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Points of Order

3.30 pm

Mr. Eric Forth (Bromley and Chislehurst): On a point of order, Mr. Speaker. Yesterday, I raised in the House the matter of the Secretary of State for Transport, Local Government and the Regions—[Interruption.]

Mr. Speaker: Order. I am listening to a point of order.

Mr. Forth: I raised the matter of the Secretary of State for Transport, Local Government and the Regions, who has just scuttled out of the Chamber. He was in the Tea Room earlier—a sure sign that he must be in trouble—and he has just sat through Prime Minister's questions in the Chamber. However, the House has not been able to hold him to account for what in the press today has been a humiliation not just for him, but potentially for the House.

Mr. Speaker, how long are you or we going to allow the matter to go unresolved while everybody in the country knows that something has gone badly wrong in the relationship between Ministers and the House of Commons? "Erskine May" is clear, as is the ministerial code. Can you advise me on what we can do to bring to account a Secretary of State whom everybody in the land believes is being dishonest with the House of Commons?

Mr. Speaker: If the right hon. Gentleman feels that there has been a contempt, he must write to me. If he wants further advice, I remind him that on some occasions when I need advice, I go to him; he knows his way round the rules of the House and well knows how to bring a Minister to account. I urge him to look at his own experience.

Michael Fabricant (Lichfield): On a point of order, Mr. Speaker. I want to bring another Minister to account on an issue that is rather less serious, but nevertheless serious enough. Yesterday, I asked the Under-Secretary of State for Health, the hon. Member for Salford (Ms Blears), who is in the Chamber—I told her that I was going to raise this point of order—a question about community or cottage hospitals in Lichfield. Replying to my supplementary question, she may have inadvertently misled the House on two points. First, she said that there would be

"52 in-patient beds, rehabilitation facilities, out-patient, diagnostics and X-ray equipment, a pharmacy, a minor injuries unit, a renal satellite dialysis unit and, I hope, a maternity unit—all under Labour."

However, we have those already. In fact, the plans for the new hospital simply provide for them, but not other existing services, so there will be a reduction. Far more seriously, however, the Under-Secretary went on to say:

"I am pleased that on his website he said that the Budget was good for the NHS."—[Official Report, 7 May 2002; Vol. 385, c. 4.]

The Under-Secretary left it like that, but are her remarks honourable, Mr. Speaker, when they mislead the House? In fact, my website says:

"The Chancellor of the Exchequer is gambling that the Government will finally be able to reverse the downward trend in the NHS services . . . It's a good budget for the NHS—if only it works. But even by 2007, the Government will still be paying less than Germany or other countries pay for their health services which operate more efficiently."

8 May 2002 : Column 154

The point is, Mr. Speaker, that the hon. Lady quoted selectively and misled the House. Perhaps everyone should look at www.michael.fabricant.mp.co.uk to learn the truth of the matter.

Mr. Speaker: That was not a point of order.

Mr. Patrick McLoughlin (West Derbyshire): On a point of order, Mr. Speaker. On 26 February at column 574 of Hansard, I asked the Secretary of State for Transport, Local Government and the Regions:

"Will the Secretary of State say whether Mr. Martin Sixsmith was a civil servant in his Department on 22 February?"

He answered:

"As I said earlier, Martin Sixsmith offered his resignation, which was accepted, on 15 February."—[Official Report, 26 February 2002; Vol. 380, c. 574.]

How can the Secretary of State stand by the statement that he made to the House of Commons?

Mr. Andrew MacKay (Bracknell) rose—

Mr. Speaker: Order. Let me answer. I am not responsible for the Minister's replies; therefore I cannot be drawn into the argument through points of order.

Mr. MacKay: Further to that point of order, Mr. Speaker. You, like all of us, are responsible for not bringing the House into disrepute. Outside in the country, the fact that a Secretary of State has misled the House in a major statement and has not been called to account at the Dispatch Box has brought the House into disrepute today. Many of us would like to know what is going to happen.

Mr. Speaker: I cannot add to my previous statement on the matter.

Sir Patrick Cormack (South Staffordshire): Further to that point of order, Mr. Speaker. Is not there an honourable custom in the House that if a right hon. or hon. Member inadvertently misleads the House, they seek to make a personal statement? If the Secretary of State should ask you for permission to make a personal statement, would you grant it?

Mr. Speaker: I would look at the matter.

Chris Grayling (Epsom and Ewell): On a point of order, Mr. Speaker. On 21 March, in a written question, I asked the Home Secretary about the abolition of the special vouchers scheme. When last week—six weeks later—I had not received a reply, I tabled a further written question asking when I might receive a reply. Yesterday I received a response from the Minister which stated: "I will reply as soon as possible." It is now seven weeks since I tabled my original question. Can you give some guidance to me and to Ministers about acceptable time frames for responding to hon. Members' inquiries?

Mr. Speaker: I will look into the hon. Gentleman's complaint.

8 May 2002 : Column 155

Performance of Private Hospitals

3.37 pm

Mr. George Osborne (Tatton): I beg to move,

That leave be given to bring in a Bill to require private hospitals to publish independently audited information on clinical performance and on complaints from patients on the same basis as that required of NHS hospitals.

A couple of weeks ago, I was at a children's tea party with my son when I started talking to Peter Touche, who was there with his twin sons, Charles and Alexander. The Bill is inspired by the tragic case of their mother, Laura Touche, who died three years ago of a brain haemorrhage after giving birth to the twins at the private Portland hospital in London.

In January this year, a jury inquest found that Laura had died of

"natural causes contributed to by neglect".

The natural causes included high blood pressure, which led to the brain haemorrhage; the neglect referred to the fact that no basic medical checks were carried out by staff at the Portland hospital for two and a half hours after her caesarean operation. It was only when Laura herself alerted medical staff to the fact that she was feeling very unwell that anyone realised that something was wrong. She was rushed to a specialist NHS neurology hospital, but never recovered.

