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2.45 pm
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I am grateful to my hon. Friend the Member for Warrington, North (Helen Jones) for raising this serious matter. I hope that she will convey my condolences to her late constituent's family. I am extremely sorry that the concerns raised by Mrs. Kelly's son and, indeed, the wider family, which my hon. Friend has taken up so assiduously, were not dealt with either promptly or efficiently by St. Helens and Knowsley NHS trust, and I entirely accept what my hon. Friend has said about the family's desire to ensure that improvements are made in the system so that such things do not happen to other people.
In my experience, many families who complain to the health service are not looking for compensation. They do not seek a financial solution; what they want is a genuine acknowledgment of what went wrong, and the changing and strengthening of systems so that disasters do not occur again. Very often, they are looking for a sincere apology from those involved.
I think that the issue has three main aspects. The first is what has happened to Mrs. Kelly, the second is the inadequacies of the complaints procedure at Whiston hospital, and the third is the question of what action can be taken to ensure that similar tragic cases do not occur.
I fully acknowledge that the time that Mrs. Kelly had to wait for an angiogram was entirely unacceptable. As my hon. Friend said, Mrs. Kelly was placed on a waiting list of between 15 and 17 months. Since then, additional investment has been made in the coronary heart disease service in Merseyside and Cheshire to meet the objectives of the coronary heart disease national service framework. Extra money is being invested for the recruitment of more consultants, and also to increase the number of cardiac catheter laboratories and cardiac theatres where angiograms are carried out.
St. Helens and Knowsley health authority has contributed £810,000 this year to support those initiatives, and a sixth cardiac surgeon was appointed in April this year at the cardiothoracic centre in Liverpool. An additional cardiac catheter laboratory is planned to open in January next year. There will be a sixth cardiac theatre before April next year. All those developments are within the same trust, serving the people of Merseyside and Cheshire.
I entirely accept that all that will give no comfort to Mrs. Kelly's family, but perhaps it will give a degree of reassurance that it has been acknowledged that waiting times for procedures of this kind have been far too long. Hopefully, extra investment in cardiac services will prevent such things from happening again.
As my hon. Friend will know, the Government are currently reviewing the NHS complaints procedure. It is working acceptably for some patients, but there are many examples of less positive experiences. We recently launched a discussion paper examining the whole procedure, and we want to make significant changes next year. However, this is not just about improving the complaints process for individuals; it is about trying to change the way in which the service works, so that the central focus of the NHS is on patients and their families. We want all who work in the NHS—those at the centre, clinicians, and trust management—to try genuinely to put patients' views at the top of their agenda when considering how to provide services, and certainly when considering how to respond to patients and their families. Later this year, we shall make further proposals in an effort to strengthen patient and public participation in the whole health service to make sure that patients get an effective and strong voice in the way in which the service is organised.
My hon. Friend mentioned provision within the trust. I am pleased to say that, instead of appointing a public relations officer, St. Helens and Knowsley trust is to participate in a nationwide initiative to establish a patient advocacy and liaison service. That is not about public relations, but about providing on-the-spot help to resolve problems when they first occur. In many cases, complaints will not reach the dreadful state that Mrs. Kelly's case has reached because people will be able to obtain immediate assistance within the trust involved. St. Helens and Knowsley trust is one of 14 trusts selected to run a pathfinder project for PALS. I understand that the
trust has appointed a PALS manager in advance of the launch, which is to take place on 1 November. I hope that it gives my hon. Friend and her constituents some comfort to know that in future there will be on-the-spot help to resolve such issues.Profound concern has been voiced about the way in which the complaint relating to Mrs. Kelly was handled by the trust. As my hon. Friend has said, the matter was taken up by the NHS north west regional office, which carried out an investigation. The regional director said that
- "the handling of this matter was not of an acceptable standard".
