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Mr. Gray: Will the hon. Lady give way?
Ms Jackson: If I may just finish. The directive was agreed in the summer of 1995 by the right hon. Member for Suffolk, Coastal (Mr. Gummer).
The hon. Member for North Wiltshire was also concerned about increasing the number of businesses to be regulated from 2,000 to 6,000. The IPPC requires that. Again, that was agreed under the previous Government by the right hon. Member for Suffolk, Coastal, for whom the hon. Gentleman worked.
Mr. Gray:
I am grateful to the hon. Lady for giving way at last. She thinks that she knows a lot about these matters. For the record, I am not and have never been a maritime lawyer, and I have never said that I was. I have never claimed to be a maritime lawyer, so I do not know to which exchange she was referring. I am afraid to say that she knows as much about what happened in the Environment, Transport and Regional Affairs Committee as she does about what happened this evening. The point I was making was that the provisions in clause 1(1)(b) and (c) go a great deal further than annexe 1 of the directive. Instead of this cheap actress activity of poking fun across the Chamber, perhaps she should address herself to the Bill. Does she accept that the Bill goes significantly further than the terms of annexe 1 of the directive? Or perhaps she does not know.
Ms Jackson:
It is bizarre that the hon. Gentleman intervened earlier and demanded to know why pollution
A point tellingly made by my hon. Friend the Member for Stroud (Mr. Drew) highlighted how the Bill can protect small businesses from the environmental depredations of larger firms and industries. My hon. Friend the Member for Waveney emphasised the importance of environmental protection in his area. He referred with no small pride to the primacy of the beach at Lowestoft, and stressed that it is by having clean beaches, sea and air that tourism, which is vital in his part of the world as it is in many parts of the United Kingdom, and the well-being of those areas and their local people can be protected and sustained.
We believe that most people both inside and outside the House will welcome the Bill. The issue of environmental protection is increasingly important, not only as it affects the quality of life, but in terms of improving the health of our people and the health of the world. Certainly, we have made clear commitments in regard to Europe; indeed, we have made international commitments. We believe that the Bill will help us to meet those commitments, and I commend it to the House.
Question put and agreed to.
Bill accordingly read a Second time, and committed to a Standing Committee, pursuant to standing Order No. 63 (Committee of Bills).
Queen's recommendation having been signified--
Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a),
Question agreed to.
Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a),
Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),
Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Standing Committees),
Mr. David Drew (Stroud):
I am pleased to be able to present a petition against the powers of the Medicines Control Agency, which was signed by 262 people, most of whom are from my constituency.
The petition supports the views of Consumers for Health Choice, the Health Food Manufacturers Association, the National Association of Health Stores and others. It
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Pope.]
Mr. Nigel Evans (Ribble Valley):
I am grateful for the opportunity to raise the issue of the dismissal of the three non-executive directors of the Guild Community Health Care NHS trust. I am also grateful for the opportunity to raise it at such an early hour. Last time I introduced an Adjournment debate, I did so after 6 am, so nowadays I think long and hard before applying for such debates.
This is a serious issue. Two of the three non-executive directors involved are constituents of mine, as are many of the trust's employees, and one of the directors is a constituent of my right hon. Friend the Member for Fylde (Mr. Jack), who is present. The three non-executive directors were sacked on 17 May for committing the crime of doing their jobs. They are well-respected citizens in the Preston area, and have served the public well with their actions during the case.
This bitter story is one of incompetence, mismanagement, intrigue, the publication of two independent reports, a murder, the suspension of a chief executive, the resignation of a chairman, the intervention of the hon. Member for Preston (Audrey Wise)--to whom I wrote telling her that I would mention her this evening--the dismissal of the three and, finally, the piece de resistance: yesterday's sacking of the chief executive.
Some might think that the timing--only yesterday--of the sacking of Les Howell, the chief executive, was rather suspicious. The non-executives wanted the chief executive removed many months ago--but therein lies another strange tale.
