Open letter signed by the leaders of 10 NHS organisations calls for ‘more measured view of how the NHS is performing’
Leaders of key NHS organisations have demanded an end to what they describe as relentless criticism of the service which exaggerates the extent of poor care and sees GPs and hospital doctors “unfairly bashed” for problems beyond their control.
An open letter signed by the leaders of 10 NHS organisations, published in the Guardian, calls for “a more measured view of how the NHS is performing” instead of emphasising past failures. The signatories blame ministers, NHS bosses and the media for creating an atmosphere in which demoralised and frustrated staff feel the service is facing constant attacks that give a distorted picture of its performance.
“As we move into 2014 can we, as organisations representing the NHS frontline, call for a new page to be turned as we start a new year?” they write.
The letter comes after 12 months in which the service had to contend with the fallout from a series of care scandals such as those at Mid Staffordshire, Morecambe Bay and Colchester hospitals, and a host of inquiries recommending improvements to care, as well as some intense criticism by Jeremy Hunt, the health secretary.
“If you listen to some of the NHS system leaders – ministers and the leaders of organisations such as NHS England, the Care Quality Commission, Monitor and the NHS Trust Development Authority – you get the impression that all NHS care is like Mid Staffs and that’s clearly not the case,” said Chris Hopson, chief executive of the Foundation Trust Network, which represents most of England’s hospitals.
“We are really concerned that when you hear these system leaders talk you get a relentless focus on the negative [and] on identifying all that’s bad, and then coming up with really quite harsh blame and recrimination. Ministers, for perfectly understandable reasons, have chosen to focus on the areas where care failures have occurred, and those are important. But it would be really good if they also publicly recognised that the vast majority of NHS care is good or very good,” he added.
Hopson said every chief executive and chair of a hospital trust had told him in recent months “that staff feel that the NHS is being unfairly bashed by a whole bunch of people, that while there are failures of care they aren’t as widespread as is being implied, and I agree with that”.
Staff are irritated that NHS bosses, with the exception of NHS England’s medical director, Prof Sir Bruce Keogh, have failed to defend the service, highlight its achievements or maintain a proper sense of balance in the many controversies that emerged during 2013, Hopson added. “That’s been sadly lacking.”
Dr Mark Porter, chairman of the British Medical Association, said ministers had unfairly besmirched the reputations of GPs and hospital consultants. He expressed disquiet about “politicians blaming GPs for pressures on emergency care [or] attacks on consultants for failing to provide out-of-hours care when we know a huge proportion do just that”.
In his new year message to doctors, Porter lamented “the perception in the media and elsewhere that doctors are part of the problem”. He asked doctors to “remember what happened when politicians made inaccurate and demoralising comments blaming GPs for the pressures on emergency care, and we must be alert to these kinds of attacks on our professionalism and integrity, and fight them with facts.”
While he did not name Hunt, it was the health secretary who last June provoked the ire of many family doctors by claiming that their abandonment of contractual responsibility for overnight and weekend care in 2004 was the cause of growing overcrowding in A&E units in 2013.
Dr Maureen Baker, chair of the Royal College of GPs, said the government should provide immediate support for GP surgeries to help them deal with the growing demand for appointments and, in doing so, “signal the start of a more productive relationship with GPs”.
The content and tone of some of Hunt’s speeches and media interviews about the NHS during 2013 caused concern within the health department, with Lib Dem minister Norman Lamb among those worried that certain statements were unfair and alienating staff.
The BMA is preparing to launch a campaign to “promote the value of the profession, a value that is not always reflected accurately by government or the media”.
Morale among NHS staff has fallen to a worrying low, warned Dr Cliff Mann, president of the College of Emergency Medicine, which represents A&E doctors. “We want to make sure that we don’t end up demoralising the very people that we need to keep our health service going at this difficult time,” he said. Singling out NHS coverage by some of “the tabloid media”, he added: “It’s very easy to think that there’s always doom and gloom. But actually most operations go ahead on time and most patients are seen by capable doctors who make timely and correct diagnoses.”
Despite the focus on poor care in some places in 2013 – which some commentators have called the NHS’s “annus horribilis” – the outcomes of treatment experienced by patients were no worse than before and had improved recently for those receiving stroke, cardiac or trauma care, Mann added.
Asked if ministers were among those who had helped to create an unrepresentative picture of NHS performance, Mann replied that “when it comes to the politics of this, some people are very selective about what they quote, so while what they say is true, it’s only part of the truth. You can nearly always find one data set to support your prejudices.”
Louise Silverton, director of midwifery at the Royal College of Midwives, said the coalition’s controversial restructuring of the NHS in England last April, which gave NHS England operational responsibility for running the service, meant “the secretary of state cannot complain if his government’s reforms result in an NHS he can’t control. All he can do is criticise. All decisions are now taken locally by clinical commissioning groups and it is these who decide what our NHS will look like and what service it will offer. Ministers need to stop complaining about NHS staff and listen to their concerns,” she said.
The Department of Health said Hunt had struck the right balance between praising excellence and highlighting the need for improvement. “The NHS is full of brilliant people who dedicate their lives to caring for our loved ones and ministers spend a great deal of time on the frontline thanking and praising them for their hard work,” a spokeswoman said. “But in the light of tragedies such as Mid Staffs, simply defending the status quo is not good enough, and we make no apology for pushing for high standards for patients.”
Hunt wrote to all NHS staff just before Christmas thanking them for their hard work over the festive period and asking patients to also offer their thanks.
Source: The Guardian Website