Britain's National Health Service, honoured as a national treasure during the London Olympics, is facing a major crisis with the release of a damning report that describes the service as failing at "every level" to care for patients.
The report by lawyer Robert Francis called for sweeping changes to the NHS and said the service has a "tolerance of poor standards," puts cost cutting ahead of patient care and has a culture that fails to follow even the most basic standards of care.
Mr. Francis headed a two-year long public inquiry into patient care at a hospital in Stafford, England. Investigations found that at least 400 patients, and as many as 1,200, died unnecessarily between 2005 and 2009 and the inquiry heard harrowing stories of filthy conditions and a lack of even basic care.
Elderly patients were often left unfed, unwashed and lying in beds soiled with excrement. Patients who had trouble eating or drinking were not helped and medicine was often not given. Some patients were so desperate for water they drank from flower vases.
In his 2,000 page report released Wednesday, Mr. Francis said the problems went far beyond Stafford and pointed to a corrupt culture within the NHS that ignored warning signs, even when confronted with reports about abuse. Numerous administrators, doctors, nurses and bureaucrats all failed to act and at times even concealed what was going on, the report found. Most were consumed by keeping costs down and managing finances, not caring for patients.
"This is a story of appalling and unnecessary suffering of hundreds of people," Mr. Francis said after releasing the report. "They were failed by a system which ignored the warning signs and put corporate self-interests and cost control ahead of patients and their safety."
The report made 290 recommendations and called for a complete overhaul for how the NHS is managed. The recommendations included new standards for patient care, improved training for nurses that focuses on compassionate care, as well as more openness and accountability. Mr. Francis also suggested the creation of a special elderly nursing designation to put more emphasis on care of older patients.
Prime Minister David Cameron said he admires the NHS and that the institution "says a huge amount about our country and who we are." But Mr. Cameron said what happened in Stafford was "dreadful" and he apologized to the families involved. He also promised to review and act on the recommendations. And he also announced the creation of a new chief inspector of hospitals to ensure standards are met.
Britain's NHS was created shortly after the Second World War and is considered a model for public health-care systems around the world, including Canada's. It remains the largest public-funded health service in the world, with 1.7 million employees and an annual budget of $170-billion.