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Government response to the Francis enquiry.

View profile for John Coulson
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Seven weeks after the publication of the Francis report the Government has released its initial response. The response announced a number of reforms and has received a mixed reception from health professionals.

Central to the Government’s response was the introduction of Ofsted style inspections for hospitals which will be introduced by a new Chief Inspector of the NHS.

The King’s Fund, an independent organisation, did however point out that there is consensus among experts that inspections do little to improve quality and only serve to ensure that minimum standards are met.

Taking into account the King’s Fund's comments, this proposal seems to fall short of the Government’s intention to raise standards in the NHS.  Jeremy Hunt’s did of course launch a recent attack on “complacent” hospitals that do not exceed minimum targets.

The Kings Fund also point out a vicious circle that can occur when reform is introduced as a result of a scandal.

First a scandal occurs which leads to the introduction of inspections. Organisations then complain about the burden of inspections and argue that the inspections are simply “red tape” and they do not give a true representation of the situation, they complain that inspectors are overly risk averse.  A new scandal then occurs that the inspections missed which then starts the entire process over again. 

Questions are raised over how effective such inspections can be at improving the care given by NHS institutions when on one hand the Government are promoting more regulations and inspections and then in the very same statement they are saying “Regulation is no substitute for a culture of compassion, safe delegation and effective supervision”. This erratic approach will do little to restore the public’s faith in the NHS.

Another major announcement was the requirement for all student nurses to spend a year carrying out basic care tasks such as washing, feeding and taking patients to the toilet. Failure to complete this training will result in NHS bursary’s worth up to £40,000 being withheld, effectively barring them from the profession.

Chief Executive of the Royal College of Nursing, Dr Peter Carter stated that important questions needed to be answered before this is implemented. Carter asked the Government to consider who will undertake this training and raised concerns about a recruitment shortfall occurring. He also urged the Government to remember the findings of the Willis Commission which found no evidence that nursing education is lacking or is in any way related to a decline of compassion in care.

It is important to remember that this announcement by Jeremy Hunt was simply an initial response; the changes announced here are by no means intended to be a complete solution to the problems facing the NHS in the coming years. It remains to be seen whether the planned reforms will make a real difference to the care patients receive or whether the NHS is stuck in an endless cycle of scandal and reform.