I know from my own son's recent birth at St. Mary's, Paddington, after caesarean section, that in the NHS a mother's blood pressure is checked regularly. It is checked every 15 minutes for the first hour after birth, every 30 minutes for the second hour, then hourly for the next three hours. In the country's leading private hospital, Laura's blood pressure was not checked at all. If that most basic of medical procedures had taken place, she may well have been alive today, and her children, Charles and Alexander, would have their mother.

But for the courage and determination of Laura's husband, Peter, the truth would never have been known. It has taken a three-year legal battle in the High Court and the Court of Appeal for the full story of Laura's neglect at the Portland hospital to emerge. It is sometimes said that individual cases make bad law, but Laura's death and her husband's struggle to uncover the truth reveal a more endemic culture of secrecy in many private hospitals, and it is that culture which my Bill seeks to attack.

Of course, cases of medical accidents and neglect sadly happen in all kinds of hospitals—NHS and private. One has only to look at the NHS's annual litigation bill to know that. It is often difficult for patients and their relations to get to the truth, regardless of where they are treated. A constituent of mine is still trying to find out what happened to the retained organs of her son, who died 30 years ago in an NHS hospital.

I hope that in the NHS at least, public scrutiny is at last prising open the closed, clam-like world of the medical profession, where few admit to a mistake and no one rats on a colleague. The inquiries at the Bristol royal infirmary in Alder Hey have certainly helped; so too has the requirement for NHS trusts to publish data on how they perform in relation to, for instance, waiting times, trolley waits, cancelled operations, hospital cleanliness, post- operative deaths and emergency readmissions.

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As a member of the Public Accounts Committee, I have seen how the performance data—especially on such things as waiting lists—can be distorted and fiddled, often under intense political pressure. I hope that the new Commission for Healthcare Audit and Inspection will be sufficiently robust and independent to ensure that that no longer happens. Nevertheless, I am happy to commend the Government on the pressure that they have put on NHS trusts to be open about their performance. It must be good for patients and for taxpayers that NHS trusts find it more and more difficult to sweep their problems under the carpet.

With the Bill I want to extend that pressure to the private medical sector, where there are not the same incentives to be open and transparent. The website of the pressure group Action for the Proper Regulation of Private Hospitals, to whose work I pay tribute, is full of examples. The problem is more general, however. In evidence to the Select Committee on Health three years ago, the Independent Healthcare Association said:

"there is frequently an undue emphasis on hotel standards such as decor and not sufficient emphasis or expertise into inspecting standards of treatment and care".

The Minister might say, if there were an opportunity to respond today, that a much stricter regulatory regime for private medical care has been introduced in the last month. That is undoubtedly true, and welcome. As of the beginning of April, all private hospitals are subject to new standards and to inspection by the National Care Standards Commission. They are now required, for example, to ensure that the risks of proposed treatment are fully explained to patients. They also have to have a proper complaints procedure, which would have helped in the Touche case.

However, there is still no requirement in the regulations for any private hospital to publish any data on its clinical performance. Unless the hospital volunteers the information, it is impossible to know how many deaths occur within 30 days of surgery or how many emergency readmissions take place, yet information of that kind is now freely available in the NHS. Although private hospitals now need to have a proper complaints procedure, there seems to be no requirement for them to publish complaints in the same detail. Other prospective patients therefore cannot judge the hospital's record for themselves.

My Bill deals with all those deficiencies in a straightforward way. It simply requires private hospitals to publish the same independently audited data on clinical performance that NHS hospitals now have to publish. It also requires private hospitals to publish, in the same detail, complaints from patients. I note in passing what officials have probably already told the Minister—that these requirements could be achieved through regulation under existing legislation—but sadly the option of a ten-minute rule regulation is not available to Back Benchers, so I am forced to propose primary legislation.

Most private hospitals have nothing to fear from being open and transparent. The staff who work in them do a great job, and many would actually welcome public recognition of the high standards of care that they offer. The Bill will, however, make life much more difficult for private hospitals with something to hide.

Some may ask why this is any business of Government. Does not private medicine mean exactly that—a private matter in which the state should not become involved?

8 May 2002 : Column 157

But the state is already involved. More and more people are being forced to turn to private hospitals for their treatment. Last year, more than 1 million patients had surgery in the United Kingdom's 230 private acute hospitals, and the number continues to rise.

The state will become even more involved in the private medical sector, if the Secretary of State for Health is to be believed. Last week he announced that he was giving primary care trusts "full discretion" to commission care from

"wherever it is best provided . . . from the public, private or voluntary sectors".

He said:

"the provider of care is less important than the quality of care provided".

I agree, but how can a primary care trust assess the best quality of care available, regardless of provider, if not all providers publish the same performance data?

If the Health Secretary means what he says about commissioning care from where it is best provided—I hope he does—that must also mean NHS patients routinely receiving treatment in private hospitals. Surely those patients have a right to know how those hospitals perform, just as they now know how NHS hospitals perform. Surely patients and primary care trusts have a right to be able to compare for themselves on the same terms the quality of care that is provided in two different hospitals. Surely the taxpayers have a right to see that their money is properly spent.

My Bill gives patients and taxpayers those rights and I commend it to the House.

Question put and agreed to.

Bill ordered to be brought in by Mr. George Osborne, Mr. Parmjit Dhanda, Fiona Mactaggart, Chris Grayling, Dr. Andrew Murrison, Mr. Boris Johnson, Mr. Mark Field, Andrew Selous, Mr. Hugo Swire, Mr. Richard Bacon, Mr. Gregory Barker and Mr. Bill Wiggin.

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