Health managers are blamed for a catalogue of serious failings in the quality of care at three NHS hospitals criticised in official reports published today.
An investigation into problems at the Oxford Heart Centre, one of Britain's leading coronary units, discovered poor standards of clinical care and under-supervision of inexperienced doctors. North Lakeland NHS trust in Cumbria is criticised by health service standards watchdog, the Commission for Health Improvement (CHI), for degrading and cruel practices, including the strapping of mentally-ill patients to their commodes.
Officials at Carmarthenshire NHS trust in Wales came under fire for failing to tighten procedures quickly enough in the wake of a blunder in which the wrong kidney was removed from a seriously ill patient.
The government is expected to ask CHI to formally investigate the Oxford Heart Centre, part of the John Radcliffe Hospital. Health minister John Denham today described the management team at the centre as "dysfunctional".
The Lakeland and Carmarthenshire reports are the first to be issued by CHI, which came into being in April. CHI has been dubbed the "Ofsted of the NHS" - a reference to the formidable education inspectorate which has "named and shamed' failing schools.
Mr Denham ordered an immediate turn-round in performance at the Oxford Heart Centre. He said: "It is a very worrying report. It paints a picture of a dysfunctional team and, more than that, a failure to deal with problems when they were first raised."
He told the BBC's Radio Four Today programme: "What we have to do is tackle the management failings, the failings of people to work on the team and get it back on the road."
The study was ordered in March this year - before CHI was set up - after staff raised concerns over operational practice.
Fears included the quality of pre and post-operative care, claims that junior doctors were not properly supervised, and allegations that there was a culture of intimidation preventing staff airing their worries.
The hard-hitting CHI report into North Lakeland NHS trust in Cumbria blames "whole systems failure" for a catalogue of degrading, unprofessional and cruel practices at Garlands Hospital in Carlisle.
The CHI inquiry report confirmed allegations that patients were tied to commodes, sworn at and denied food, clothing and blankets. The trust chairman and the director of personnel have been dismissed, while the chief executive has been suspended pending a disciplinary hearing.
Other senior managers have received warnings. CHI chief executive Peter Homa said: "The abuse of elderly people was appalling. At the time of our visit to the trust, we could not be sure that it could not happen again.
"The culture of this organisation needs to change fundamentally, so that the rights of patients are understood across the trust."
The CHI report into failures at Carmarthenshire NHS trust stemmed from the case of Korean war veteran Graham Reeves, who died in February after surgeons at the Prince Philip Hospital in Llanelli removed his healthy kidney by mistake, leaving him with just his diseased kidney.
CHI said that the trust had drawn up an action plan to address the problems, but had been slow in implementing it.
It also found there was still confusion in the minds of some staff about the handling of critical incidents.
CHI chief executive Peter Homa said: "While we cannot be specific about the failures that led to Mr Reeves's death, we can say that the trust's action plan addresses the right issues, but is taking longer to implement fully than it should."
The Royal College of Surgeons and the trust, which runs the hospital where the mix-up took place, have already carried out investigations into the incident, but their findings have not been released.
