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David Cameron’s sombre response to Mid-Staffs report includes hint of political row to come

6 February 2013

David Cameron does big solemn occasions well. He’s skilled at taking a statement above the usual tit-for-tat partisan exchanges in the Commons. Everyone knows that, as does the Prime Minister, which is why he made the statement on the Francis Report rather than the Health Secretary. The Tories know that turning the response to this inquiry into a political football would not serve the party well, given Labour’s 16-point lead in the polls on the NHS.

The tone was sombre, with the Prime Minister apologising for the suffering caused by failures at the Mid Staffordshire NHS trust. He also emphasised that today was not about hunting down scapegoats, even though some are calling for the resignation of Sir David Nicholson as NHS chief executive. But though he sought to make the tone of today’s statement apolitical, with Andy Burnham, who was Health Secretary at the time, nodding his head in a agreement at a number of points in the statement, the Prime Minister did point to one part of the government’s response which could well spark political tensions with the opposition.


It is difficult to disagree with his emphasis on a culture of care in the health service, but the Prime Minister did also tell MPs that he was minded to support performance-related pay for staff. He said:

‘Nurses should be hired and promoted on the basis of having compassion as a vocation, not just academic qualifications. We need a style of leadership from senior nurses which means poor practice is not tolerated and is driven off the wards. Another issue is whether pay should be linked to quality of care rather than just time served at a hospital. I favour this approach.’

Given the reaction of the teaching unions to performance-related pay, doing the same for nurses could well be difficult for Labour to support, and when such proposals come to Parliament, there is unlikely to be such a solemn tone in the Chamber as there was today.

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  • arnoldo87

    As usual, when it comes to serious issues such as the state of the NHS, Cameron is at his most Prime Ministerial. There is nothing to be gained by turning this into a party political issue.
    The lack of care on the wards highlighted by the report is clearly a cultural issue by dint of its ubiquity. The difficult bit is reversing this culture, and I don’t think it will be helped by linking nurses’ pay to quality of care, unless the measurement of that quality is performed against ward level or higher. A hospital depends on teamwork far more than a school does, so the team should be judged and not the individual, and there could be invidious situations arise where a nurse is directed away from what she believes to be optimum care for the patient by a ward sister instruction.
    One simple improvement that could be effected immediately (and this may already be a recommendation – I haven’t yet read the report) is to stop the control desk in a ward being the place where nurses share their social life experiences with each other. For patients and visitors, this is pretty disconcerting to listen to, especially if suspicions of lack of care on that ward exist.

  • Charles Hedges

    It defies any sense of decency that Sir David Nicholson remains chief executive.

  • realfish

    I thought that Cameron got it spot on with his statement today, his non-partisan approach was Prime Ministerial. Not so Miliband, his response was formulaic and for him, typically shallow.

    Miliband’s jibe about the dangers of repeated NHS organisations was beneath him – an attempt at politicising the debate, at distraction and something that instantly put him on the wrong side of the argument. Does Miliband REALLY believe that given the deaths at Stafford, Redditch and Maidstone that the NHS, as organised by Labour, ‘was fit for purpose’ and not in need of urgent repair?
    Miliband’s other problem is Burnham. While Francis was keen to press for more accountability …but bizarrely reluctant to name names, Burnham is damaged goods. He cannot now be seen as being a credible participant in any healthcare debate or someone who could be trusted as a future health minister.

    • telemachus

      Why beneath him?
      In 1997 half the folk on cardiac surgery waiting lists were dying
      By 2010 everyone was getting treatment within 18 weeks
      This required the iron fist and investment of Gordon
      It is truly sad that Lansley came in to destroy this and Cameron let him

      • HJ777

        The ‘maximum 18 weeks waiting time’ measure was for the wait to be seen by a specialist. not to be treated. The wait to be treated (or even diagnosed) was often far, far, longer as my mother can tell you.

