Jeremy Hunt attacks 'complacent' hospitals

nurses Mr Hunt said his words were aimed at the bulk of hospitals that were not excellent and not poor

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Too many hospitals are coasting along, settling for meeting minimum standards, according to the health secretary.

In a speech on Friday, Jeremy Hunt will attack a culture of "complacency" and "low aspirations", which he believes is holding the NHS in England back.

He is expected to say while there is a concerted effort to tackle failing hospitals, there should also be a focus on "mediocrity".

Labour's Andy Burnham blamed ministers for the failings in front line care.

Mr Hunt's comments come a month after the problems at Stafford Hospital were laid bare.

The final report of the public inquiry into the scandal, published at the start of February, attacked the way the system protected corporate self-interest rather than putting patients first.

The warnings have already led to investigations into 14 hospital trusts with high death rates.

But Mr Hunt, in a speech to the Nuffield Trust think-tank in Dorking, Surrey, will say part of the challenge is tackling "mediocrity and low expectations before they turn into failure and tragedy".

So how many hospitals are mediocre?

The health secretary will make it clear in his speech that he is not saying the vast majority are mediocre, but according to sources his words are aimed at a significant bulk of those plodding along in the middle.

It is commonly said about a 10th of hospital trusts are failing, although double that are actually not meeting all the essential standards set out by the Care Quality Commission.

That leaves about 80% of trusts that are doing what they should. Some of these will be excellent - perhaps about 10-15% - and some will be striving to become excellent - perhaps a similar number. That leaves close to half that could be said to be stuck in the middle, coasting along.


"Coasting can kill. Not straight away, but over time as complacency sets in, organisations look inwards, standards drop and then suddenly something gives," he will say.

"I would never describe the majority of hospitals or wards in the NHS as mediocre - but I do believe our system fails to challenge low aspirations in too many parts of the system.

"Imagine for a moment that the main objective for our Olympic athletes was not to win but to 'not come last'. How many gold medals would we have won then?

"It sounds ridiculous doesn't it? But today I want to suggest that too much of the NHS is focused on doing just that.

"Not on achieving world class levels of excellence - the gold medals of healthcare - but meeting minimum standards, the equivalent of 'not coming last'."

Sources said Mr Hunt's words were aimed not at those that are failing minimum standards or waiting time targets, but the bulk in the middle that were not excellent and not poor.

Family test

He is expected to single out Walsall Manor, a hospital in the West Midlands, which has turned itself around after faring badly in the national patients' survey two years ago. The hospital decided to carry out one-to-one interviews with 100 patients to find out what they thought of their care and the staff that looked after them.

On the Today programme, Richard Kirby, chief executive of Walsall NHS Healthcare Trust, said this led to investment in specific areas flagged up by patients and a better understanding of what patients want. The Trust has also introduced a friends and family test.

"Every patient who is admitted to our hospital is asked when leaving if they would recommend us to friends and family and scores are shared with all of our teams week in, week out.

Jo Webber from the NHS Confederation: ''People come to do the best they possibly can for patients''

"We get critical and positive responses. It gives us a simple, clear way of understanding how we are doing."

Katherine Murphy, of the Patients Association, said the health secretary was right to draw attention to the issue.

"There is a malaise in the NHS which has allowed mediocrity to become commonplace," she said.

"We hear from patients every day who are not happy with their care. I am not talking about the really bad, just those that are not putting patients first."


But shadow health secretary Mr Burnham said it was "no good for ministers to blame hospitals and staff when it is they who have thrown the whole system into chaos with a huge re-organisation, which has siphoned £3bn out of front line care.

Shadow Health Secretary Andy Burnham: "Coasting is the last thing hospitals are doing - they are working flat out."

"Hospitals across England are on a knife-edge and they need a government that provides support rather than points the finger," he said.

Royal College of Nursing director general Peter Carter said: "From one perspective I absolutely agree with him, of course we don't want mediocrity.

"But to make sure that does not happen we need to invest in staff. When we won one gold medal in the 1996 Olympics we started investing in our athletes, rowers and cyclists.

"To achieve gold medal standards in the NHS we need to do the same. It requires proper leadership, time to train and appropriate pay."

Mike Farrar, chief executive of the NHS Confederation, said there was room for improvement, adding hospitals needed to be more open and transparent.

"I believe that there is a crucial opportunity to make this culture change happen. We cannot miss this chance to deliver better care."


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  • Comment number 824.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 823.

    What ever job u do if u are committed and have the interests of your customers at heart then you wont give 2p about what this Tory has to say its the parasitic, lazy, work shy people who exist in every sector who find it easier to hide in big organisations being protected by the out dated self promoting Unions who have been replaced by employment legislation but dont seem to have clocked this yet

  • rate this

    Comment number 822.

    #815 Seeker
    Suspect that's the view of the McKinsey "expert" architects of Lansley's travesty of a botched's almost as if they're trying to fail...?

    Love to think you could be right - experience and cynicism militate too strongly against.

    How about we invite the Germans to do it - stakeholder interests pivotal to planned outcomes and all that malarky...?

  • rate this

    Comment number 821.

    Maybe mediocrity arrives when you have to focus all of your efforts on meeting artificial targets that distort priorities in secondary care.

