:01:23. > :01:26.In the Midlands, new figures for the Sunday Politics reveal many
:01:27. > :01:36.patients go I it of their way to avoid Stafford Hospital.
:01:37. > :01:37.
:01:37. > :42:32.Apology for the loss of subtitles for 2455 seconds
:42:32. > :42:36.With the nurses of the future go Hello again from the Midlands. I'm
:42:36. > :42:39.Patrick Burns. And both our guests today ran their own companies
:42:39. > :42:42.before emerging as influential figures in their respective parties.
:42:42. > :42:45.Margot James is the Conservative MP for Stourbridge, and a
:42:45. > :42:48.Parliamentary Private Secretary at the Business Department. Lorely
:42:48. > :42:53.Burt is the Liberal Democrat MP for Solihull, and she chairs her party
:42:53. > :42:55.in Parliament. Welcome to you both. And of course, as former
:42:55. > :42:58.businesswomen, Margot and Lorely will need no reminder that the
:42:58. > :43:04.catastrophe at Stafford Hospital was fundamentally a failure of
:43:04. > :43:11.management. Ever since the sheer scale began to emerge of what
:43:11. > :43:13.happened there over four years from 2005, the hospital has struggled.
:43:13. > :43:16.Now, figures obtained exclusively for the Sunday Politics reveal just
:43:16. > :43:23.how sharply public confidence in the hospital's services has fallen
:43:23. > :43:26.away. In the five years since 2007, the number of people opting for
:43:26. > :43:36.treatment at Stafford through the NHS Choose and Book system has
:43:36. > :43:37.
:43:37. > :43:39.plummeted by 67%, from almost 16,000, to just 6,500. The sharpest
:43:40. > :43:47.falls came after 2009, when the Healthcare Commission's report was
:43:47. > :43:49.published, revealing "appalling" standards of care. Well, Stafford's
:43:49. > :43:55.Chief Executive says it's suffered the equivalent of a �3.7 million
:43:55. > :43:58.drop in income every year since then. Even if we hadn't had the
:43:58. > :44:00.reputational issues around Mid Staffs and the poor failings of
:44:00. > :44:03.care, I think a small district hospital like ours, with a
:44:03. > :44:05.relatively small income every year of �150 million, will find that
:44:05. > :44:15.increasingly difficult to sustain independently without working with
:44:15. > :44:18.
:44:18. > :44:20.others. Margot, you of course managed part of a major global
:44:20. > :44:23.healthcare business before entering Parliament, so in a way you feel
:44:23. > :44:25.for the management there in Stafford, but equally it's
:44:25. > :44:35.understandable, given what we've seen and heard over the last few
:44:35. > :44:36.
:44:36. > :44:39.years, should decide to give it a miss and look elsewhere. Well, I'm
:44:39. > :44:44.surprised that even 6,500 people are willing to choose it, given the
:44:44. > :44:49.reputational damage that the Chief Executive referred to. But I think
:44:49. > :44:51.it's the wider implications for the NHS that are of most concern. There
:44:51. > :44:59.are four hospitals with way above average mortality rates that are
:44:59. > :45:01.being investigated at the moment, and I fear that there will be more.
:45:02. > :45:04.And it's important to point out that at Stafford, their mortality
:45:04. > :45:08.rates have improved a lot, the performance of the hospital is
:45:08. > :45:11.actually improving. But they are saddled with the equivalent of �3.7
:45:11. > :45:14.million every year, Lorely, and as a former businessman, you know you
:45:14. > :45:22.can't really cope with a weight like that when you're trying to get
:45:22. > :45:27.the numbers up, can you? No, it's really difficult. And I think that
:45:27. > :45:31.confidence will be restored eventually. If you speak to people
:45:31. > :45:38.in the street and they have been to hospital, 9.5 times out of 10 they
:45:38. > :45:42.will say they have had excellent and caring service. We need to keep
:45:42. > :45:45.that in context when we are talking about the NHS generally. Margot, I
:45:45. > :45:49.saw you shaking your head. Well, I take a slightly different view,
:45:49. > :45:54.because we've got to take a realistic view. Yes, is excellent
:45:54. > :45:59.care in the NHS. But I think too often when we get a crisis like
:45:59. > :46:03.this, people rush to say the vast majority is absolutely excellent.
:46:03. > :46:07.That is I'm afraid not true. I'm afraid there's too many pockets of
:46:07. > :46:09.bad care. And every time there is a report, and they come with alarming
:46:09. > :46:19.frequency, showing especially for older people in hospital poor
:46:19. > :46:19.
