If you were to choose when and where to fall ill between January 2005 and March 2009, you’d have been wise to avoid Stafford General Hospital. For over a thousand people, without the choice, their illness led to avoidable death. The NHS in Stafford killed more people than Harold Shipman. Within weeks, the inquiry into what went wrong will be published, and ministers will respond.

The inquiry, led by Robert Francis QC, has heard heart-breaking evidence from hundreds of relatives, and endless stories of mismanagement, bullying and cover-ups. Dr Chris Turner, clinical lead for the accident and emergency unit, described the A&E as a ‘disaster’, and the worst he has seen in quarter of a century. Ambulance drivers tried to avoid taking sick people to Stafford General because they knew what might happen to them, according to Tony Wright, the former MP for Cannock Chase. Terry Deighton, a member of the public and patient involvement forum, was written to by Stafford General Hospital’s solicitors informing him he might be prosecuted if he went near the hospital.

When the report is published in a few weeks’ time, it has the potential to radically alter the way the NHS works. First will come the media furore. What the people of Stafford have been living with for eight years will become known to a wider audience. We will be appalled at the stories of the avoidable deaths of people such as Bella Bailey, mother of campaigner Julie, or the 20-year old John Moore-Robinson who died of a ruptured spleen in 2009 after NHS staff said he only had injured ribs.

Then will come the blame. According to the Health Service Journal those NHS managers singled out for specific blame have already been informed. Some will lose their jobs and reputations. The biggest fish in the barrel is David Nicholson. Sir David, chief executive of the NHS commissioning board (the new body established by Andrew Lansley to run the entire NHS), was chief executive of Shropshire and Staffordshire Strategic Health Authority during 2005 and 2006. He wants to stay, but he may not get the chance.

Julie Bailey told the Daily Telegraph that ‘Sir David needs to stand down immediately if he has got any conscience – he has stood by and watched hundreds of people die.’ The campaign group she founded, Cure the NHS, is demanding that all NHS officials blamed in the report be sacked. New health secretary Jeremy Hunt seems to agree. In an article last week he wrote ‘Just as a manager wouldn’t expect to keep their job if they lost control of their finances nor should they expect to keep it if they lose control of the care in their organisation either.’ Once Francis reports, we can confidently expect to hear tumbrils being wheeled towards the guillotine.

But what then? I hope that the relatives of all those lost at Stafford General find some peace. After years of campaigning, fighting and grieving, the resignation of a few well-paid NHS managers will probably be anticlimactic. They may find their feelings of anger and loss are made worse, not better, once the camera crews have moved on, and ministers have gone back to London.

Cameron and Hunt, never ones to let a crisis go to waste, will use the Francis report as a stick with which to beat the Labour party. It was Labour secretaries of state – Patricia Hewitt, Alan Johnson and Andy Burnham – who were in office at the time. Gordon Brown failed to give the campaigners the judge-led inquiry they wanted. Unseemly political point-scoring will also be the result of the Francis report. The Tories will try to blame individual Labour politicians, a calumny so vile it deserves to fail completely.

The big political reaction to the report, which the Tories and their cheerleaders are already mounting, is to blame ‘target culture’ in the NHS. The Tories want to create and sustain the narrative that it was Labour’s system of targets, inspections and quality control which meant that NHS staff took their eye off the ball. The point of targets in the NHS is to improve patient care, not hinder it. If the targets are measuring the wrong thing, or creating perverse incentives, then change the targets. The system must be flexible enough to adapt from the bottom-up.

In April 2011, Lansley scrapped the four-hour A&E wait target. In December 2012, the Care Quality Commission reported that waits in A&E are going up. A third of the 46,000 patients surveys had waited more than 30 minutes before seeing a nurse or doctor. A third spent more than four hours in A&E, an increase since 2010. Scrap the target, and waits in A&E get longer.  To scrap targets altogether, and allow individual hospitals to do what they like, is a recipe for greater failures of care, and more, not fewer Staffords.

Of course, our immediate attention must be on the quality of patient care, and the avoidance of medical accidents. Labour must not cede an inch of ground to the Tories on this. Our system works better than theirs. In their system, the NHS becomes a patchwork, with better care in affluent areas, and a make-do-and-mend service for the poorest. In ours, the NHS is continually improving, with equality at its heart.

There is a broader issue which needs to come from the Francis report: democratic control and accountability. The report will show that shocking lapses in care were exacerbated by officials’ indifference towards the victims’ families, official secrecy and back-covering on a grand scale. Labour abolished the community health councils in 2003, which had provided a public and patient voice inside the NHS since 1974. We never really cracked how to replace them. Stafford shows that there must be a strong voice for patients and carers in the running of the NHS, that whistle-blowers must be protected, and that complaints must be properly investigated. The NHS must not be a secretive cabal of ‘professionals’. It belongs to the people.

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Paul Richards writes a weekly column for Progress, Paul’s week in politics. He tweets @LabourPaul

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Photo: Chris Jones