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BILL PRESENTED
Waste Prevention
Mr. Gary Waller, supported by Sir Teddy Taylor, Mrs. Diana Maddock, Mr. Cynog Dafis, Sir John Hunt, Mrs. Helen Jackson, Sir David Knox, Mrs. Margaret Ewing, Mr. Matthew Taylor and Mr. Barry Sheerman, presented a Bill to enable certain local authorities to make arrangements to reduce, prevent or avoid waste in their area; and for related purposes: And the same was read the First time; and ordered to be read a Second time upon Friday 28 February, and to be printed [Bill 108].
Ashworth Hospital
3.30 pm
The Secretary of State for Health (Mr. Stephen Dorrell): With permission, I should like to make a statement about action being taken to address the allegations involving the personality disorder unit at Ashworth hospital in Merseyside. The unit comprises six wards, with 115 patients, within the total population of Ashworth hospital of 473 patients.
Hon. Members will be aware that last Friday I instituted urgent action to address the very serious situation that had been brought to my attention in the preceding few days. In October last year, Stephen Daggett, a patient at Ashworth hospital, made a number of allegations, including the misuse of drugs and alcohol, financial irregularities, the availability of pornographic material, and possible paedophile activity involving a child visitor within the personality disorder unit.
I am advised that the hospital began investigations at that time and that a subsequent ward search on 17 January found a large amount of pornographic material. Despite the availability of this evidence and of Mr. Daggett's allegations, the hospital continued to maintain that press reports of unacceptable and possibly unlawful activity within the personality disorder unit were unfounded.
On 28 January, the Home Office received a letter from the hon. Member for Halifax (Mrs. Mahon) enclosing a 60-page dossier setting out the detail of Mr. Daggett's allegations. The dossier was passed by the Home Office to my Department.
On 31 January, police visited the home of a former Ashworth patient who had continued to be a frequent visitor to the hospital. Following that action, a child has been taken into the care of the local authority under an emergency protection order.
In light of the allegations made by Mr. Daggett and of other evidence that has recently become available, I made three announcements on Friday of last week. First, the hospital has suspended three members of staff, including the chief executive. An acting chief executive was appointed with immediate effect. He is Mr. Erville Millar, chief executive of Lambeth Health Care NHS trust, who has a strong background in mental health services. I can further inform the House this afternoon that the hospital has today suspended a member of its medical staff.
Secondly, I established on Friday a statutory inquiry under section 84 of the National Health Service Act 1977 to review the clinical policies and the management of the personality disorder unit at Ashworth hospital. The inquiry will be led by His Honour Judge Peter Fallon QC, a recently retired senior circuit judge. A section 84 inquiry has the power to summon witnesses and to take evidence on oath. The inquiry will determine how and on what terms it takes evidence. It will also be for the inquiry to ensure that its work does not compromise continuing police investigations or possible criminal proceedings, but I would expect it to report within a year. That report will be published.
The terms of reference for the inquiry will be published as soon as possible. They will make it clear that, as it is activities within the hospital's personality disorder unit that have caused recent concern, the inquiry should focus on the policies, management and clinical care provided by
that unit. The inquiry will, however, also wish to follow up any wider questions that are necessary to the proper consideration of the issues.
The third announcement I made on Friday was on the alleged involvement of a child. The chief inspector of social services, Sir Herbert Laming, has asked the local authority concerned for a full report on the handling of the case by its social services department. I will decide, in the light of that report, whether further action needs to be taken.
The allegations that have been made about Ashworth hospital are extremely serious, and the public are entitled to reassurance on two counts. First, Ashworth hospital must be properly managed and must provide a high level of security for the benefit both of patients and of the public at large. Secondly, the hospital must also ensure that its patients receive a high standard of clinical care. The action that I announced on Friday is directed at the achievement of both those objectives.
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.
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