NHS leaders should be held accountable for the Stafford Hospital scandal according to Professor Aidan Halligan, England's former deputy chief medical officer.
He says the roots of the Mid Staffordshire affair go "much deeper" than the hospital staff who caused harm to patients.
Writing in the Journal of the Royal Society of Medicine, Professor Aidan Halligan says cultures of "target setting and corner cutting" were set higher up in the health service.
Professor Halligan, now director of education at University College London Hospitals NHS Trust, said that there has been a "deafening silence" from the medical profession since the release of the Francis report into serious failings at the Mid Staffordshire NHS Foundation Trust.
The Health Secretary, Jeremy Hunt, has today outlined new plans for NHS following the Stafford scandal.
Charlotte Grant went to ask the relatives of some Stafford victims what their responses are to the new proposals.
A legal duty of openess and honesty to expose wrong-doing in the NHS is to be brought in by the government following the Stafford hospital scandal.
A breach could lead to a criminal conviction. It is part of the government's response to the Francis report which said the system was to blame for hundreds of needless deaths.
Nurses will also have to spend 12 months on the wards as health care assistants before they can qualify in future. And there has to be an end to gagging orders.
Health Secretary Jeremy Hunt wants to create an NHS where patient care will be put first. He has also called for the inquiry into Staffordshire Hospitals to be known as a 'catalyst for change' rather than a 'by-word for failure'.
The Head of Nursing at Unison says even if recruitment standards are consistent across the country, today's recommendations don't go far enough. Ail Adams said:
"Nurses have been trained in the fundamentals of care.
"But I think the Government has fallen short today with staffing levels. It's all very well to recommend the health watchdog NICE develops the guidelines for them to be applied locally."
"But if we look at other international models, in America and Australia they have minimum nurse to patient ratios."
Speaking to ITV News Julie Bailey, from the 'Cure the NHS' campaign, said today's announcement only amounted to a small step in the right direction.
"We know there are failings in the NHS now and there's nothing being done about it. We need to ensure the culture changes, and the behaviour of the people in the NHS, and that starts at the top.
"These were systemic failings from the ward right to the top of Whitehall. I don't seem to see anything in the recommendations to ensure that Whitehall has learnt."
Today's announcement from Jeremy Hunt means failing NHS bosses will be put on a blacklist which will stop them working in the health service:
- The Health Secretary wants a "national barring list" for managers who let their patients and the NHS down
- If trusts do not deliver adequate care to patients they could be put into a "failure regime" and may ultimately be put into administration
- Mr Hunt also confirmed that hospitals would be subject to Ofsted-style ratings - where hospitals will be rated as outstanding, good, requiring improvement or poor
The Health Secretary is expected to announce a ban on gagging orders, which prevent NHS whistleblowers expressing concerns about patient safety, in a response to the Francis Report on Mid Staffordshire Trust.
Chris Dalziel lost her husband George after a routine operation at Stafford Hospital in 2007.
She said: "We've got to have people that will actually stand up, and they're not going to suffer by losing jobs through whistle blowing. People need to come forward, they need to be honest about everything that's going on in the hospital".