Question 10:

Read the following cases and answer the questions listed below:

When hospital staff failed to speak out about poor care, the challenge began to fall on relatives. Julie Bailey began to take on Stafford General Hospital. Believing that it would never happen to her, it happened at Stafford where she took her mom. Julie Baileys mother, Bella, had been taken to Stafford General Hospital in September 2007. But, from her first impressions, she believed something was wrong. She recognized that the patients in her moms ward couldnt speak for themselves and the relatives were visiting them oblivious to what was going on. For 8 weeks, Bellas family members maintained a 24-hour watch at her bedside keeping a record of what they saw. Julie Bailey reads the records made and indicated the fear they had for being branded troublemakers. Bella Bailey died in the hospital in November 2007. Julie Bailey created a determined campaign, in her caf, to make people aware of what she had seen but struggled make her voice heard. In an interview, Julie listed all the people she tried to speak to with the intent to try and tell as many people as possible.

At that time she was unaware that the primary investigator of the Health Care Commission was planning to investigate high death rates at the hospital between 2005 and 2008. The report, when made public, showed managers putting targets ahead of patient care. With the mortality rates being further investigated, the report agreed there were serious concerns about patient care. It appeared that some doctors were even, privately, aware of the problems. The Commission report also said that of the majority of doctors interviewed said they would not have been happy for a relative to have been treated there. Julie Bailey expressed her concern that it wasnt good enough for their relatives but it was good enough for ours. She says if they had known or the doctors had spoken out none of their relatives would have been put there. A Staffordshire MP, Tony WrightLabour, Cannock Chase, could not believe that doctors would be happy delivering that level of care and that nurses must have been unhappy working in that situation. He had helped introduce legislation to encourage employees to speak upThe Public Interest Disclosure Act of 1998 was intended to give whistleblowers legal protection from dismissal or victimization. Mr. Wright indicates that the whole point of these provisions was so that individuals could raise their concerns properly without threatening their job, without damaging their career, and without having to go to the media. However, in Staffordshire, there was a whole culture that discouraged complaints. The investigation indicated that nurses felt poorly supported as a profession and consultants appeared to have given up expressing their views since managers were said to dislike critical comments and ignored them. Mr. Wright says that the governments should revisit what it said to health organizations in the pastthe good things such as the need to get whistleblower protection in place. The new leadership at Mid Staffordshire NHS Foundation Trust has now made it known that quality of care is now its primary concern. To this end, it is investing 12 million pounds in frontline clinical staff, improved training and facilities, and has published a new no blame whistleblowing policy aimed to bring poor practice out in the open.

Required:

1. What corporate governance mechanisms failed at Stafford General Hospital?
2. Were there possibilities of agency problems within Stafford? Why or why not? Could managerial opportunism be an issue?
3. Can the Trust Foundation for Stafford be effective as a market for corporate control?
4. What role do you think the corporate governance structure of the United Kingdom played in the problems at Stafford?
5. How do you think the situation at Stafford will impact global corporate governance?