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Doctors reject Hunt's mediocrity jibe

Health Secretary attacks culture of 'complacency' and 'low aspiration' in the NHS

Mark Gould

Monday, 11 March 2013

Sir Richard Thompson, the president of the Royal College of Physicians (RCP) has hit back at accusations by Health Secretary Jeremy Hunt that too many NHS trusts were happy to accept mediocrity.

Mr Hunt launched the attack in a speech on Friday at the Nuffield Trust think-tank where he said that part of the challenge of improving quality and performance in the NHS is tackling "mediocrity and low expectations before they turn into failure and tragedy".

"Coasting can kill. Not straight away, but over time as complacency sets in, organisations look inwards, standards drop and then suddenly something gives," he said.

"I would never describe the majority of hospitals or wards in the NHS as mediocre - but I do believe our system fails to challenge low aspirations in too many parts of the system.

"Imagine for a moment that the main objective for our Olympic athletes was not to win but to 'not come last'. How many gold medals would we have won then?

"It sounds ridiculous doesn't it? But today I want to suggest that too much of the NHS is focused on doing just that.

"Not on achieving world class levels of excellence - the gold medals of healthcare - but meeting minimum standards, the equivalent of 'not coming last'."

Sources said Mr Hunt's words were aimed not at those that are failing minimum standards or waiting time targets, but the bulk in the middle that were not excellent and not poor.

While Sir Richard said Mr Hunt was right to highlight that there is variation in the standards of hospital care across the NHS he said that it was wrong of him to imply that hospital staff are prepared to accept mediocrity. "This is not my experience. Most trusts are struggling to cope with an impossible burden of a relentlessly increasing workload coupled with financial restrictions."

He said that in September last year the RCP highlighted the systemic problems in the NHS in its report Hospitals on the edge? which calls for all health professionals to promote patient-centred care and to treat all patients with dignity at all times. He said the RCP’s Future Hospital Commission, due to report in June 2013, is reviewing the standards and processes for care of patients in hospital and will outline how parts of the system must change to better meet all patients’ needs by placing them at the centre of all we do.

“This work is underpinned by playing a leading role in accrediting healthcare services and auditing clinical and organisational practices and outcomes. This process empowers health professionals to drive real service improvements across the system. We believe the development of this has a strong role to play in the widespread improvement of patient outcomes," Sir Richard added.

Professor Tim Evans, the RCP’s lead fellow for the future hospital, who spoke at the same Nuffield Trust summit as Mr Hunt, highlighted the need for strengthened medical professionalism to sit alongside radical change in the way services are structured, saying:

“Senior doctors have to be accountable for coordinating and assuring patients’ care, beyond specialties. There are good hospitals out there; the difference is the leadership and teams they put in place.”

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