10/02/2013 Sunday Politics West Midlands


10/02/2013

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In the Midlands, new figures for the Sunday Politics reveal many

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patients go I it of their way to avoid Stafford Hospital.

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Apology for the loss of subtitles for 2455 seconds

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With the nurses of the future go Hello again from the Midlands. I'm

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Patrick Burns. And both our guests today ran their own companies

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before emerging as influential figures in their respective parties.

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Margot James is the Conservative MP for Stourbridge, and a

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Parliamentary Private Secretary at the Business Department. Lorely

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Burt is the Liberal Democrat MP for Solihull, and she chairs her party

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in Parliament. Welcome to you both. And of course, as former

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businesswomen, Margot and Lorely will need no reminder that the

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catastrophe at Stafford Hospital was fundamentally a failure of

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management. Ever since the sheer scale began to emerge of what

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happened there over four years from 2005, the hospital has struggled.

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Now, figures obtained exclusively for the Sunday Politics reveal just

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how sharply public confidence in the hospital's services has fallen

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away. In the five years since 2007, the number of people opting for

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treatment at Stafford through the NHS Choose and Book system has

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plummeted by 67%, from almost 16,000, to just 6,500. The sharpest

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falls came after 2009, when the Healthcare Commission's report was

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published, revealing "appalling" standards of care. Well, Stafford's

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Chief Executive says it's suffered the equivalent of a �3.7 million

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drop in income every year since then. Even if we hadn't had the

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reputational issues around Mid Staffs and the poor failings of

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care, I think a small district hospital like ours, with a

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relatively small income every year of �150 million, will find that

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increasingly difficult to sustain independently without working with

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others. Margot, you of course managed part of a major global

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healthcare business before entering Parliament, so in a way you feel

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for the management there in Stafford, but equally it's

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understandable, given what we've seen and heard over the last few

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years, should decide to give it a miss and look elsewhere. Well, I'm

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surprised that even 6,500 people are willing to choose it, given the

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reputational damage that the Chief Executive referred to. But I think

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it's the wider implications for the NHS that are of most concern. There

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are four hospitals with way above average mortality rates that are

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being investigated at the moment, and I fear that there will be more.

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And it's important to point out that at Stafford, their mortality

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rates have improved a lot, the performance of the hospital is

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actually improving. But they are saddled with the equivalent of �3.7

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million every year, Lorely, and as a former businessman, you know you

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can't really cope with a weight like that when you're trying to get

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the numbers up, can you? No, it's really difficult. And I think that

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confidence will be restored eventually. If you speak to people

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in the street and they have been to hospital, 9.5 times out of 10 they

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will say they have had excellent and caring service. We need to keep

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that in context when we are talking about the NHS generally. Margot, I

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saw you shaking your head. Well, I take a slightly different view,

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because we've got to take a realistic view. Yes, is excellent

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care in the NHS. But I think too often when we get a crisis like

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this, people rush to say the vast majority is absolutely excellent.

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That is I'm afraid not true. I'm afraid there's too many pockets of

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bad care. And every time there is a report, and they come with alarming

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frequency, showing especially for older people in hospital poor

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standards of basic nursing care. in a nutshell what would you do I

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you were one of the managers there, as a former businessperson yourself,

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how would you turn it around as a business, Lorely? I think it is the

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culture. We need to make people feel relaxed about reporting

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incidences of bad practice. And not to allow anybody to have that

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responsibility 0.21 side, to look after people properly. -- put to

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one side. When I spoke to Robert Francis QC

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shortly after he'd delivered his report, he told me he'd been

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personally distressed by the evidence he'd had to hear. He said

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it wasn't his job to reset the moral compass of the NHS, but he

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knew his recommendations were bound to be used as pointers towards new

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ways of stopping this ever happening again.

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It traumatised the communities it was meant to serve, and scandalised

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the country as a whole. How could this most caring of the caring

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services abandon patient care? For the Prime Minister himself to front

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up for the Government, registered the gravity of the Francis Report,

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placing it alongside the Bloody Sunday and Hillsborough inquiries.

