An inquiry into the scandal-hit Mid Staffordshire Hospital today exposed a catalogue of failings which contributed to hundreds of deaths.
Inquiry chairman Robert Francis QC found that there was a culture of putting profit before patients at the hospital, an untrained and understaffed workforce, a failure to act on complaints and many issues relating to a pre-occupation with top-down targets.
He laid out 290 recommendations into the failings at Mid Staffordshire NHS Foundation Trust that left between 400 and 1,200 patients dead over a three-year period from 2005 to 2009.
Mr Francis recommended staff be given a legal "duty of candour" to reveal bad practice and called for a "zero-tolerance" approach to poor standards in the health system.
Health Emergency campaign group director John Lister said: "What's interesting about the report is what it doesn't say. The fact is that most of the problems it highlights such as the target-driven culture are a product of market reforms.
"Mid Staffs was so focused on becoming a foundation trust that nothing else mattered."
In a previous report into care failings at Mid Staffs published in 2010 Lord Francis found that problems at the trust were exacerbated at the end of 2006-7 when it was required to make £10 million in savings.
But Mr Lister warned there were dozens of trusts that were having to make £10m in savings each year, including Whittington Hospital in its bid to reach foundation trust status and PFI-laden Peterborough and Stamford hospitals.
Under NHS reforms the government is demanding that all hospitals achieve foundation trust status.
Green Party health spokesman Stuart Jeffery said the report revealed that foundation trusts were a "fundamentally flawed policy that is a key part of the pseudo market in health care services."
He called for the "market experiment" to end now.
Union Unison's head of health Christina McAnea said the report revealed that patients clearly suffered as a result of understaffing and lack of skills on hospital wards.
And she indicated that the government's £20 billion "efficiency savings" target will not help implement Lord Francis's recommendations.
Unite national health officer Rachael Maskell demanded NHS head Sir David Nicholson resign for earmarking the colossal savings targets in the first place.
In a statement to the House of Commons following the report's publication a sheepish David Cameron promised to analyse its recommendations and respond in full next month.
But the Prime Minister made some immediate measures to improve care including powers to suspend a trust's board for failures in care not just in finance and the creation of a chief inspector of hospitals responsible for the hospital inspection regime from this autumn.
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