- "should have received a better response from the trust"
An immediate independent review of complaints arrangements within the trust was ordered. The review team finalised its report in July, concluding that the introduction of new arrangements had improved quality. However, the team made 12 recommendations which the trust has accepted and is in the process of implementing. Those include changing the organisation of correspondence, reviewing the use of standard paragraphs in correspondence—which, as my hon. Friend pointed out, is entirely inappropriate—monitoring complaints responses and carrying out a systematic review of complainants' views on how their complaint is proceeding. That will provide a real check at every stage on whether people are content with the handling of their complaint.
Progress against that action plan will be reviewed by the regional office to ensure that all the recommended changes are implemented. I am pleased to say that my hon. Friend's intervention regarding the Kelly case has proved to be a catalyst, driving action within the trust to improve its performance.
Helen Jones: Will my hon. Friend confirm that as well as carrying out a review of the complaints procedure, the hospital will establish a strategy for learning lessons from complaints about its clinical governance and procedures? It is not solely a matter of apologising and dealing with a complaint from a particular person, but one of learning lessons to improve the way in which the hospital is run.
Ms Blears: My hon. Friend is right. We are trying to instil throughout the NHS the principle of being an organisation with a memory, so that when such cases arise, clinicians, managers and other staff do not gloss over them but learn from them and absorb principles of good practice into future organisation.
I have some remarks about clinical governance that should give my hon. Friend some comfort about the future of the trust. I do not doubt that in the Kelly case the complaints procedure failed Mrs. Kelly's family and my hon. Friend. That underlines the importance of changing the way in which the public and patients are involved in the NHS.
As a consequence of the concerns that have been raised, I have asked the NHS north west regional office to bring to the attention of the Commission for Health Improvement the details and outcome of the independent review of complaints handling by the trust. We shall ensure that consideration of complaints and how well the trust learns from them is brought into the wider review of clinical governance that CHI assessors are due to undertake at the trust in mid-November.
My hon. Friend has also raised concerns about mental health services in the trust. An independent report was published on 23 October, which clearly highlights failings in the system of care and concerns about the management of care in supporting mental health services in St. Helens and Knowsley, although it emphasises that the professional staff involved in a particular patient's care could not have predicted what happened.
In the light of that incident, the health authority and the trust have developed an action plan to ensure that local mental health services meet the needs of all patients. Subject to public consultation and ministerial approval, mental health services will transfer from St. Helens and Knowsley trust to Warrington Community Health Care NHS trust on 1 November. That is a transitional step towards ultimately transferring services to a specialist mental health trust, which is where they ought to be and which will cover the wider area.
The Commission for Health Improvement has a routine review of St. Helens and Knowsley trust scheduled for mid-November. However, in line with a recommendation of the mental health report, St. Helens and Knowsley health authority has written to the commission to request that the routine review be expanded to consider clinical governance arrangements. That will involve taking a much wider view of mental health services in the trust.
I have asked the commission to consider the complaints procedure to ensure that the organisation learns from its experiences. The commission's review and its reports will provide us with a great deal of extremely useful information in respect of monitoring and, I hope, improving services available from the trust to local people.
My hon. Friend has done the House and the NHS a great deal of good in raising those issues robustly and directly. It is crucial that we deal openly and transparently with matters that go wrong in the health service. The fullest possible information should be put in the public domain and people and their families should keep their dignity and be shown respect. They should be made to feel that their experience has not gone unremarked and unrecorded and they should not think that we have failed to act.
We have a responsibility to do our best to ensure that similar tragedies do not happen in future. Although it is impossible to say that such incidents will never happen again, I hope that it is some comfort to Mrs. Kelly's family, who fought with determination and commitment to get action taken, that we are absolutely determined that a full review of the trust will be carried out and that action will be taken, not just to improve services but to ensure that it responds properly to complaints.
Complaints are a serious matter for the NHS. We must learn to improve the services that we provide and we should not be afraid to acknowledge our shortcomings or to put in place improvements to drive up standards so that we can treat people such as Mrs. Kelly much better.
- Adjourned accordingly at two minutes to Three o'clock.
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