:46:19. > :46:22.standards of basic nursing care. in a nutshell what would you do I
:46:22. > :46:32.you were one of the managers there, as a former businessperson yourself,
:46:32. > :46:33.
:46:33. > :46:37.how would you turn it around as a business, Lorely? I think it is the
:46:37. > :46:46.culture. We need to make people feel relaxed about reporting
:46:46. > :46:51.incidences of bad practice. And not to allow anybody to have that
:46:51. > :46:55.responsibility 0.21 side, to look after people properly. -- put to
:46:55. > :46:58.one side. When I spoke to Robert Francis QC
:46:58. > :47:00.shortly after he'd delivered his report, he told me he'd been
:47:01. > :47:04.personally distressed by the evidence he'd had to hear. He said
:47:04. > :47:07.it wasn't his job to reset the moral compass of the NHS, but he
:47:07. > :47:09.knew his recommendations were bound to be used as pointers towards new
:47:09. > :47:12.ways of stopping this ever happening again.
:47:12. > :47:16.It traumatised the communities it was meant to serve, and scandalised
:47:16. > :47:19.the country as a whole. How could this most caring of the caring
:47:19. > :47:22.services abandon patient care? For the Prime Minister himself to front
:47:22. > :47:27.up for the Government, registered the gravity of the Francis Report,
:47:27. > :47:31.placing it alongside the Bloody Sunday and Hillsborough inquiries.
:47:31. > :47:39.Now, as then, the Prime Minister was "truly sorry". And the report's
:47:39. > :47:45.author was determined lessons must be learnt. This is not a problem
:47:45. > :47:50.that will be solved by a simplistic solution of finding a scapegoat and
:47:50. > :47:55.sacking them. We need to change the culture in the system, and until we
:47:55. > :47:59.do that, you can sack as many people as we like, it will not make
:47:59. > :48:06.a difference. The number of people choosing Stafford Hospital has
:48:06. > :48:12.plummeted. Do you find that understandable? It is
:48:12. > :48:17.understandable and distressing. It shows the power of information, and
:48:17. > :48:22.amongst my recommendations, some of them are designed to improve the
:48:22. > :48:27.information available to the public so that there is a balanced picture.
:48:27. > :48:30.So that trusts admit their failures, and what they are going to be going
:48:30. > :48:32.about them. So, the questions for MPs joining
:48:32. > :48:35.me on Westminster's famous green. Will this report start the business
:48:35. > :48:40.of restoring confidence? I think it will, because the central tenet of
:48:40. > :48:43.it is it will put patients right at the heart of the NHS. Absolutely,
:48:43. > :48:46.because what this report talks about is zero harm, and that's
:48:46. > :48:49.absolutely key. Zero harm for patients, putting patients first,
:48:49. > :48:52.with the quality of care there. These hospital inspectors will be
:48:52. > :48:55.vital I think, and will give people confidence in the future, but
:48:55. > :48:58.there's a great deal more to be done.
:48:58. > :49:01.The hospital itself has wounds to bind. Its emergency department has
:49:01. > :49:04.been closed overnight for 15 months. Local support groups say it is
:49:04. > :49:14.putting its house in order, but the hospital continues to survive, only
:49:14. > :49:15.
:49:15. > :49:21.with government handouts. What exactly will it take to
:49:21. > :49:29.restore trust in Stafford and the NHS as a whole? That is the subject
:49:29. > :49:35.of my latest block. Joining me here is Dame Julie Moore,
:49:35. > :49:40.the chief executive of University Hospitals Birmingham. You are one
:49:40. > :49:45.of the people Robert Francis talked to. I am sure many people at Hulme
:49:45. > :49:52.are astonished that health professionals who have a recommend
:49:52. > :49:56.-- reputation for dedication, lost sign of the patient. I cannot
:49:56. > :50:01.account for how things went terribly wrong at Stafford, but we
:50:01. > :50:05.have a terrible problem at the moment. Who would want to have a
:50:05. > :50:10.career in health care management at the moment? There responsibility
:50:10. > :50:16.for the culture of the Organisation his mind and the board's, and I
:50:16. > :50:22.would be proud for everybody in that my family to be treated at a
:50:22. > :50:28.hospital. Because I am not proud of the work our doctors and nurses do,
:50:28. > :50:33.and I do not want them to be tarred with the reputation but it is
:50:34. > :50:39.coming across the hall of the NHS. But we have too many organisations,
:50:39. > :50:45.too many bodies telling us what to do. What would you do it to the
:50:45. > :50:49.cure the NHS campaigners, who feel that heads must roll some work,
:50:49. > :50:54.whereas people have been promoted? One of the things the report
:50:54. > :51:00.pointed out was how many organisations have been involved.
