The problems at Stafford Hospital, where more than 400 deaths were caused by poor care, remain a real risk in the NHS and could easily happen elsewhere, doctors warned yesterday.

The preoccupation with budgets and targets is exposing the NHS to pressures that compromise care standards, with managers too quick to pursue financial incentives, such as turning their hospitals into foundation trusts, the British Medical Association’s annual conference was told.

George Rae, a member of the BMA’s council, said that the Government’s reform agenda and its “misplaced confidence in markets getting the right solutions” was one of the main reasons that problems had arisen at Mid-Staffordshire NHS Foundation Trust.

A highly critical report from the Healthcare Commission, published in March, detailed a catalogue of failings at the trust, which runs Stafford and Cannock Chase hospitals, prompting apologies from the Prime Minister and the Health Secretary.

Shocking standards of care for patients admitted through A&E put many people at risk and led to deaths, the report concluded. Its authors said that between 400 and 1,200 more people had died than would have been expected in the three-year period to 2008.

The report, the most damning yet compiled by regulators on an NHS hospital in England, also raised serious questions about the monitoring and regulation of Mid-Staffordshire, which was awarded elite foundation status and continued to receive positive annual reports despite its many problems.

Gordon Brown said it was an isolated incident, adding that the Healthcare Commission, the predecessor to the newly formed Care Quality Commission, had assured him that there were no other hospitals or parts of the NHS that had displayed similar failings.

But Dr Rae said that the failings in Mid-Staffordshire were “an inevitable, almost inexorable result of a market-based health agenda in England”, which made co-operation and collaboration in the NHS “almost an anathema”.

Speaking in support of a motion highlighting the concerns and condemning the perverse impact of targets and financial incentives, Mary McCarthy, a doctor from Shrewsbury, said that other hospitals were under similar pressures.

“The problems that occurred at Mid-Staffs are not unique,” Dr McCarthy said. “The concentration on targets distorts clinical care and the pressure by trusts to keep patients out of hospital may not be clinically safe.”

Dr McCarthy said that England had fewer beds per 100,000 population than anywhere else in Europe “by a long way” — 388, compared with 640 in Belgium, 720 in France and 870 in Germany.

“The concern is that the Mid-Staffordshire problem is not an isolated incident but has the potential to happen in every other area,” she said.

Families described “Third World” conditions at Mid-Staffordshire, with some patients drinking water from vases because they were so thirsty and others screaming in pain. The Healthcare Commission found deficiencies at virtually every stage, including inadequately trained staff who were too few in number, junior doctors left alone in charge at night, and dirty wards and bathrooms.

The motion, which was passed unanimously, also called for greater support of whistleblowers who raise patient safety concerns.

Speaking on the opening day of the BMA’s conference, Hamish Meldrum, the association’s chairman, issued a warning to the Government. “Don’t play around with our health service. It’s not a toy you cast aside and replace with the latest product off the shelf when you’ve tired of it. It needs looking after. It’s our NHS, make it yours too,” Dr Meldrum said in his keynote address.

He said that there had never been a better time to abandon the market reforms in England, calling on Andy Burnham, the new Health Secretary, to “end this ludicrous, divisive and expensive experiment of the market in healthcare in England”.

He added that a target-driven culture had “infested the NHS in recent years and that seems to put financial outcomes for trusts above clinical outcomes for patients”.

“We will not tolerate a substandard service for our patients and we will not tolerate a culture of muzzling or bullying of our staff,” Dr Meldrum said.

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