An important theme of this chapter is the rise of a new regulatory state: control of public bodies has shifted to an emphasis on performance measurement by officially created indicators and by oversight through external regulatory bodies. The Francis Report (published February 2013) casts doubt on the efficacy of all this. This was the report of a public inquiry chaired by Robert Francis QC into the clinical management by the Mid Staffordshire NHS Foundation Trust. It documented a history of horrifying neglect and abuse of patients at the Trusts hospital. The inquiry showed that much of the history of neglect was due to a diversion of resources from care to ensure that the Trust fulfilled official performance measures; and in 2003, despite the existence of abuse, the Trust received a 3 star (outstanding) rating from its main regulator, the Health Commission. The scandal thus raised three questions about the new world of regulation.
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