Sam Smith makes the case for sacking Jo Williams immediately, withdrawing her DBE and ostracising her from society.
It has been said that for evil to triumph all that is necessary is for good men to do nothing. That grim maxim could easily serve as the motto for troubled Labour-founded quango the ‘Care Quality Commission’.
In the three years since it was founded, the CQC has been hit by a series of catastrophic scandals – most infamously its failure to act when warned of abuse at Winterbourne View, an institution run by Castle Beck. The site was eventually closed after filming by the BBC revealed institutional abuse of residents by staff.
Damningly, the CQC had been expressly warned of the scandal by a whistleblower and failed to act, one of many failings that eventually led to the resignation of CQC Chief Executive Cynthia Bower.
The CQC was not merely supine, however. New evidence has emerged that not only were concerns raised about the CQC’s management but that CQC Chairwoman Jo Williams was determined to silence critics and hide problems. Quite astonishingly the Independent has reported that Jo Williams obtained a psychiatric assessment of a member of the CQC’s Board, Kay Sheldon, and attempted to procure her dismissal.
The ‘expert’ – a hired gun such as those who have been so stridently criticised for the poor quality of their evidence in the Family Courts, lost no time in forming the ridiculous opinion that Kay Sheldon was possibly suffering from ‘Paranoid Schizophrenia’. This doctor was not a psychiatrist and had never met Ms Sheldon. At the time no one else, including any of her family, friends or colleagues had expressed concerns about her mental health.
Mrs Sheldon had done no more than give evidence to the public inquiry on Mid Staffordshire – an inquiry into serious concerns about events that cost between 400 and 1200 lives. She was not alone in her concerns – she was backed at the inquiry by another whistleblower.
The CQC is one of Labour’s greatest scandals. It is an organisation charged notionally with protecting the vulnerable from poor care. However in fact it was set up to fail from the beginning. The first Chief Executive of the CQC, Cynthia Bower had been the Chief Executive of the NHS’s West Midlands strategic health authority when concerns first arose about Stafford hospital. In 2010 she abolished the CQC’s successful Central NHS Team that had taken part in that investigation and which had criticised the authority she had led.
The CQC was formed from the merger of the Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Act Commission but has a lower budget than its three predecessors. A procession of resignations has followed poor care scandals. In fact the leadership of the CQC, lacking the resources to properly regulate the many organisations it is responsible for has consistently favoured light touch regulation.
I personally favour extremely heavy handed regulation. In this I am joined by many of those who feel, sometimes as a result of personal experiences, that the current state of accountability in health and social care is lamentable. However in this context it would be extremely simplistic to scapegoat Jo Williams merely because the CQC had been ineffective. It is an organisation that was always doomed and some might even suspect that Labour Ministers and Civil Servants were unenthusiastic about NHS problems being exposed.
No, the reason that Jo Williams should be sacked, stripped of her gong and made persona non-grata is in the Care Quality Commission’s attacks on whistleblowers and its attempts to gag them along with her direct attempts to secure the dismissal of Mrs Sheldon.
A report by the Commons Public Accounts Committee found that “2. The Commission has been poorly governed and led” and that “The Commission is regarded as overly focused on reputation management and has included gagging clauses in its severance deals with staff. Such clauses discourage people from speaking out and making public information that would help drive improvement and hold the Commission to account. The errors in the Commission’s annual report to Parliament also raise questions about the effectiveness of governance and internal control.”
Whatever the undoubted challenges faced by the Care Quality Commission and with the blame firmly pinned on the Labour Government for the creation, perhaps intentionally, of a monstrously inadequate regulatory organisation it is still the case that this woman has to go. It is one thing and quite understandable to put a brave face on a difficult situation. It is another for one of the country’s most important regulators to be gagging staff and for Jo Williams personally to be questioning the mental health of internal critics.
What the Care Quality Commission needs is a larger budget, more teeth and a focus on investigating patient and carer complaints. It needs serious sanctions and legislation, fining private companies and jailing people – not lowly care workers but managers whether in the NHS or the private sector. People need to fear the regulator. Offences of strict liability need to be created to ensure that denying knowledge does not get managers of the hook.
The problems of ineffective regulation are not new nor unknown to mankind. In the Sententiae of Publilius Syrus, a Roman writer from the first century BC, it is said, “Invitat culpam qui peccatum praeterit” which translates as “Pardon one offence and you encourage the commission of many”. It was also said that, “Iudex damnatur ubi nocens absolvitur” or “The judge is condemned when the guilty is absolved”.
Put in modern terms a weak regulator of care is an enabler of all those it is supposed to stop – paedophiles, gerontophiles, financial abusers, murderers, the incompetent and those who simply find it profitable to provide poor care. 400 – 1200 people died in Staffordshire. The CQC’s wide remit covers the protection of people from all walks of life. The old, the young, the sick, the disabled and the mad – we all at some time or another will need the CQC for ourselves or our families and it is failing.
Jo Williams is not the author of all the CQC’s problems. It would be facile and wrong to engage in scapegoating which will obscure real issues. She is however a despicable woman and one whose OBE for “services to people with learning disabilities” now has a ring of bitter irony. She has presided over a service which again and again has been alleged to be failing, to be overstating its achievements and oppressing whistleblowers. She has taken ownership of some of that wrongdoing of her own volition and must bear the responsibility.
If the CQC by its incompetence has made it harder to detect abuse and in so doing enabled the abusers then that is in part the doing of its leadership. That leadership needs to pay the price and it must be a heavy one.