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Mid Staffs reveals double standards between private and public health sector regulation
Important differences in reaction to public and private scandals
The Mid Staffordshire NHS Foundation Trust neglect scandal rumbles on this week, most prominently with Sir David Nicholson refusing to have the blame badge pinned on him. If we compare the reaction of the regulatory function to Mid Staffs with the well-known private health care scandal at Winterbourne View, we can see that there are some important differences.
Public sector health scandal - Mid Staffordshire NHS Foundation Trust
The incidents of neglect that may have led to as many as 1,200 premature deaths at Mid Staffs, include:
- Unwashed for a month and forced to soil themselves
- Dehydrated and drinking water from vases
- Denied pain relief which had been prescribed
These details have the power to shock but there are a number of aspects that are really alarming. These include:
- Neglect was perpetuated over some 3 years
- The regulatory system failed to pick up what was happening
- Whistleblowers allege they were gagged or intimidated
Private sector health scandal - Winterbourne View
Exposed by BBC Panorama in 2011, secret filming revealed the scandalous abuse of those with learning disabilities and challenging behaviour at Winterbourne View, a privately operated facility in Bristol.
Examples of abuse described by a clinical psychologist as ‘torture’, include patients being:
- Restrained under chairs and given cold punishment showers
- Abused with mouthwash, which was poured into their eyes
- Mocked after attempting to jump from a second floor window to escape torment
Mid Staffs versus Winterbourne View
On the face of it Winterbourne View is shocking, however, the scale and effect is significantly less than that observed at Mid-Staffs. Yet compare the results:
Winterbourne View: The shut down of Winterbourne View and closure of three other institutions owned by the service provider, Castlebeck Care. This led Norman Lamb to announce the reassessment of 3,400 patients in similar facilities with a view to moving them into NHS accommodation. 11 people pleaded guilty to criminal charges and six were jailed. Castlebeck went into administration on the 5th March 2013.
Mid-Staffs: A £13 million public inquiry has produced a 1,782 page report. This was sanitised by Whitehall - allegedly, which has done nothing but fuel suspicions of a whitewash. The report identifies failures at all levels and it is fair to say that it shows systemic failure. So far there has been a woeful lack of responsibility, and indeed it seems that the question of accountability of individuals for their actions (or inactions) is being avoided.
Impeccable credentials with QCS compliance management
A number of inferences may be drawn from this comparison. Commentators have given voice to a number of popular ideas. Among them are that the NHS is a lot like a financial institution - it is simply too big to fail; another is that Sir David Nicholson is too important to the NHS reform programme to be removed.
Most importantly what this means for private health care providers is that there seems to be a double standard operating here. Private health and social care organisations must establish impeccable care quality standards and compassion. QCS compliance management is identified by customers as putting CQC compliance at the centre of organisational practice and driving up care standards.