:51:00. > :51:04.Who is accountable for the things that went on? By think there are
:51:04. > :51:08.too many organisations and responsible bodies at the moment,
:51:08. > :51:14.and if we had an inspector on top of the other bodies that will not
:51:14. > :51:18.help the problem. I welcome an inspector if we will do so some of
:51:18. > :51:23.the many bodies inspecting a hospital. One more it will not make
:51:23. > :51:28.a difference. There is also the idea that managers who are
:51:28. > :51:32.responsible for failures in patient care but no fundamental standards
:51:32. > :51:37.can be sacked themselves. It is that a useful stick for the
:51:37. > :51:42.Government to bring to bear? have sacked doctors, nurses, people
:51:42. > :51:47.who do not come up to standard, I think we often have a belief it is
:51:47. > :51:53.difficult to sack a doctor. You hear of people being suspended for
:51:53. > :51:59.years and years, and that is wrong. We have had a thing in the NHS
:51:59. > :52:03.called for no blame culture, and that meant you could not hold
:52:03. > :52:08.people to account. In the trust we have a policy of Fair
:52:08. > :52:15.accountability, and we expect people to act as professionals and
:52:15. > :52:20.if they did not, we hold them to account. People have seen some of
:52:20. > :52:27.these health executives being promoted. You can understand surely
:52:27. > :52:32.why the campaigners want heads to roll? Yes, I think the failings
:52:32. > :52:38.were so serious that certainly be chief executive and the board of
:52:38. > :52:44.Stafford Hospital should have gone, and why were no nurses and doctors
:52:44. > :52:51.struck off? I think that they cure the NHS campaign have serious
:52:51. > :52:56.questions that need answering. have to agree with Margot. I am
:52:56. > :53:05.interested in some of the changes being proposed, such as the duty of
:53:05. > :53:09.candour. You will be required to report something, not just see it.
:53:09. > :53:13.Doesn't it implied a right to fail as well, if you are being
:53:13. > :53:20.absolutely candid? Better to reports something that is failing
:53:20. > :53:25.it and sort that out, but not to report it at all? Very often with
:53:25. > :53:30.failing hospitals, there is another one I know well in Northamptonshire
:53:30. > :53:35.which was given over to the private sector in the end. That was a case
:53:35. > :53:40.of a very senior doctor running a department who was not operating
:53:40. > :53:46.well. And too many things going wrong. People below him were
:53:46. > :53:50.frightened to report him. I think if we have this duty of candour
:53:51. > :53:57.written into law, people will have a legal duty to report him, and
:53:57. > :54:01.they will be big day and abetting a cover-up if they do not.
:54:01. > :54:08.It will be difficult to be as open about your failings as your
:54:08. > :54:12.successes. It is a difficult thing to do. We have had such a policy at
:54:12. > :54:17.the Trust for a long time, but it is very difficult to own up to
:54:17. > :54:22.mistakes. The current set-up does not make that easier. The
:54:22. > :54:28.Litigation Authority advises you not to do it. One of our mottos is
:54:29. > :54:32.do the right thing. For the moment, thank you very much
:54:32. > :54:34.indeed. David Cameron told MPs Stafford had
:54:34. > :54:36.revealed "completely inadequate standards of nursing". He pledged
:54:36. > :54:39."consistent training" and better support. But with Stafford's
:54:39. > :54:42.medical reputation so badly damaged, how can it attract the brightest
:54:42. > :54:45.and best as its carers in the future? BBC Stoke's Political
:54:45. > :54:47.Reporter Phil McCann asks if trainees at one of the top-rated
:54:47. > :54:57.nursing courses in the country, at Worcester University 60 miles south,
:54:57. > :54:59.
:54:59. > :55:03.would be prepared to help turn Stafford around.
:55:03. > :55:06.This is a story of a poorly and unnecessary suffering of hundreds
:55:06. > :55:08.of people. It was a sobering moment for these
:55:08. > :55:11.trainee nurses. Another reminder of the failings at Stafford, a
:55:11. > :55:20."disease" that had caused the entire system to fail. And it was
:55:20. > :55:24.difficult to believe just how bad things had got.
:55:25. > :55:29.I understand the demands placed on nurses and health care staff, but
:55:29. > :55:33.still, to that extent is really shocking. And the fact that it has
:55:33. > :55:41.not been dealt with much sooner. But with 290 recommendations
:55:41. > :55:47.contained in the Francis Report, what did they make of the "cure"?