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Now, as then, the Prime Minister was "truly sorry". And the report's

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author was determined lessons must be learnt. This is not a problem

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that will be solved by a simplistic solution of finding a scapegoat and

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sacking them. We need to change the culture in the system, and until we

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do that, you can sack as many people as we like, it will not make

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a difference. The number of people choosing Stafford Hospital has

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plummeted. Do you find that understandable? It is

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understandable and distressing. It shows the power of information, and

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amongst my recommendations, some of them are designed to improve the

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information available to the public so that there is a balanced picture.

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So that trusts admit their failures, and what they are going to be going

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about them. So, the questions for MPs joining

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me on Westminster's famous green. Will this report start the business

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of restoring confidence? I think it will, because the central tenet of

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it is it will put patients right at the heart of the NHS. Absolutely,

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because what this report talks about is zero harm, and that's

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absolutely key. Zero harm for patients, putting patients first,

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with the quality of care there. These hospital inspectors will be

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vital I think, and will give people confidence in the future, but

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there's a great deal more to be done.

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The hospital itself has wounds to bind. Its emergency department has

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been closed overnight for 15 months. Local support groups say it is

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putting its house in order, but the hospital continues to survive, only

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with government handouts. What exactly will it take to

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restore trust in Stafford and the NHS as a whole? That is the subject

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of my latest block. Joining me here is Dame Julie Moore,

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the chief executive of University Hospitals Birmingham. You are one

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of the people Robert Francis talked to. I am sure many people at Hulme

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are astonished that health professionals who have a recommend

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-- reputation for dedication, lost sign of the patient. I cannot

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account for how things went terribly wrong at Stafford, but we

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have a terrible problem at the moment. Who would want to have a

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career in health care management at the moment? There responsibility

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for the culture of the Organisation his mind and the board's, and I

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would be proud for everybody in that my family to be treated at a

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hospital. Because I am not proud of the work our doctors and nurses do,

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and I do not want them to be tarred with the reputation but it is

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coming across the hall of the NHS. But we have too many organisations,

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too many bodies telling us what to do. What would you do it to the

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cure the NHS campaigners, who feel that heads must roll some work,

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whereas people have been promoted? One of the things the report

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pointed out was how many organisations have been involved.

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Who is accountable for the things that went on? By think there are

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too many organisations and responsible bodies at the moment,

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and if we had an inspector on top of the other bodies that will not

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help the problem. I welcome an inspector if we will do so some of

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the many bodies inspecting a hospital. One more it will not make

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a difference. There is also the idea that managers who are

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responsible for failures in patient care but no fundamental standards

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can be sacked themselves. It is that a useful stick for the

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Government to bring to bear? have sacked doctors, nurses, people

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who do not come up to standard, I think we often have a belief it is

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difficult to sack a doctor. You hear of people being suspended for

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years and years, and that is wrong. We have had a thing in the NHS

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called for no blame culture, and that meant you could not hold

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people to account. In the trust we have a policy of Fair

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accountability, and we expect people to act as professionals and

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if they did not, we hold them to account. People have seen some of

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these health executives being promoted. You can understand surely

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why the campaigners want heads to roll? Yes, I think the failings

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were so serious that certainly be chief executive and the board of

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Stafford Hospital should have gone, and why were no nurses and doctors

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struck off? I think that they cure the NHS campaign have serious

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questions that need answering. have to agree with Margot. I am

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interested in some of the changes being proposed, such as the duty of

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candour. You will be required to report something, not just see it.

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Doesn't it implied a right to fail as well, if you are being

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absolutely candid? Better to reports something that is failing

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it and sort that out, but not to report it at all? Very often with

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failing hospitals, there is another one I know well in Northamptonshire

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which was given over to the private sector in the end. That was a case

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of a very senior doctor running a department who was not operating

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well. And too many things going wrong. People below him were

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frightened to report him. I think if we have this duty of candour

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written into law, people will have a legal duty to report him, and

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they will be big day and abetting a cover-up if they do not.

