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Francis criticises council scrutiny 'failure'

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The Francis report on NHS care failings has raised serious concerns about the “concept” of local government health scrutiny, pointing to major errors by Staffordshire CC and Stafford BC in holding health services to account.

The report by Robert Francis QC, published on Wednesday, accused scrutiny committees at both authorities of a “conspicuous failure” and said all health scrutiny committees should have the power to inspect providers.

It said it had found “a number of weaknesses in the concept of scrutiny”, which may mean that regardless of how “capable and conscientious” the individual members of a council’s scrutiny committee were, the system could still be an “unreliable detector of concerns”.

Future problems could be avoided by giving the committees more powers, such as the ability to inspect providers, it said.

It said councillors could not be expected to be experts in healthcare, pointing to “limits on what a committee of elected councillors can be expected to do in scrutinising a hospital”. However, it said, members of both authorities’ scrutiny committees could have done more to expose problems at Stafford Hospital.

They had failed to “detect or appreciate the significance of any signs suggesting serious deficiencies” at the hospital, where abuse and neglect from 2005 to 2008 led to hundreds of unnecessary deaths, it said.

It said Staffordshire CC’s health scrutiny committee was “wholly ineffective”, having “confined itself to the passive receipt of reports” about the hospital, without properly challenging the information they contained.

The report has also criticised the committee for its apparent lack of interest in the views of the public. It quotes Jim Muir, a former councillor and former chair of health overview and scrutiny committee, as saying that it would have been “pointless” to seek the views of the public about local health services and that he “would have gone home” if he was asked to canvass views about it.  

In a statement Staffordshire CC leader Philip Atkins (Con) said: “The county council has made its own scrutiny role of NHS partners more robust with better training, specialist support and encouraging members of the public to attend meetings and ask questions directly of senior NHS officials.”

Stafford leader Mike Heenan (Con) said many of the weaknesses identified by the Francis report had been pointed out by the council, he said, including the limit to what councillors can be expected to do. “We relied on professionals and organisations better equipped to tell us what was happening at the hospital,” he said. “But like others it is now obvious the committee were misled about the true situation by the hospital management.”

He added: “We must now help to ensure the recommendations relating to local authority scrutiny are implemented in full.”

  • The Francis report also recommended that councils should be required to hand over the funds that they received for local Healthwatch groups directly to the groups themselves, making them accountable for the use of the funds and intervening only if the group was “incapable of performing its functions”.
  • It said local Healthwatch groups should have a consistent structure nationally and “appropriate training and access to advice”.
  • It also said Public Health England should review the support and training that health protection staff could offer councils to help with the oversight of  health providers’ arrangements for infection control.
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