Review Into Hinchingbrooke Hospital 'Relied On Tittle Tattle'
3 February 2015, 06:16
A health watchdog has been accused of relying on "anecdote and tittle-tattle'' in a damning report into standards at the first NHS hospital trust managed under franchise by a private company.
But giving evidence to the House of Commons Public Accounts Committee, the head of the Care Quality Commission, David Behan, insisted he stood by the report, which last month branded Hinchingbrooke Health Care NHS Trust in Cambridgeshire ``inadequate'' and called for it to be taken into special measures.
The chief executive of Circle Holdings, Steve Melton, said the CQC report was not the reason why the company had decided to withdraw early from the contract to run Hinchingbrooke, which he blamed on financial unsustainability caused by rising demand and cuts in funding.
Mr Melton told the committee hearing he was ``proud'' of what Circle had achieved at the hospital since 2012 and would be ready to consider taking on similar contracts in future, if the terms were right.
The Department of Health's director of finance Richard Douglas said there was nothing in Circle's performance that would prevent them being considered for future contracts, but added: ``I don't think there will be any more of the kind of franchising we have had until we have resolved some issues.''
The committee's chairwoman, Labour MP Margaret Hodge, said the decision to award the contract to Circle had been ``rash'' and that health service officials played down the risks when they entered into the private sector franchise.
She said former strategic health authority boss Sir Neil MacKay negotiated the deal, and it was ``not acceptable'' that he was still being paid for advice by NHS bodies. ``Somebody has got to be accountable,'' said Mrs Hodge. ``You don't walk away from a decision.''
But Mr Douglas said: ``Clearly there was risk. Any major transaction, there will be risk in it. There would have been risk if we had carried on as before. Clearly this has not ended up the way we wanted it to.''
Circle announced on January 9 that it was in talks to ensure an ``orderly withdrawal'' from its contract to run the hospital, near Huntingdon, citing ``unprecedented'' increases in A&E attendances and funding cuts totalling 10%. Hours later, the CQC released its report which made Hinchingbrooke the first trust in England to be rated inadequate for caring, and raised ``a number of serious concerns'' about staffing, risks to patient safety and medical care.
Committee member Stewart Jackson, Conservative MP for nearby Peterborough, said the trust had recently received awards for its care. He questioned whether the widely criticised CQC was ``fit for purpose'' and claimed its report was ``based on anecdote - some might say tittle-tattle''.
Hinchingbrooke chief executive Hisham Abdel-Rahman told the committee he found the CQC inspection ``problematic'' and had identified 300 factual errors in the report, 65% of which the watchdog had accepted.
In one case, a member of staff was criticised for shouting at a patient, who later turned out to be profoundly deaf, he said. In another, a student nurse, who was heard telling a patient not to misbehave because ``you know what happens when you misbehave'', was trying to be ``endearing'' by engaging in ``banter''.
Mr Jackson told Mr Behan that the report's finding that patients had been told to soil themselves was ``anecdote which you have not been able to prove''.
``You should perhaps be a little bit suspicious of unsubstantiated innuendo masquerading as proven, demonstrable fact,'' said the Peterborough MP.
Mr Behan said: ``We should be healthily sceptical. What I am trying to do, as clearly and honestly as I can, is say what my team found and how they recorded it. Is that comfortable? No, it isn't comfortable, but that's what we found and what we are standing by.''
Mr Jackson told him: ``You have traduced the reputation of a popular hospital. You should be ashamed of yourself.''
Mr Behan replied: ``I am not ashamed of myself. We undertook our investigation. We did find good care at Hinchingbrooke but we also found care that needs to improve and needs to improve quickly.
``Our job is to judge that care impartially and fairly and that is what we have done.''
He added: ``We were surprised to find what we found at Hinchingbrooke, but the fact is that those patients and staff who spoke to us and raised concerns did speak to us and raise concerns and we need to take them into account.
``The issue about people who were told to soil themselves came to us as a fact. You can't discount that.''
Mr Behan said he had instituted reforms to the CQC since it was criticised under a previous chief executive. Though he acknowledged that the watchdog was 600 short of its desired 3,000-strong manpower, he said 30 people - including doctors and nurses - had taken part in the inspection of Hinchingbrooke.
He rejected Mr Jackson's suggestion that there may have been a conflict of interest as one of the inspection team had previously voiced opposition to private sector involvement in running NHS hospitals.
Mr Behan accepted that some changes had been made to his team's report after Hinchingbrooke complained of inaccuracies, but said that some of these had involved spelling mistakes.
Mr Melton said the process of transferring Hinchingbrooke back into NHS hands should be complete by the end of March.