21 December 2013
Last updated at 06:05 ET
The health regulator said the NHS should not be treated as a “national religion”
The NHS “became too powerful to criticise” despite many patients receiving a “wholly unsatisfactory” service, the health regulator has said.
David Prior told the Daily Telegraph that even the most senior staff were afraid of speaking out.
The Care Quality Commission chairman said the NHS should not be treated as a “national religion” beyond criticism.
He said the health service was becoming more honest about failings, which made it more likely they would be addressed.
Mr Prior warned that the service’s perceived status had left some areas of care “out of control” because honesty about failings was not tolerated.
Mr Prior said: “It became too powerful to criticise. When things were going wrong people didn’t say anything. If you criticised the NHS – the attitude was ‘how dare you?’
“No organisation should be put on such a high pedestal that it is beyond criticism. Now it is getting more honest about our failings – which I think makes it more likely that we will address them.”
Mr Prior said the emergency care system should be a priority for change and it was “wholly unsatisfactory” that so many patients struggled to get an appointment with their GP.
He said: “Their opening times have to be geared around the patients
“It’s no surprise that Sainsbury and Tesco do most of their business outside office hours because that’s when people can get to shop. Working people need to be able to see their GP in the evening or at the weekend.”
Mr Prior described a “chillingly defensive” culture in which even the most “alpha-male surgeons” felt frightened to speak out for fear of ending their careers.
“I had not realised that the culture in some of our hospitals was so damaged. That was an awakening,” he said.
“When you are compared to a national religion, that is the problem,” he said in reference to a description of the NHS by Lord Lawson.
He added: “I think targets can be distortive. Every time a patient arrives [in AE] the clock starts ticking and not a lot happens.
“At three hours people start to get interested – and at three hours 55 minutes the chief executive is down in the AE department. That doesn’t make any sense.”
Mr Prior also said it was “crazy” for Health Secretary Jeremy Hunt to be telephoning around hospital chief executives who had missed AE targets.
“There is an obsession. It’s crazy to have a secretary of state doing that,” he said.
“Of course he’s doing it, because he’s held accountable but what it all leads to is more money being put into AE departments when that money should probably be put into primary and community care to stop people falling ill.”
The Department of Health said Mr Hunt “would not be doing his job” if he did not speak to the bosses of hospitals struggling to meet AE targets.
A spokesman for Mr Hunt said some targets, including those for AE waiting times, had been relaxed and others scrapped since the coalition came to power.
However, he said there was a “balance” to be struck because the public needed guarantees that they would be treated quickly.
The spokesman also defended the performance of AE units, saying they were “holding up well” and more people than ever before were being seen within four hours.
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