X

Create an account to continue reading.

Registered readers have access to our blogs and a limited number of magazine articles
For unlimited access to The Spectator, subscribe below

Registered readers have access to our blogs and a limited number of magazine articles

Sign in to continue

Already have an account?

What's my subscriber number?

Subscribe now from £1 a week

Online

Unlimited access to The Spectator including the full archive from 1828

Print

Weekly delivery of the magazine

App

Phone & tablet edition of the magazine

Spectator Club

Subscriber-only offers, events and discounts
 
View subscription offers

Already a subscriber?

or

Subscribe now for unlimited access

ALL FROM JUST £1 A WEEK

View subscription offers

Thank you for creating your account – To update your details click here to manage your account

Thank you for creating your account – To update your details click here to manage your account

Thank you for creating an account – Your subscriber number was not recognised though. To link your subscription visit the My Account page

Thank you for creating your account – To update your details click here to manage your account

X

Login

Don't have an account? Sign up
X

Subscription expired

Your subscription has expired. Please go to My Account to renew it or view subscription offers.

X

Forgot Password

Please check your email

If the email address you entered is associated with a web account on our system, you will receive an email from us with instructions for resetting your password.

If you don't receive this email, please check your junk mail folder.

X

It's time to subscribe.

You've read all your free Spectator magazine articles for this month.

Subscribe now for unlimited access – from just £1 a week

You've read all your free Spectator magazine articles for this month.

Subscribe now for unlimited access

Online

Unlimited access to The Spectator including the full archive from 1828

Print

Weekly delivery of the magazine

App

Phone & tablet edition of the magazine

Spectator Club

Subscriber-only offers, events and discounts
X

Sign up

What's my subscriber number? Already have an account?

Thank you for creating your account – To update your details click here to manage your account

Thank you for creating your account – To update your details click here to manage your account

Thank you for creating an account – Your subscriber number was not recognised though. To link your subscription visit the My Account page

Thank you for creating your account – To update your details click here to manage your account

X

Your subscriber number is the 8 digit number printed above your name on the address sheet sent with your magazine each week. If you receive it, you’ll also find your subscriber number at the top of our weekly highlights email.

Entering your subscriber number will enable full access to all magazine articles on the site.

If you cannot find your subscriber number then please contact us on customerhelp@subscriptions.spectator.co.uk or call 0330 333 0050. If you’ve only just subscribed, you may not yet have been issued with a subscriber number. In this case you can use the temporary web ID number, included in your email order confirmation.

You can create an account in the meantime and link your subscription at a later time. Simply visit the My Account page, enter your subscriber number in the relevant field and click 'submit changes'.

If you have any difficulties creating an account or logging in please take a look at our FAQs page.

Leading article

Bad care

2 February 2013

9:00 AM

2 February 2013

9:00 AM

When the letters ‘NHS’ appeared to the world above the dancing nurses at the Olympic opening ceremony, many in Britain will have imagined two darker words hovering alongside: ‘Mid Staffs’. Few of those affected will have been able to forget what now seems to be one of the greatest scandals in the history of British health care. Its horrific details will be laid out in full next week when Robert Francis QC publishes his report into Mid Staffordshire NHS Foundation Trust.

What we already know about the level of care at the Trust is shocking — and goes far beyond patients left in soiled bedclothes. There was the case of the elderly patient left to bleed to death because a nurse failed to act upon the telltale signs of rising heart rate and falling blood pressure. The hospital seems to have recorded between 400 and 1,200 more deaths than would have been expected over a three-year period.

Had this happened in a private hospital, it would be described as one of our worst peacetime disasters: worse than Lockerbie, Hillsborough, Hatfield and Potters Bar put together. Margaret Hodge, chairman of the Commons Public Accounts Committee, would emerge as the lead inquisitor. Union leader upon union leader would reject the notion of ‘system failure’ and call for jail sentences — perhaps accusing shareholders of having blood on their hands. The government, too, would feel obliged to take action, terminating the contracts of other, perfectly good hospitals.

Yet when the Francis report is published on Wednesday, no one will call for the NHS to be closed down. No one will call for charges of ‘corporate manslaughter’. No one will argue that the disaster was the inevitable result of human laziness, recklessness or greed. There will instead be an awful lot of talk about the need to ‘tighten up procedures’.

[Alt-Text]


Compare and contrast with the case of Winterbourne View, the privately run Bristol hospital for patients with learning difficulties, where staff were filmed physically abusing patients by an undercover BBC reporter. The hospital was closed. Six staff were jailed. And Norman Lamb, a health minister, announced that 3,400 patients in similar hospitals would be reassessed with a view to moving them into NHS accommodation. The implication is that all private providers are suspect. The Cameron government tries to encourage independent providers into the system, but did nothing to defend them.

It ought to be plain to anyone that bad doctors and nurses, like bad professionals of all kinds, lurk in the public and private sectors alike. A Bupa nurse is every bit as much a public servant as an NHS nurse. And for every cowboy surgeon implanting dodgy breasts in a private clinic, there is an NHS doctor botching treatments. There is nothing that can be learnt from picking out the extreme examples of bad apples and trying to make conclusions about the public and private barrels in general.

But the futility of trying to use the occasional negligence and wrongdoing of private companies to attack capitalism in general will not stop the likes of Ms Hodge. Last year A4E, one of the companies involved in running welfare-to-work programmes, found that some of its staff had been fraudulently massaging figures to increase payments, and reported the matter to the police. Hodge did not even try to hide the fact that she was on a crusade against the involvement of private companies in public services, declaring: ‘The profits you make come from the taxes that ordinary, hard-working people pay.’

Far from providing a damning judgment on private companies who provide public services, the case pointed to something quite different: that private companies are far better at weeding out wrongdoing. Studies suggest fraud is significantly more likely to be detected in the private sector than in the public sector. Consider the case of the Whitehall civil servant who concocted invoices to divert £246,000 of public funds to his own account. He was caught only after his suspicious bank manager made inquiries, and even then the case was never reported in the press. Had this been carried out by an accountant in one of Michael Gove’s free schools, Labour would probably have called for every one of them to be closed down.

Lies, book-fiddling and blunders are inevitable in every walk of life. The question is how quickly they are detected and dealt with. There is a striking contrast between A4E, which moved rapidly to deal with the fraud it uncovered, and the Mid Staffordshire NHS Trust, which dismissed and then tried to discredit statistics which suggested it had a worryingly high death rate. To those operating in a competitive environment, reputation is everything. There is nothing more fatal than being seen to act recklessly or to try to brush aside public concerns: just ask BP’s shareholders, who were taken to the cleaners after the Deepwater Horizon disaster.

The Stafford Hospital scandal is a painful reminder that things can and do go horribly wrong in the NHS — but, worse, due to its ponderous bureaucracy, the problems can go undetected for a long time. If it wasn’t clear before the Mid Staffs scandal that the NHS can benefit from more independent providers, it should be now.

Give something clever this Christmas – a year’s subscription to The Spectator for just £75. And we’ll give you a free bottle of champagne. Click here.


Show comments
Close