February 19 2024
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No new dawn

No new dawn

It might be possible for a banker to earn a six figure sum and survive public hostility but it’s not so easy if you head the body that is supposed to regulate hospitals and care homes in order to protect the public.

When public hostility is oiled by a public inquiry whose criticism (almost) knew no bounds and allegations that the body that whistleblowers should be able to turn to was accused of victimising its own whistleblowers, then it became clear time was up.

Thus it was that Cynthia Bower head of the Care Quality Commission has resigned her £195,000-a-year role.

She surely had to go because of the multiple failures of the CQC, but before the cheering gets too loud bear this in mind. If Andrew Lansley’s Health and Social Care Bill becomes law we will need a ferocious regulator to even keep things as they are, never mind improve them due to the utterly confusing lines of accountability and privatisation it will introduce,

And who, effectively, gets to appoint Ms Bower’s successor? Why, none other than the author of this dog’s dinner of an NHS plan, one Andrew Lansley.

Cynthia Bower has decided it is ‘time to move on’ after four years in post just after the Commons health select committee and the National Audit Office both published highly critical reports about the CQC and a few weeks before the Mid Staffs Inquiry report is expected to provide a withering judgement on her role in the Mid Staffs Hospital scandal. The final straw was a CQC performance and capability review by Department of Health permanent secretary, Una O’Brien.

Lest we forget, however, many of the CQC shortcomings were primarily due to its compliance with a Government strategy of light touch regulation and an acceptance of increased responsibilities at a time of a reducing budget and a massive merger. A perfect storm brewed up by Gordon Brown and fanned by Andrew Lansley.

Bower’s resignation is likely to be followed by a further reshuffle of NHS regulation after the publication of the public inquiry findings arising from the Mid Staffs scandal. The problem is that this is government dismantling regulation on all fronts at the same time as radically changing the NHS and cutting funding as needs rise. Cynthia Bower was the public face of a failed organisation and had to go. But she was far from being the root cause of what went wrong and the determination of this Prime Minister to simultaneously privatise and deregulate services bodes ill for those who use health and social care.

The farewell messages from the good and the great certainly came to praise and bury her. Dame Jo Williams, chair of CQC, whose own demise may be imminent says ‘she has shown tireless commitment’; Una O’Brien, Department of Health, who wrote the disastrous performance and capability review which finished Bower off praised her ‘energetic leadership’; NHS chief executive, Sir David Nicholson, praised her ‘great vision, leadership and resilience’.

Kay Sheldon, a CQC board member, and whistleblowers had a different take. She gave extraordinary evidence about its failings in the Stafford hospital inquiry. ‘People will not be surprised to learn that I believe Cynthia Bower should have left before now given the serious and ongoing problems the organisation has faced.’

Beware. No one can have confidence that Andrew Lansley plans to put in place the sort of well funded robust regulation that will highlight the impending failings of the new NHS he is busy trying to shoehorn into place. Cynthia Bower’s departure is not a new dawn.

Roger Kline is co-author of a forthcoming book giving practical guidance to health service and social care professionals on how to challenge poor practice