It is time to call the chief of the NHS to account

Sir David Nicholson, KCB CBE

Needing a Pharmacist on Bank Holiday Monday, I logged onto the NHS website to find its list of pharmacies due to be open on 29th August – and found one, less than a mile from my home in west London. “Marvellous” I thought, “what a useful website”. How foolish of me – of course, the pharmacy was firmly shut. Why does the NHS bother with a website at all, if the information is incorrect?

No GP is available on a bank holiday – even though, by opening on these days, it might give people an opportunity to see their own doctor without having to take time off work. My surgery has now, virtually, given up booking appointments ahead of the day. “Ring at 8am on the day” is the mantra – so, as the surgery switchboard will not accept the telephone call-back facility, it means dialling and re-dialling and, inevitably, being beaten at the post by another of the surgery’s 9,000 patients. If you do get an appointment, the eight minutes allowed means that, if the GP thinks you need a blood test, a smear or a swab – which, nowadays, is only done by a nurse – you will have to make a separate appointment for yet another day, or go and sit for several hours at your local hospital, but not on a Bank Holiday!

Which brings me back to the subject of Scarborough Hospital. Since I first described how badly the staff at the hospital treated my elderly mother-in-law, I have received many heartbreaking emails detailing similar – or worse – experiences at this hospital.

Richard wrote to tell me how his wife had been admitted for a routine operation – with a three per cent chance of mortality – but, through neglect, her condition deteriorated to such an extent that “matters became irretrievable” and she died. Part of the problem was that, post-operatively, she saw no consultant surgeon for many days because there was confusion as to which consultant was in charge of her case – and then she contracted MRSA. How can such “confusion” happen?

Jane described a “botched” job on her badly broken leg, which has left her permanently disabled; being shouted at by a doctor after she complained that the pain was intolerable and her toes had turned blue – eventually the “pot” was removed but the leg is still scarred; how she witnessed the nursing staff deliberately ignoring the requests of elderly patients to be taken to the lavatory, leaving them desperate and crying, or falling as they struggled to walk there unaided. So shocked was she by the callous behaviour of the staff, that she and several other patients on the ward took matters into their own hands and rang their bells persistently on behalf of the elderly people, until the staff got the message. What goes on in the minds of these nurses?

Sara was pregnant with her second child – she was told the baby was a girl and would weigh 7-8 ozs. There were problems with the placenta, so she was seen by a consultant. However, when the baby was born – two weeks overdue – he weighed 3lbs 13 ozs and it was discovered that Sara had a condition known as polyhydramnios (where there is too much amniotic fluid – sometimes three times the normal amount) and the baby boy had Edwards syndrome (a chromosome disorder). If this was not enough with which to contend, the insensitive attitude of the nurses to Sara and her very sick baby, she says, was a disgrace. It would seem that there was no communication at all between the nursing staff – or the doctors – and, very sadly, after two days, Sara’s baby died. Her description of the experience makes very hard and sad reading. No apology has ever been received. Instead she was told it was her fault because she declined the amniocentisis.

These are just three examples. What is happening at Scarborough Hospital? As far as I can see, as Richard put it: “Unless you have the literacy skills to compete, in effect to make complaints staff, arrogant clinicians, the national ombudsman and the General Medical Council pay attention and take you seriously, you would appear to have little prospect of raising a complaint successfully.”

I have written repeatedly to Scarborough MP, Robert Goodwill, but have received only computer- generated responses, or, on one occasion, an email detailing the IT system at the House of Commons into whose “spam” bucket, he suggests, my email could have gone. Nonsense – I would have received no answer at all if that was the case. All of this but never an answer to my questions about Scarborough Hospital’s appalling record and how patients might elevate their complaints. Perhaps he could bring himself to read this blog post and respond to my original request for intervention and advice – and not just send a computer-generated email.

Complaints of negligence to GMC hearings have to be proved “beyond reasonable doubt” – which is virtually impossible. So, if – as it appears – the MP for the area cares so little about his hospital, the way it is run, the attitude of the staff and its general reputation, who is there to whom patients and their families can turn?

Let us not forgot Sir David Nicholson KCB, CBE. He is the Chief Executive of the NHS – and has been since 2006. Earning over £200,000 per year plus £35,000 in expenses, why is he allowing hospitals like Scarborough to continue in this fashion? Surely it is his duty to ensure that the budget – which comes directly from us, the taxpayer – is used wisely, efficiently and with total focus on the care of patients. The people who pay Sir David’s wages – us – want to see wards that are run for the benefit of the patients and not the staff; to see the right type of person being recruited into the nursing profession and being trained in pastoral, as well as medical care. It costs nothing to learn the lessons of the corporate world about customer care and how to deal with complaints. Even an informal complaint in the NHS is met with hostility and if you take it any further, you enter – as emailer, Tom, put it – “a Kafka-like process”.

It is long overdue for Sir David to be called to account. He presides over the largest employer in Britain, the largest spending public service and, frankly, in the private sector his performance would be deemed wholly unacceptable. This is without the recent announcement that part of the new NHS computer system (costing £7 billion) was so unworkable that it had to be scrapped.

If he can carry on in post, without fear of dismissal and the local MP cannot be bothered to respond to criticism of Scarborough Hospital, then just who is in charge of the clattering train? More importantly – who is accountable to the tax payer for the efficient spending of their hard-earned tax pounds?

To help Sir David along the way, what about this for a thought? Jobs at hospitals like Scarborough are not seen by ambitious young doctors as residencies which will further their careers. Perhaps, in order to attract top-class medical staff, Sir David might consider turning the pay structure on its head and offering a better salary package to those prepared to work in unfashionable, non-teaching hospitals? That way, the standards of care might rise and patients outside the large cities might have a better chance of good treatment. Scarborough Hospital should be first on his list.