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Ms Tessa Jowell (Dulwich): I welcome the Secretary of State's statement, and his action in setting up the inquiry under Mr. Fallon. I should also like to pay tribute to my hon. Friend the Member for Halifax (Mrs. Mahon) for her action, on behalf of her constituents, in ensuring that the terrible allegations were brought to light and investigated.
The revelations are shocking. Equally disturbing, however, is the fact that the alleged pornography trade and paedophile activity could have gone on undiscovered in a hospital that has recently already been subject to a fundamental and far-reaching inquiry, under the chairmanship of Sir Louis Blom-Cooper. That inquiry was to have led to the introduction of a new complaints procedure, 24-hour nursing across the hospital, and an independent patients' advocacy service. I understand that Ministers were also to monitor the hospital's performance in acting on the inquiry's recommendations, through the so-called "accountability review process". The new allegations illuminate the failure of any effective accountability in the hospital.
Will the Secretary of State tell the House when allegations related to this inquiry were first made to any party? Were the allegations--or allegations on related matters to do with Ashworth hospital--reported at any earlier time, before 28 January, to the Secretary of State, to his predecessor or to any Minister; or to the High Security Psychiatric Services Commissioning Board, to the Ashworth hospital board or to the Mental Health Act Commission? If so, what action was taken in each case?
What visits were paid to the hospital by Ministers or by any of the bodies I have mentioned between October, when the allegations were first made by Mr. Daggett, and receipt of the dossier submitted by my hon. Friend the Member for Halifax to the Secretary of State? What conclusions, if any, were drawn from those earlier visits? Were unannounced visits made to the hospital by the commissioning board in the second half of last year? If not, why not, given Ashworth's history? Does the right hon. Gentleman not accept that the allegations expose the dreadful inadequacy of the monitoring systems which are supposed to ensure safety at high-security hospitals?
As for the future, we welcome the inquiry, but we hope that it will be held in public. Will the Secretary of State assure the House that the inquiry will deal with the
hospital's chronic staff shortage--which has come to light only because of the dreadful allegations? Does he accept that the gagging of staff, which was introduced by the Government, has made it more difficult for such allegations to come to light? Will he now join Labour in a commitment to end the gagging of staff in the national health service?
After yet more allegations about abuse and depravity in a special hospital, will the Secretary of State also establish an additional and separate inquiry to examine the appropriate treatment and custodial arrangements for people suffering from personality disorder, as part of the wider review called for by Sir Louis Blom-Cooper and Dr. John Reed into the future of the three large special hospitals as appropriate institutions for the care of dangerously mentally ill people?
We do not doubt the seriousness with which the Secretary of State has taken these allegations since they were brought to his attention by my hon. Friend the Member for Halifax, but perhaps he needs to be reminded that the people of Britain want a Secretary of State for Health working on health and not devolution, fighting for patients and not the Tory party leadership.
Mr. Dorrell:
The Blom-Cooper inquiry made a number of recommendations, all of which except one were implemented. I was on a radio programme with Sir Louis on Saturday morning when he was good enough to acknowledge that, as a consequence of the recommendations that he had made, there had been substantial changes in the regime at Ashworth, changes that he welcomed and which he said reflected the burden of his report.
The only recommendation of the Blom-Cooper report that we did not implement was that we should put an end to the use of seclusion in special hospitals. We stated at the time that we did not intend to accept that recommendation because we felt that it was not possible to run hospitals of that nature while eschewing ever the use of seclusion. Every one of the other recommendations of the Blom-Cooper report was implemented. I shall return to this, because there is an important lesson in the fact that we implemented all but one of Blom-Cooper's recommendations, which we should keep in mind now.
The hon. Member for Dulwich (Ms Jowell) asked when the allegations were first made. The answer is that they started to circulate in the press in the autumn of last year. It is precisely because the advice and information relating to the allegations and coming to the Department of Health from the hospital now appears to suggest that adequate knowledge was not then being passed on to the Department that we have made the changes that I announced on Friday--the suspension of the manager and the establishment of the inquiry to ascertain exactly what happened, what should be happening and, more important, what should happen in the future.
The hon. Lady also asked whether the inquiry would take place in public. I was careful to say in my statement that that was a matter for the inquiry itself. Therein lies one of the lessons of the Blom-Cooper process. That inquiry was held wholly in public. One of the lessons that we should draw from the Blom-Cooper process is that it did not resolve all the issues for the future of Ashworth.
More recent inquiries, especially that surrounding the events of the Beverley Allitt case, suggest that it is easier for independent inquiries of this nature--I stress the words "independent inquiries"--to get to the bottom of what exactly happens in these very difficult cases if at least some of the evidence is taken in private.
That specific provision was included in the announcement that I made on Friday so that Mr. Fallon should have that option open to him if he wishes to take it. It is a matter for him and his inquiry. The inquiry report will of course be published.
I reject what the hon. Lady said about what she calls gagging clauses. The only provision that we have made in contracts for staff of the health service is that, where there is a disagreement between members of staff and their employing authority, the staff should first take their disagreements to the authority. We have never sought to prevent members of staff taking their disagreements outside the authority if they fail to get satisfaction. With respect, it is not members of staff who have been the key to the changes that I announced on Friday.
The hon. Lady is right about the treatment of personality disorders. One of the difficulties surrounding the treatment of mentally ill and disturbed patients is knowing how to deal with those suffering from long-term personality disorders. That question is currently the subject of discussion with the psychiatric profession and is, I suggest, best dealt with in that context, as it is the clinicians who ultimately have to make the decisions about the treatment of individuals.
The commissioning board is part of the Department of Health. It is conducting a review of the future of special hospital provision and high-security psychiatric care. That is one of the issues that Sir Louis Blom-Cooper feels that we should consider in the light of the history of the special hospitals. That is why the commissioning board is reviewing it.
Mrs. Alice Mahon (Halifax)
rose--
Mrs. Mahon:
I welcome the Secretary of State's decision to set up the inquiry. Will it investigate the treatment meted out to Stephen Daggett, who went to extraordinary lengths to get the inquiry under way, including absconding and, when he was moved to Rampton against his will, going on hunger strike? Can I have an assurance that his case will be looked into? Will the Secretary of State also give other whistleblowers, such as staff who might want to speak out, some protection? I share the anxiety about gagging clauses expressed by my hon. Friend the Member for Dulwich (Ms Jowell).
Is the Secretary of State aware that the chief executive of Rampton had Stephen Daggett's report on 25 November? Did she call the police, inform the Department of Health or the Home Office, or--as I am led to believe--simply photocopy it and send it back to Ashworth, saying to Mr. Daggett, "This is an Ashworth question, not ours"? If she did, will her behaviour be included in the investigation?
When did the visits to Lawrence ward by the little girl mentioned in the report stop? Does the Secretary of State agree that, if they were allowed to continue after early October, many people who should have known better left her unnecessarily exposed to danger?
Mr. Dorrell:
I am grateful to the hon. Lady for the way in which she has responded to the announcements that I made on Friday. I should also have said that I am grateful to the hon. Member for Dulwich for the way in which she and her hon. Friend the shadow Secretary of State for Health have responded. To the extent that examining the background to Mr. Daggett's care is relevant to the wider inquiry on the way in which Lawrence ward has been run--it is clearly one of the central issues--of course the inquiry will look into the nature of the care that he received and where it went wrong.
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