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Over the past decade in England and Wales, over two thousand people have died in care homes or hospitals while dehydrated or malnourished. Charities and politicians have expressed outrage. Some of these deaths are due to neglect, which should end – but unjustly blaming staff or managers when patients die for other reasons should also be avoided.
A report on why Mid Staffordshire hospital failings went unchecked for so long makes important points. Robert Francis QC, who led the inquiry, avoided the temptation to blame all that went wrong on a few people who could then be punished, or call for yet another round of reorganisation. Instead he revealed disturbing flaws in the culture of the NHS and other agencies linked with health and social care.