Jeremy Hunt attacks 'complacent' hospitals
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.
"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."Investment
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.
"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."