The NHS is a closed shop. We pay for it. We depend on it to save our lives. Yet when it fails, it’s apparently not a matter for our concern. The people who run the service can just carry on as normal – business as usual.

This was the message West Hertfordshire Hospitals NHS Trust sent out with their handling of the report into failings that affected the urgent cancer referrals of more than 800 patients.

The report highlighted a string of blunders and oversights that allowed this problem to develop and continue from as far back as 2010 (no one actually knows when it started).

Yet the trust refused to say if any staff had been disciplined over the errors. Apparently, no one was to blame as it was a problem with “the system”.

In any other profession such a colossal and long standing failure would merit serious action. 

The person ultimately responsible for what goes on in the hospital is the chief executive. That’s part of the reason they command such huge salaries.

And this week the Watford Observer has seen a management report by the former chief executive, Jan Filochowski, that shows he knew there were serious problems with outpatient services as far back as 2010. 

At the time, he set up an Outpatient Project Steering Group and arranged for an outside consultant to look at the system.

Yet for all the jargon and talk of action, the serious failings of urgent cancer referrals went unnoticed until 2013. Even when a GP raised concerns about one of his cancer referral patients not being seen within the two weeks in November 2012, the trust failed to get to grips with the problem.

Watford Observer: Jan Filochowski

Jan Filochowski

The more you look into this broken system that failed more than 800 people, the more it appears the management was just not up to the job. 

Meanwhile, as this catastrophic failure was unfolding, Mr Filochowski was enjoying a gilt-edged salary of £243,000 a year (that put him in the top five NHS earners) and cashing in more than £40,000 in performance bonuses. 

Then he left West Herts in November 2012 for another top job as chief executive at Great Ormond Street Hospital where his salary was reported to top £280,000, before retiring from the post in November. 

Since then Mr Filochowski appears to spend most of his time as a management consultant and promoting his book entitled: Too Good to Fail? Why Management Gets It Wrong and How You Can Get It Right. 

This whole episode speaks of an alarming disconnect between the top and bottom of the NHS. The senior end of the organisation is a cushy environment where managers are insulated from any blame or recrimination. 

In contrast, for the people affected by these blunders, the stakes could not be higher. Often it is literally a matter of life or death.

Mr Filochowski inadvertently summed up the problem with the top echelons of the NHS in an interview with the New York Times last year promoting his new guide for management.

“Many organisations get into trouble because they choose to live by their own measures of success and ignore the measures of success that other people expect of them,” he said. The health service needs to be made open and accountable to the public it serves.