Robert Francis QC lambasted an NHS culture that "measured care out of existence". But data doesn't have to be reductive. To be truly human is to know what you believe, and to put your beliefs into action.
In Mid Staffordshire inconvenient people and facts were systematically massaged out of the way so that a pre-written story of organisational success - designed in this case to win for the Trust coveted 'foundation' status - could be trumpeted. This was a management culture big on value and short on values, a culture that "measured care out of existence."
A nurse interviewed anonymously on Radio 4's Today programme on the morning the Francis Report was published told how a national regulator had sent inspectors into one of the Mid Staffs hospitals and the nurses told them 14 audits were taking their eyes off the basics of patient care. The inspectors said: "Oh dear, we'd better have an audit about that". Professions of all kinds have encouraged - either explicitly or implicitly - a culture of collective emotional detachment, a merging of the individual into the collective, and justified this via a doctrine of self-preservation.
But medicine is different. And it started with Hippocrates of Kos, the first doctor to promote a culture that put values into action.
The honourable foundations of the NHS were also all about values-into-action, and were backed by important currents in post-War philosophy. Oxford's Gilbert Ryle invented "behaviourism", the idea that the right values lead to the right actions. Classical renaissance philosopher René Descartes had argued that mind and body were radically different, and questioned how one could directly influence the other, but Ryle dismissed this as the "myth of the ghost in the machine", and argued that beliefs were the mother and father of their corresponding actions.
Behaviourism lives on, thank heavens. As recently as December 2012 a nursing document Compassion in Practice proposed a Rylean view of mind and matter in dynamic relation, with the regular use of a "cultural barometer" to test whether values are really understood, owned and put into practice. Then, in April 2012, the NHS announced a £1m fund aimed at "creating wholly patient-focused organisations".
I responded to this at the time by proposing a series of pan-organisational interventions based on storytelling, where an agreed theme - such a caring for patients with learning disabilities - was explored from the perspective of both individual patients and individual staff. Stories could then be compared and analysed using a method developed in the 1960s by two US sociologists called Glaser and Strauss, overcoming language differences and identifying shared themes. Hundreds of ideas were voted on, and this one came top in the country.
In response to findings from the work, one of the hospital trusts introduced a training course for nurses and a volunteering scheme to help local disabled people get more involved in the hospital, building new networks of peer support. There was a 60 per cent reduction in complaints, and an eight-fold increase in formal compliments received by staff, accompanied by an Olympic leap in performance in the Net Promoter Score of the then new Friends and Family Test.
When the NHS was founded, it was undoubtedly a little easier to line people up behind a single set of beliefs. Most people wore the same clothes, listened to the same wireless programmes. In today's super-connected world people pick and choose their identities in ways our ancestors could only dream of. The modernity paradox is that no system can arrive at consistent values and standards without engaging the people who use and deliver its services as individuals. Data that links values with action doesn't have to be reductive, in fact by sharing it in the right way you can cause it to drive the very actions to which the values aspire.
Next time a thousand people die who should not have done; next time people's loved ones are physically or mentally abused, or left in their own urine, which individual will say 'stop'? Just like medicine itself, it has to start with someone.