:55:47. > :55:52.am hoping that maybe the Government to make rethink about its idea of
:55:52. > :55:56.reform within the NHS with regards to budgeting and trying to save a
:55:56. > :55:59.pound here and apparent there. And put more resources into the NHS.
:55:59. > :56:02.Their course leader welcomed most of his findings, but was concerned
:56:02. > :56:12.about one of the proposed changes - an obligation to tell patients when
:56:12. > :56:18.things go wrong. We want to have an open discussion with patients, but
:56:18. > :56:21.we do not want to instigate a culture of blame. That is what
:56:21. > :56:24.Francis is trying to get away from. It was budget cuts that helped
:56:24. > :56:26.precipitate the crisis here at Stafford Hospital. The challenge of
:56:26. > :56:36.the Francis Report is how to prevent problems happening again
:56:36. > :56:40.
:56:40. > :56:43.anywhere in the NHS when budgets remain very tight. We have looked
:56:43. > :56:46.at a catheter bag. Back in Worcester, having heard the
:56:46. > :56:54.horror stories from Stafford, just how willing would these trainees be
:56:54. > :57:00.to work there themselves? The only way I would be able to take on a
:57:00. > :57:05.brawl at a place like fat is if I knew I was being supported. Be a
:57:05. > :57:09.does put you off a bit. Nurses that are confident in whistle-blowing
:57:09. > :57:14.and making sure that higher standards of care are happening all
:57:14. > :57:18.the time should be working at places like mid Stafford, to give
:57:18. > :57:21.the population at the confidence that this is no longer
:57:21. > :57:25.Signs of compassion already? A willingness from the next
:57:25. > :57:34.generation to get the weakest parts of the NHS back to full health -
:57:34. > :57:41.while ensuring the scars left by Stafford are never forgotten.
:57:41. > :57:45.It does put you off a bit, said one of those trainees, when asked about
:57:45. > :57:50.the prospect of working in it nursing in Stafford. You can
:57:50. > :57:55.understand why they are struggling to get overnight accident and
:57:55. > :58:01.emergency going again, for example. I understand that those trainees
:58:01. > :58:06.were actually, their level of compassion was actually part of the
:58:06. > :58:11.selection process. I think that is a good start. If they have a
:58:11. > :58:16.culture to go into, which is supportive of them and gives them
:58:16. > :58:21.the time and the ability and the support to do a good job, to be
:58:21. > :58:26.caring, to do all of those nursing things that nurses were always
:58:26. > :58:31.renowned for, they have got a place to go. Are you saying that is a
:58:31. > :58:36.change from the culture we have had for the last few years. Yes, and I
:58:36. > :58:40.think this is the kind of stories that you hear. But there is still a
:58:40. > :58:45.great deal of compassion I think in the NHS, it just needs to be built
:58:45. > :58:50.up a little bit more into the culture. The the other thing that
:58:50. > :58:56.came across very strongly was their concern about one shake-up on top
:58:56. > :59:01.of another. Isn't it merely compounding the difficulties for
:59:01. > :59:05.hospitals but of the be very seriously challenged, to be
:59:05. > :59:11.inflicting I think it is �20 billion of savings within ring-
:59:11. > :59:17.fenced budgets? The savings are designed to try to get better care
:59:17. > :59:21.in the end. The overall budget for the NHS is ever so slightly
:59:21. > :59:26.increasing, so we are trying to get savings in order to get care where
:59:26. > :59:31.it is needed. We have not talk about social care, but it is really
:59:31. > :59:35.needed out in the community. There are too many older people in
:59:35. > :59:41.hospital who should not be there. Many should have never been
:59:41. > :59:45.admitted, and many who were there are already fit 40 -- discharge in
:59:45. > :59:52.many cases. They are not being discharged because the support in
:59:52. > :59:58.the community is not fair for them. And that is tying up hospital beds
:59:58. > :00:02.which are very much needed. The NHS was designed to deliver a different
:00:02. > :00:07.model of care to today. But I trained as a nurse, there has
:00:07. > :00:13.always been a high degree of compassion and caring in nurses. I
:00:13. > :00:18.can take you to be places where you would find really high quality
:00:18. > :00:26.compassionate care. Are unconcerned we are going to try and of a
:00:26. > :00:32.regulate and overburden it. The idea we will be given a performance
:00:32. > :00:38.related pay regime fig -- fills me with horror. Nurses enter it
:00:38. > :00:43.because it is a vocation, not to earn millions of pounds. We have
:00:43. > :00:49.seen a failure of local scrutiny in Stafford, and the Government's
:00:49. > :00:52.health watch vision for scrutiny of local hospitals, do you think that
:00:52. > :00:58.might build up further defences against a repeat of what we have
:00:58. > :01:03.seen here? It has to involve patients that have used the service,
:01:03. > :01:09.but also doctors and nurses and all kinds of people who are in current
:01:09. > :01:14.practice. We have had very hub for inspections, but equally some by
:01:14. > :01:20.that -- people who have not been in practice for years. The credibility
:01:20. > :01:30.of these reports are not as helpful. So what is the model that would
:01:30. > :01:30.