The chief executive's suspension can be traced back to 8 March 1996, when one of the trust's patients, Daniel Holden, murdered a 42-year-old man named David Spencer. The East Lancashire health authority established an independent inquiry into Daniel Holden's care and treatment, which was chaired by William Greenwood, a solicitor, of Steele, Greenwood, Burnley. Also on the panel were a former consultant forensic psychiatrist, a former director of clinical services, and a former director of personnel of a national health service trust. They are all extremely well-respected figures in the medical profession, and it would behove anyone to take heed of their findings.
The inquiry's damning report was made available in October. It described Daniel Holden's treatment as far from ideal, and said that Daniel was not receiving the care to which he was obliged by statute to receive.
At the time of the murder, Daniel was on the supervision register of the Langdale unit, which is a medium secure unit at Whittingham, in my constituency. The inquiry described enormous deficiencies in Daniel's care and treatment, and said that he did not have a proper care plan, that his case notes were inadequate, and that procedure had been largely ignored. It also said that interdisciplinary and interpersonal workings within the trust were inadequate, and that communication between Daniel's family, his general practitioner and other groups was deficient.
Page 44 of the report states that the shortcomings and omissions in the supervision register included:
On page 51, the report describes some of the problems with the chief executive. It states:
Attempts to change the culture by Dr. Kendle--a non-executive--with a statement of intent were reluctantly accepted by the chief executive. The chief executive had a very close working relationship with the chairman of the trust, Patricia Diamond. It was in no way surprising that the statement of intent was ignored, the culture of blame remained and senior staff continued to leave the Guild trust, demoralised.
When the Holden report was sent to the Guild trust, the chief executive responded to it with no reference to the board. The non-executives were informed of the
report's findings only after the chief executive's response. That was the final straw for the three non-executives, who went to the regional headquarters with three executive directors to discuss their concerns and seek advice. Those at regional headquarters said that they shared the concerns of the board members and supported the course of action that the non-executives proposed--to vote on a motion of no confidence in the chief executive.
Before that action could be taken, the chairman of the board, Patricia Diamond, placed the chief executive on extended leave, which, after pressure from the board, was converted into suspension on full pay. That again demonstrates the close working relationship between the chief executive and the chairman.
The Guild trust then set up its own inquiry with the following terms of reference:
The report also says that, because of the close working relationship between the chief executive and the chairman, an avenue of checks and balances of corporate governance of the trust was lacking. Page 12 states that the panel was also greatly concerned by the weight of opinion among the consultant body showing a lack of confidence in Mr. Howell's management style.
The report's first recommendation said:
After this was raised with the regional office by the non-executive directors, Patricia Diamond, the chairman, visited the regional office and was asked to resign, which she did in January 1999. The regional office then recommended that a solicitor, Mr. Martin Edwards, be appointed to help handle the departure of the chief executive. Many options were investigated. But for the cost of litigation, there would have been immediate dismissal. However, the solicitor cautioned the board to be very careful about its decision and suggested that a compensation package for Mr. Howell's departure might be appropriate.
As discussions ensued, the hon. Member for Preston wrote a letter to the acting chief executive of the trust, challenging the Holden report and commenting on the Galbraith-Campbell report. In her letter of 17 January, the hon. Lady wrote:
The hon. Member for Preston says in her letter that all the board members were ineffectual, but that cannot have been true because at least three non-executive directors pushed the case to where it is today. The hon. Lady's letter is one of the oddest that I have read. It even states at the end that the chairman should be reinstated and the report rejected.
I also understand that the hon. Member for Preston spoke with the Secretary of State for Health, pressing her rather strange ideas on him. He may not have agreed with her every word, but he has agreed with her conclusions: to get rid of all the board members. It is a great shame that when I asked the Secretary of State for Health about the matter, he did not reply to my question himself even though he was the man responsible for the sacking. I wrote to him asking him to be here this evening, so that he could answer some of the points directly, but he is not here.
I should like to know whether the discussion between the hon. Member for Preston and the Secretary of State was minuted; if so, will he publish the minutes of that discussion? What discussions did the Secretary of State have with the region? The region fully backed the actions of the board, but in May it told members of the board that it had lost control four months earlier. To whom had it lost control? Did it lose control directly to the Secretary of State for Health? What has been his involvement in the affair?
