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HOUSE OF COMMONS COMMISSION
The hon. Member for Roxburgh and Berwickshire, representing the House of Commons Commission, was asked--
Clerk of the House
44. Mr. Tam Dalyell (Linlithgow): To ask the hon. Member for Roxburgh and Berwickshire, representing the House of Commons Commission, on how many occasions since 1998 the Clerk of the House of Commons has been sued in legal action; by whom; and what the cost was to public funds in each case. [146225]
Mr. Archy Kirkwood (on behalf of the House of Commons Commission): The Clerk of the House, in his role as Corporate Officer, has been involved in no litigation since 1998. In 1996, action was taken against him as Corporate Officer by Harman (CFEM) Facades (UK) Ltd. That case was settled, as set out in a written answer in my name in the Official Report on 2 November last year. In addition, the hon. Gentleman may wish to know that several civil actions have been brought against the commission as an employer during that period.
Mr. Dalyell: Are we sure, as the House of Commons, that the Clerk should, through the system, be dragged through the courts?
Mr. Kirkwood: I share the hon. Gentleman's concern about the involvement of Officers of the House in litigation in the courts of the land. The hon. Gentleman may know that the Parliamentary Corporate Bodies Act 1992 made the Clerk the Corporate Officer of the House. Under that Act, he is given managerial responsibilities for the heritable property of the House and, in that capacity, is enabled to enter into contracts.
Royal Liverpool Children's Inquiry
3.31 pm
The Secretary of State for Health (Mr. Alan Milburn): I wish to make a statement about the inquiry into events at Alder Hey hospital, Liverpool.
I am today publishing the report of the inquiry into the Royal Liverpool Children's NHS Trust, known as the Alder Hey Hospital. I am publishing alongside it two further documents. First, the chief medical officer's census into the extent of organ retention in the NHS in England. Secondly, the chief medical officer's recommendations for reform of organ retention procedures. All three documents are now available in the Vote Office. I am grateful, Mr. Speaker, for your agreement that the parents affected at Alder Hey should also have access to copies of the report.
I would like to record my thanks to the chairman of the Alder Hey inquiry, Mr. Michael Redfern QC, and his fellow panel members Dr. Jean Keeling and Mrs. Elizabeth Powell, for conducting what has proved to be an extremely difficult inquiry. The inquiry was established in December 1999, following evidence to the Bristol inquiry that a large number of hearts from deceased children had been retained at hospitals in the NHS. Alder Hey was one such hospital. It is a world-renowned hospital treating 200,000 children a year. For many years, the hospital has made use of human hearts for research and teaching. The Redfern Report says:
- "there are now more than 1,600 living children who would have died in infancy or childhood without the improvements in surgical techniques and care which were pioneered in Liverpool."
- "a lack of respect and a failure to appreciate the circumstances which led to the . . . taking of human material."
- "Neck deeply lacerated. Pull it to pieces some time and reject."
During van Velzen's time at Alder Hey between 1988 and 1995, he systematically ordered the unethical and illegal stripping of every organ from every child who had had a post-mortem. He ignored parent's wishes, even when they told him explicitly that they did not want a full post-mortem, let alone the retention of any of their child's organs.
According to the report, van Velzen lied to parents. He lied to other doctors. He lied to hospital managers. He stole medical records. He falsified statistics and reports, and he encouraged other staff to do the same.
For any parent, the death of their child is a tragedy. To bury that child, to grieve, to hold precious their memory over the years is how many families gradually come to terms with their loss. It is hard to imagine the trauma and
anguish that each of the Alder Hey parents faced when, many years later, they discovered that their child's body had not been buried intact, as they believed, but had been stripped of its entire internal organs, leaving the body as a shell.That happened not to one set of parents in Liverpool, but to several hundred. The hospital and the university now admit that they will never be able accurately to tell parents what happened to every organ of every child between 1988 and 1995.
What we do now know is that the vast majority of organs that were taken were never used for medical research. Parents cannot even take comfort in the knowledge that their children's organs were used to help other children. It is clear from the report that the understanding of cot death--for which van Velzen was funded--was not advanced one iota by his practice of stripping organs from the bodies of children.
The question in the minds of parents and others is how van Velzen got away with it for so long. The answer is that the hospital authorities and the university of Liverpool failed to monitor his practices and failed to take action to stop them. Numerous complaints were made. Problems were not properly investigated. Action was not taken.
These failures were compounded by the incompetence and the insensitivity of both the hospital and the university authorities, once the truth did begin to emerge. The hospital seemed overwhelmed by events. The university seemed simply to have turned its back on parents. Some parents faced up to four funerals, as different organs from their children were returned to them at different times. The pain caused to the parents by this dreadful sequence of events is, in my view, unforgivable. I am deeply sorry for the wrong that was done to them, their families and their children. Those who did wrong will now be held to account.
The inquiry report says that Professor van Velzen must never be allowed to practise again in this country. I can tell the House today that he has been referred to the General Medical Council for disciplinary action. I understand that he has been summoned to appear before the GMC later this week. I can also tell the House that the inquiry report has been referred to the Merseyside police and passed to the Director of Public Prosecutions. They will determine whether criminal prosecutions should now proceed.
