cathywarwickThe Royal College of Midwives has heavily criticised the government's response to the report into care failings at NHS Staffordshire Hospital Trust, claiming it is "muddlend and piecemeal".

Health Secretary Jeremy Hunt told parliament of a package of measures to be put in place across the NHS after Robert Francis QC's report into neglect and abuse at Stafford Hospital claimed patients had been "betrayed" by the health system.

These measures, delivered in response to Francis' 290 recommendations, include a 'duty of candour' for NHS boards, a new ratings system for hospitals and care homes and changes to nurse training.

However, Cathy Warwick (pictured above), chief executive of the Royal College of Midwives, said she was "dismayed" by the government's response.

"We are very disappointed that the government has chosen not to adopt to the report’s central and integral recommendation that NICE set minimum safe staffing levels for the NHS and this should underpin services the NHS provides, including maternity services.  For more than a decade, the NHS in England has had a shortage of midwives and this was a huge opportunity missed and wasted to address safe staffing levels. 

"The RCM also believes the Government has missed another crucial opportunity by not introducing the registration and regulation of support workers (HCAs). While we do welcome the pledge to end the practice of using contractual clauses to prevent NHS staff from raising concerns about safety and quality issues, overall, the Government’s report raises more questions than it answers."

Statistics from the Francis Report showed that there were between 400 and 1,200 more deaths at Stafford Hospital than would be expected from 2005-2008.

The Health Secretary has now laid out his plan to create a culture of "zero harm" through the changes. Key to this will be the new post of chief inspector of hospitals and the statutory duty of the NHS to be honest about mistakes, known as a duty of candour.

But the government said it would wait before deciding whether to make individual doctors and nurses criminally accountable for hiding mistakes as recommended by the inquiry as it was concerned about creating a "culture of fear".

Crystal Oldman, chief executive of the Queen's Nursing Institute, was slightly less critical of the response but did also express disappointment at the lack of regulation for health care assistants.

"We welcome the renewed emphasis on practical, hands-on education for student nurses," she said. "However, many nurses already undertake caring roles as part of their preparation when considering a nursing career and many universities already have this as a prerequisite to applying for a nursing programme. 

"It is great to see support for minimum education standards for healthcare assistants (HCAs) but disappointing that HCAs will not be regulated. They are often delivering the most intimate of care and require regulation in the interests of public protection. This is at least as important in the community as it is in hospital settings, as so much community care is delivered unsupervised, behind closed doors."