Today’s long-awaited publication of the second
Francis Report into
Mid-Staffordshire NHS Trust is being hailed by many as a watershed in the
National Health Service. Whereas the
four previous inquiries into the failure at Mid-Staffs focussed on the specific
failures of the hospital staff and management, this second report from Robert
Francis QC focusses on why the many checks and balances in the NHS regulatory
system so completely failed to pick on the problems.
The report highlights a massive managerial, cultural and
organisational failure not just at the trust, but in commissioning bodies,
professional bodies, training institutions, the NHS Executive and the
Department of Health. Somehow or other,
every part of the system had a vested interest in ignoring or marginalising
reports from staff who were raising concerns about the failures at
Mid-Staffs.
Of particular concern to nurses are the failures highlighted
in the Royal College of Nursing in its role as both a professional body and a
trade union. It failed to support
whistle blowers, and failed to take seriously the issues its own members were
bringing to its attention.
As Christians we are obviously concerned to show the love
and compassion of God to our patients – it’s why we went into nursing. But as a
report on the BBC Radio 4 Today
Programme this morning highlighted, so many nurses and midwives across the
NHS even now struggle with staff shortages, target culture and pointless
bureaucracy which constantly put pressure on them to spend less time and energy
actually caring for their patients’ needs.
One midwife sadly said that while she loved being a midwife, her advice
to anyone training today would be to seek as soon as possible to practice
anywhere other than within the NHS or the UK! All those speaking in this report wanted to
remain anonymous and had their words spoken by actors – such is the climate of
fear many feel in the NHS. To speak out
is to jeopardise your career.
This sounds very dispiriting, and I hear other stories
regularly of very good care, and of nurses and midwives loving their work and
working environment. But so many also
report their struggles with a system that tries to stop them caring. Francis challenges this, proposing that
openness and a culture of transparency are vital for the professions and
institutions in the NHS. Speaking out for the poor and the vulnerable is a core
calling for all God’s people, and we should be the first in line to speak out
appropriately when things are wrong.
The report also challenges all NHS staff to change the
workplace culture away from protecting the institution and its priorities and
towards caring for the patient and their needs.
It seems shocking that this needs to be said in this day and age, but
the evidence of the report suggests that too often it is the protection of organisational
interests that trumps care for our patients.
Christians
are
called to show compassion to all who are in need, and to be
salt
and light wherever we find ourselves.
How can we be agents for change in our places of work? How do we each
day model to our students, our colleagues, our managers and our juniors how to
truly care? What values and priorities do we bring to the workplace each day,
and how much do they rub off on those with whom we work? It goes both ways, of course, so we need to
be regularly filled with the Spirit and fed on the Word if we are going to come
in a different spirit. For that we need
not only our churches to support and pray for us in our work – we need to seek
each other out and support and pray for one another.
We will be waiting until March to hear what the government
is going to do – how many of the Francis Report’s 290 recommendations it will
actually put into practice waits to be seen.
But the report makes one thing clear – it will be bottom up change from
ordinary staff that will truly revolutionise our health service, not more top
down reforms. That is a challenge to us, to be the hands and feet of Jesus in
the NHS and be his agents for change.