Whatever the rights and wrongs of punishing NHS staff for mistakes (New law means future medical scandals could be missed, says NHS watchdog, 1 April), the government is ignoring a fundamental cause of the dreadful events described in the Ockenden report. Poor staffing can lead to problems such as a lack of listening and empathy, rudeness, mistakes and bullying.
Imagine you are constantly rushing between too many labouring women, or “ignoring” a new mother’s buzzer because another is in floods of tears, or trying to monitor several abnormal foetal heart rates simultaneously. Is it surprising that your stress means you don’t listen properly, are unintentionally abrupt, miss something vital and are bullied by your manager, who is also stressed and bullied by theirs? You will be too exhausted, demoralised and scared to blow the whistle.
Increased workforce numbers would help. The government has refused to take a vital step here, rejecting an amendment to the health and care bill that would have required it to publish an independent review of NHS workforce requirements every two years. The amendment was backed by Jeremy Hunt, the chair of the health select committee, and Simon Stevens, the former NHS England chief executive, but voted down in the Commons last week.
The government has just cut £330m from the NHS budget, so of course it doesn’t want the inevitable demand for more money for staff and training that would undoubtedly be recommended in these workforce reviews. Yet £6bn is being spent on more expensive agency staff. So I beg MPs to vote for this amendment when it returns from the Lords.
Gay Lee
London
• Avoidable baby and mother deaths are almost certainly not confined to Shrewsbury and Telford hospital NHS trust (Police examine 600 cases after damning NHS baby deaths report, 30 March). A factor common to all hospitals was the use of the number of caesarean sections as a negative performance indicator. Clearly, top-down pressure to minimise caesareans might override clinical judgment in individual cases.
The use of this performance indicator has been criticised for over a decade, but it was not until February this year that NHS England and NHS Improvement said hospitals should no longer use “total caesarean section rates as a means of performance management” because it may lead to decisions that “may be clinically inappropriate or unsafe in individual cases”.
In the time it took these august bodies to arrive at this glaringly obvious conclusion, at least 201 babies and nine mothers died unnecessarily in Shrewsbury and Telford, many because of resistance to performing caesarean sections. These deaths, and many others that have probably occurred at other trusts for the same reason, should be blamed largely on NHS England and, ultimately, successive health secretaries.
Geoff Renshaw
Leamington Spa, Warwickshire
• Re Gaby Hinsliff’s article (The horrific birth stories from Shrewsbury NHS trust are haunting. Sadly, they’re not unique, 31 March), you might add another to the list that extends from Shrewsbury to East Kent, Morecambe Bay and Nottingham. Our daughter was born and died on 23 June 1978 in Groundslow hospital, Stoke-on-Trent. I was shocked that when the doctor spoke to me, his closing remarks were: “Oh, it died, by the way.” “It”.
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