Sunday, 4 March 2012

The Investigation

It is clear from listening to the evidence at the inquiry that the investigation, conducted by a team led by Dr Heather Wood, evoked some very strong responses from the different people caught up in the process.
The investigation was set to be one of the last of its kind, as the investigation team, which was a part of the HCC, was to be disbanded once the CQC took over the regulatory role in April 2009. It is not clear at what point this decision was made or what effect if any this might have had on the way in which the team approached the assignment.  
It is clear to anyone who reads the evidence from the Inquiry that the relationship between the HCC Investigation team and the CQC was a very strained one.
It is not clear how this model of investigation arose, but it involved a team coming into the hospital and spending more than a year looking at every possible detail.  Hospital staff speak of their shock. We hear of the huge burden that the investigation placed on the hospital in seeking to respond to the highly detailed demands for information. Whereas the relationship with the Local HCC team was essentially an open and supportive one, the Investigation team made it clear that they were not there to help, they were there to find out what had gone wrong and why and to identify who  was to blame
We heard from many people who felt the impact of this. The CEO, the Chair, Members of the management and the board, a number of staff, The Coroner, The SHA, Monitor, the Health protection agency, the Health and safety executive, the DoH. All of these individuals and organisations had their reservations about the conduct of this Investigation.
There are comments about the way in which people were interviewed, the level of demand placed on the hospital, the sheer length of the investigation, the lack of communication with other bodies, either in letting them know an investigation was in progress, or in informing people how it was going, and the way in which it delayed people being able to take action to support the hospital to deal with its problems.
The Health and Safety Executive had no direct involvement with the HCC investigation team, but were asked at a much later time to use the report as a basis for legal action against the hospital. They found that this was impossible as little if any of the “evidence” had been corroborated to the standards that their quasi legal processes required. They found some of the evidence had even been drawn from newspaper reports. 
The effect of the investigation on the patient group was interesting. The fact that the investigation was taking place confirmed their impression that something highly unusual had taken place in Stafford, and this fuelled the coverage of the story in the local press. The reporters understandably  saw themselves as playing a key role in a very important public interest story.
Before the investigation team moved in,  the public Inquiry has established that there was virtually nothing in the way of complaints from the public about the hospital. The regular items now appearing in the press may have helped to generate new complaints, and the creation of a hotline to capture public opinion, which was publicised in the press on numerous occasions helped to increase the flow. Some of these appear to have dated back some years. The protest group on a number of occasions demonstrated outside the hospital, making the investigators very aware of the strength of their feeling, and this was of course all reported in the press. No one at this time would have dreamt of questioning the appropriateness of any of this. There were a group of people who had suffered, they wanted answers, and the Investigation team should be able to provide them.
The question of why there were so few complaints before this time is an interesting one. Did people simply take it for granted that they would receive bad care and that there was nothing they could do about it, did they see that the staff were doing as well as they could given the pressure they were under, did the press reports and the publicity prompt them to see their experiences in a different light?
Julie Bailey, who became the spokesperson for the pressure group, tells us in her evidence to the inquiry that when things became too much for her that she would be able to ring Dr Heather Wood. Dr Wood was someone that she seemed to feel really understood her point of view well.
As time passed the DoH, the SHA and Monitor were all concerned about the major effect that the investigation was having on the hospital and wanted to be able to take action to help, but preserving the independence of the regulator meant that they could not force this process. They had to allow things to take their course. 
The HCC had originally raised a number of immediate concerns, which were addressed by the hospital, but then as late as October 2008 they were reassuring the DoH that the hospital was safe and that the scale of problems was not as great as in the previous “scandal” hospital at Maidstone & Kent.  This would appear to indicate that whatever the problems were they did not appear to be on a massive scale to trained investigators even after many months of investigation, I believe that this means if would also be unreasonable to expect any less expert people to have “known”  what was wrong at Stafford. 
Bill Cash
Towards the end of 2008 the pressure group made contact with Bill Cash MP He was very supportive, and instead of submitting a report based on his own knowledge of the hospital to the HCC investigation as the other MPs had done, he encouraged the pressure group to prepare a dossier of their complaints which he then submitted to the HCC on their behalf.  Will the HCC have viewed these complaints any differently coming through this source? Will they have expected that he would have made independent enquiries to verify the details? He also later claimed to a public meeting that he had taken on the role of being the media mentor to the group. We do not know the details of how he discharged this role.

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