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11.15 pm
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I congratulate my hon. Friend the Member for Coventry, North-West (Mr. Robinson) on securing time to debate a topic that is clearly of considerable concern to him, as well as to my hon. Friend the Member for Coventry, South (Mr. Cunningham), and the Under-Secretary of State for the Environment, Transport and the Regions, my hon. Friend the Member for Coventry, North-East (Mr. Ainsworth), in whose constituency the Walsgrave hospital lies, but who, by convention, cannot raise any matters that relate to the hospital in the House. I am glad to see that my hon. Friends are in the Chamber for the debate.
For my hon. Friends' benefit, I wish to start with a few general observations about the Walsgrave hospital. Some newspaper headlines have given the impression that the hospital is in total crisis. The Walsgrave Hospitals national health service trust changed its status to that of a university teaching hospital at the end of October last year, when it became the University Hospitals Coventry and Warwickshire NHS trust. The trust is made up of Walsgrave hospital, Coventry and Warwickshire hospital and the Hospital of St. Cross in Rugby.
Against the backdrop of a challenging agenda, including changes to the configuration of services, the trust has achieved success in a number of areas. The cardiac services directorate has gained national recognition for mitral valve repairs and receives referrals from throughout the country. A new renal dialysis satellite unit has recently been opened at the Hospital of St. Cross in Rugby. I recently visited the hospital and saw the new unit. The trust's renal transplant department is in the upper quartile nationally for graft acceptance. The radiology department has recently taken delivery of a new £1.2 million mobile magnetic resonance imaging scanner, to be moved regularly between the South Warwickshire General Hospitals NHS trust, the George Eliot Hospital NHS trust and the University Hospitals Coventry and Warwickshire NHS trust.
Work has recently started in the radiotherapy and oncology department to provide state of the art linear accelerator facilities, involving an investment of about £6 million. In partnership with the local community trust, a walk-in centre has been established, offering a seamless service to patients.
The trust is also taking the lead as the English national pilot site for colorectal cancer screening. With a catchment population of around 1 million, the uptake to date is well in excess of the target set for the pilot.
These are just some of the successes that the trust can demonstrate, in addition to which it reports a reduction in the number of nursing vacancies, and a 30 per cent. increase in the number of consultants. Of course, last year the trust achieved accreditation as a university teaching hospital.
The first issue of substance in tonight's debate was the suspension of a medical consultant at the University Hospitals Coventry and Warwickshire NHS trust. Where concerns are raised about professional misconduct it is
right that, as an employer, the national health service is able to investigate concerns expressed about the competence or behaviour of that employee.Although that course of action should be a very rare event, occasionally it is necessary to suspend an employee. It is important to stress that, although it is not always perceived as such, in legal terms suspension is a neutral act and must not be used as a disciplinary sanction. Suspension is intended to protect the interests of patients, other staff and the employee or to assist the investigative process.
As my hon Friend the Member for Coventry, North-West will be aware, issues around staff management are a matter for the employing national health service body--in this case, the University Hospitals Coventry and Warwickshire NHS trust. That includes matters relating to the suspension of staff from their duties. Clearly, it would not be appropriate for me to intervene or comment on the individual case highlighted by my hon. Friend in the House tonight, as I understand that the case is still subject to legal proceedings. However, I note the points raised by my hon. Friend and will ensure that they are drawn to the attention of the regional director of the NHS executive regional office.
My hon. Friend will be interested to learn that we are revising guidance on the handling of suspensions. In future, there should be less need to suspend employees, because medical staff with developing problems can refer themselves--or be referred by their employers--to the National Clinical Assessment Authority--the NCAA. Through a swift and accurate identification of problems and solutions, the NCAA is intended to ensure that fewer suspensions will be necessary.
The NCAA will issue guidance to NHS organisations late in 2001 to help them to identify suitable cases for referral, and to advise them on how to make such referrals. As part of its remit, the NCAA will also consider any outstanding cases that are still awaiting resolution.
In future, NHS employers must ensure that suspension is used only after all other alternatives have been considered--for example, a period of supervised retraining pending outcome of formal investigation; voluntary restriction; or referral to the NCAA with voluntary restrictions. When an employee is suspended, employers must ensure that it is for the minimum necessary period of time.
My hon. Friend draws attention to the importance of taking seriously concerns raised about the performance of individual staff members. We expect a climate of openness and dialogue in the NHS, and a culture and environment that encourage staff to feel able to raise concerns about health care matters sensibly and responsibly, without fear of victimisation.
Wherever possible, concerns raised by staff should be dealt with locally, in accordance with local policies and procedures. However, in some cases, individuals have considered the local response provided to them to be inadequate; as a consequence they have sought to raise their concerns with the NHS executive.
Officials are liaising with the regional offices to develop a protocol for handling cases raised with the NHS executive. That is likely to include identifying a first point of contact in each region. Public Concern at Work-- a leading authority in that sphere--has offered to provide staff working in the Department and the NHS executive
with training on how to respond to individuals who contact the NHS executive to raise concerns. Of course, I realise that the case raised by my hon. Friend is still subject to legal proceedings, but I shall ensure that the regional office is aware of his concerns. I hope that some of the issues that he highlights are less likely to occur in future because of the measures that we are putting in place.Before I address my hon. Friend's concerns on the standard of colorectal services at the trust, it is important to raise a matter covered in the local press today. I read a leading article stating that
- "Surgery in the hospital is in turmoil."
On the standard of colorectal services at the trust, I am advised that my hon Friends have already had sight of the outcome of the detailed investigations conducted by both the trust and the regional director of public health following the concerns that were raised. I have read the report; the regional director agreed that there were issues that needed to be addressed at the trust. I understand that the regional director of public health made recommendations relating to future staffing levels for the service, and to the appropriate grading for staff involved in provision of colorectal surgery at the trust. I am informed that the trust is acting on those recommendations, and that a fully qualified colorectal surgeon has been appointed and is expected to start employment with the trust next week. I have asked the regional office to continue to monitor the establishment of that service at the trust in the short to medium term. I take the point made by my hon. Friend the Member for Coventry, North-West about the basis of some of the statistical analysis. I think it would be best for me to write to him after the debate with precise details of how the analysis is determined.
My hon. Friend also expresses concerns about the trust's senior management team, noting that there had been a vote of no confidence by a very small number of surgeons at the trust. I am aware that, on 26 February, my hon. Friend and some of his colleagues met Nigel Crisp, the chief executive of the NHS so that he might have an opportunity to take account of their concerns about the management of the trust. I understand that, following that meeting, Nigel Crisp spoke to the regional director of the NHS executive and asked him to ensure that concerns raised by my hon. Friends were being addressed.
I am also of course aware of the issue that was raised as a point of order in the House on 17 January, relating to the use of a letter. Mr. Speaker has responded and it would be inappropriate in that context for me to add anything further.
Mr. Geoffrey Robinson: Does my hon. Friend agree that it was disgraceful for the management to seek to use a letter written in confidence to my hon. Friend the Member for Coventry, South (Mr. Cunningham) and copied to myself, as a reason for not reinstating and
putting in hand the part II recommendations? Would she not as a parliamentarian, let alone a Minister, deprecate that form of behaviour?
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