James Lee, chairman of the Maidstone & Tunbridge Wells NHS Trust, has resigned following the Healthcare Commission's report on an outbreak of C. difficile there that has claimed over ninety lives. The Telegraph have seen his letter to Alan Johnson. He wrote: "We had to be concerned about finance because this trust has been struggling with a state that is pretty close to bankruptcy. We knew that the Treasury was pumping money into the NHS, but quite frankly none of this seemed to be getting to the 'coalface'."
He added: "It has become clear to the members of my board that the NHS is run on the basis of command-and-control. I personally have never experienced such centralised or detailed control. I doubt whether it can ever work. This way of managing things is fundamentally incompatible with the whole concept of independent trusts with non-executive directors."
In some ways Lee is quite right. His letter exposes the extent to which the NHS is managed by diktat from demanding politicians. Hopefully Lee would support a new system with managers of decentralised services held to account by customers who can vote with their feet. I worry that he would rather just not be held accountable by anyone.
In other ways he is passing the buck. While the Trust may have been under financial pressure you only have to look at their Annual Report for 2006-07 (PDF) to see that they had a questionable sense of priorities. It shows that the number of nurses fell by 123 while the number of admistration and estates staff only fell by 65. While hospitals do need to be organised and the Trust's estate would obviously need planning, particularly with a new hospital on the way, it appears that these staff were prioritised over the front-line staff who were needed to prevent the horrors discovered by the Healthcare Commission.
Lee is right that the Maidstone & Tunbridge Wells NHS Trust's problems are driven by broad problems beyond the Trust itself but for him to be so unwilling to accept personal responsibility for such a tragedy taking place on his watch is deeply unimpressive.