On 19 May during an Opposition Day debate on the health service, the Secretary of State said:
What I find confusing is the disparity between the Secretary of State's statement during the debate, when he said that he did not have the power to sack NHS staff, and the press release, which states quite clearly that he did sack the non-executive directors.
Is the Secretary of State aware that it was the region's solicitor, Michael Edwards, who was urging caution? Is he aware that, on two separate occasions, board members wished to proceed with the removal of the chief executive? They were asked to halt discussions by the region because the matter was politically sensitive. Really? Politically sensitive to whom? When the board wished to use the sickness procedure--which would have brought the issue to a head--the dismissal letters for the non-executives arrived, and not the dismissal notice for the chief executive. He remained on suspension, but on full pay.
The subsequent sacking of the non-executives has enormous repercussions for other trust boards throughout the country. One board member contacted me, wishing to remain anonymous, and stated her fear that non-executives would have to toe the line or risk losing their positions. That simply cannot continue.
The three non-executives felt it wrong to resign because of the message that that would send to other non-executives. It might also be interpreted as a betrayal of those who had courageously given evidence to the Galbraith-Campbell inquiry. We must remember that Les Howell, the chief executive, was sacked only yesterday, so it is understandable that the non-executives wanted to see the matter through to the end. After all, they had instigated the report.
Both Mrs. Galbraith and Mr. Campbell have said that they are willing to speak to the Secretary of State, the hon. Member for Preston and others about their findings. Why has the Secretary of State still not spoken to the authors of the report? Will the Minister assure the House that he accepts the findings and recommendations of the report, the appointment and terms of reference of which were agreed by the Government's north-west regional office?
Will the Minister confirm the necessity in cases such as this for protecting the evidence of whistleblowers who, without such protection, may feel too fearful of the consequences of speaking out about any problem besetting their health authority or NHS health trust? Does the Minister understand that the report was a consequence, and not the cause, of the chief executive's suspension, which was justified by the existing evidence? Does the Minister understand that the report was commissioned to investigate whether there had been a loss of confidence in the chief executive? It was not a disciplinary investigation.
Why was the acting chairman, Dr. Kendle, instructed not to operate the trust's sickness procedure in respect of the suspended chief executive when he started to submit sick notes to the trust in early April? Why were the non-executives instructed in April to stop everything and to do nothing with regard to the suspended chief executive? Why did the regional office of the Department of Health inform the three non-executive directors in May 1999 that the regional office had lost control of the situation four months previously?
Did not the Minister take the easy way out by removing all the non-executive directors, rather than those responsible for dysfunctional activities in respect of the suspended chief executive? Does the Minister feel that the new board will be compromised in view of the fate of the three predecessors, who acted with conviction, in good faith and on the instructions and advice of the north-west regional office of the Department of Health?
I want the Secretary of State to initiate a full public inquiry into the goings-on at the Guild trust since the publication of the Holden report. The Government were elected on a manifesto which promised openness and transparency. If the Minister stands by that, a public inquiry must be the next step. I understand that the hon. Member for Preston has stated that if the chief executive were dismissed, she would demand that a public inquiry be set up by the Secretary of State. Does she stand by those words? If so, I will be delighted if she joins me in asking the Secretary of State for a public inquiry, and I look forward to her giving evidence to such an inquiry.
This morning, the three non-executive directors who had been sacked issued a statement. Referring to the sacking of the chief executive yesterday, they said:
That, for the purposes of any Act resulting from the Pollution Prevention and Control Bill [Lords], it is expedient to authorise the payment out of money provided by Parliament of--
(a) any expenditure incurred by any Minister of the Crown in consequence of the Act, and
(b) any increase attributable to the Act in the sums payable under any other Act out of money so provided.--[Mr. Pope.]
That, for the purposes of any Act resulting from the Pollution Prevention and Control Bill [Lords], it is expedient to authorise the imposition of charges under regulations made under the Act.--[Mr. Pope.]
Question agreed to.
That the Local Government Finance (England) Special Grant Report (No. 46): Private Finance Initiative (HC 408), which was laid before this House on 7th May, be approved.--[Mr. Pope.]
Question agreed to.