Four NHS staff, including the current chief executive of the trust, have today been suspended. Their employers will consider appropriate disciplinary action. The role of other NHS staff will be examined by their employers. The doctors criticised in the report have been referred to the General Medical Council. Other staff have been referred to the Council for Professions Supplementary to Medicine.
My right hon. Friend the Secretary of State for Education and Employment has asked the president of the council of the university of Liverpool to review the evidence in the report and to take appropriate disciplinary action. The current acting chairman of the trust board is today leaving the trust, along with two non-executive directors whose resignations I have today accepted. Also today, I have appointed Angela Jones as the new chair. It is right that the trust should have a fresh start.
Alder Hey hospital relies on its dedicated staff, who have been as shocked as we all are by these events. I want to thank those staff, who have continued through these
difficult times to provide treatment and care for children from Liverpool and elsewhere. The action that I have taken today should help them to re-establish the hospital's relationships with the community that it serves. I am confident that Alder Hey can recover and rebuild its reputation as a leading national and international centre for specialist paediatric care.
- "the exceptional practice of van Velzen"
Professor Donaldson's census shows that 105,000 organs are retained throughout the country. Poor standards of cataloguing and record keeping mean that those figures may not be wholly accurate. Twenty-five hospitals account for 88 per cent. of the organs. At least 16,500 of the organs and tissues have been retained in apparent contravention of the law, as they were used for coroners' post-mortems and should not have been kept beyond the time needed to establish cause of death. As at Alder Hey and Bristol, the coroner system throughout the country has proved ineffective in that respect. The current law and post-mortem consent forms are both ambiguous. They talk of taking tissues when they often mean taking organs and they record lack of objection rather than informed consent.
In the past four years, the Government have made an unprecedented effort to protect patients better. The changes that we have already made and the reforms that are still to be introduced enjoy widespread support among both patients and doctors. The NHS is full of good doctors, not bad ones. Our reforms are aimed at supporting them to become even better. They include a new statutory duty on quality for every NHS trust, independent inspection through the Commission for Health Improvement, annual appraisal of doctors that is linked to periodic revalidation, and reform to make self-regulation faster, more open and more accountable.
Now we need to go further. The chief medical officer's census, our consultation with parents and the medical profession, and the reports from Bristol and Alder Hey have formed the basis for Professor Donaldson's recommendations for reform. I am accepting them in full. The major proposals are as follows. First, I am establishing a special commission under the chairmanship of Margot Brazier, professor of law at Manchester university, to oversee the return to families of organs and tissues from around the country, should those families wish to have them. We have ensured that parents who are seeking more information today can obtain it by contacting the NHS Direct telephone helpline.
Secondly, my right hon. Friend the Home Secretary has set in train a review of the coroner system so that we can learn the lessons of what went wrong at Alder Hey and elsewhere.
Thirdly, my right hon. Friend the Secretary of State for Education and Employment will establish a review of the accountability and management arrangements between
NHS trusts and universities where senior staff are employed on joint contracts. Fourthly, we will ensure that all NHS trusts provide support and advice to families at the time of bereavement. I expect that arrangement to be in place throughout the NHS later this year.Finally, the law will be changed to enshrine the concept of informed consent. The existing law in this area has become outdated. The Human Tissue Act 1961 does not even contain penalties for breaches of its provisions. The law has ill served bereaved parents in our country and causes confusion for staff. It must now be changed.
I will therefore bring forward measures urgently to amend the Act to clarify that informed consent must be given, that organs and tissues must be specified and to make it a criminal offence to ignore informed consent.
We will also undertake a wider review of existing laws on all aspects of taking, storing and using tissue and organs from both the living and the dead. When the review is completed, we will seek to legislate to introduce the necessary changes.
The changes in the law will be supported by a new statutory code of practice, which will be issued to the national health service. It will cover organs that are used by the pharmaceutical industry, and it will be accompanied by a new standardised consent form, which will be introduced throughout the health service.
There is one other important point. Informed consent does not need to be at the expense of medical research. Proper post-mortem procedures and archived tissues and organs hold the key to many medical advances, such as discovering the effects and causes of disease, and finding cures for illnesses that disable or kill. However, retaining public confidence in those procedures requires public consent. Members of the medical profession share that view. Indeed, it is reflected in the recent guidance issued by the Royal College of Pathologists.
When I met families from Alder Hey, Bristol and elsewhere, many told me that if they had been asked properly, they would have been only too willing to allow their child's death to help another child live.
Doctors and pathologists have an incredibly difficult job. They have usually acted with the best intentions to create greater understanding of disease and to improve standards of care in a way that avoids causing further anguish to grieving families. Those are laudable aims and honourable intentions. However, as the events at Alder Hey show, modern patient expectations and traditional clinical practices have grown apart. The national health service can no longer assume that the benefits of science, medicine or research are somehow self-evident, regardless of the wishes of patients or their families.
The relationship between patients and the service today has to be based on informed consent. That will require changes in practice, policy and medical education. As I have made clear today, it will also require changes in the law.
The parents whom I have met from Alder Hey and elsewhere have acted with great dignity and purpose. I pay tribute to them. I hope that our reforms will provide some comfort for the pain that they have endured. I commend the reforms to the House.
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