NHS reforms

26.03.19

Sir Robert Francis says new regulator needed as ‘fit and proper person test’ not fit for purpose

The chairman of the Mid-Staffordshire Public Inquiry has said the NHS’s fit and proper persons test is “not fit for purpose” anymore and recommended a new regulator to oversee NHS managers.

Sir Robert Francis, in written evidence to MPs on the Health Select Committee, said that the system devised following his own inquiry “has not delivered the desired level of accountability” over NHS managers.

His statement said the fit and proper persons test “is not working and has regrettably been found to be not fit for purpose,” adding that it was not effective in “protecting the public from the very limited number of directors who should be considered to lack fitness to hold such a post.”

He said the current system suffers from a number of weaknesses, with trusts lacking the necessary tools.

Sir Robert Francis gave evidence as part of an inquiry into Tom Kark’s recent review of the NHS fit and proper persons test, which called for a new regulator with the ability to bar senior managers.

Francis said he has now arrived at the same conclusion that such a body was required, and said the new body should have power to obtain necessary evidence, provide a fair and objective judgement and offer due process to protect the public interest and rights of the individual.

He also said that an extension of the scope of the regulations to CCGs was “an essential step” in order to prevent disqualified NHS trust directors being able to escape to other organisations closely associated with the health service.

He backed other recommendations made in the Kark review including more support and training for managers, a database of past employment history and mandatory references.

Francis chaired two inquires in the Mid-Staffordshire disaster where hundreds of hospital patients died as a result of substandard care at two hospitals between 2005 and 2009.

Appointed last year as the new chair of Healthwatch, Francis said: “It is the best way of correcting the deficiencies in the present system I have summarised.

“It would provide a body which would have the power to obtain the necessary evidence to support or refute an allegation; would be able to provide a fair and objective judgment of the issues; would offer due process which would protect the public interest and the legitimate rights of the individual.”

He told the MPs: “I considered then, as I do now, that it is important for there to be a level playing field between all members of a health service board. All should be held to account for compliance with the same set of standards when performing this important role.”

Image credit - Dominic LipinskiPA ArchivePA Images

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