The Mid-Staffordshire inquiry: where there’s a political will, there’s a way

There are interesting parallels between the Francis report and the Macpherson inquiry report into the death of the black teenager Stephen Lawrence.

We hope and expect that implementation of our Recommendations will ensure that the opportunity for radical thinking and root and branch action is seized. Nothing less will satisfy us and all those who so passionately spoke to us during our hearings

These words are not taken from the long-awaited Francis report, but rather from the Macpherson inquiry report (1999) into the death of the black teenager Stephen Lawrence on a south London street in 1993.  

There are a number of interesting parallels between the Francis and Macpherson reports. Both followed lengthy inquiries into specific incidents involving local "branches" of much wider public services - the Metropolitan Police and Mid Staffordshire NHS Foundation Trust. Each inquiry team was exhaustive in the way it examined the evidence presented to it. Both reports provide a damning analysis of unjustifiable operational, management and systems failings.

Arguably, the real significance of both reports is not simply what they told us about the individual public services concerned, but rather what they revealed about society and our expectations of key public services.  The true relevance of the Francis report is not simply limited to the relatively small number of NHS hospitals; rather, its findings will impact across the whole health and social care system. Just as the Macpherson inquiry report led to systemic changes within the Metropolitan Police and all other police forces, so Francis must trigger a recalibration of all health and social care services, regardless of location, size or the type of organisation providing the service.

All organisations which deliver health and social care services would be wise to spend the next few days and weeks determining what the report’s 290 recommendations mean for their services and the people they care for. Just as it is not possible to read Francis’ weighty report in a single sitting, so it will take a significant period of time for all of us to get our heads around what we need to do as a result.  

The thing which ultimately determines whether such a report sinks or floats; whether its recommendations are fully implemented or gather dust on the shelves alongside so many other reports down the years is political will. The primary reason why people remember the Macpherson report is because the government of the day took its lessons and not only ensured that they triggered change in the Metropolitan Police and the wider police service, but also legislated to ensure that, through the Race Relations Act 2000 (Amendment) and the Race Equality Duty, it led to more wholesale changes to the way all public authorities addressed the issues it raised.

The proposals set out in the Francis report are wide-ranging and ambitious. They include a shift to more patient centred services, an emphasis on zero harm, renewed stress on transparency, fundamental challenges to professional practice and priorities and a wholesale rebalancing of regulation across the health and social care system. The sheer number of recommendations means that it cannot possibly succeed without robust political backing. Day one, at least, suggests that such political will might just exist. The Prime Minister’s decision to deliver the government’s formal response underlined the importance of this issue and hopefully underscores the degree of political commitment to implementing its recommendations.  The Prime Minister’s response made clear that the government is pushing ahead to deal with a number of issues raised by the report.  He has asked Don Berwick to examine how the NHS can implement a "zero harm" approach and Sir Bruce Keogh is reviewing the five NHS Trusts with the highest mortality rates; small steps, but a start nonetheless. The real work and the true test will come over the coming months. Change will require major decisions about the introduction of a statutory Duty of Candour, a fundamental rebalancing of priorities, major shifts in nursing and other care services and a reorganisation of the regulatory landscape with a likely shift in powers between Monitor and the Care Quality Commission and other regulatory bodies.  

The next few months will determine whether there is the political will required to push through the raft of changes to attitudes, perceptions, responses, professional norms and working practices set out by the Francis report. It will also help determine whether, like Macpherson before it, the Francis report is destined to be cited for years to come as a real agent of change, or whether it has more in common with other authoritative reports which have been delayed or simply disappeared from view because of a lack of political will or the absence of a cross-party consensus.     

Dr Phil McCarvill is Head of Policy at Marie Curie Cancer Care
 

Photograph: Getty Images
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Commons Confidential: Could Corbyn's El Gato kick Larry out of Downing Street?

The No 10 cat fight.

A rolling revolt is gathering speed, as the suspicion grows that Theresa May called her snap poll to escape potential by-elections, should the Crown Prosecution Service find that her MPs were involved in electoral fraud during the 2015 campaign.

A growing number of Tory MPs are informing HQ that they don’t want a battle bus visit. Driving the rebellion is the hard-boiled Andrew Bridgen, who made his cash by selling prewashed spuds to supermarkets. “I’m going to post party workers on every route into my constituency,” growled the veg baron, who is defending an 11,373 majority in Leicestershire, “with orders not to let any bloody bus on to our patch.” Here’s an opportunity for Tory command to raise a few bob: flog tyre-bursting spike strips to candidates.

Fur would fly in the unlikely event that Jeremy Corbyn moves into No 10. The more optimistic among his entourage fret over whether the moggy El Gato could cohabit with Larry the Downing Street cat. Corbyn muses that El Gato is a socialist, sharing food with a stray that turned up in his north London garden. If Labour wins, I understand that El Gato is the top cat or Larry is out with May. Jezza’s first call wouldn’t be to Donald Trump or Angela Merkel but to Battersea Dogs and Cats Home.

George Osborne’s £650,000 BlackRock sinecure is jeopardised, I hear, by his London Evening Standard editorship. An impeccable source whispers that the world’s largest investment fund, controlling £4trn of loot, anguishes over possible conflicts of interest. BlackRock hired Osborne to nurture high-net-worth clients, who are suddenly wary of divulging secrets to an ambitious hack. Perhaps the super-rich should relax. He is incapable of recognising a story, even missing Standard deadlines with his resignation as a Tory MP.

The word is that Ukip’s seven-time loser Nigel Farage declined the chance to risk an eighth loss to retain his £800-per-hour LBC radio gig. The Brexit elites’ Don Farageone needs the money – a chauffeur-driven Range Rover with tinted windows won’t be cheap.

Corbyn’s war on dandelions is on hold during the campaign, with green-fingered comrades tending his allotment. Cherie Blair was accused 20 years ago of mentally measuring up curtains for No 10. Corbyn quipped that he is tempted to measure flower borders to plant runner beans. Labour’s No 10 would certainly be no bed of roses.

What will retiring MPs do? Middlesbrough South’s Tom Blenkinsop informed colleagues that he might join the army. My hunch is that at 36, with a Peaky Blinders haircut, the general secretaryship of the Community trade union is more likely.

Kevin Maguire is the associate editor (politics) of the Daily Mirror

Kevin Maguire is Associate Editor (Politics) on the Daily Mirror and author of our Commons Confidential column on the high politics and low life in Westminster. An award-winning journalist, he is in frequent demand on television and radio and co-authored a book on great parliamentary scandals. He was formerly Chief Reporter on the Guardian and Labour Correspondent on the Daily Telegraph.

This article first appeared in the 27 April 2017 issue of the New Statesman, Cool Britannia 20 Years On

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