Francis on Future of the NHS

The head of the public inquiry into the Mid-Staffs scandal, Robert Francis QC has said that politicians must stop treating the NHS as a ‘political football’, must stop ‘throwing brickbats’ over the NHS and have an honest debate about the future of the health service.

Speaking on the anniversary of his report, Robert Francis said difficult discussions were needed about how to ensure good care for patients, even if that meant closing some services or rationing spending on some treatments.

He told an audience of healthcare professionals at the Nuffield Trust conference in London that parts of the NHS are not currently providing acceptable care. He said, ‘if we stop being frankly dishonest or at least disingenuous about what can be done and we are accurate in our description of the quality [currently] being provided then we can have a sensible and open discussion about what our priorities are.’

He also spoke about how there are limits to what the NHS can afford and that it needed to decide what to prioritise, ‘No one is going to tell me that it is not possible to clean patients who are vulnerable and to feed them. If a provider truly has not got the funds to provide a better service than that it should decline to offer the service at all. To pretend an acceptable level of service can be delivered when it is not possible to do so, is to deceive patients and the public.’

He said he feared the quality of debate would worsen over the next year saying, ‘part of the problem we are facing in the next year is that we’ve got an election coming up. The political system will go into meltdown and brickbats will start being thrown about whose fault all this is – that will change absolutely nothing.’

At the conference, senior NHS managers said significant changes were needed within the NHS to ensure acceptable levels of care are provided. Dr Mark Newbold, chief executive of Heart of England NHS Foundation trust said, ‘there is a degree of honesty needed with the public about the longer term future. I suspect we will not be able to sustain the present model of care – the present number of sites for some services at the minimum acceptable level and we will have to think imaginatively about how we deal with that.’

Dr Mark Newbold said that Robert Francis’ inquiry had shown how important it was that NHS trusts did not respond to financial pressures by ‘thinning out the frontline’ and cutting back on staff.

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