A Labour government would ban NHS managers found guilty of serious misconduct in the aftermath of the Lucy Letby case, Wes Streeting has announced. The shadow health secretary noted that bank managers are more regulated than people running hospitals, as he pledged a new professional regulatory system, plus training for managers and strengthened accountability. The British Medical Association and some senior Conservatives have demanded a similar reform that would bring NHS managers into line with doctors and nurses, after it emerged that managers at the Countess of Chester hospital failed to stop Letby as she murdered seven babies. At least one of the managers involved went on to work elsewhere in the NHS. Labour said the lack of management regulation risks a “revolving door” that allows individuals with a record of poor performance or misconduct to continue to work in the health service. Streeting’s move will increase pressure on the health secretary, Steve Barclay, to spell out government plans. The Department of Health and Social Care said NHS England has recently strengthened processes to ensure accountability of NHS directors, adding: “We keep this policy under active review,” a spokesperson said. This week the NHS England chief executive, Amanda Pritchard, is to hold discussions over whether managers should be regulated in the same way as doctors and nurses, telling colleagues it is “the right time to look again”. Streeting said: “NHS leaders have enormous responsibility for the health of their patients, yet currently face less regulation than bank managers. To protect patient safety, this must change. “The case for a proper system of accountability has been made again and again. Labour will introduce this in office, and make sure those found guilty of serious misconduct are disbarred.” Liam Fox MP, a former cabinet minister and Conservative shadow health secretary, said last week that “there is no reason why doctors and nurses should be accountable to professional bodies for conduct and performance but not managers”. Dr Stephen Brearey, one of seven senior medics who repeatedly tried to alert managers at the Countess of Chester hospital to Letby’s actions, also called for regulation. “Quite often we’ll see senior managers who have no apparent accountability for what they do in our trusts, and they move to other trusts, and you worry about their future actions,” he said. “There doesn’t seem to be any system to make them accountable and for them to justify their actions in a systematic way.” Labour said “though managers play a significant role in patient safety and clinical outcomes as leaders and in service design and delivery, there is no formal system through which they can be held accountable for their decision-making and conduct”. The party said it would consult on the details of the regulatory system once in power, including the roles it should cover, the most appropriate regulatory body, and the competencies themselves. These would include responding to whistleblowing and empowering staff to raise concerns. “Any system will be proportionate and supportive and aim to deliver excellent management and leadership throughout the NHS,” the party said. An NHS England spokesperson said: “It is absolutely vital that concerns raised by staff are acted on and the NHS reminded leaders of the importance of this following the verdict”. “Every trust is expected to adopt an updated national Freedom To Speak Up policy and we have asked them to urgently ensure staff have easy access to information on how they can raise concerns, while we are also supporting the trusts who are most challenged in this area to improve their speaking up arrangements.”
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