That this House takes note of European Union Document No. 5263/99, a draft Council Regulation on the provision of assistance to economic reform and recovery in the Newly Independent States and Mongolia; and supports the Government's position that the proposed Regulation is broadly acceptable, that the Government will work with Member States to secure a Regulation which will ensure greater emphasis on social and environmental issues, maintain TACIS as a technical assistance instrument, improve procedures and incorporate a dialogue-driven approach to programming.--[Mr. Pope.]
Question agreed to.
8.56 pm
Declares that Government proposals would give the Medicines Control Agency . . . virtually unlimited powers to classify safe products as medicines. This would mean that the MCA could remove at a stroke products that are vital to the good health of many consumers and are currently sold under food law. This is an abuse of the democratic process and a denial of freedom of choice.
To lie upon the Table.
The Petitioners therefore request that the House of Commons urge the Department of Health to reconsider its proposals and to introduce an immediate moratorium preventing the MCA from declaring these safe products to be medicines except on the grounds of illegal claims or safety, and, further, to introduce new legislation appropriate to the special needs of safe, natural health products.
8.58 pm
"a care plan that aimed to reduce risk and ensure that Daniel Holden's care needs were reviewed regularly, and that contact by a key worker was maintained;
care programme approach;
allowing for Daniel Holden's social worker, his GP, a relative or carer--or indeed even Daniel Holden himself--to participate in the initial discussion and decision;
ensuring that the initial decision to put Daniel Holden on the Supervision Register was part of the"
"discussion;
The report goes on to describe deficiencies in the care programme approach, including omission of
the carrying out of a risk assessment;
taking evidence from the criminal justice agencies when making the original judgments;
informing Daniel Holden orally of his inclusion on the register".
"written evidence of systematic assessment of health and social care needs;
The report is damning.
a care plan agreed between relevant professionals, Daniel Holden and his carers recorded in writing;
close working between health and social services . . .
a clear understanding of what to do if Daniel Holden failed to meet requirements or commitments."
"However, it is consistent with our other findings about the managerial style of the trust, which was detached, uninvolved and autocratic. The chief executive insisted that Dr. Guly"--
who was the consultant forensic psychiatrist--
"carried an onerous work load of 24 beds plus a clinical directorship, and then put further pressure on her to assume responsibility for the high dependency unit. We find this attitude to have been oppressive. Whatever problems the trust may have had, it should not have acted in a manner that could have led to inadequate performance of her clinical duties and the clinical directorship."
On page 57, the report recommends:
"We believe that chief executives should be highly visible individuals who draw together responsibility for the planning, implementation and the achievement of corporate objectives, to provide the best possible care to patients within existing resources. In our view, these responsibilities have not been adequately discharged--hence the plethora of critical reports about the unit".
The Guild Community Health Care NHS trust was itself at that time facing the threat of losing the contract for medium secure services. Therefore, the chairman, Patricia Diamond, and four non-executives met the chief executives of the four purchasing authorities. At that meeting, the chief executives of the purchasing authorities spoke of their concern about the trust's management style, and the consequent culture of blame and fear within the trust.
"To investigate the criticisms of the Chief Executive of the Trust made in the draft Report into the care and treatment of Daniel Holden dated July 1998.
and various other individuals, and--
To investigate the conduct of the Chief Executive following the receipt of the draft Report.
To investigate the Chief Executive's management style and conduct of relationships with Board members"--
"to make such recommendations to the Trust Board as the Panel considers appropriate."
The panel consisted of Anne Galbraith, the former chairman of an NHS trust in Newcastle upon Tyne, and Neil Campbell, the chief executive of the Dumfries and Galloway health board. They are well respected in the health service and serious attention should be given to their findings. The panel spent five days in Preston taking evidence and was keen to preserve the anonymity of the witnesses. The report makes chilling reading and is more damning than the Holden report. It says that the chief executive's handling of the report was ill advised. Page 7 talks of the chief executive's autocratic and non-consultative approach. Page 8 states:
"the overwhelming number of respondents do not have confidence in the Chief Executive."
The report further states that those who had lost confidence in the chief executive, Mr. Howell, included virtually all the consultants in the trust, the major purchasers from the trust, the community health council, some representatives of the university, the trade union representatives and a sizeable number of trust board members, as well as a number of operational directors.