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It will be difficult to be as open about your failings as your

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successes. It is a difficult thing to do. We have had such a policy at

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the Trust for a long time, but it is very difficult to own up to

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mistakes. The current set-up does not make that easier. The

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Litigation Authority advises you not to do it. One of our mottos is

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do the right thing. For the moment, thank you very much

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indeed. David Cameron told MPs Stafford had

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revealed "completely inadequate standards of nursing". He pledged

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"consistent training" and better support. But with Stafford's

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medical reputation so badly damaged, how can it attract the brightest

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and best as its carers in the future? BBC Stoke's Political

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Reporter Phil McCann asks if trainees at one of the top-rated

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nursing courses in the country, at Worcester University 60 miles south,

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would be prepared to help turn Stafford around.

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This is a story of a poorly and unnecessary suffering of hundreds

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of people. It was a sobering moment for these

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trainee nurses. Another reminder of the failings at Stafford, a

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"disease" that had caused the entire system to fail. And it was

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difficult to believe just how bad things had got.

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I understand the demands placed on nurses and health care staff, but

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still, to that extent is really shocking. And the fact that it has

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not been dealt with much sooner. But with 290 recommendations

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contained in the Francis Report, what did they make of the "cure"?

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am hoping that maybe the Government to make rethink about its idea of

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reform within the NHS with regards to budgeting and trying to save a

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pound here and apparent there. And put more resources into the NHS.

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Their course leader welcomed most of his findings, but was concerned

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about one of the proposed changes - an obligation to tell patients when

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things go wrong. We want to have an open discussion with patients, but

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we do not want to instigate a culture of blame. That is what

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Francis is trying to get away from. It was budget cuts that helped

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precipitate the crisis here at Stafford Hospital. The challenge of

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the Francis Report is how to prevent problems happening again

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anywhere in the NHS when budgets remain very tight. We have looked

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at a catheter bag. Back in Worcester, having heard the

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horror stories from Stafford, just how willing would these trainees be

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to work there themselves? The only way I would be able to take on a

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brawl at a place like fat is if I knew I was being supported. Be a

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does put you off a bit. Nurses that are confident in whistle-blowing

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and making sure that higher standards of care are happening all

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the time should be working at places like mid Stafford, to give

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the population at the confidence that this is no longer

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Signs of compassion already? A willingness from the next

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generation to get the weakest parts of the NHS back to full health -

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while ensuring the scars left by Stafford are never forgotten.

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It does put you off a bit, said one of those trainees, when asked about

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the prospect of working in it nursing in Stafford. You can

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understand why they are struggling to get overnight accident and

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emergency going again, for example. I understand that those trainees

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were actually, their level of compassion was actually part of the

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selection process. I think that is a good start. If they have a

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culture to go into, which is supportive of them and gives them

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the time and the ability and the support to do a good job, to be

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caring, to do all of those nursing things that nurses were always

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renowned for, they have got a place to go. Are you saying that is a

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change from the culture we have had for the last few years. Yes, and I

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think this is the kind of stories that you hear. But there is still a

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great deal of compassion I think in the NHS, it just needs to be built

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up a little bit more into the culture. The the other thing that

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came across very strongly was their concern about one shake-up on top

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of another. Isn't it merely compounding the difficulties for

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hospitals but of the be very seriously challenged, to be

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inflicting I think it is �20 billion of savings within ring-

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fenced budgets? The savings are designed to try to get better care

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in the end. The overall budget for the NHS is ever so slightly

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increasing, so we are trying to get savings in order to get care where

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it is needed. We have not talk about social care, but it is really

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needed out in the community. There are too many older people in

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hospital who should not be there. Many should have never been

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admitted, and many who were there are already fit 40 -- discharge in

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many cases. They are not being discharged because the support in

