£50 for anyone who can send us a correct image.
Every public inquiry has a “secretary”. Somebody usually parachuted in from the civil service department under criticism to provide back office support. This role can be very important. At the Bristol Inquiry, Una O’Brien was the secretary, and she has now risen to the Permanent Secretary, Queen of Wonk role.
So who’s holding the pencils at Mid Staffs? At the Inquiry, the mandarin behind doors goes by the name of Alan Robson, the eyes and the ears, and possibly the dead hand, of the Department of Health. Who he? Step forward none other than the Department of Health’s lead on enforcing the 18 week elective wait times. In his first report, Robert Francis QC found that targets themselves had created the pressure which led to loss of lives:
“63. This evidence satisfies me that there was an atmosphere in which front-line staff and managers were led to believe that if the targets were not met they would be in danger of losing their jobs. There was an atmosphere which led to decisions being made under pressure about patients, decisions that had nothing to do with patient welfare. As will be seen, the pressure to meet the waiting target was sometimes detrimental to good care in A&E.”
Another colorectal surgeon told Francis that they had not done any audit on quality of surgery as they were under immense pressure to meet “process” targets. So the mandarin at the Inquiry, Alan Ronson, is charged with looking into the targets, that he himself was responsible for as head of the policy unit on 18 week targets at the Department of Health.
Given the Francis report has now been pushed into the long grass after the summer, Medical Harm wanted reassurance that the so-called “independent” Inquiry would not be tacitly guided by what is “appropriate” from the Department of Health, and its well-placed mandarin. The Inquiry team found it difficult to provide straight answers to Medical Harm but we eventually arrived at the following:
· Does Mr Robson have any role in the selection of witnesses? No
· Does Mr Robson have any role in the selection of evidence? No
· Does Mr Robson has any role in the publication of evidence? Yes. He leads the team which is responsible for updating the Inquiry website with those statements that are read into the record by the Inquiry Legal team.
The “secretary” to the Inquiry is undoubtedly a powerful position in selecting appropriate witnesses. Many whistleblowers sent evidence to the Inquiry. Not many of them were called as witnesses.
As Sir Ian Kennedy of the Healthcare Commission said of the Department of Health in his evidence this year, “My experience of the Department of Health is that they have a tendency to shoot the messenger rather than embrace changes that need to be made. Their first priority is to ‘handle’ the situation, rather than consider and implement change…” Indeed.