"In the light of Mr. Howell having lost the confidence of many of the key leaders in the trust, including the clinical community and significant external partners, to an extent that his position as chief executive has become untenable, the trust board are recommended to take immediate appropriate action."
Significantly, the report does not ask for the resignation of the non-executives, who raised the issue and pushed it when that was difficult. After it was published, the chairman and another board member, David Nelson, met
consultants, union representatives and community health council representatives without consulting other board members about what they were doing.
"As I read the Report, I found myself repeatedly thinking, 'But this is childish". I looked for evidence of wrong-doing and all I saw was gossip and intrigue against the Chief Executive.
As we saw at Question Time today, the hon. Lady has not changed her mind. She fully backs and endorses the chief executive, even though the Holden report and the Galbraith-Campbell report are damning and even though the chief executive was sacked yesterday by the new chairman of the trust, with the unanimous support of the board. I assume that that decision has been endorsed by the Secretary of State for Health and by the region.
I do not believe that the Chairman resigned willingly or that she accepts this Report.
I do not accept this report. If I did I would have to conclude that the only sensible course for the Secretary of State to take would be to dissolve the whole Board and start again. No-one comes out of it with credit, and the Board members themselves appear from it to be totally ineffectual."
"Whistleblowers on the staff should have nothing to fear provided of course that they tell the truth."
When my right hon. Friend the shadow Secretary of State for Health said, "So why sack them?" the Secretary of State replied:
"I cannot sack any NHS staff. That comment just displays the ignorance of Opposition Members."--[Official Report, 19 May 1999; Vol. 331, c. 1143.]
If that is the case, it is interesting that in a press release issued on 17 May 1999, the NHS Executive stated:
"Mr. Dobson had concluded that relations between members of the Guild board had become irreconcilable and they have been asked to resign in the interests of the people the Trust serves.
That is exactly what has happened.
The Secretary of State has made it clear to the five non-executives that he will consider applications for NHS trust board membership from any who resign but, in the interests of the effective management of the Trust, if they refuse to resign, they will be dismissed."
"This decision by the new Trust Board totally justifies the stand we have taken. It completely exonerates our position because we are the very people who decided to dismiss the suspended chief executive officer because of the widespread loss of confidence in him and we three are the very people who were stopped from doing just that by political interference inside and outside the Trust.
8 Jun 1999 : Column 549
We acted throughout on the instructions of the Regional Office of the Department of Health and on the advice of the solicitor nominated by the North West Regional Office. Our negotiations to terminate the Chief Executive's employment were frustrated by political interference from Mrs. Audrey Wise M. P. and from the North West Regional Office who twice halted and delayed those negotiations, the reason given being "political sensitivity". The nature of that political sensitivity has never been explained and it is surely a dangerous precedent for the internal affairs of a Trust to be disrupted on the basis of undisclosed political sensitivity.
It is most interesting that the announcement of the termination of the Chief Executive's employment should be made on the very morning of the day of the adjournment debate which has arisen as the result of our actions. No doubt people will draw their own conclusions from that.
This is not a party political issue. The Guild Trust's affairs are not just the province of Mrs. Audrey Wise M.P. but also of Nigel Evans M.P. and Michael Jack M.P. who asked us what on earth was happening in the Trust. When we were invited to resign by theN.W. Regional office we were told that we had behaved impeccably, that we had not put a foot wrong and that they were most anxious to use our considerable expertise in the future in the service of the NHS. To have accepted that invitation would have compromised our integrity and made it impossible for us to speak out as we are doing now about the way that our role as non-executive directors has been disabled and undermined by political interference."
The Secretary of State must prove that he has the interests of the patients and the people of Ribble Valley and Preston, as well as non-executives in the rest of the country, at the forefront of his mind. The setting up of a public inquiry will enable him to do that. I know that the Minister will mention the words "fresh start", as if that could make everything right. Does not he accept what the non-executives say: that Les Howell was sacked only yesterday and that, as they had initiated that course of action, they should have seen it through to the end? What about the message sent to all the other non-executive directors? The Minister cannot hide behind a simple fresh start.
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