A health service that needs special measures The vitriolic parliamentary discussion of Professor Sir Bruce Keogh's investigation into 14 sub-standard hospital trusts yesterday contrasted with his report's moderate tone. Jeremy Hunt's entirely justified criticism of Labour's record - the creation of an NHS culture in which "the system's reputation mattered more than individual patients, targets mattered more than people" - was met with an angry response from Andy Burnham. Indeed, in his denunciation of Tory partisanship - and his efforts to pin the health service's problems on the Coalition's own decisions - the shadow health secretary managed to be far more partisan than Mr Hunt. Entirely absent from Mr Burnham's self-justification - and those of the other Labour grandees who spoke in the Commons - was any acknowledgement of culpability. That is a grave shame. For Sir Bruce's report was not a melodramatic potboiler, an anguished denunciation of callous doctors or unfeeling nurses. It was a meticulous examination of a system "trapped in mediocrity." The problems varied from trust to trust: in one, inspectors stepped in when they noticed staff forced by rotas to work 12 days in a row; in another, they asked for the immediate closure of two operating theatres due to inadequate maintenance. Yet the common threads were plain to see - not least the inadequate leadership and neglected data that meant managers had no idea what was going wrong in their hospitals, and why. As a result, 11 of the 14 have been placed in "special measures." Despite Labour's histrionics, Sir Bruce was explicit that the excess mortality in these trusts was unrelated to their level of funding, now or then. The trigger was that they failed to cope with added pressure on urgent and emergency services. This pressure was caused in large part by increasing numbers of elderly patients with complex problems - in short, by the demographic transformation that is set to put the NHS under extraordinary strain. The Keogh review, therefore, is not so much a watershed for the health service (although its transparent, data-driven approach is hugely promising in terms of improving care). Rather, it is another brick in a towering wall of evidence that the NHS needs to change in ways that move beyond sterile rows over "privatisation." This should not be a party-political point: witness the improvements achieved by Tony Blair and Alan Milburn's tentative embrace of choice and competition. That their successors have chosen to retreat to their ideological comfort zone - at a time when the constraints of cost and demography make reform more necessary than ever - is one more NHS tragedy to add to an ever-lengthening list.