  • Colonel Mustard

    By apologising on behalf of Labour and letting them off the hook he once again does his party no favours. Much of the electorate are stupid enough to take his apology for responsibility.

    The BBC manages to lay part of the fault at the door of the cost-cutting and target-chasing culture without once mentioning that culture was the responsibility of the Labour government who were pouring money into the NHS.

    Once again teflon coated Labour get away with it. Just imagine how this would have played out if it had happened under a Tory government.

    • James Strong

      I’ve just read the link you posted.
      Twice it refers to the period 2005-2008.
      I don’t think that ‘much of the electorate are stupid enough’ not to know who was in government then.
      ‘Just imagine how this would have played out if it happened under a Tory government,’ you write.
      So now we blame the BBC for how they didn’t report an event that didn’t happen?

      • realfish

        There was exposure of a number of deaths at Alexandra Hospital, Redditch recently, followed immediately by criticism on various websites (notably the Daily Mail) of the Tory’s record and complicity. This criticism, from at least one Labour MP and many members of the public.
        The deaths took place between 2007 and 2009

        • James Strong

          I accept what you say, I accept that the Conservative government was not complicit and I accept that it is wrong to blame them.
          I expect Labour MPs to make political points, and I’m not surprised at poor reporting from the Dailty Mail.
          But none of this is evidence of BBC bias.
          A prediction was made that the BBC would report this story in a biased way, there has STILL been no evidence of that.

  • the viceroy’s gin

    I’m curious as to why you Speccie teenagers consider it your sworn duty to elevate this lilliputian Cameron?

    Nobody anywhere would consider this guy anything other than a careerist political hack, and yet you kids insist on celebrating some non-existent gift or another.


    • Fergus Pickering

      ‘I have climbed to the top of the greasy pole’ Disraeli.

  • HooksLaw

    Pay went up under Labour and standards of compassion went down. North Staffs was caused by poor management which gave in (and gave up) to fulfilling political motivated targets rather than speak out against them.

    I should add that the management of health care that I am familiar with is very much concerned with compassion, so its not all a one way street.

    • HooksLaw

      And …
      Cameron may well have to apologise for another scandal under labour as today RBS were fined for their involvement in the LIBOR scandal. Will labour be calling for inquiry into what happened on their watch. Will Ed Balls volunteer any information?

    • James Strong

      True that Cameron had to apologise on behalf of the last Labour Government; he’s the head of government now, it’s part of his job to go through the form of words. That is not the same as accepting the blame.
      You know, do you, that Ed Milliband has apologised for what the Labour Government did, I just heard him say that, on the PM programme, on Radio 4, on the BBC.

      • telemachus

        No actual need to apologise overall for the major investment that has saved probably hundreds of thousands of lives.
        That the professionalism of the staff was found wanting is not a political failure

        • starfish

          whereas we KNOW what NHS negligence did in this case
          do you approve?

  • starfish

    Given that the stated purpose of the NHS is to heal the sick I believe linking acceptable caring behaviour to pay is entirely appropriate

    Or does it exist to provide employment to the producer interests….?

    • telemachus

      The NHS is a low pay demoralised organisation
      Remember that the cabinet is backing a plan for regional pay, which would mean that nurses, midwives, hospital porters, cleaners and paramedics would earn less if they work in the north or the Midlands rather than in the south of England. Official documents reveal that the only exemption backed by the Department of Health would be for highly paid managers working in new bodies established to deliver Lansley’s controversial NHS reform programme, widely criticised as a privatisation of the health service.
      Is Stafford in the Midlands?

      • starfish

        Noticed your absence yesterday – what were you up to – getting instructions from the hive collective?
        It makes no sense for staff working outside the SE to earn more for doing the same job
        That is the socialist way isn’t it?

        If you need help with UK geography I suggest you look at a map

        • telemachus

          The way forward is to value staff by verbal and pay reward wherever they happen to live

      • HJ777

        The OECD says that “compensation” [i.e. pay] levels in the NHS are high compared to comparable countries.

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