Hunt’s hospitals speech may haunt him

Jeremy Hunt’s speech to the Nuffield Trust conference has all the hallmarks of “bog standard comprehensives”, giving rise to the obvious danger that his remarks will forever haunt him. His main thesis today (and he has said it before) is that too many “middle of the road hospitals” are “hitting targets but missing the point”.

He says that hospitals that simply meet minimum standards should tackle “mediocrity and low expectations before they turn into failure and tragedy”.

The reference to Mid Staffs is loud and clear and indeed picks up on Sir David Nicholson’s point at the health select committee that managers were so obsessed with targets that they forgot the patient.

Mr Hunt goes on to say that “coasting can kill”, he adds that “not bad is not good enough”.

It is a difficult time to be having a go at hospitals just weeks off the start of the massive NHS reforms and in the middle of huge financial restraints. Some interesting research has just been published that shows (and this might seem obvious) that good nurse-patient ratios lead to better outcomes.

Yet nursing posts are being cut and there is a shortage of registrars and midwives. The Department of Health has said it will look at the issue of staffing levels but that is work that has not yet begun.

The shadow health secretary Andy Burnham says hospitals are on a knife-edge but it is also the case that there have always been hospitals that are better than others and one of the clearest messages from Mid Staffs was about failure of management. In fact, Sir David, rightly or wrongly, also said to the health select committee that some people were promoted to chief executive level of a trust and simply are not up to the task.

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