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NHS staff must own up to their mistakes, Francis report will say, as consultants are overpaid and older mothers drive up birth defects

A legal duty could be placed on NHS staff to own up to their own mistakes, with the proposal set to form part of the report from the public inquiry into the Mid Staffordshire scandal set to be unveiled later today.

Monopolising today’s newspaper headlines, the report is expected to say that if such a legal ‘duty of candour’ was placed on staff before the hospital scandal, the failings in care that went on between 2005 and 2009 would have been detected and stopped much sooner.

The Guardian reports that the Liberal Democrats and leading patient groups support the move, which if implemented would mean that NHS personnel had to start being open and honest when they made an error, such as giving a patient the wrong drug or getting the dose of their medication wrong.

‘If Robert Francis is recommending a statutory duty of candour and the government accept it, it would be the biggest advance in patient rights and patient safety in the history of the NHS,’ said Peter Walsh, chief executive of the patient safety group Action against Medical Accidents.

‘Openness and transparency are essential components of patient safety. If people feel comfortable squeezing things under the carpet when things go wrong in healthcare, then lessons will continue not to be learned. The government surely must accept this recommendation’, Walsh added.

The Patients Association and National Voices, an umbrella group representing 130 health charities, have also been lobbying for the change.

Francis will detail the moves he believes are necessary to minimise the chances of what he in a previous report into the scandal called “shocking” care ever happening again at another hospital. He also heard evidence in favour of legally-binding minimum staffing levels in hospitals to help guarantee safe care, such as those that already exist in Australia. He is expected to argue for the NHS’s different supervisory and regulatory bodies to work together much more closely and share information to help detect care failings sooner.

Staying with the hospital theme, consultants’ high pay rates are coming under fire in The Telegraph, as a National Audit Office (NAO) report has concluded that there is ‘significant room for improvement’ in how NHS trusts in England manages their consultants, who collectively cost the taxpayer £5.6 billion.

Last year the average basic salary of the 40,294 consultants was £84,000, found the NAO. But extra pay from what the NHS terms “additional work” - plus annual bonuses called clinical service awards - boosts the pay of most to six figures. Almost two-thirds (63 per cent) earn over £100,000, the audit office said.

It found widespread variation in pay rates for ‘additional wor’”, ranging from £48 to £200 per hour. The 2003 consultants’ contract, negotiated by Labour, did provide ‘a clear structure for paying for additional work at defined contractual rates’, noted the NAO. But it said nine out of 10 NHS trusts continued to use ‘locally agreed rates’ for additional work, ‘for example to help reduce waiting times’.

‘This is likely to be linked to the fact that the contract allows consultants to refuse to work outside 7am to 7pm Monday to Friday,’ said the NAO, suggesting this had given them the upper hand. The 2003 contract also gave consultants an overnight, above inflation 12 per cent pay rise, concluded the report. Although it did lead to an increase in the amount of work they did, this came at the price of productivity falling, found the NAO. Productivity is the amount of work done per pound spent.

‘While indicators show that consultant productivity has continued to fall, the rate of decline has slowed significantly,’ continued the report.

Returning to a theme of care failings, the Daily Mail reports on the tragic case of a pensioner being left to die when the private company managing her care was shut down.

Eighty-one-year-old widow Gloria Foster starved to death after she was ‘forgotten about’ by the care system for nine days. She depended on agency nurses who visited her home four times a day for food, water and medication. But after the agency was closed down last month - for allegedly employing illegal immigrants - her council did nothing to look after her.

When someone eventually went to her home, in Banstead, Surrey, on January 24, they found that Mrs Foster had all but wasted away. She was severely dehydrated, suffering kidney failure, had serious bed sores and only a faint pulse. She was taken to Epsom Hospital but died on Monday. Yesterday her friends said what happened to her had been ‘appalling’ and demanded answers from Surrey County Council, the local authority responsible for her care.

Back in The Telegraph, we conclude the news digest with a warning that older mothers are driving up birth defect rates. The study has found that increasing numbers of older mothers and use of IVF has led to a marked increase in the number of babies born with birth defects since the 1980s. Researchers looked at 5.4 million births across 14 European countries between 1984 and 2007. They found the overall congenital birth defect rate increased by about 50 per cent over that timescale.

The risk was 27 per cent higher in multiple births such as twins, than in single deliveries.

Professor Helen Dolk, from the Centre for Maternal Fetal and Infant Research, University of Ulster, and the co-author of the study, said: ‘The increase in multiple birth rates may be explained by changes in maternal age and increased use of assisted reproductive technology (ART).’

‘It is clear that more research needs to be done to determine the contribution of ART to the risk of congenital anomalies in multiple births.’