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Former NHS chief exec says Francis ‘let Government off the hook’

Report ‘has enabled politicians to indulge in characteristic evasion’

Louise Prime

Thursday, 18 April 2013

A former NHS chief executive has accused the Francis inquiry of allowing the Government to evade the truth, in a personal view published on bmj.com. He says he feels disturbed by both the second Francis report, and by the Government’s response to it.

David Hands, visiting professor in health policy and management, University of Glamorgan and former chief executive of North Wales Health Authority, said he finds it “astonishing” that although Francis recognised inappropriate culture and system failure, he nevertheless focused blame on the local trust and professional behaviour.

He claims the “myopia” in the report – which he claims did little more than embellish the facts in the first report three years before – “has enabled politicians to indulge in characteristic evasion”.

Professor Hands criticises NHS England’s chief executive Sir David Nicholson practice of deploying management consultants to “review” persistent concerns. He writes: “These superficial exercises inevitably find ‘no evidence’ to warrant full investigation.”

He points out that he offered extensive evidence of “apparent serial clinical and management malpractice related to bullying” to a review at Northamptonshire Healthcare NHS Trust, but the review team chose not to interview any of the 70 potential witnesses, and decided that no investigation was necessary. His concerns about this “cover-up” were, he said, not acted upon by the trust chairman, the SHA, regulators, or Sir David Nicholson. Yet he discovered, when giving evidence to the Francis enquiry in 2011, Department of Health secret papers wrongly stating that his concerns had been “fully and impartially investigated”.

Professor Hands wrote: “Predictably, the government has acted quickly to devolve blame to the front line, to reinforce already top-heavy regulatory bureaucracy, and to defend Sir David Nicholson. It is imposing yet more top-down reorganisation on a punch drunk NHS. The goal is privatisation. How will these actions achieve the commonly shared values and open culture that Francis rightly identifies as crucial to the safeguarding of patients?

“In his evidence to Francis, Sir Ian Kennedy said, ‘My experience of the Department of Health is that they have a tendency to shoot the messenger rather than embrace changes …. Their first priority is to ‘handle’ the situation.’ The establishment, management of, and response to Francis’s second inquiry illustrates this tendency perfectly.”

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