When the disgraced Chief Executive of the Care Quality Commission (CQC), Cynthia Bower, resigned last year with a gold plated pension pot of £1.35million, she received glowing tributes from top Department of Health officials. She even went on to join the board of the Skills for Health, lecturing other countries on how to deliver quality healthcare (without any irony).
Yet just a month earlier in a car crash performance at the Public Accounts Committee (PAC), MPs across the political spectrum had given a damming verdict. The committees report stated that the CQC has been ‘poorly governed and led’.
Her involvement in Mid Staffs presented this week as a new revelation was also well known at the time, not least as her predecessor as Chief Executive of the Strategic Health Authority responsible for the scandal ridden hospital was Sir David Nicholson.
It remains unclear whether Sir David and Una O’Brien, Permanent Secretary at the Department of Health, still stand by the eulogies to Cynthia Bower as a great leader which they made last year (http://www.cqc.org.uk/media/cynthia-bower-announces-resignation-chief-executive-cqc).
It is also unclear why they made such comments in clear defiance of the concerns raised by the PAC. It gives the impression that they simply dismissed Parliament’s concerns.
Nothing better highlights the limitations of parliamentary select committees than the continued problems at the CQC, five years on from the death of James Titcome’s nine-day-old baby, Joshua, at Furness General Hospital.
When the new chair of the CQC this week said inspectors were not fit for purpose, with firemen inspecting hospital wards, it was regrettably not a surprise. The transcript of the parliamentary hearing held 18 months ago shows that officials were challenged on precisely this point when I raised the importance of inspectors understanding the industry they are inspecting, and asked how many inspectors were qualified as doctors.
Parliament received reassurance from the permanent secretary at the Department of Health that concerns with the quality of inspectors were urgently being fixed, with Una O’Brien saying ‘quality assurance systems’ were in place to ensure that improvements took place.
Ms O’Brien should now clarify what work took place to delivering that assurance, given that the new Chair of the CQC is saying that 18 months on the problem is still acute.
Similarly, the fact the CQC had a deliberate policy of burying bad news is not new. Whilst this week’s revelations graphically highlight the cynicism and self interest of healthcare bosses at the CQC, an expert witness had already told parliament about the organisations’ approach.
Examples include the CQC’s decision under Cynthia Bower to scrap the national investigation team, abolishing the dedicated whistleblower line, the use of gagging clauses against their own staff, including a member of the board, and changing their media strategy so that negative stories were only released to regional and not national media.
The gulf between what some senior official told Parliament and what was happening on the ground is also starkly highlighted in today’s National Audit Office (NAO) report on the systemic abuse of taxpayers’ money to pay off and silence whistleblowers. Department of Health officials have continued to tell Parliamentary Select Committees that the issue had been fixed, not least with guidance in 2004, protections in the NHS constitution, legislation in the form of the Public Interest Disclosure Act and letters of instruction from David Nicholson in recent years.
Today’s independent report by the NAO reveals the reality behind the rhetoric. The assurance of officials simply disguised the continuation of an abuse of taxpayers’ money.
As officials prepare to appear once again before Select Committees, MPs will no doubt be told the problem is being fixed. Yet civil servants have proven time and again their inability or unwillingness to take on the cover up culture within the NHS.
Parliamentary Select committees have again shown their ability to identify the correct issues long before they are dealt with by officials. It is time to look again at their powers to ensure that their recommendations are acted on.
This article first appeared on Politics Home, here: http://centrallobby.politicshome.com/latestnews/article-detail/newsarticle/steve-barclay-mp-who-regulates-the-regulators/