be treated no better or worse than any other NHS member of staff.

We wish to emphasise that the complaint to the Head of the Civil Service will not be a re-run of the Mid Staffordshire Inquiry which was about a narrow issue of one specific hospital.  Indeed the Inquiry refused to accept evidence of broader NHS failures and so much of what we will raise has never been the subject of a proper independent investigation.  It is now clear that there are widespread systemic failings in the NHS which Sir David has been responsible for leading.  We utterly refute that this is scapegoating.  It is holding those in a position of trust and authority to account.

You will be aware of the NHS Code of Conduct for Managers requires Sir David to make the care and safety of patients my first concern and act to protect them from risk’ and ‘to accept responsibility for my own work and the proper performance of the people I manage’; you will also be aware of concerns about the use of public funds to protect personal or institutional reputations and the role of the Accounting Officer.  In addition there are allegations concerning United Lincolnshire Hospitals NHS Trust.

From the above you will realise that we are truly horrified by media reports which suggestion that Sir David is not to be exposed to the same system of personal accountability you are proposing for the rest of the staff of the NHS, allegedly due to his close relationship with Ministers and the ‘debt’ owed to him by your party.

Dr Kim Holt, Consultant Paediatrician MBCHB BSc DCH MRCP MSc, Chair of ‘Patients First’ and Lead Consultant.  Jennie Fecitt, RN, BSc (Hons), Specialist Practitioner (Adult Nursing), NMP, PGCE Lead Nurse, ‘Patients First’. Julie Bailey For ‘Cure the NHS’.

 

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