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Madam Deputy Speaker (Mrs. Sylvia Heal): Order. I see that a considerable number of Members wish to contribute to the debate. If hon. Members make their comments even shorter than 10 minutes, several more may be able to catch my eye.
5.48 pm
Mr. John McDonnell (Hayes and Harlington): I wish to raise two constituency cases relating to the investigation of and response to complaints about health treatment. They have led me and many others to draw attention to the need for further reform of the NHS complaints procedures. The first case relates to an elderly man, and the second to a child.
The elderly man, Mr. Alfred Riddle, was taken into hospital on 8 March 1993. He was advised by his consultant that he had a small bleeding ulcer that required surgery. The family were advised that there was some risk, owing to his age. The operation was carried out on 10 March. He was then admitted to the intensive care unit. He died 16 days after the operation. The family were informed half an hour before he died that he had been suffering from stomach cancer and that it had spread, causing major organ failure. The family refused the death certificate as a result. They asked the key question why incorrect information had been provided before surgery, thus precluding Mr. Riddle senior and his family from making an informed decision about the proposed treatment.
When the hospital was questioned, it gave several different responses at different times. The family took up the complaint formally with the hospital trust in 1994. They were dissatisfied with the reply, which they found to be dissembling. They requested an independent review. The request was considered by the associate director of public health, but was deemed inappropriate. The family were instructed to resolve the matter locally. No appeal against that decision was possible under the procedure at that time. A number of meetings were held with the family. That did not resolve the complaint.
The family then approached the health service commissioner to seek an intervention, but with no success. The commissioner rejected the case because complaints should normally reach the ombudsman within a year of the event taking place or coming to his notice.
I wrote to the Minister, Baroness Jay, suggesting an independent review to satisfy the family. That was rejected. The advice provided was that the only alternative was for the family to seek legal advice. I sought a further ministerial meeting, this time with Baroness Hayman. I was then informed that no appeal against the decision to refuse an independent review was possible under the original procedures and new procedures for NHS complaints had been instituted, but that a complaint that had first been lodged under the old procedures could not be taken up under the new procedures.
The system has proved to be totally inadequate in establishing the truth of the case, in satisfying the family's concerns and in demonstrating that any lessons have been learned for the future so that no one else has to go through that experience. Naturally, the family are not only concerned but extremely angry. Nearly 10 years after the event, they still do not know the facts of what happened to their beloved father.
I turn to an equally, if not more, tragic case: the case of my constituent Joanna Nash. She was aged six. She became ill on 31 August 1994, at which time she was taken to her doctor. The doctor advised her mother not to take her to hospital immediately, but on the following day she was no better. On 1 September 1994, Mrs. Nash took Joanna to Hillingdon hospital, where it was felt by the treating doctor that she should not be admitted; gastro-enteritis was diagnosed.
On 3 September 1994, Mrs. Nash took Joanna back to the hospital as there were no visible signs of improvement in her daughter's condition. This time, Joanna was admitted to hospital. Her kidneys had failed. On Sunday 4 September 1994, Joanna was transferred to Great Ormond Street children's hospital where her condition was immediately diagnosed as haemolytic uraemic syndrome and she was put on a dialysis machine. Unfortunately, that six-year-old child died on Friday 9 September 1994 at Great Ormond Street hospital.
The family were concerned with the treatment that Joanna received at Hillingdon hospital and met the consultants to question them about the nature of the treatment that was received, about the treatment that should have been received and about what the diagnosis should have been. They found the answers to be insufficient, to say the least. They went to an independent professional review. They discovered that even during the independent review, a number of factors had not been taken into account. Hillingdon hospital had refused to supply a blood sample to specialists so that they could further the investigation.
At no stage have the family been given a copy of the report that the specialists undertook in the investigation itself. Later, they discovered that the condition was caused by the bacterium E. coli O157, but the review itself never discovered that. They had to find that information themselves.
Joanna's notes were looked at independently as a result of the family's own intervention. It became apparent that errors were made in her "treatment", which not only failed to diagnose the problem, but even made the condition worse.
On the basis of that information, the family sought to reopen the inquiry. They were refused and told that it was not possible within the existing procedures, so there has been no opportunity to investigate and to demonstrate
whether the practices for treating Joanna were adequate or whether any lessons have been learned. The Nashes have set up an organisation that has campaigned over a number of years, linking families who have gone through similar experiences. I pay tribute to the work that they have done to raise awareness of that condition and of the need for better treatment. However, throughout all this, they have been told that the time limits preclude any further investigation of their daughter's death.I believe that it is time to review the NHS complaints procedure to deal with the difficult cases that have been caught in the transitional process of change between the two complaints systems: the one prior to April 1996 and the one after it. There is a need to review cases that have been debarred simply because they were initially pursued under the system before 19 April 1996. There is a need to institute procedures for reopening inquiries when new information comes to light. There is a need for greater flexibility in the administration of time limits. No time limits are set in relation to serious crimes or miscarriages of justice and none should be set in these cases. There is now a need for a specialist agency to investigate complex cases that is similar to the Criminal Cases Review Commission which investigates miscarriages of justice. I urge that there should be greater lay input to any new procedure that we may establish.
