Page last updated at 06:59 GMT, Wednesday, 1 April 2009 07:59 UK

'We will be putting patients first'

By Nick Triggle
Health reporter, BBC News

Cynthia Bower
Cynthia Bower is promising to bridge the gap between health and social care

It may only be her first day in office, but already Cynthia Bower has found herself under attack from all sides.

Her appointment as head of England's new health super regulator, the Care Quality Commission, was questioned by the Tories last month.

And, as she formally takes up the reins, she finds her role being branded an "April fools joke" by patients.

The reason for the disquiet? Stafford Hospital.

Between 2006 and 2008 she was in charge of the health authority that oversaw the now notorious hospital, which was branded appalling in an official report last month.

But despite the criticisms, Ms Bower told the BBC News website she is not bitter.

"I can understand why people are asking these questions.

"It is right someone who takes my role is accountable to people and gives an account of what they have done."

The Stafford Hospital report was compiled by the Healthcare Commission, which is one of the bodies being merged to create the CQC.

Poor care

The watchdog said patients had needlessly died because of the poor care and criticised the failure of local health organisations to spot and tackle the problems.

Ms Bower says she was notified of concerns over high death rates in April 2007 and launched an investigation immediately.

This involved bringing together managers from the trust and four others where concerns had been highlighted as well as senior people from within the health authority.

With the help of Birmingham University experts they analysed data and case notes, but eventually concluded over a year later that there were no systematic problems.

We will be tough and we will put patients first

Cynthia Bower, of the Care Quality Commission

By this time the Healthcare Commission had launched its own investigation which resulted in last month's report.

But she says there were reasons why the health authority investigation missed the failings.

"The Healthcare Commission has access to information and resources that we as the health authority just didn't.

"They had patients coming to them with complaints. We didn't. They have much more resources to analyse the data they collected.

"We are all indebted to them for the job they have done."

Ms Bower believes she has learnt from the experience and it has made it clear that if concerns are raised you have to "act as early as possible" and "share information".

"It is important we make quality of care a priority and that is what I will do as regulator. We will be tough and we will put patients first."

And it is this emphasis on the patient that she believes is going to define the future of health in the 21st century.


She says that following the government's NHS review last year, the health service is fully aware they have to be designing services around the patient.

She believes this could mean providing access to mortality rates and outcomes for surgery down to the level of individual doctors if necessary.

"Patients and those commissioning services need to have good information to help them make decision.

"I think we are entering an era when we have to open about this."

She also says she is determined to close the gap that exists between health and social care.

It is an issue which has been a constant source of frustration to the elderly and those with long-term conditions, such as diabetes, in particular.

Patients have complained of being marooned after being discharged from hospital or having to pay for care while councils and health chiefs bicker about which is responsible for them.

The Care Quality Commission brings together the functions of three regulators - the Healthcare Commission, Commission for Social Care Inspection and Mental Health Act Commission
It is in charge of inspecting, rating and assessing NHS trusts, councils, private companies and charities involved in health and social care provision
It has the power to fine and close services that are failing and is demanding providers meet certain standards before they can even register with the regulator

Ms Bower, who used to be a social worker, says: "I think it is the biggest challenge facing services in the 21st century.

"With the ageing population, more and more people are going to need access to that care that spans across both social services and the NHS.

"It is a real pinch point at the moment and it is up to the system to respond.

"I think having a regulator that covers both will focus the minds on the issue, but we will be following this up with assessments and audits which will look at how the two are working together."

Indeed, one of the first major reviews she will be overseeing is on this very theme as the super regulator is set to announce an investigation into the state of health care in care homes.

She says: "People in care homes tend to be the most vulnerable and in need of services.

"The care home is where they live so there is no reason why they should not have access to services in just the same way someone living in their own home does."

Despite the negativity which has surrounded her appointment, it seems clear Ms Bower aims to hit the ground running.

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