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Dr. Fox: The Minister is right that the issue is complicated. None of us expects a simplistic solution, but can he give us a rough idea of when the Government might be able bring their proposals to the House?
Mr. Hutton: We will do it as quickly as we can and I hope that, in the not too distant future, we will have the White Paper. I cannot give a specific date—[Interruption.] That is what it says here, anyway. The hon. Member for Woodspring must understand that these are complicated issues. If we were to rush to produce an unsatisfactory White Paper, he would be the first to jump up and say that it was a rushed job. The seriousness of the issues raised today means that the most detailed consideration will be required before the White Paper is produced.
The hon. Member for Oxford, West and Abingdon made one of his usual speeches about the NHS and offered his prescription for what is wrong with it. He started where the Liberals always start—with resources.
[Interruption.] The hon. Gentleman is not here? Then this will not be nearly as much fun. [Laughter.] That is a great shame. I am sure that he will be listening through the monitors. If not, I shall send him a video of my remarks.The hon. Member for Oxford, West and Abingdon spoke about resources, and made a perfectly fair criticism in that regard, but there are two points that I should make. First, Kennedy himself recognised and acknowledged the importance of the extra investment that the Government are making in the NHS. That is an important point to get on the record. Secondly, Professor Kennedy's report made it clear that the problems at Bristol were not caused by underfunding. He made it clear in paragraph 39 that that is not his view of the problems. That is not to say that there were not resource pressures at Bristol, but they were being experienced in every other hospital across the country at that time, and Bristol's performance was significantly poorer. The problems are clear and Professor Kennedy's analysis was specific.
I have dealt with the concerns expressed by the hon. Member for Oxford, West and Abingdon about recommendation 119, albeit perhaps not to his satisfaction. I welcome his support for the general direction in which we are travelling in relation to the reform of inspection, but I am disappointed, although I cannot say that I am surprised, by his comments on the CHI and the role of Ministers in setting priorities for the NHS. I have told him many times that that is a perfectly legitimate job for Ministers. It is Ministers' job to set priorities for the NHS—it is our responsibility to this House and the public at large.
I must take issue with the hon. Gentleman's view that there is any benefit or constitutional propriety in shuffling off that responsibility to the CHI, whose job is different—to inspect the NHS and to advise this House and Ministers about the quality of NHS care, not to supplant the proper role of Ministers in determining the overall priorities for the NHS.
We are making substantial extra resources available to support the introduction of the NICE guidelines. The hon. Gentleman took a rather cynical attitude to the issue of making more information available to patients—an issue to which we shall return in future. I was left in some doubt, however, about whether he was on the side of patients in this regard, and he needs to make up his mind about that.
My hon. Friend the Member for Bristol, West (Valerie Davey) made an impressive speech, and I echo and endorse her praise for those who not only campaigned on behalf of patients caught up in the tragedy but worked tirelessly to support their families. She mentioned Maria Shortis and Trevor Jones, and I echo her support. She was right to reflect the commitment and professionalism of staff at the BRI, who will continue to dedicate themselves to the needs and interests of their patients.
I agree with my hon. Friend about the benefits of publishing more health care information. Along with the hon. Member for South Cambridgeshire (Mr. Lansley), my hon. Friend raised the important issue of service reconfigurations affecting children in the NHS. The report makes a number of important recommendations in this regard. The hon. Gentleman referred to developments that are planned or under consideration in his constituency. He will know that we are committed to establishing a new national service framework for children's services across
the NHS. It will be an important step forward in improving services along the lines that Kennedy would like. Everyone in the House who is concerned about the welfare of children would like to see that as well. The work is being led by Professor David Hall, President of the Royal College of Paediatrics and Child Health, and Jo Williams, the director of social services in Cheshire, with the support of a number of leading professionals in the field.That is about all that I can say today about how the reconfiguration will be addressed. It will form part of the work of the external reference group, and ultimately it will be reflected in the national service framework.