:01:30. > :01:35.work? I think the CQC has been been proved, and that has been tusk with
:01:35. > :01:38.better inspections, and also inspections of the weekends. Last
:01:38. > :01:43.year I found that all of their inspections took place during the
:01:43. > :01:48.working week. We know that mortality rates in hospital
:01:48. > :01:55.increased at the weekend, and that is where we want inspections. Also,
:01:55. > :02:00.the leadership of the CQC has also been changed, which I called for
:02:00. > :02:05.last year. Because interestingly, the woman who was the chief
:02:05. > :02:08.executive of the CQC was also on the West Midlands strategic health
:02:08. > :02:15.authority when the mid- Staffordshire Health crisis was at
:02:15. > :02:22.its peak. David Cameron said the voice of the patient must now bring
:02:22. > :02:27.out. Can it? I think it can. There are a lot of hospitals, indeed my
:02:28. > :02:32.own hospital in Solihull, is working hard on good culture change,
:02:32. > :02:35.and I think it is working in Solihull, it can work throughout
:02:35. > :02:38.the NHS. "What of the rest of the political
:02:38. > :02:45.news?" I hear you ask. BBC Coventry and Warwickshire's Political
:02:45. > :02:48.Reporter, Sian Grzeszczyk, has this week's round-up, in 60 Seconds.
:02:48. > :02:51.Back from the brink - Birmingham City Council's announced it won't
:02:51. > :02:55.be putting up council tax bills as planned this year, for fear of
:02:55. > :02:57.being penalised by the Government. Midlands farmers are also
:02:57. > :03:02.potentially facing financial ruin, as they begin losing livestock to
:03:02. > :03:07.the Schmallenberg virus. One sheep and cattle farmer in Herefordshire
:03:07. > :03:11.says there needs to be a vaccine. Personally we've lost about 20% of
:03:11. > :03:15.our herd. And on a cost figure, I guess it's cost us 20 grand the
:03:15. > :03:18.last 12 months. Plebgate returned to the news this
:03:18. > :03:23.week, after the Sutton Coldfield MP Andrew Mitchell gave a TV interview
:03:23. > :03:26.attacking Number 10 for not doing enough to help him clear his name.
:03:26. > :03:33.While Coventry's MPs attended a meeting to try to save 400 jobs at
:03:33. > :03:36.Rolls-Royce in Ansty. Unions fear defence cuts will mean redundancies.
:03:36. > :03:42.But, the Malaysian firm Genting was promising a jobs jackpot - 1,100
:03:42. > :03:50.new posts. It's started work on a giant casino complex at the LG
:03:50. > :03:56.arena in Birmingham. And I can tell you that Lorely Burt
:03:56. > :04:01.was at the turf-cutting for that casnio. Digging in! Well, 1,100
:04:01. > :04:05.jobs, thank you very much. Are we becoming a nation of gamblers,
:04:05. > :04:08.Lorely? Well, I don't think that's quite right. I don't ever gamble
:04:09. > :04:12.myself. So you're not going to be rolling the dice or spinning the
:04:12. > :04:18.roulette wheel? No, but it has to be remembered that only 11% of that
:04:18. > :04:21.whole big development is actually casino. It means a lot of jobs. It
:04:21. > :04:24.also means creating a destination for the West Midlands, a great
:04:24. > :04:31.place for people to not only come and visit the NEC, but come and
:04:31. > :04:35.stay. Aren't you jealous, really, no Sunset Strip for Stourbridge?
:04:35. > :04:39.I'm not, actually! I love the jobs angle, but I think we've got enough
:04:39. > :04:43.gambling, really. But I'd be doing what Lorely was doing if it was in
:04:44. > :04:47.my area obviously, because it is jobs in the region. And do we not
:04:47. > :04:57.look too closely at the colour of the money, and not worry too much
:04:57. > :05:01.about the effects of gambling addiction and so on? I am concerned
:05:01. > :05:08.about gambling addiction. The online world is the big worry.
:05:08. > :05:14.Particularly among women. The debt burden that it creates.