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Career fear the reason why no doctor blew whistle on Mid Staffs

The scandal of the poor quality care at Mid-Staffordshire NHS Trust does not surprise the Jobbing Doctor, because like all GPs he spends a lot of time with patients who tell him all about their hospital.

The scandal of the poor quality care at Mid-Staffordshire NHS Trust does not surprise the Jobbing Doctor, because like all GPs he spends a lot of time with patients who tell him all about their hospital.

We are told on a daily basis about patients' stay in hospital. There are a number of reasons for this, including the fact that I may have made the decision to admit them to hospital, or they know that the arrangements for discharge summaries remain appalling, or maybe they just wish to tell their stories to somebody else.

The stories that I hear are not encouraging. And I am aware that the District General Hospital I have dealings with is pretty average, although there are a lot of dedicated and talented people there.

No, I'm not surprised because it still takes too long for in-patients to be discharged, as they seem to be waiting for endless investigations. The nurses are working hard, but much of their work is filling in bureaucratic forms. The documentation is profuse, endless and pretty pointless, as everything needs to be written down. Why? To reduce the risk of legal redress.

No, I'm not surprised as there is absolutely no continuity of care within the hospitals, so they get told one thing by one doctor and another thing by another doctor, so it is a frequent occurrence that I am left as the GP to tell them why they were in hospital, what the diagnosis was, and what the prognosis is as well.

No, I'm not surprised that the regulatory authorities failed abysmally to pick it up until it was an elephant right in the room. The regulatory system is specifically light touch, and the development of semi-autonomous Foundation Hospitals is a step towards privatisation. Their financial security is much more important than clinical quality. Thus various organisations were unaware of the problems within these hospitals, as they weren't looking for problems.

The problem in a centralised system often emanates from the centre and is as a result of policy decisions made at a strategic level. What on earth was the Strategic Health Authority doing here? In my view they're not strategic, they don't care much about health and have no authority.

But surely clinicians will be able to raise their concerns about quality with their relevant authorities: the West Midlands Deanery, perhaps? The relevant Royal Colleges, maybe? The Nursing and Midwifery Council? The Chief Medical Officer? The General Medical Council? We are told that complaints are valuable and help to improve systems. Why weren't all these important people crawling all over this trust years before all those poor patients died?

I'll tell you why. Because those who have acted as whistleblowers in the past have seen their careers wrecked, that's why. One brave doctor reported a neighbouring trust and as a result was investigated by the GMC, had allegations about her mental health raised and since then her career has been affected. Another had to move to the other side of the world to be able to work.

The Jobbing Doctor can confidently predict that all these named people and organisations will say that the responsibility lies elsewhere. Nothing will be done. People will still come into my room and tell me about the amputation they had to have because of MRSA, or the C. Difficile that nearly killed them.

John Donne said that ‘any man's death diminishes me'. We are all shamed by the events in Stafford.

The blame will be pinned locally. But the real blame lies right at the very heart of Government.

The Jobbing Doctor. Local GPs would have known about the Mid-Staffs Hospital failings, but too scared to blow the whistle

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