MPs were debating accountability in the NHS following the Mid-Staffs scandal today, and as part of that, the argument about who – if anyone – should be held responsible continues to rumble on. Charlotte Leslie and many of her Tory colleagues want to see Sir David Nicholson gone (and The Telegraph‘s Robert Winnett reports that senior government figures are considering a route by which he can exit). But the focus of Jeremy Hunt and other Conservatives is on Andy Burnham instead. Today Hunt said:
‘[Nicholson] does bear some responsibility. He said himself ‘we lost our focus’, he has apologised and has been held to account by this House and others. But I don’t believe that he bears total responsibility, or indeed personal responsibility for what happened.’
Hunt said Nicholson had ‘consistently warned’ of the dangers of hitting targets without improving care, and added that ‘others do bear a far more direct responsibility’, including the board of the Trust. But he also rejected the argument advanced by Andy Burnham that ‘there were cases where the underlying culture of the NHS didn’t change’ in spite of ‘well-meaning’ policy changes. Hunt said that ‘Labour did make three huge policy mistakes and he must accept that it is not simply a question of government policy not being implemented’. Hunt also had a little moan about the way Labour likes to focus on the motives of the current government in reforming the NHS rather than the detail.
The shift from ‘there should be no scapegoats’ to ‘Labour has questions to answer’ happened last week. The Prime Minister’s PPS, Sam Gyimah, included a question about Labour and the Mid Staffs scandal on the list of suggestions for PMQs that he sent to Tory MPs. In the end, it fell to a Labour MP to raise Nicholson, which allowed David Cameron to say ‘other people, frankly, should be thinking of their positions too’.
Burnham was understandably anxious about what the Francis Report might say about him, although in the end the final publication made more comfortable reading than he’d anticipated. He took care today to say that Labour ‘will face up to what went wrong… and I repeat that apology for the families of those who suffered appalling abuse and neglect’. He also criticised ‘a tendency to pull the shutters down’ in the NHS when complaints appeared. But his argument that good policies weren’t being implemented was not particularly convincing.
Actually, if Labour were the party in government now and Mid-Staffs had happened on the Tories’ watch, it’s hard to imagine today’s debate being quite so polite. But Hunt dismissed ongoing concerns about Nicholson and aimed again at Burnham. Nicholson may need to stick around to implement the complex web of NHS reforms in the next few weeks, but the Tories must beware of attacking just one group that was involved, rather than all groups. Labour does have questions to answer. But it’s not the only name in this row. Jeremy Hunt wants to paint himself as a ‘patients’ champion’, and to that end he needs to look at those other managers involved in Mid-Staffs. He made some moves on this today, attacking the board members at the Trust who ‘seem to have melted into thin air’. There is a danger that the Conservative party turns this issue into a political game if it just focuses on Burnham and other Labour figures. So it does need a plan for Nicholson, even if it involves him implementing the reforms and then going in the summer.
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