My sympathy goes out to the families who have suffered so much--the Riddle family and the Nash family. They have suffered because the system was inadequate to meet their concerns. However, I salute them for their persistence in seeking reform and justice.
5.55 pm
Mr. Tony Baldry (Banbury): I shall try to be extremely brief as I appreciate that colleagues wish to contribute to the debate. However, given that we shall have a 12-day recess, it is a great pity that time could not be found for a proper day-long debate on the impact of the foot and mouth crisis which is affecting many hon. Members. I think that many people in the countryside will find it bizarre that we shall be taking a recess of almost a fortnight in which hon. Members will have no opportunity to question Ministers. I am also still waiting for just one answer to any of my written questions that is more substantive than, "I will write to the hon. Gentleman as soon as possible."
Some weeks ago, at Little Chesterton in my constituency, we had an isolated outbreak of foot and mouth. It was a devastating tragedy not only for the farmer concerned, Clive Hawes, but for the surrounding area. The result of that isolated incident was that MAFF designated an area within a 16 km radius of the outbreak as an infected area. The designation covers a vast area, going from Abingdon to Witney, round to Buckingham, Aylesbury and Thame and back to Abingdon, and affects a large number of farmers.
The effect of being in a designated area is that farmers inside it are subject to even tighter controls than those applying outside it. They cannot, for example, send their animals to slaughter or move them more than half a kilometre. It is also difficult for farmers in the area to enter animals into the welfare disposal scheme because, whereas animals in an infected area have to be slaughtered within that area, there is no slaughterhouse in the area. Although on-farm slaughter is an option, that option does
not seem to have been approved yet by MAFF and the Intervention Board. So, the animals are trapped on the farms, and the farms are rapidly becoming overstocked. We shall have some extremely distressing animal welfare problems.Yesterday, I informed the Agriculture Minister of the concerns of Mrs. Wilcox, who has 3,000 piglets on her farm in temporary straw accommodation which has become waterlogged from the heavy rain. They cannot be slaughtered or moved. Almost daily, farmers telephone me in considerable distress because they cannot resolve issues in relation to ewes that are lambing in inappropriate conditions. However, their stress is compounded by the fact that they cannot get any answers from MAFF. No one answers the telephones or will tell them what is happening. More important, no one seems to recognise the problems that those farmers are facing.
To date, there have been no further outbreaks of foot and mouth in Oxfordshire. In previous outbreaks, the boundary of an infected area could be reviewed and reduced. Now, we have a ludicrous situation in which MAFF can designate an infected area of 16 km, but says that it cannot lift the designation without authorisation from Brussels. There does not seem to be an accepted understanding or process of how such authorisation is sought.
Therefore, large numbers of farmers in Oxfordshire seem to be stuck in a system in which their farms are simply over-burgeoning with livestock that they cannot move or have slaughtered, producing ever-increasing animal welfare problems. MAFF officials do not yet seem to be able to consider ways of approaching Brussels to determine how they can modify an infected area boundary. They seem to have the power to impose draconian restrictions, but no power to remove them.
I entirely accept the need for livestock movements to be controlled, especially in the tragic areas where the disease is running riot, but common sense must prevail. In the case of farmers in my constituency, there must be a strong argument for an urgent review of the existing control measures. Those farmers cannot simply be left to struggle on until MAFF officials get round to dealing with their problems.
I ask the Minister to use his influence with his MAFF colleagues to encourage them to carry out an urgent review of the current infected area imposed in Oxfordshire. I believe that there are similar problems in Leicestershire and Northamptonshire, where isolated outbreaks have also taken place. Can there please be some recognition of the problems that are being experienced? Otherwise, over the Easter break Ministers will see on their television screens an increasing number of distressing pictures of animals that are themselves in considerable distress--scenes that I think would be offensive to everyone, and which are already causing great concern to the Royal Society for the Prevention of Cruelty to Animals and others. Farmers are powerless to act, and they are becoming increasingly upset.
I would like to say much more about the impact of foot and mouth disease on individual farmers and businesses connected with tourism in my constituency, but I know that time is short and others wish to speak. I hope that the Minister will take my points on board. I would welcome a substantive written reply to my queries, and something more from the Government than everyone seems currently
to be receiving--the standard response to parliamentary questions, which is that an answer will be given as soon as possible. What we would like, and our farmers would like--as would others who are involved--is some answers today.
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