20th June 2013 

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News and Comment from Roy Lilley

I've been on the road for most of the week.  Talking to the front line.  South Wales, North Wales, Midlands, East and the North West.  It's a fair salami-slice.  People busting a gut to make a health pound go where, once, two were needed. 


In another hotel room I awoke to the news that there is a plan to send recalcitrant bankers to jail and the report into the failings of the CQC over the Morecambe Bay maternity deaths, where no one is going to jail.  I wondered if I was on another planet?


I listened to the Chairman of the CQC Thingamabob-Prior talking on the Today Programme.  A woeful, inadequate, shambolic performance?  No.  No, don't you believe it.  It was carefully constructed, rehearsed and manicured.  Interviewer John Humphries was conned.  Prior is new in place and can wring his hands and say how awful it was.  How that was then and this is now. 


In the report the names of the key players in this tale of death and disaster have been redacted.  Thingamabob was so sorry but the Date Protection Act made it impossible for him to name names.  Oh, it was all about the lawyers and being sued and libel, but that was then and this is now and lessons have been learned.  Hospitals will be inspected by 15 people, who know what they are doing, for a month at a time. 


A consummate demonstration of how to scrape the muck off your boots and appear more concerned about the muck than the boots.


Later I watched the BBC coverage of David Behan, the CQC boss, speaking at his press conference.  A metronomic performance from a bureaucrat; the type of man who will always know where the fire exits are.   An emotionless, flat delivery reading paragraph one hundred and something or other.  Incompetent?  No, a highly-skilled Teflon routine; dumbing down, damage limitation.  Lip service to whistle-blowers; that was then, we are listening now.


To a casual observer we might be talking about the late delivery of a parcel or the failure to finish a decorating contract on time.  Actually, it was about babies who died.  One of which bled to death.  Young families that have had young lives snatched from them.  The expectation of what a son might achieve.  How a daughter might grow up in the image of her mother and be a mother herself one day.  The birthdays so heavily remembered, the anniversaries that will never be celebrated, family moments gone forever.  Sorry doesn't do it.


A clean sweep of the board, a fresh stat and a new beginning. A line in the sand.  Fair enough?  No.  Absolutely not.


The old brigade at the CQC were time served, experienced, skilled people who started with the ambition to do a good job.  The new brigade are time served, experienced, skilled people who have the ambition to do a good job.


The old brigade lost their way, got confused, the weight of the task slipped through their fingers and they became dishonest.  They covered up, shoved a damaging report into the shredder and denounced each other.


Why will the new brigade be different?  What will keep them honest?  What are the pressures that build within an organisation that turns it dishonest?  No mention from Thingamabob or Teflon man that they had learned about organisational dynamics or what turns honest people bad?  'They've gone', is not good enough. Who are these people?  Are they still in or around the NHS?  How will you run your affairs differently? 


It is not honest to say the CQC can keep us safe.  It can't.  A new Inspector of Hospitals will add to the labyrinth, the layers and the very complexity that defeated their predecessors and made it easier to deceive than denounce.


It is not honest to say central regulation works.  It self evidently doesn't.  However, CCGs, with their honest-to-goodness local knowledge and contacts, are nimble enough and connected enough to keep us safe.  They should be given the CQC resource and held to account for the safety of what they commission.

Isn't it time for some honesty?

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