The awful truth comes out

Today the report on the disgraceful shambles at the Mid-Staffordshire hospital has been published. Its conclusions are devastating. It says that the NHS "put corporate self interest and cost control ahead of patients and their safety".

As someone who has worked in, and been totally committed to, the idea of the NHS, this is deeply depressing. One tends to hold a fond belief that things get gradually better with time. Society becomes (albeit agonisingly slowly at times) more humane, compassionate and fair as time passes. Not in this case apparently. Here we have seen how compassion and caring went out of the window in the frantic rush to achieve "targets" (targets, by the way, that were introduced under New Labour, who therefore have their own terrible responsibility in all this). I recall a widow speaking on the Today programme the other day of the treatment meted out to her husband during this dark time. Having found her husband sitting helpless in his faeces and urine soaked bed, she confronted the nurses on the ward about why he and his bed had not been cleaned. She was told there was "no time".

I remember at medical school learning to my surprise that the enormous improvements in the health of the population in the last 150 years were due to improvements in housing and sanitation and not from the attentions of the medical profession. In other words, the simple act of separating drinking water supply from sewage systems saved more lives than all the antibiotics, all the clever diagnosing and all the heroic surgery put together. Our society continues to become healthier and longer-lived. Yet it seems that this has not come about as a result of better care in hospital, but because of improvements in diet and exercise, as well as the general reduction in smoking.

What this report shows is that in some ways the NHS has actually got worse in the 40 years since I qualified, and not better, as it should have done. At this very moment I am listening to David Cameron telling the House of Commons that the situation will change for the better as a result of this report. I hope he is right. But who will take responsibility for their actions at Mid Staffs? Will there be resignations, sackings, prosecutions for neglect or even corporate manslaughter? I doubt it. If experience is anything to go by, we may even see those responsible being moved, or even promoted.to more senior jobs elsewhere.

I say: nail the bastards responsible for transforming this and other hospitals from places that heal into places that harm. Nail them now!