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the community is not fair for them. And that is tying up hospital beds

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which are very much needed. The NHS was designed to deliver a different

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model of care to today. But I trained as a nurse, there has

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always been a high degree of compassion and caring in nurses. I

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can take you to be places where you would find really high quality

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compassionate care. Are unconcerned we are going to try and of a

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regulate and overburden it. The idea we will be given a performance

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related pay regime fig -- fills me with horror. Nurses enter it

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because it is a vocation, not to earn millions of pounds. We have

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seen a failure of local scrutiny in Stafford, and the Government's

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health watch vision for scrutiny of local hospitals, do you think that

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might build up further defences against a repeat of what we have

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seen here? It has to involve patients that have used the service,

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but also doctors and nurses and all kinds of people who are in current

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practice. We have had very hub for inspections, but equally some by

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that -- people who have not been in practice for years. The credibility

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of these reports are not as helpful. So what is the model that would

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work? I think the CQC has been been proved, and that has been tusk with

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better inspections, and also inspections of the weekends. Last

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year I found that all of their inspections took place during the

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working week. We know that mortality rates in hospital

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increased at the weekend, and that is where we want inspections. Also,

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the leadership of the CQC has also been changed, which I called for

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last year. Because interestingly, the woman who was the chief

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executive of the CQC was also on the West Midlands strategic health

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authority when the mid- Staffordshire Health crisis was at

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its peak. David Cameron said the voice of the patient must now bring

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out. Can it? I think it can. There are a lot of hospitals, indeed my

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own hospital in Solihull, is working hard on good culture change,

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and I think it is working in Solihull, it can work throughout

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the NHS. "What of the rest of the political

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news?" I hear you ask. BBC Coventry and Warwickshire's Political

:02:38.:02:45.

Reporter, Sian Grzeszczyk, has this week's round-up, in 60 Seconds.

:02:45.:02:48.

Back from the brink - Birmingham City Council's announced it won't

:02:48.:02:51.

be putting up council tax bills as planned this year, for fear of

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being penalised by the Government. Midlands farmers are also

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potentially facing financial ruin, as they begin losing livestock to

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the Schmallenberg virus. One sheep and cattle farmer in Herefordshire

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says there needs to be a vaccine. Personally we've lost about 20% of

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our herd. And on a cost figure, I guess it's cost us 20 grand the

:03:11.:03:15.

last 12 months. Plebgate returned to the news this

:03:15.:03:18.

week, after the Sutton Coldfield MP Andrew Mitchell gave a TV interview

:03:18.:03:23.

attacking Number 10 for not doing enough to help him clear his name.

:03:23.:03:26.

While Coventry's MPs attended a meeting to try to save 400 jobs at

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Rolls-Royce in Ansty. Unions fear defence cuts will mean redundancies.

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But, the Malaysian firm Genting was promising a jobs jackpot - 1,100

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new posts. It's started work on a giant casino complex at the LG

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arena in Birmingham. And I can tell you that Lorely Burt

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was at the turf-cutting for that casnio. Digging in! Well, 1,100

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jobs, thank you very much. Are we becoming a nation of gamblers,

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Lorely? Well, I don't think that's quite right. I don't ever gamble

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myself. So you're not going to be rolling the dice or spinning the

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roulette wheel? No, but it has to be remembered that only 11% of that

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whole big development is actually casino. It means a lot of jobs. It

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also means creating a destination for the West Midlands, a great

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place for people to not only come and visit the NEC, but come and

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stay. Aren't you jealous, really, no Sunset Strip for Stourbridge?

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I'm not, actually! I love the jobs angle, but I think we've got enough

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gambling, really. But I'd be doing what Lorely was doing if it was in

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my area obviously, because it is jobs in the region. And do we not

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look too closely at the colour of the money, and not worry too much

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about the effects of gambling addiction and so on? I am concerned

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about gambling addiction. The online world is the big worry.

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Particularly among women. The debt burden that it creates.

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