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Editorial - Could ‘Mid Staffordshire’ happen here?

Almost 250 INMO members attended this year’s national professional conference in November, the theme of which was Maintaining Safe Practice.

It is my firm belief that every member who attended the conference left the event acutely aware of how patient care can be severely compromised when financial and other targets become the priority within any health system.

The conference heard presentations based on the statutory inquiries in the UK into the care given to patients of the Mid Staffordshire Trust between 2005 and 2008. We were told that the board of the Trust was completely influenced by, and focused upon, financial and other targets. There was a complete disconnect between senior management and the delivery of frontline services. The standard of nursing care was wholly unacceptable and the representative bodies were also criticised for their failure to speak out on behalf of frontline members.

The starkest finding of the inquiries was the determination that there was between 400 and 1,200 avoidable deaths during this period. Almost 50 nurses have been referred to the UK’s Nursing and Midwifery Council for investigation under its Fitness to Practise proceedings.

Against this shocking background, the key question is: could a ‘Mid Staffordshire’ situation occur in Ireland’s health system under the current priorities, policies and practices?

It can be argued that due to the smaller scale in Ireland, it is highly unlikely that such poor practices and patient outcomes could ever occur here without there being public outcry, media attention or some form of whistle-blowing.

However, it can equally be argued that due to the unprecedented challenges facing our health system (four successive years of financial cutbacks, bed closures, staffing shortages, and inadequate or unbalanced resources), Ireland has the potential to repeat the mistakes of Mid Staffordshire. Already, numerous press statements, public comments and policy documents argue that – notwithstanding service reductions, curtailments and shortages – full attention is still being given to the delivery of a safe and comprehensive service.

History shows that this is exactly what the Mid Staffordshire Trust was saying throughout its four year period of failure. It can also be said, as occurred in Mid Staffordshire, that no attention or differentiation is being given to the impact of reductions in frontline staff, reductions or elimination of in-service education and the hasty redeployment of staff, regardless of their competence or skills, to paper over the cracks of staff shortages.

All INMO members will know that these very measures, promulgated by senior management fixated on balancing books, are now the order of every day in the Irish health system.

The majority of INMO members do not have the power and authority to hire staff, fill vacancies or curtail services where staffing levels are unsafe. However, every member must use the INMO to speak out when patient care is negatively affected by the decisions of those not on the frontline. We all have an obligation to learn the necessary lessons from these reports on events within the Mid Staffordshire Trust.

INMO members must not fail in their duty to patients. Over the years, nurses and midwives have proudly advocated on behalf of their patients. When nurses stop doing this, serious harm is done to those most in need of our care.

Arising from individual responsibility supported by the collective strength of the INMO, we must now, more than ever, speak out for patients. Silence, reluctance, acceptance and excuses must never form our response.

Liam Doran
General Secretary, INMO

Editorial - Could ‘Mid Staffordshire’ happen here?
Dec 2011/Jan 2012 Vol 19 (10)
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