Comment

The CQC – no care and no quality

The Care Quality Commission (CQC) was formed in 2009, as a merger of three existing healthcare regulators, but its competence to perform regulatory duties has come under close scrutiny in the past week with the latest controversy at Furness General Hospital (part of Morecambe Bay NHS Trust). Concerns had been raised as early as 2008 about the hospital’s high mortality rates but a CQC inspection in 2010 deemed the hospital to be satisfactory. An internal review was ordered in 2011, when the hospital’s maternity wards had the highest death rates of any in the country, but the subsequent report was never published or brought to public attention; it was believed to be overly critical of the CQC. There is now increasing pressure to reveal the scale behind this concealment and why decisions were made which prioritised the regulator’s reputation above all else.

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Photo: The Independent

The health secretary, Jeremy Hunt, has acknowledged in an interview with the BBC that he has ‘little confidence’ in the current CQC’s capabilities, but will simply changing the executives really make a difference to patient care? Mr Hunt has commented that ‘an Ofsted’ form of inspections would be welcomed, but is using a one-fits-all style of inspection inappropriate for both health and education? Perhaps, the health secretary should not simply focus on the failings at Furness General Hospital as a one-off tragic incident, but instead focus on the wider circumstances within which the CQC operates and take greater preventative measures accordingly.

The public is used to the frequent ‘scandals’ of bankers, celebrities, and politicians – so this latest controversy will barely register as anything overtly new in today’s press. The NHS is never far from the headlines, whether children’s heart surgery at Leeds, or the appalling treatment of patients at the Mid Staffordshire Trust, and whilst many may call for the CQC to be removed, it is these failings which highlight the urgent need for reform. If the CQC cannot report on failing hospitals for fear of its own indictment, there is something seriously wrong with the practice undertaken by regulatory bodies. The deaths of patients should not be dismissed as incidents to cover up; how undignified and disrespectful to those families who have lost mothers and children. The fear of being exposed escalated quickly, and a culture of cover-ups was allowed to overshadow this tragic loss of life.

Any hope of restoring confidence now lies in taking clear, decisive action to bring failing hospitals to the appropriate standards, regardless of CQC cover-ups in the past. There is a need for regulation in the health service and the CQC should work independently, morally, and with a clear focus on medical expertise to ensure high levels of clinical competence and patient care. Let us hope that the health secretary is able to make meaningful, non-partisan changes to this crucial area of his remit. The general public invests a great deal of trust, money, and pride into the health service. We should expect nothing less than proper regulation, treatment, and care in return.

30/06/2013

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