My hon. Friend the Member for Bristol, West said that, although the Kennedy report made it clear where the responsibilities lay, she had been asked to whom the Department of Health was accountable. I can tell her that the Department is responsible to the country, the public and hon. Members. Long may that remain so: we are fully accountable, in this House and outside it, for our decisions. The country will be the final judge of our performance.
The hon. Gentleman made a considered speech, as always. He was right to look at the report's implications for other parts of the country and of the NHS. He focused on children's services in the NHS. As I said, matters to do with reconfiguration will be dealt with as part of the work on the national service framework.
The hon. Gentleman was right to say that it will not be enough just to publish another report on improving those services. All of us know, from our experience in the House, in business or in government, that reports do not implement themselves. They need to be monitored and implemented. There will be a clear timetable for implementation of the national service framework, and that will form the benchmark for CHI inspections. We are under no illusions about the job that needs to be done, but I assure the House that this report will not gather dust on anyone's shelf.
I am grateful for the support that the hon. Member for South Cambridgeshire expressed for the families of sick children. He and other hon. Members asked about recommendation 142, which covers the hospital travel costs scheme. We have to make a difficult judgment on the matter. It is right that NHS resources are targeted on those whose need is greatest in regard to travel and support costs, but he will know that trusts use their general powers of discretion to provide a range of support facilities for patients and family members caught up in terrible events such as happened in Bristol.
Hon. Members will, like me, have visited hospitals where trusts make overnight accommodation available to parents and others and that provide a range of other services to support patients and families who have to travel with sick children. Again, long may that continue to happen, but we have to make a hard judgment about access to the travel costs scheme. We believe that help should be focused on those with the greatest need, but we will also do everything in our power to support the wider use of trusts' discretionary powers.
I agree with my hon. Friend the Member for Kingswood about the importance of the report. I welcome his support for the Government's response. He was right to emphasise the need for national standards. He and my hon. and learned Friend the Member for Dudley, North
(Ross Cranston) raised concerns about the extent and scope of the Public Interest Disclosure Act 1998 in relation to Dr. Stephen Bolsin.We have corresponded with Public Concern at Work on the matter. In the light of Professor Kennedy's recommendations and conclusions in that regard, we have carefully looked again at the scope of the 1998 Act. We are completely satisfied that if the Act had been in force when Dr. Bolsin made his recommendations, it would have given him the necessary protection and cover, as it was designed to do.
My hon. and learned Friend the Member for Dudley, North made a scholarly and learned speech, in which he referred very politely to my legal training—although I do not think that my training was quite as good as his. I can confirm to him, as I have to Guy Dehn at Public Concern at Work, that the legal advice that we have received supports that organisation's interpretation of the relevant sections of the 1998 Act. I am therefore satisfied that Dr. Bolsin would have been fully protected by the legislation. We will, of course, keep the matter under the closest scrutiny.
The hon. Member for Westbury rightly called the Kennedy report a magisterial tome, and welcomed both it and the Government's response. He described the report as sensitive and reflective, and he was right to do so. We certainly benefited from hearing his personal and professional observations about working at the Bristol royal infirmary. I welcome, too, his support for expanding recruitment to medical schools to a wider social range. That is the right thing to do.
My hon. Friend the Member for Bristol, North-West (Dr. Naysmith) described the recommendations as clear, concise and easy to understand. That is true. Like other Bristol Members, to whom I pay tribute, he emphasised the high quality of paediatric cardiac services at the BRI. Kennedy's recommendations were sensible and achievable. I agree with my hon. Friend in that regard.
I have referred already to the comments of my hon. and learned Friend the Member for Dudley, North, who rightly described the Kennedy report as an historic document. I am grateful for his support for the measures that we are taking.
Professor Kennedy's report on events at Bristol royal infirmary between 1984 and 1995 marks a seminal moment in the history of the NHS. It not only accurately identified the problems that existed at Bristol and across the NHS at that time—the lack of national standards, the absence of a proper system for monitoring and ensuring quality, the lack of information for patients, no effective role for the public in local health care services and inadequate regulation of both professions and services—but pointed the way forward in ensuring that the NHS learns from those events and improves its service to patients. We intend to make sure that that happens.
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