    I wonder where those targets came from Mr Hunt... but what do we expect from someone that called for the NHS to be dismantled, supports homeopathy, wants to restrict abortion...

  • rate this

    Comment number 820.

    How much the government as cost people in the UK earning over £1 mill zero given them a 5% increase
    earning £250,000.00 increase costs by 2% earning £50,000.00 increase costs by 5% earning £25,000.00 increase costs by 10%
    earning £12,000.00 increase costs by 24% those reciving benefits increase costs to them by 30% minimum to a maximum 65%
    same with the NHS is not safe with this government

  • rate this

    Comment number 819.

    If private hospitals weren't allowed to transfer their botched operations to A&E at the nearest NHS hospital their rates would reflect their true performance and put their patients off of paying extra for a bad service.
    Having picked up a hospital acquired infection from a private hospital in my experience its ot that good.

  • rate this

    Comment number 818.

    I agree the source of the criticism is dubious but does it make the actual critique anything less?

    We have a beloved NHS monolith which no one really knows how to tackle. To find a solution is a bit like searching for the holy grail. Sorry to sound like such a pessimist.

    Glass half empty.

  • rate this

    Comment number 817.

    Having had a few spells in hospital over the last 20 years, I appreciate what the NHS has done for me. However, the idea that certain hospitals are doing the bare minimum has a lot of truth to it. My own local hospital has been good and awful during the last 20 years. St George's in Tooting has been great to me, but while the treatment stayed decent under Labour, the food turned to pigswill!

  • rate this

    Comment number 816.

    I have just returned home from an extremely long and demanding day working in a front line NHS ward. I am furious to read Mr Hunt's comments that too many people working in the NHS are happy to settle for mediocrity. This is an insult to all the highly committed, industrious professionals that I work with and who strive to deliver the highest standard of evidence-based patient centred care.

  • rate this

    Comment number 815.

    759.Billythefirst "753 ExiledBlade asks a good question given how easy it is to circumvent KPI's in more straightforward commercial environments
    737 Soothseeker

    I bet we three could work together on designing even just a few productivity metrics that were simple, cheap to implement, and crystal clear indicators of real added value, to patients AND to NHS staff AND to taxpayers. It can be done.

  • rate this

    Comment number 814.

    How come there is no HYS where we can discuss the chairman of the Office for Budget Responsibility saying that David Cameron is a liar?

  • rate this

    Comment number 813.

    Yes he only wants to put it in to private hands so those friend of the Tories can pick it up and make money out of the sick

  • rate this

    Comment number 812.

    810 Swing Lowe
    Unfortunately they "serve" themselves!,follow cabinet ministers,prime ministers,and even MPs,after they have either been kicked out or resigned and observe the obvious employment patterns and relationships with central government or in their local constituencies,"follow the money"or contract!

  • rate this

    Comment number 811.

    I suffer from numerous chronic conditions, as such, since 1976, age 14, I have needed the NHS on a regular basis and its kept me alive on many occasions. I have experienced variations in the quality of nursing and doctors over the years, which to be expected. Ive never known a health minister attack the reputation of so many dedicated people with such regularity. He is anti NHS and is a disgrace!

  • rate this

    Comment number 810.

    Is it me - in the 14 years Blair was PM he started the process to put the NHS in the position it is in now and also destroyed the economy with borrowing and blowing the national rainy day fund now his parasitic replacements are blaming others for this, can someone please tell these Politicians they are accountable and it is their fault and they need to work together to serve our country

  • rate this

    Comment number 809.

    Baring in mind how many years it is possible for Hospitals to "coast along" before being flagged up,or the dangerous ones with the totally avoidable suffering and increased mortality rates as well,and if you throw in the numerous wasted reports,commissions,recommendations,over the years, many repeating the obvious,you are left asking,"who is complacent"Mr Hunt!?

  • rate this

    Comment number 808.

    Dear Jerry, you deserve a gold medal for your little fandango with Nick Clegg & Levenson, I suggest you give some gold medals to Politicians & banksters as they certainly won! I also suggest a gold medal for ATOS for a job well done. Now call a General election and see where these gold medals would be fitted & you can take that as a triple A rating. You are beyond contempt!! ADIOS

  • rate this

    Comment number 807.

    766.ovalball ---756.Alan T -- ""My post was designed to regard for Mr J Hunt ... without offending any more people than is necessary... I thought I had done in a light hearted way"

    Hello ovallball. I think Alan's reaction was just a groan of despair and boredom at seeing yet another post making the same tired and obvious joke. There are 800 posts, and we've seen it a hundred times.

  • rate this

    Comment number 806.

    JH says he we shouldn't have an NHS that is target driven that only achieves minimum standards. But... it's government that sets the targets and standards. Don't the government realise that constant changing of the structure of the NHS means that they have to start from scratch at the whim of ministers. It's no wonder the NHS can't build a high tower when the government keeps knocking it down.

  • rate this

    Comment number 805.

    The day in day out life of the NHS cannot be compared to the Olympics. If you asked any Olympian if they could get the same medal standing every single day, they would be horrified! For athletes it is all about pivotal moments and events.
    The NHS, its staff particularly, are trying to deliver this pivotal performance every day, despite deep budget cuts and the fact that they aren't superhuman!


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