"DUTY OF CANDOUR"

Francis described a culture of secrecy and defensiveness in which whistleblowers were silenced and bereaved relatives who asked questions were ignored.

He said hospital managers were focused on a narrow set of bureaucratic targets and on balancing the accounts so that they could obtain the coveted status of "NHS Foundation Trust", instead of paying attention to the quality of care.

A woman leaves the Stafford Hospital in central England Feb 6, 2013. The deaths of hundreds of hospital patients, left without food or water in filthy conditions, exposed an urgent need to change the culture of Britain's National Health Service (NHS), a report said on Wednesday. Between 400 and 1,200 patients are estimated to have died needlessly at Stafford Hospital in central England between January 2005 and March 2009 in one of the worst scandals to hit the NHS since it was founded in 1948.[Photo/Agencies]

Francis said the NHS had undergone one root and branch re-organisation after another over the decades and he did not want to recommend yet another upheaval. He stressed that what was needed was cultural, not organisational change.

"My recommendations are intended above all to support all in the service to make patient-centred values and standards real, but also to bring teeth to the task of changing behaviour when required," he said.

His 290 recommendations included that there should be a legal "duty of candour" on doctors, nurses and all others in the health system to be open with patients about any mistakes and that breaches of this duty should be a criminal offence.

The report also said contractual gagging clauses silencing whistleblowers should be banned.

Cameron said the report's findings of systemic failure in the NHS meant that "we can't say with confidence that failings of care are limited to one hospital."

He said he would create a new post of chief inspector of hospitals and enforce a new regime of hospital inspections by the autumn.

Underlining the special place the NHS holds in British life, Cameron prefaced his statement by declaring: "I love our NHS".

"What makes our National Health Service special is this very simple principle ... that whoever you are, wherever you're from, whatever's wrong, however much you've got in the bank, there's a place you can go where people will look after you," he said.

"The shocking truth is this precious principle of British life was broken."