If David Cameron wants to save the NHS, he should sack David Nicholson

Twenty-five years ago, when he had left the Communist party and taken over as chief executive at Doncaster Royal Infirmary, Sir David Nicholson made a point of promising his staff a ‘job for life’. He has certainly stuck to his ideology. This week he admitted his part in the Mid Staffordshire hospitals scandal, in which up to 1,200 patients died from poor care and neglect. He confessed that as chief executive of the Shropshire and Staffordshire Strategic Health Authority — the body which was supposed to oversee Stafford Hospital — he had failed to notice its high death rates. And yet still he appears to believe that he has the right to stay as NHS chief executive for as long as he likes.

If Sir David’s career were one of those charts at the bottom of an NHS bed, it would now be flat-lining, with just an occasional flicker. He commands no authority and inspires no confidence. In front of the health select committee this week, he excused himself — and all other individuals — from personal blame for Mid Staffs on the grounds that the scandal coincided with a period of reorganisation. He then explained that he had to stay in his job because the NHS was again undergoing great bureaucratic change and he was needed to see it through.

The words with which he tried to excuse himself from the Mid Staffs scandal deserve closer examination: ‘For a whole variety of reasons, not because people were bad but because there were a whole set of changes going on and a whole set of things we were being held accountable for from the centre, which created an environment where the leadership of the NHS lost its focus. I put my hands up to that and I was a part of that.’